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Mom's living in a private pay facility and has 5 months of funds available. I don't know what to do or where she will have to live. It seems such a shame at 93 1/2 that we have to move her. We can't afford to pay for her monthly rent and care plan.


I am looking for ideas on where to start.

This is a NH correct? If so and it’s only private pay accepted at this place, I’d get a copy of the contract and find out exactly how much Notice mom needs to give to leave without penalty. Give Notice and drill down big time in the 4 weeks (hopefully not more Notice needed than 30 days) to find a NH that takes Medicaid AND private pay. And move her. Believe me there will be a NH that takes Medicaid & would love a resident who can private pay for 4 months prior. If mom has a somewhat higher monthly SS or other retirement income, that is a real plus as well.

Now if this is AL, it’s going to be different challenges. Mainly you’ve got to find out ASAP is if in your state Medicaid pays for AL. AL is overwhelmingly private pay nationwide. Most state’s Medicaid do not cover AL. If that is your situation you are going to have to do things to build up her health chart to show “need” for a NH. So mom moves into a NH rather than an AL.

Medicaid has “at need” requirements for BOTH financial & medical “need”. financial is what you hear abt the most but medical is just as important. Most go into a NH from a hospitalization & the common drama is mom falls & breaks a hip; gets hospitalized (MediCARE pays) & has surgery (MediCARE); then mom discharged for rehab at a NH (again MediCARE pays & for up to 100 days); usually they plateau out at 20/21 days & it’s determined mom cannot return home so she segueways from a rehab patient to a NH LTC resident; MediCARE does not pay for LTC so they apply for Medicaid. Now under this scenario, NH has gotten the much much higher MediCARE rate for weeks so they are happier, AND, the elder has a nice fat health care chart that clearly shows them to be “at need” medically for skilled nursing care. So facility knows the medical “at need” is ok. Family often don’t even know the Medicaid medical “need” has to be justified. Family is busy with getting years of financial & legal stuff so that’s their priority.
BUT
Your mom is not coming from a hospitalization. What might happen is that Medicaid will want to establish that mom is medically “at need” for care. If she’s been in a NH sometimes a NH will accept a private pay resident who is actually “custodial care” rather than being “skilled nursing care” as a resident. If your state actually pays for AL, that too will have “need” but it should be pretty straightforward review of old AL chart. State will want to review her health chart in some way.

I moved my mid90’s mom from IL to a NH and mom’s Medicaid application had medical need issues & I had to file an LTC Medicaid medical appeal. NH takes lead in this type of appeal as they have to input stuff into health chart. For us, it was RXs and labs from her doctors office that were left out of her chart at the NH when she entered. It was all resolved way b 4 the appeal hearing date. My point is, if your mom could in anyway be viewed as purely custodial care, & she’s wanting to go into a NH, she might need to have her chart beefed up before she files for LTC Medicaid.

if she is currently single room status, pls realize once she goes onto Medicaid more than likely she will have a small closet & will be sharing a room. So keep that in mind as you pack and try to jettison what you can. Often the most they can bring in is a chest of drawers & a chair; maybe a narrow bookshelf. If your mom has a ton of clothes, perhaps convert 1 of your closets into seasonal storage for her clothes & shoes.
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Reply to igloo572
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disgustedtoo Apr 9, 2021
"...perhaps convert 1 of your closets into seasonal storage for her clothes & shoes."

OR as a place to find replacement clothing for missing items. I've been trying to sort through everything they boxed up and sent to me when mom passed. We were not allowed in, so this it what they packed. I had already, before the lockdown, noted mom wearing some things I'd never seen before.

I've found about a dozen stretchy undies (she NEVER wore any like that and had been in briefs for several years - we removed all her undies to help the transition.) I've found towels that I KNOW are not hers. She was partial to pink colors, so all hers were pink or had pink. There are some pink ones that I also know aren't hers, but blue and turquoise? There are also clothing items that I know aren't hers. Styles and sizes are way off, and I knew what most of her clothes looked like. I feel bad for those who have "lost" these items, but I have no way to know who they belong to, is the person still alive, is the person still living there?

So, the closet storing the "extras" can be seasonal, but also spare clothes!
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Find a Skilled Nursing Facility in your area that accepts Medicaid; get her in there NOW and private pay with your Medicaid application PENDING. It's easier to get a person into a SNF while you are private paying than it is AFTER her $$$ runs out and you are THEN applying for Medicaid. Then ask the SNF if they can turn you onto a person/company that can HELP you go thru the Medicaid process; the SNF I will be using for my 94 y/o mother gave me the name of 3 such companies that will help me; they provide the forms and the assistance to apply for Medicaid, then the gal puts the application in herself and keeps up with the process, and any further requirements needed, etc. There is a fee for such a service, here in Colo for me it's in the neighborhood of $1400.

I feel the same way you do; I hate having to move my mother at 94+ years old but in a while, there will be no other options as her $$$ is running out for private pay. Extreme old age is nobody's friend, that's my opinion on the matter. With advancing dementia and a good many other issues at play, the quality of my mother's life has diminished tremendously at THIS point. Having a roommate in a SNF surely won't make it any better.

Good luck!
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Reply to lealonnie1
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Nor should you attempt to pay for the care, as this will rob you of funds you will in future need for your OWN care. Your Mom will have to move to a place that accepts medicaid now. You will need to begin process of application. It would be wonderful if the facility where she lives would be able to suggest and help you. I would explain to them just where you are and ask if they have any ideas for you.
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Reply to AlvaDeer
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I urge you to see a Medicaid Attorney TODAY (not an Elder Care Attorney)--someone who specializes in Medicaid rules and allowances. There are answers, but you can't wait until the 11th hour to seek them out -- I'd say you're at 10 o'clock right now.
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This is what I did. Mom had 20k left in her bank account. I placed her in a nice LTC facility. The 20k paid for 2 months privately and got her under the 2k income cap. She moved in May 1. Medicaid, in my State, only allows 90days from initial application to place the recipient, get them spent down and get all info needed to them. Mom paid May and June and July Medicaid took over. I started the process in April.
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Reply to JoAnn29
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If your mom has uncomplicated assets (no home owned, no car, just a checking account and SS) AND you have not been co-mingling her funds with yours or doing anything that appears as "gifting" money, property or assets to each other in recent years -- then you can certainly fill out the app yourself. You'll need basic information like her birthday, SSN, address, ability to provide copies of banking statements, copies of medical bills, etc. After application it can take about 3 months to hear if she qualifies. In my state of MN there is a 5-year "look back" period for the application. This means if my mom signed over any assets to me (or anyone) that long ago then Medicaid will include that info as they consider her eligibility.

If it's more complicated then I would certainly invest in hiring an elder law attorney to advise you and help fill out the form.

FYI usually a Medicaid bed is in a shared room, but my MIL has been in LTC on Medicaid since 2016. We moved her to a different facility that was closer and better managed. They have been remodeling and improving this older facility and she's been in a private room since last June.
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Check for PACE a program nationwide that combines Medicare with Medicaid.
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It just shouldn’t be this difficult to care for our elderly loved ones.
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TouchMatters Apr 8, 2021
Yes. Amen. This country has no respect for us as we get old. It is disgraceful.
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Immediately talk to the facility - do they subsidize patients. Some will and some won't but at least you will know. Talk to a social worker and contact the local Office on Aging and start learning about Medicaid. If she is placed into a nursing home, Medicaid should be willing to pay. There is help out there but you have to start searching for answers. I do not think they can just dump someone on the street - so find out what your options are. And contact an Elder Care attorney for help and advice. Also ask the local hospital if they have someone to talk to.
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DianaMiller Apr 8, 2021
I have a mom with Lewy Body Dementia 83, a mentally challenged Aunt 73 and my Dad 84 all under one roof. My Aunt would like to get away from my mom so I did a little research into Medicaid. My Aunt has very little money and can't take care of herself but can do chores so she would like a room and bathroom to herself. You will have to check with your state since they differ. I live in TX and I contacted Medicaid and was told that if my Aunt went into a facility Medicare would cover the first 100 days while we filed for Medicaid. It was a little difficult to contact Medicaid by phone since it under different names in the different counties. So contact a facility in your county to find out the name. Hope it helps and good luck.
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If you can just hold out a little longer, President Biden is working on it. He put back $400 Billion for senior care and there caregivers: https://www.washingtonpost.com/us-policy/2021/04/02/caregiving-elderly-white-house-infrastructure/
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sazure Apr 8, 2021
Sure more Government bureaucracy. If it passes at all it will take many years if not DECADES before the final (mandate, act, resolution??? will be passed if at all) (recall the separate houses of Congress)

(I minored in that area in NYC long ago - lots of talk, talk, talk...) We shall see. The bottom line is people pay into social security and medicare and it is difficult to get assistance later.
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