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My mom is on Medicaid in Ohio and we are about to sell her house because we can’t afford 2 sets of bills plus she’s in there long term. It’s only been appraised at $13,500. The nursing home is saying that they can’t switch her to private pay then when the money has been used, switch her back to Medicaid. Anybody been in this situation and know how to manage or spend down that kind of money ? Unless the nursing home is wrong? I was told by the case worker that was what they would do. Have the rules changed in Ohio on this?

An elder law attorney is well versed in Medicaid. They can also help with house closings
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Reply to MACinCT
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buy her clothes, beauty parlor trips, cell phone, dentures, eyeglasses and keep an accounting of it until its all gone and only spend it her needs, and ask elder lawyer is that correct.
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Reply to lovelyliz
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my2cents Nov 13, 2022
Spending down before entering Medicaid bed would work like that. Once under the resource limit, which is quite low, Medicaid kicks in and pays for her bed. After certification, money over the limit in her bank account would mean she wasn't eligible for State Medicaid to pay her bill.

You can't just keep it in her account and spend it until it's all gone because each month that the balance is over the limit (probably around $2K), she is not eligible that month for state to pay the Medicaid bed bill.

Definitely needs to talk to the Medicaid worker or an atty.
(1)
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Consult with an attorney who knows elder law.
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Reply to NancyIS
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Get an attorney.
Keep good concise records
Call Medi-Caid.

I am not in this situation. I would get professional advice.
You do not want BILLS after her death - or even before - due to errors in how finances handled.

Gena
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Reply to TouchMatters
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Rose61mary: Perhaps you would do yourself a favor by retaining an elder law attorney.
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Reply to Llamalover47
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Call the Medicaid office. I'm not sure why the NH is telling you that because they accept people every day who start as self pay and end up with Medicaid application and processing once the funds are spent down. Medicaid rep can also tell you when to file the reapplication - at what point as money spent down. It sounds more like the NH doesn't want to do any extra paperwork now that they have her on Medicaid....prefer to leave as is.

Actually, you are required to report changes in income/resources. Money from sale of house is a new countable resource. House was excluded all this time because a form was signed indicating her desire to return. So not reporting it could result in penalty months where Medicaid won't pay. Social workers at NH should certainly be aware of requirements to report.

You also have the option of going to elder atty to set up trust so that the funds can be used for medical needs and other things mom might need, however atty fees could possibly eat up much of the sale of the house.
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Reply to my2cents
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Rose, if mom doesn't need anything, I would just payback Medicaid and not go through the hassle of her going off and then having to re-apply.

You could buy her some cozy winter clothes and a few nice blankets, warm slippers maybe a few pairs, a new summer wardrobe, new shoes and slippers, some snacks she enjoys, buy shelf stable items and buy extra. Does she use a wheel chair? Buy her seat cushions and several lovely covers. How about the in-house beautician? Can you have her hair and nails done, weekly for the month she is flush. Definitely buy the staff at the nursing home pizzas, for all three shifts and enough for everyone. Showing them how much their care of mom means to you can make her caregivers a little less stressed and win her more regard. There are lots of ways to spend a few grand.

I would make this as easy as possible for you. Get a plan together before you have the money in hand, that way it is quick and simple. Order items or go shopping and whatever is left goes to Medicaid. I think you run into a problem when the money shows on a beginning balance, so request the check the 1st day of her statement cycle, this should be no problem, then you have to spend whatever you are buying for her and write a check to Medicaid before the last day of the statement cycle.

Oh, I would buy her a couple of beautiful silk floral arrangements to brighten her room. You could get an extra set and rotate them out.

Anything to help her feel special is a good thing.

Is 13.5 the actual appraisal? Because that # will be quite a bit less after all the real estate and title company fees, keep that in mind.
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Reply to Isthisrealyreal
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Missy68 Nov 7, 2022
I would be very careful doing this. I just had to explain every single charge over $200 after the sale of their home and we were having to apply for Medicaid for my father. Also, be careful with the lawyers and make sure you understand everything they are doing as they are doing it. I'm currently going thru this process and my father has just passed away days before he got approved. Get everything in writing from them. Protect yourself as well.
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I live in Georgia so rules may be different. I would go to an elder attorney. They can help set up a trust so you don’t lose all her assets. When I worked at hospice I knew several families who benefited from their services. It may cost up front but it helps through the process.
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Reply to CyndiP
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I have an elder law attorney in downtown Toledo. Don't know if that is too far for you. I went to High School with him, Nic Thakur (pronounced tah koor). Maybe call him, ask if he would take a case that is a little distant, maybe he could recommend someone. Tell him I recommended him, Karen Carpenter. Also you could call the Ohio Medicaid ombudsman. In the past they were knowledgeable when jobs and family knew nothing about my program. However, last time, j&f took me off my program, I got yelled at by the Medicaid office saying my income went up. It hadn't. She didn't listen to me and the somewhat rare program I was in. Luckily j&f fixed it. These places are hit or miss. But it might be worth just to see if they know about any rules with the sale. Right now I don't qualify for Medicaid due to sale of my home and couldn't afford to buy in this market. But there is a COVID moratorium on now. Your Medicaid has to be restored to the same level until the moratorium is lifted. So I have Medicaid until the Ohio legislators cancel the covid protection. Rumor has it, maybe January.
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Reply to Karenina
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Hi to you,..The 30 days for “Spend Down rule “is always counted from the First day of each month so if you receive a check or the check-money clears in the bank in the middle of the month after your mom’s Valubles sold ,..than only lives you with so many days to spend the money down what is left from the same month. Therefore the check has to clear on the First day of the month when you ready to “spend down” A SNT attorney can advise you if you wan to open a Special Need Trust for your mom with her own mint after everything was sold . But if the whole after sale-Valubles is under $20000 than maybe the best to spend down in 30 days and buy all or something that your mom’s needs . Because You going to have to show to Medicaid ,..what the money was spend to and for your mom to benefit . Otherwise Medicaid can take all the money to compensate Itself for all those for providing benefits by Medicaid was giving for many years of care for your mom . This is call a Payback Medicaid Rule” The best and easiest way to spend down to buy a Car but in both of your name and make sour you know to have / put on the Title “ and “ between the two names ( your mom’s name & yours ) because if they put “ or ‘ that is not good . This way you can later explain Medicaid your mother benefited by buying a car because this way you are able to visit her. So trade your car in at the same time and get a better car on both of your name ( putting her name first “ and “ your name . This way Medicaid can not take the car from you for “ payback “ once your mom left her body . Always good to talk with a SNT attorney about these. Good luck and be aware of the “Medicaid Payback law”
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Reply to Elizabeth5
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Since there are closing fees even on the sellers side, the value is even less. A lot of those properties will just sit on yhe market. Is family paying those fees? If she is the sole owner and she is insolvent, you might want to speak to a lawyer about abandoning the property. Whoever she pays taxes to can add it to what she owes towards the value. Whatever she makes in SS cannot be garnished.
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Reply to MACinCT
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Yes, as others have said, get with an attorney -- elder care and specifically experience with Medicaid in YOUR State. While Medicaid is a shared State/Federal program; many aspects of the program are State-specific.

Not that this is legal advice for you to take any specific action listed herein without actual legal advice from a licensed attorney in your state and one experienced with elder care/Medicaid issues; but worth checking on these potential options:

-- Many states will allow one to "pre-pay" funeral expenses but that may have to be paid before qualifying for Medicaid long term care coverage in your State. I did this w/my mom; we prepaid all her funeral expenses in advance and that took up about $13K of her assets NOT including the burial plot which had been part of a prior family "purchase" years ago. Yikes I know, expensive for burial/funeral and this included no service other than a gravesite service. We live in an expensive urban area on the east coast.

-- My mom's nursing home (and she qualified to Medicaid long term care coverage in our State well over a year ago) will let me to "write an extra check" as needed to the nursing home to "keep her below out State's asset limit." Because there is NOT much of anything to spend my mom's money on (she has dementia and is pretty far along, not like she goes out or does much) AND she gets both a monthly Social Security payment and Federal Employee "annuity payment" (my dad passed away when I was a kid, he worked for the USG and mom never remarried; so she get's his "pension") AND Medicaid only allows my mom to keep about $90.00 but the bank account nevertheless has to remain under a total of $2K; I often have to write an "extra check" to the nursing home just to keep her under the $2K total asset limit. I suppose other states allow this as if there is not much to spend what little money there is on anything, then what to do?

-- Other option (dependent on proper legal advice) is take the funds and tell your State Medicaid Office. She would be "disqualified" for the period of time until which she re-qualifies after the funds are spent down. With the cost of long-term nursing home care it may only take one month of paying privately whereby that $13K in proceeds from the sale of the house are spent down AND THEN she reapplies for State Medicaid long-term care coverage. There was a point last year where my mom may have been in line to inherit some funds from a distant relative and those funds would have put her over our State Medicaid asset limit. Our attorney said, she would just remain where she was at her current nursing home and we would start the spend down process again and, then, re-apply for Medicaid once she had spent down. Good news for us, that relative had a newer Will which did NOT give my mom anything, so this potential issue was all moot. But still good to know in our State the "spend down" process just restarts if your LO comes into some larger funds.

All to say, get with an elder care lawyer licensed in your state w/Medicaid experience. Your LOs nursing home may have some names to suggest. OR contact your area agency on aging for a recommendation for a lawyer. Last option, contact the law schools in your State as many run "pro bono" or low cost "legal aid" programs to help folks with various legal matters when paying a lawyer is out of the question. AND of course you can pay that lawyer with the proceeds of the sale of the property too which may be another way to "get rid" of some of the funds legally.
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Reply to Sohenc
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March over to an eldercare attorney ASAP.
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Reply to Patathome01
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Its not up to the NH, its Medicaid rules. They will not pay if Mom goes over the income level allowed. What is this a trailer? You need to sell it at Market rate. With 13.5 k that would cover one month of care. Call your Moms Medicaid case worker and see how the proceeds can be handled. If we are correct, then Medicaid needs to call the NH and put them straight. The NH just might not want the hassle.
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Reply to JoAnn29
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The HOUSE is only worth $13,500? That seems impossible in this market.

Whatever you do, be totally transparent in the sale and where you put the proceeds. I have pretty much no experience with Medicaid, but am trying to help a friend work within the Medicaid system. So, I'm learning the hard way. I know she wants a divorce, but says that if she and her hubby split up, they will lose their house as neither can afford it. Putting her half of the house sale in the bank disqualifies her for Medicaid and she'd have to spend that all down before she began the Medicaid runaround all over.
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Reply to Midkid58
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Becky04469 Oct 29, 2022
Mid, It might be a house in one of almost abandoned steel cities where property prices are ridiculously low, a ghetto area in one of the large cities or a small rural town in the middle of nowhere. I lived in a community north of Cincinnati with an average house price $250,000 to $450,000. About 4 miles down the road was a little town with prices from $20,000 to $30,000.
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Rose, you had asked a similar question regarding funds from a home sale. Go to this link to see answers :)

agingcare.com/questions/money-from-home-sale-any-advice-477874.htm
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Reply to freqflyer
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Get an attorney to advise. I'm thinking another option would be to just deposit the funds in an interest bearing bank account and don't touch them. Then, when mom passes and the state may seek to recover costs, you can provide them the funds from that account.
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Reply to mstrbill
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