Does my mom's social security income get reduced or eliminated since Medicaid is paying for her nursing home? - AgingCare.com

Does my mom's social security income get reduced or eliminated since Medicaid is paying for her nursing home?

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My mother has advanced dementia and has been admitted as a permanent resident of a nursing home. I understand that Medicaid is paying for everything, and she has no out of pocket costs or deductibles. But I am researching that. My only question is whether her social security income might be reduced or eliminated since Medicaid is paying for her nursing home and she has no expenses.

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Drew- the $ snafu is happening cause mom went into the NH for "rehab" after a hospitalization due to her fall.

Mom is a dual Medicare & Medicaid. When she went into the hospital, Medicare was primary for paying. Mom then got discharged from hospital to a NH for "rehab". Both her hospital stat and post-hospitalization rehab is a Medicare benefit AND the usual pattern is the first 20/21 days at 100% medicare coverage AND then up to 100 days at 80% Medicare and the remaining 20% from her secondary insurer (medicaid).

During the entire "rehab" phase - as it's based on post hospitalization admission - its all getting paid from her M&M's with NO SS income diversion to be paid to the NH. So the NH isn't YET asking for her SS $. Medicare is primary payor & facility is happy.

At some point - like when either mom gets to day 101 or stops "progressing" in her rehab - mom will go from rehab to a permanent resident in the NH. Once that day happens Medicare stops paying. From that day forward mom will then have Medicaid paying for her LTCroom & board AND the NH will need to get paid her SS and any other monthly retirement income as the required co-pay or her SOC (share of cost) under Medicaid rules. Comprende?

Usually it's during the rehab phase that families are scrambling to do a massive spend down so that their elder can segueway from Medicare to Medicaid. Your mom is already on Medicaid, so it's probably going to be simple straightforward paperwork to get her on LTC Medicaid but Medicaid is going to need to know her income (like her award letter from SS that states to the penny what she will be paid in 2017) & assets nevertheless so that Medicaid can send out her eligibility notice with the monthly SOC in the notice.

Now under NH Medicaid rules, mom cannot have over 2K in assets (assets is like savings or $ just sitting in her checking account at the end of the month). So depending what her SS check is AND if she had any $ in her bank AND how long she is in rehab..... the $ she gets from SS could take her over 2k. If that is looking likely, you as her dpoa have to spend her money ASAP so that she is clearly under 2k in assets at day she has the switch from rehab to permanent resident with Medicaid paying for the NH. This is important!

If mom doesn't have a preneed funeral done, maybe use the $ towards this; really it could be the easiest way to spend down in a single move & you may be able to do all over the phone or via email with a FH in moms town. Or buy her extra eyeglasses and easy to care for/sturdy clothing. Or a better walker than the basic ones paid for by Medicaid. She's got to have a bank statement that ends the month under 2k to be ok for LTC Medicaid.

Btw right now the facility as they are being paid by Medicare, are getting paid double or triple what medicaid would ever pay. So the facility is all fine for $. They haven't asked for any of moms SS income as Medicare is paying. But- again - the day she is off Medicare, off rehab, the facility will need her SOC to be paid & pronto. As your sister is moms MPOA, please try to have her keep in contact with the PT & OTs to see where mom is in rehab and how she is progressing. They are doing daily notes in moms health chart and can pretty well tell when she's winding out of rehab. Which means she switches to Medicaid and it's strict rules on $.

You as the DPOA don't want to get stuck that mom has 3 mos of SS checks sitting in her bank and is $ 400 over in assets for Medicaid approval......
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SW is social worker. Yes Medicaid requires that you re-certify at set periods determined by each state, some annually and some every 3-5 years. The certification is time sensitive and if not completed in time your mother can lose Medicaid. If you are not able to manage the info from afar perhaps you should get services of a good elder care attorney or geriatric case manager. If she loses Medicaid due to paperwork snafu or money building from special needs account, it will be quite unpleasant.
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Veronica91, your post was very helpful. You used the acronym SW in relation to the nursing home. What is an SW?
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Thanks everyone for your comments. This community is great.

I just learned that mom has been on Medicaid for several years, but I assume she needs to re-apply in some fashion to get approved for long-term nursing home care.
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Medicaid will take Moms SS and she will get a small monthly allowance to cover personal items.
After you have followed all the above advice contact the SW at the NH and arrange to pay whatever is in Mom's bank account towards her NH costs. And become more involved in Mom's affairs or you will be paying for the funeral. Medicare usually allows pre-payment of funeral expenses.
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Make sure, in the meantime, that your sister did not sign the admissions documents indicating that she would be responsible for payment.
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I will contact the NH soon. For what it is worth I live out of state. She fell, went to the hospital, was transferred to the NH for rehab, and then stayed as a resident. I was granted POA several years ago, can't find the document, and asked the lawyer who drew it up to send me a copy. Once I get that in the mail, and get a copy to the NH, I will be able to be involved.
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You are financial poa but you weren't involved in the Medicaid application?

Was mom admitted to the nh " Medicaid pending"? Did you take a lawyers advice on whether mom was Medicsid eligible? Or did the nh sw help with the application?

Where is mom's ss income being deposited? Did anyone advise you that her assets needed to be kept under $2000. for Medicaid to be apptoved?

I think I would be in touch with t he business office at the NH assp.
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The SS will definitely go to the NH.
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For the record, my sister and I are the only heirs and neither needs nor wants my mothers SS money. I forgot to mention that my mom has no assets, no property, no nothing.

I should mention that mom only went into the nursing home a couple of months ago, so it is possible that the Medicaid application may still be being processed.

My sister has the medical POA, and has been handling things so far. I have financial POA but have not been involved in the nursing home situation till now. My sister told me that so far, the nursing home has not made any claim on mom's SS income. This goes against everything I have read on these forums for the last few months.

Assuming the nursing home never makes a claim on the SS money, it will just pile up in a bank account. One thing I am worried about is that when the balance gets to high, it will disqualify her from Medicaid.
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