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Something like the spousal impoverishment law. My father entered a skilled nursing facility upon a hospital discharge for rehab before coming home. His health issues worsened and he had to remain in the facility with a medicaid pending status. The initial Medicaid application was made while he was at home by direction of his social worker who saw he needed far more home care.

Thankfully the Medicaid was granted, and I (disabled adult daughter/caregiver) was informed by the nursing facility Medicaid liaison I would definitely qualify for MMMNA in lieu of a spouse (we lost my mother 8 years ago) as my father is the primary income for our household and my disability began before the age of 22.

I'm now being told I by the nursing facility I have two options. Leave my father in the facility which will require all of his income paid to them. I do understand this, but was told we would be able to divert some of his income so I would not be left impoverished and be able to have our home to bring dad back to. I cannot keep the household going on only my disability income. Their other suggestion was to clear our belongings out of our home, which we only rent and do not own, and ask a friend or family member if I can move in with them. Our intention was always to bring him home, but due to caregiving for him my own health has deteriorated to the extent of needing two separate emergency operations on top of trying to deal with multiple sclerosis. I can barely take care of myself at this point and haven't been able to move forward with any surgery in trying to settle his care and financial issues first. Our hope was to get my health under control enough to bring him home and care for him as I have done for the last six years.

The nursing facility has set a discharge of my father due to non payment of patient liability. Non payment was due to me never being informed of the determined liability or any deductions, never able to apply for MMMNA or similar possible deductions. The first notice of any liability was a bill sent in late August for the months of July and August for an amount of a liability higher than my father's income. Our combined incomes are necessary to pay the monthly household bills. The facility will now not even speak about deductions for my father's liability amount, not even the personal needs allowance or insurance premiums required by law. The administrator was quite blunt in his feeling about MMMNA or any similar protections for family. That income could be diverted to me and I could "blow it" however I wanted. All I want is my father to receive proper care, to survive paying our bills while I regain enough of my own health in order to bring dad home. Instead I am facing becoming homeless or bringing him home and being unable to care for either of us. We have previously had home health aids for him thankfully, but it isn't enough anymore especially if I were recovering from surgery, he needs 24/7 monitoring, has had numerous falls and can do nothing on his own.

I just find it preposterous that if I were a spouse there would be no issue and there are also laws that would help if we owned our home, but there is nothing for any other family members who lived with and cared for the patient who goes into a facility. So many of us give up our lives, health, jobs to care for our loved ones and face these issues. And not for personal gain, I stand to inherit no home or savings, everything is depleted. It is done out of love and this is the result?

Any help, advice, suggestions would be greatly appreciated. I have researched and talked to everyone I can think of, but everything is a dead end or brick wall. I have not contacted an elder law attorney simply because I cannot afford to.

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Thank you Babalou. Nothing has been changed as of yet, the holiday weekend made things more difficult for all the different communication between everyone. In a holding pattern currently.

Also I wanted to add some information that was suggested to me (because of my surgical need being considered an emergency) and might help someone else.

A social worker with our local senior center suggested because he could qualify for Hospice care they could take over his care and Medicare would cover his costs which would please the NF as their payment. And dad wouldn't need to be uprooted and moved, which is so difficult for neurological patients especially. She said she's seen this done many times and it wouldn't be a set amount of time, it would all depend on his condition.

While we are not at DNR status, by my father's choice, this wouldn't really work for us, but I thought it may be of help to someone else.
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Lavanilla, I'm glad this seems to be working out! Has the NF rescinded the order to discharge, I hope?

I'm hoping that going forward, you can get your own health issues under control and make plans for your own future.
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I think perhaps there were some misunderstandings of what I initially wrote. I thought it terribly long and didn't want to add further to an already convoluted issue.

Kixxybaby and BUCKEYEPRIDE my prayers are with you, I am so sorry. It's truly devastating to see and experience not only the illness our loved ones suffer, but also the greed and disinterest in anything aside from the bottom line, too prevalent in the medical community. Thank God there are those special doctors, nurses and aides that truly do care.

As for this thing called "get a job" to supplement my income. I am quite familiar with the concept and would love to, however I lost that ability many years ago due to multiple sclerosis. A small home business of my own had to be given up when dad got sick, I could not keep up with both. That is why I remained in my family's home caring for my father for the last six years. 24/7 around the clock alone. There are few family members left, they are elderly themselves and I am an only child. With only 5 hours divided twice a week of respite, enough time for grocery shopping, and against all advice of family, friends and doctors. I chose this, to do all I could with my own physical limitations, do not think it's been easy. And before dad got sick himself, he and I did the same during the three years my mother was ill before we lost her.

I have spent the last 11 years of my life being a caregiver. I have sacrificed much including my own heath. But I would change nothing. We each do what is right for us and in my family you take care of each other. Out of love. Out of respect. No, we aren't always prepared for what's to come and don't always plan accordingly. Many fall into that trap, not knowing or dreaming such circumstances could come. But I will not be shamed or made to feel lesser because of this situation. Yes, obviously mistakes were made, but I can look myself in the mirror and know I did not let them down.

And I have had many doctors say that my dedication and care for both of my parents has been exemplary, above and beyond. That they lived longer because of my care. I'm not praising myself, I still feel I fail every day, that's exactly why I posted, I didn't want to miss anything or do anything wrong. But to be admonished or accused?

Taking care of my own, being prideful, simply not wanting to be a burden and ask for help sooner was apparently my downfall. I can do it, we're okay and a smile are my normal responses. Many of the responses I received here are a good example of why I have tried to do it all on my own and never ask for help. Many didn't even read what I wrote correctly and the advice given wasn't even applicable. And others responded not even understanding the laws themselves. Of course I have contacted an Ombudsman already who is now prepared to represent us, along with Proseniors. I have researched and learned as much as I can on my own, even the medicaid liaison said I had a good grasp on this information. I was, and am, trying to protect my father, our home and myself. And no, we do not own our home, we only rent it. When I refer to our home I mean the place we have lived for years, our memories are here, where my mother lived with us and went through her own illness, this is "home" to my father and where he wants to return. This isn't simply about me or housing, this is for him. Also misunderstood by some, I am on disability and do receive Social Security. Subsidized housing and whatever else it will take to survive after my father is gone has always been in my mind. But that's for later, he's my focus now.

And he will remain my focus as long he lives and chooses to live. In her last days my mother said she was tired and ready, so we broke our hearts, signed the DNR and let her go while we held her in our arms. I will do the same for him, whenever and whatever he chooses.

As an update on my situation I spoke with the NF social worker today and they do see there is an issue with personal needs allowance, medical premiums (due to the possibility of a hospitalization that will not be covered by institutional medicaid) and other deductions have not yet been dealt with in my father's case.
The initial patient liability evaluation by the NF medicaid liaison for my father was approximately $700 per month, not the current $2000 plus.Yes, there are deductions, family allowances, asset and income protection that vary for nearly every patient and their families.

While everything varies state to state and many medicaid laws changed on July 1 of this year, I am adding a link that may be useful to some. It is for my state, but perhaps it will help others to find information regarding their own states and situations. http://codes.ohio.gov/oac/5160:1-3-04.3v1

While it doesn't apply to everyone who responded, some clearly need to think before they type. And do some research of your own before you condemn and hurt others with misinformation and ignorance.
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Contact an elder care attorney. They know so much and can get you through all the red tape.
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Kathy has a point on this one. I don't know your whole situation, but you may want to start making plans for your own future, and the best time to start is now but it would've been better to start much sooner. Anytime someone is helping you, you must realize they won't be around forever and you're going to have to have a plan B for down the road when they're no longer there. The sad thing about this whole thing is that so many people take their loved ones for granted thinking they'll always be around, only to face reality later. Definitely start planning for the future now and figure out how you're going to support yourself when your loved one is in a facility
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Kathy1951: I agree with you.
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If you have been taking your father's social security money and using it to pay your rent etc that will not be possible any more when he lives in a Medicaid bed in a facility. SSD will be all you have to live on, because its often higher than your parent's Soc Sec check. I see no chance the government will not come after you for that money if you are the representative payee for your father's social security. New plans for you will be imperative soon. I also see no chance the government will let a disabled adult child keep some of Dad's SS money, because they are already paying you up to their limit. Essentially, you have other income which is your own. It was good that you sustained for as long as you did by partnering, but the next phase has arrived.
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No, I never heard of such a thing as income protection but I have heard of such a thing as get a job and supplement your income. If you can't work, you can apply for benefits according to your needs. Other than that I'm not aware of anything else. Of course there is also one more option of selling stuff to supplement your income but I'm not aware of any special program out there to replace lost income but people do get jobs every day
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I understood he's no longer in rehab because or at least his health issues - have - worsened and he was having to remain as regular long term care with Medicaid pending, which is the part I don't fully understand, with Medicaid being granted, except that was while he was at home for more inhome care; Medicaid in a facility/NH is somewhat different; I would have thought the NH Medicaid liaison would have filed for the disabled allowance for her since she told her she would qualify but possibly they don't since that would go against the nursing home's interest, but also I'm not sure that if you are just renting that that's allowed anyway; my dil's grandmother didn't get it when her husband went into a facility with them just renting, but I don't understand the bill with Medicaid pending, unless there's either some reason the Medicaid was denied or, which sounds more like the care, this particular nursing home no longer wants to wait on it and is wanting to get paid something in the meantime, which I'm wondering about his social security as well; some nursing home at least try to demand it be sent directly to them, for just this very reason; it sounds as if they didn't or else op didn't want to do it that way because she needed it; this sounds so very much like a situation my friend had when she placed her mother in the NH; her sister - mom's other daughter - had been living with her and was/is also disabled beginning before she was 22, but I'm not sure anything was said about her being able to keep any of mom's income, even though it was the primary income as well; at least pretty sure she didn't and was left to have to keep up her - then - household on just her income, which could possibly be done, especially with mom not there anymore to require any expense, but still be difficult, because not everything would go down that much, some, of course, not at all, but she was married, so might have had something to do with it; I'm wondering what insurance premiums she's talking about that she's saying are required by law; health insurance? her mom had that Medicaid already for that as supplement to her Medicare; I wonder if that's the Medicaid her dad had been granted; I think that's at least part of the reason why nothing was said and/or done about them continuing to receive any of mom's income, was because it was considered that it would be "blown" by them as well, since that had been an issue for quite some time anyway, that the nursing home felt they were entitled to it to provide the care for the mom while, certainly while they were waiting on the NH Medicaid to come through; their concern was not the disabled daughter who was still staying in the home; that's a Medicaid issue to allow her to be able to stay; it was a family issue that mom could no longer stay there; the whole Medicaid thing of them being willing to pay for a NH vs help in the home is a big controversial issue; I think it has to do with skilled care, but regardless, as of now that's the way it is, but I also think the whole personal allowance for the one left in the home is also somewhat contingent on the one being left being considered disabled or not; yes, in theory they can stay, but in reality can they really? but, again, it's more related to home ownership, in the sense that that issues hinges on them not taking the home, which, of course they can't do if it's just a rental anyway, so, therefore there's no interest either way in them caring about the personal allowance to allow the disabled family member to stay because, as atwhitsend said, they can live in income based housing, which my dil's grandparents had been doing for years anyway, going back and forth from one type unit to another, as their disabled daughter would live with them or be in a NH, then the same with the grandmother as the grandfather was placed in a NH
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To clarify the situation, are all of these true: He needs long term skilled nursing and is in a rehab bed at a nursing home which does take Medicaid? This nursing home wants most or all of his social security check and it has been spent? You are on SSD as your sole income, and you are not in Title 9 housing? You need much or all of his social security check to continue living where you are renting now?
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I am in a similar situation. I had been taking care of both of my parents (divorced) while dealing with my own health issues. Both parents had strokes 3 months apart in Jan (Mom) and then March (Dad) 2013. I have my own residence, but moved in with my Mom after her stroke and then was dealing with her and then my Dad who ended up in a Nursing Home. Dad was in and out of the hospital six times his last year. Dad died March 2014 and Mom went into the Nursing Home in July 2014. Both required Medicaid. Once Mom went into the Nursing Home and was on Medicaid ALL of her money was to go to the Nursing Home. While receiving almost daily calls to come to the Nursing Home to sit with my Mom because of her Dementia Sundowners I was still taking care of her. They said they couldn't calm her down. She had multiple hospital stays from falls at the NH. I had not been able to further my own Social Security Disability claim ( I have Pulmonary Hypertension) with testing with my specialist 1.5 hours away. Mom had a patient liability that I was not paying every month. Because I did not live full time with her I did not qualify for any adjustment in her patient liability so I could continue to pay my bills as I had done for 10+ years. They filed discharge papers on her for non payment and then sued me personally for the debt. I had signed her in as her POA and because of that they were able to sue me and are now trying to take my home in a law suit. After legal advice, I filed Bankruptcy and included her NH bill in the filing and the NH is now fighting it's discharge in Bankruptcy court. Needless to say I am going to lose my house now.

Call your local or state OMBUDSMAN (google it). They will protect your loved one from any unfortunate discharge. Because the NH was unable to find another Nursing Home to take her they were forced to keep my Mom, but I am going to be homeless now. I have no equity in my home, but I fear they will still process foreclosure on my home out of spite since they told me they would. My OMBUDSMAN advised me NOT to agree to take my Mom if they tried to discharge her. She said they have seen where a NH will wait in a van with a families loved one and then put the resident on the family members front door and leave. Just the thought of that to anybody is repulsive. But, when it comes down to it, it is ALL ABOUT THE MONEY! I love most of the people who care for her in the NH, the nurses and aids, they are overworked, shorthanded and underpaid, but Management is all about the Money!!

Please call your OMBUDSMAN NOW!!!.

I am the one who should be suing them for neglect. My Mom fell on her face broke her nose and had a brain bleed, they were Medically restraining her with over kill on the medication and had to send her to a facility to detox her. While she was there I noticed finger print bruising all over her legs from the NH. I have NO ENERGY to pursue that option.
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In a case where you're disabled and struggling financially, you may be able to call the nursing home and explain this, especially if you're on fixed income. If you can't afford to pay the bill, you may suggest your love one be put on Medicaid. A friend of mine kept getting nursing home bills, but he's unemployed with no income. Due to the situation we're in, I was able to inform the nursing home on his behalf of him having no income due to long-term unemployment and that reemployment is not likely at this point. I suggested the nursing home put the patient on Medicaid. It really wasn't hard to talk to the nursing home, if I was able to do it, if so can you. If the money's just not there, say so when you call the nursing home to explain the situation. You don't have to go into a long drawn out story with them, just explain if you happen to be unemployed or you're on fixed income and the money is just not there and your loved one will most likely need Medicaid, plain and simple
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As a former social worker in a nursing home, if your father is on Medicaid, almost all of his money, minus like $50.00 is given to the nursing home for payment. Where you are disabled , you should be able to apply for medicaid for yourself through The League of Human Dignity. It is available to people under the age of 65. Plus you should be able to find housing that is income based, title 9 it is called in Nebraska. I don't know what it is called in other states. The most important advice I can give you is that when filling out the application, call your caseworker within a week of sending in paperwork. Make sure you have not missed anything! Most applications are denied because of a missing piece of information! I don't know how many times an income verification or something of that sort was not turned in by the family on time so help was rejected. A social worker can only assist so far, but does not have access to personal information. Also ,most utility companies have programs to help when people are unable to pay. It does take quite a bit of legwork, but it is possible. Churches are a great resource for emergency payment of rent and utilities. One time only usually. If you have been legally declared disabled, you should have a caseworker of your own. Be pushy, but nice. Every caseworker has a stack a mile high, and the people that stick out in their minds are the nice ones and the mean ones. They are more inclined to help more if you are nice. It shouldn't be that way, but it is. Make copies of everything you turn in so just in case paperwork gets lost you have it to replace it immediately. I cannot stress enough that everything is time sensitive! Hope this helps.
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Its a horrible feeling:( I am a spouse. My husband who has alzheimers along with several health issues. Has been in a few homes for a year and a half. First one took all our savings, second one lied, and after 4 months produced a bogus bill for 15,000 dollars. We are only living on his SS and pension do i managed to get him into another place. I know about dropping the ball. They did that to me too. I called every one under the sun for help. They made promises then never kept them. Finally after going to the ER for myself 2 months ago, i have a caseworker helping out with the medi-cal application. But its too late. I am so sorry for you, its not right. I sit here with 150 dollars that is supposed to carry me thru the month of september and i am scared and angry. I am the improvished spouse, but where for the love of god is my help? Or yours?
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