My mother is 54
A stroke has made her very dependent.
Her Medicaid won't pay for long term care since she has a trailer in her name. She's alternate until I sign some papers agreeing to pick her up at the new place under the agreement they say she will have 24 hour care at home.
Since the place is a (much better) facility. I'm considering to sign the transfer even when I'm not ready and feel I'm not the right person. At least she will be around the equipment and maybe learn to at least eat on her own. What should I do.. I'm a 33 year old student with no finances and my mother is on ssi. Cigna total care..

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The facility your mom is currently in is saying she will have 24 hour care at home. Who will be providing that 24 hour care for her? You need to ask them this question and make yourself very clear about it.
If you don't think you are the right person to take on the responsibility of your mother and her care, then you most certainly should not do it.
Is there another family member who will assume this responsibility for her. Do you have siblings? Does you mom? Does she have a spouse?
If the answer is 'no' then the facility she's in will get a conservator appointed to her by the court who will be in charge of making her health care and financial decisions.
Medicaid will indeed pay for her to be in LTC even if she has a trailer in her name. The home will have to be listed for sale. While it's listed she will be accepted into LTC.
Medicaid will not pay for her to have 24 hour care at home. You state that you're a student with no finances. Do you also live in your mom's trailer? If so, then you will have to move. Not immediately but the trailer will have to be listed for sale. It only has to be listed. That will give you some time.
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Contact social services in your mom's area or the social worker at the facility she is now in to see if they can help you in this journey. Call her insurance - hopefully you are allowed to talk to them - and see if they have a case manager for your mother - see if they can provide any direction.

Are there any law clinics in your mom's area that cater to low income? If so, use their services in your mom's benefit. If your mom is competent, you should get a DPOA (Durable Power of Attorney) to enable you to make decisions/act for her in her best interest. You either need 2 DPOAs - one for medical and one for financial or a DPOA - or 1 DPOA that combines medical and financial in one document.

You said you are a student - if you are at a university - you may want to find out if the school has any resources open to you to give you assistance or information.

Each state's medicaid have their own rules.

Whatever you do - DO NOT sign anything making you responsible for her financial responsibilities.

Good luck to you and your mother.
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In most states, Cigna would be a supplemental Medicare policy, I do not know if that is the case where you live. Medicare does not cover long term care.

Also, there is a difference between Medicaid and Medicaid waivers which pay for long term care. My first step would be calling the DHS worker to verify the right application was filled out.
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Is the property that the trailer sits on valuable?

That would be the problem with getting Medicaid. All states have a cap on the value of the home to qualify for public assistance.

If this is the reason, then you will have to sell the property to pay for her care.
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Theres something amiss in all this….. what program are you trying to get your mom into….. to have her move into a facility and become a permanent resident there? So she is in a place that has 24/7 oversight. This would be LTC Medicaid.
is it to be that mom gets on a care plan that’s community based so she continues to live in her trailer? And she has care team coming over to the trailer maybe 3x a week or she gets picked up 3/5x a week and goes to a center for day care. Sometimes this is called the PACE program. But someone - like you or other family - needs to live there to provide whatever else needed by her.
is It that she is able to go into a transitional unit that usually adjacent to & connected to the main hospital because she has significant issues that require more intensive care - usually hospice care - than most NH can provide? Sometime these beds are in Kindred facilities. My mil was in a place like this….. got bad bad pneumonia & moved from the hospital to the in-unit hospice next door as she was very septic and cascading organ failure, more drugs and oversight than what a NH is set up to do. Is this kinda what your moms “alternate” place is?
These are way, way way different approaches. which is it?

if you cannot be 24/7 for her, personally I would not sign any paperwork that puts you to take her as her caregiver. The hospital has discharge planners that can find a place for her to move into from the hospital. Discharge planners tend to push / encourage family to come and get their parent and once that happens, their job well it’s all done. Their work is over, moms care is now totally on you. If the supposed “alternate” program has some sort of glitch, it’s your problem not the hospitals. If you cannot provide the level of care, security and oversight for your mom, you have to, HAVE TO, be firm with the planner and tell them you cannot come & get her and will not be doing this at all. Be firm and deliberate.

The trailer is considered her home is exempt asset for both community based as she continues to live there AND ALSO for LTC Medicaid. I do not underwhy you would have been told that. It’s an exempt asset.
However, the issue for LTC Medicaid is that this program requires mom to use basically whatever monthly income she gets to be paid to the facility as her required copay. So mom will have NO $ to pay any costs associated with the trailer…. Like if she’s in a park and has lot rental or utilities to pay; or the trailer is on land she owns but she won’t have any $ to pay the county property taxes. You do not have to pay her lot rental, taxes, etc. But if you’re living at the trailer, & were living there before mom was hospitalized, you might want to pay lot rent for a couple of months till stuff is straightened out for moms care. it’s been yiur home so nobody can force you out if it’s current on rent.

I’d try to find out exactly the status on her trailer. It should be exempt asset. But will morph into a problem over time. It’s a back burner problem, you can fret about trailer later like 3 months from now.

It may be that there’s a place for her closer to Birmingham. B’ham has a huge # of excellent health care facilities and pretty deep experienced health care professionals as well.

Right now, I think you have to decide if she’s best in a LTC facility or you become her 24/7. Your 33 in school and limited resources, to me, moms best in a place with 24/7 care & oversight. The discharge planner can find a place. That’s their job to do. Be firm and let them know they need to find her a place. Good luck.
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Have you checked this information. Medicaid exempts the live in home. They will do claw back after death when property is sold, however. Unless you are very wealthy, or she is, 24 hour care at home will not be possible. It is extremely expensive.
You should make it clear to social services that your Mother cannot afford in home care and that there is no one who can be there 24/7 to care for her and that she requires long term care placement. If you do not wish to be the POA the state can appoint one, but at that time all decisions are out of your hands.
I caution you not to take on 24/7 care of a mom who is 54 and could easily live for 4 more decades. This is basically giving up your own life on some sacrificial altar. Of course this is what the people at your Mom's facility want to hear, that you will take on this care and give up your own life. I think you understand that would be a grave mistake.
Tell Social Workers that you are unable to handle any of the details of this, and that they should consider your Mom to be without resources (if this is the case) and in need of 24/7 care. They will handle placement.
I am so dreadfully sorry your Mom is facing this at her young age, but it is not a reason to give up your own life, which you are apparently just getting together with your own education.
Wishing you good luck. Speak to discharge planners and social workers.
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Contact the health department agency that covers long-term care in your state to be sure your mom's home would be considered an asset.

The agency can also direct you to care options like Community First Choice that provides nursing home care at home. Since your mom's on SSI, she automatically qualifies. And if she's on SSI, I'd think she's eligible for Medicare home health coverage.

Home health care saves the insurer money so they're happy to encourage it.

What's expected for your mom's recovery? Ask specific questions of your mom's doctor(s) - how much therapy will she need? can it be done at home? would a rehab hospital be better? Many stroke patients recover full functionality after therapy.

Call the benefits number on your mom's Cigna card and ask what post-stroke recovery your mom is entitled to. Is she eligible for home care?

I don't think anyone is ever fully prepared to be a caregiver. Having resources lined up ahead of time is invaluable.
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I don't see

For me, your post is confusing. I found this:

"Mobile homes, also called trailer homes, are considered to be homes (or “homesteads”) by Medicaid. However, it is important to clarify that one's home is considered to be an asset by Medicaid, but in most cases, it is considered to be exempt, or in other words, it is not counted towards Medicaid's asset limit."

If your Mom lived in a trailer, then its an exempt asset. Medicaid does not count it.

Did your Mom go to rehab from the hospital? Her insurance is paying for rehab? So now they want to discharge her and are requiring you sign you will be her 24/7 caregiver or hire 24/7 care givers? This is called a safe discharge and you don't seem to be able to provide it so don't sign it. Now it gets confusing when you talk about transferring her. How can you when you have said Medicaid will not pay for LTC because of a trailer. I think Mom may not be able to get LTC with Medicaid paying because she is not 65.

If you are not her POA, I would not sign anything. You may be held responsible for her care and that can cost at least 10k a month. You say she has Cigna total care, does this mean Cigna will pay for LTC? Really need more info.
Helpful Answer (2)
Vpujia33 May 2021
I was disgusted with the nursing home for many reasons
so I encompass was the primary choice because it is connect to the hospital. And she is an alternate until they have my signature to move her there. It will be under the terms that she can get 24 hour care because she will have exhausted her benefits. Can i switch insurance or can she file bankruptcy? The nursing home she is in is tellng me no long term because of property. Her name is on the deed and it's. a trailer that sits on it
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