Mother has Alzheimer’s and receives A&A. She needs LTC in a facility but funds nowhere near covering. Can she live in the local Vets Home?

So sorry about your mother. I’ve had my parents on the local VA nursing home wait list for years . Finally my dad had to go in and stayed only about 6 weeks before passing. My mom is on the list and hopefully will also be able to go there. It was a great place (for a nursing home) so check with the local home to get on the wait list. My mom had to pay for dads stay about $4000/month because they had too much in assets to qualify for Medicaid. I’m also applying for aid and attendance for Mom. Don’t know how long that will take. But she is under the asset limit to be eligible. I’ve never been able to find out if they have to be getting paid aid before applying to be eligible. Her money would be spent down real fast if we have to hire someone esp full time. Anyway I suggest that you talk to the local VA nursing home now. They can help with the financial situation to get her eligible. Also please note that the VA homes give preference to veterans and only allocate few rooms for widows. At least the one here operates like that. There were mostly men at the one dad was in.

I’d suggest you get her on the wait list for MC at the VA Yountville. Like get this done this coming week.
This way you know you’ve got that possibility going, ok.
Then call every 2 weeks to see whats what. Not to sound callous, but due to Covid, facility occupancy rates can change from day to day. Where I am, VA Biloxi had like 4 veterans with it end of March / early April & some families chose to move their family member out permanently. Meanwhile VA hospital in New Orleans transferred all vets they could to Biloxi VA LTC & hospital. Done so when we had our big surge there were extra Covid beds available at the new Nola VA for anyone (not just vets). Our Phase 1 surge is kinda past now, and NOLA vets transferred back. So the Va Biloxi LTC has beds available. My point is right now occupancy is very much a moving target. There could be an opening in MC week after next. But you gotta get her on the list and call repeatedly to see what’s what.

So shes still in AL but they are pressuring you to get her moved out? So do you think they really truly need her out... like is she doing stuff that places herself and others in jeopardy? Like she’s wandering into the street or physically being a buttrash to other residents or staff?..
or
is it she has to be regularly redirected to where her room is but otherwise she’s behaving appropriately? If it’s this, I bet they will be ok on her staying till a MC opens up. It may be that she needs an aide 5 hrs a day that you may need to private pay for. Her AL may rather have her as they know her than take in a new resident they know nothing about in this time of Covid concerns.

As Cali & JoAnn posted, she cannot be eligible for LTC Medicaid AND VA A&A$ at the same time. LTC Medicaid covers all room & board costs for NH / SNF, so Medicaid is the better option once they have spent down their assets. The A&A gets suspended and instead she will get $90 @ mo from VA as a personal needs stipend.

The problem is that IF your mom is not yet assessed to need NH / SNF, medicaid will cover MC and AL only, again only, if your state does Medicaid waivers to shift Medicaid $ to do this (pay for AL or MC). It sounds like California does not do waivers (that’s right isn’t it, Worried?). So if that’s accurate, your options are limited. Find a vA with MC somewhere in the state that will admit her..... or see what might could be done to have your mom assessed to be needing a NH or SNF level of care. If she has never had a needs assessment done, I’d try to get one done to see just how far off she might be to ever needing a NH. If she’s like pretty solid for just a MC, then you imho kind need to be laser focused on find a VA MC somewhere. You can get her transferred to the one by you once there’s an opening. Good luck.

Terri, have you talked to the local vets house to find out how to get her the care she needs? Can she go into the facility?

This is awful that she can't get LTC Medicaid because she is getting A&A.

It is my understanding that you cannot have Medicaid and A&A to pay for care in a LTC facility. Both are are government subsidies. So if you apply for Medicaid (ur State MediCal), they should not be counting the A&A as income. Medicaid is going to be higher than the 2 in paying for Moms care, so A&A will be dropped. Mom will need to go to a LTC facility for Medicaid to pay.

What you need to do is make an appt with MediCal. Then make an appt with the VA dept in your County.

When it comes to the VA, it all depends on Dads service. He was in the service, not Mom. Was he retired from a branch of service? Did he serve during wartime? (To receive A&A u proved that) There are so many factors that go into what Mom is entitled to. Once you have a better picture, then decisions can be made.

To be able to go to a VA home, you need to put your Mom or dad on their wait list. That's what I did for my parents. When the time came, we were able to get my Dad placed at our local VA home which was a wonderful place! He was only there 6 weeks before passing. However, my mother had to pay for the assistance which was about $4,000/month. Although much less than other private nursing homes, it was a big expense for my Mom. She only has about $70,000 in savings to live on in addition to SS. We applied for assistance through our State but you have to spend down to $2,000 in order for State to pay for nursing home. My Mom is also on the wait list...she is 90. Should she have to go in, she would have to pay for her care until we spend down to $2,000 ..then the State would start paying.

Aid & attendance is NOT countable income. Medi-cal will not count it when they determine her eligibility. And the local VA home which is the Yountville facility does have memory care. If she goes on medi-cal then she won’t even need aid and attendance because Medi-cal will cover everything after her share of cost. When it comes to LTC, medi-cal/medicaid is better than aid and attendance.

Terri, you don't have to give up anything yet; what you need to do first is explore the options and conditions covering them.  Gather the facts, flesh out the ptions, then you can make your decision.   Right now, you don't have enough information to make an informed decision on whether or not the local VA facility is even an option.

And one of the first things to do is to determine if the local VA home has  a memory care option.

I think Medi-cal does consider her VA A&A as income.

I’m so afraid of giving up A&A because it took us 2 years to even get it! I fought long and hard for it when simultaneously she ran out of money for Assisted Living and they said she could no longer live there because she couldn’t find her apartment anymore. Others have said, give it up, go on Medi-cal and then we can receive IHSS too. Do we discontinue VA help so we can get Medical-cal? I’m so confused. Do we fall into the arms of the state or will the VA catch us?

She can apply for Medi-cal & go to
memory care. She’ll lose the aid & attendance though but she won’t need it because Medicaid and her social security will cover the entire cost of memory care. Also aid & attendance isn’t countable income for medi-cal but she can’t receive medi-cal and A&A at the same time.