How to pay for nursing home when not qualified for Medicaid?

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I've posted previously and greatly appreciated the feedback provided. To make a long story short, our family learned that my mother has dementia this year. I believe she has been hiding her symptoms for awhile. My children and I currently reside with her and had planned to move this summer because she can be abusive. Since that time, I have found a telecommuting job and another family member has stepped in to help out but now they said they will not be helping as often (if at all) because of her combative nature.

I haven't left yet for a couple of reasons - I found legal documents naming me POA and Trustee (major shocker), her bills have not been paid because one day the lights were turned off so I've now been trying to clean up all debts and keep the lights on which is difficult because she still thinks she is paying bills, but the main reason is because she does not qualify for Medicaid and does not have enough money saved to pay for nursing home care.

She withdrew a lump sum payment three years ago on a reverse mortgage. In the past year while she was trying to hide symptoms of dementia, she let both her long term care and life insurance lapse. I am totally freaking out! We reside in a filial responsibility state and I don't want to be trapped taking care of her with my children that try to stay out of her way. I know it will only get worse because she is not bathing, does not put her toilet tissue in the toilet, believes she is talking to 'others', refuses to accept she has memory issues - therefore, will not take medication. I don't know what to do between cleaning up after her, trying to make sure she is fed when she will only eat specific food without a temper tantrum (delivery pizza and ice cream!) but my stress level is so high that sometimes my hands are shaking and sometimes I start crying and when that happens it can go on for either hours or days. Is there any options so that I can place her in a nursing home and not have my credit ruined with nursing home bills???

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Pls read my answer to the person that asked about her Father -in-law. Call the Alzheimer's association. Here are their numbers: Alzheimer's Disease Education and Referral (ADEAR) Center
P.O. Box 8250
Silver Spring, MD 20907-8250
Phone: 1-800-438-4380
www.nia.nih.gov/alzheimers

alzheimers.gov
www.alzheimers.gov

This website a free resource about Alzheimer's disease and related dementias from the Federal Government. It has an overview of the disease as well as information about treatment options, planning and paying for care, and advice for caregivers. Each section contains links to authorative, up-to-date resources from agencies and organizations with expertise in these areas.

Alzheimer's Association

The Alzheimer's Association offers information, a help line, and support services to people with AD and their caregivers. Local chapters across the country offer support groups, including many that help with early-stage AD. Call or go online to find out where to get help in your area. The Association also funds AD research.

Alzheimer's Foundation of America

The Alzheimer's Foundation of America provides information about how to care for people with AD as well as a list of services for people with AD. It also offers information for caregivers and their families through member organizations. Services include a toll-free hotline, publications, and other educational materials.
Go to alzheimers website and clik on or in the Search Box type "Getting Help with Caregiving". This should give you a good start on this disease and help you to educate yourself about it which is the most important thing you can do.
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Fab that you are not giving up your job. No matter what, never do that!
You have all sorts of complicated layers issues, good you are seeing an attorney.

Ok, about the LTC cancellation. You need to send a registered letter (keep it short but with policy # and insurance co info) to your state Dept of Insurance and then also to whatever your state has for Dept of Elderly /Senior affairs and Dept of Consumer Affairs. The LTC guys won't on their own reinstate the policy, but often will if the state does an inquiry into the matter. Your mantra needs to be "Mom did not have the cognitive ability to do any of this on her own, so she should not be responsible for letting it lapse". You will need to be able to pay the past due amount and whatever penalty on it too via a certified check (so if you don't have the funds to do this, then I wouldn't bother). I think you can do this yourself, but can turn it over to the attorney (and their fees) if that works better for you.

Now about the RM. Something about this doesn't sound right? If say she got 50K as income from the RM and spent it on things for herself or her needs, then the 50K in income should not be an issue for Medicaid. That money was paid years ago and is spent. Now if she just put the 50K in a savings account, then it is an issue as her assets have to be at a maximum of 2K for Medicaid. She would have to spend down 48K to be Medicaid eligible for assets. Now Medicaid income is about how much they receive each month as income - like what she gets each month from SS and retirements. Like for TX the maximum Medicaid monthly income is $ 2,163 so if your monthly is under that amount, then you are OK for Medicaid. Over that in income you may be able to do a Miller Trust to qualify.

Now possibly is she still getting income from the RM? If that's the case, then that income could be taking her over the Medicaid limit for monthly income.

About the RM, well this is going to be a clusterF to deal with no matter what. Whatever you do, do NOT spend a penny to do anything on the home. You will never see daylight on any $ you spend on the house. I bet the amount owed on the RM far exceeds whatever the house could ever sell for. The fees for RM's are high. Sounds like mom took it as a lump sum and those have the highest rates (a line of credit RM is somewhat better, still a bad idea but not quite a costly).

When you speak with the attorney, ask about how to best deal with the RM. Foreclosure could be the best option as then it forces mom to have to move to a facility. You know with RM some of these things are out of your hands. Like if mom has not paid the required property taxes and insurance required as per the RM, she is out of compliance and the RM comes due. They could call in the loan. Mom is not maintaing the home (yard not cut, roof needs repairs), they could call in the loan. She would have to move as property foreclosed upon. In some ways, this could be a positive as you are not the bad guy in all this. Good you are seeing an attorney as dealing with RM's when they go sour will have lots of legal to be dealt with.

If she defaults on the RM, she probably will get a 1099-C (Cancellation of Debt). Foreclosures trigger 1099-C's, it's routinely done. IRS filing will need to be done to show impoverishment for that tax year. Done in IRS form 982. This is totally sticky to deal with but has to be done otherwise the amount in the 1099-C will be "income". And although it is totally zombie income, it counts as an asset/income for Medicaid & makes her ineligible unless she files the 982. Clearly speak with the attorney about whom to see for dealing with mom's IRS filing on this in the future in dealing with the RM. Good luck and keep a sense of humor going.
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Thank you for the link. Her LTC lapsed last year. I contacted the company because I was unaware how rapidly she was declining nor that she had dementia at the time it lapsed. There was only a five month time frame to request reinstatement.

I'm working on setting up a consultation with an elder care attorney and also checking with the Area Agency on Aging for more resources. Until Medicaid is approved (crossing fingers that it does), I'm going to also look into adult day care because giving up my job is not an option.
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You should definitely speak with an elder care lawyer, find out where she used the money she got from reverse mortgage. Unless she gifted the money, she can still qualify for medicaid. When does her long-term care insurance lapse? Check out with the insurance company as well. A social worker can also help you in finding a good long-term care facility.
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No, she will definitely not going willingly. The advice I was given was to call social services when I'm about to leave. I feel uncomfortable about doing it but I can't leave her alone without any assistance.
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The kind of lawyer you should see is one who specializes in Elder Law.

Is Mom going to go willingly to a nursing home?
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A loan is never considered income. She's probably quite eligible. You might want to try the admissions coordinator at a nursing home. If they have room for her, they'd probably be happy to help with the paperwork.
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If you live in New Jersey there is an excellent resource. Each state has different regulations for Medicaid.
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Okay, maybe I misunderstood when it was initially explained to me. I thought the money had to be spent the same month it was recieved on home repairs, etc. to not be viewed as income. She used it for home repairs (just not the same month recieved). To my knowledge, it was not given to anyone.

I'm going to make an appointment with an attorney to make sure and get help with filling out the paperwork. I can't keep living like this - it's not good for me nor my mother. Thank you both for answering my questions.
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The lump sum payment from the reverrse mortgage does not disqualify her unless she gave it to someone. If she used it to pay bills, for heaven's sake, it makes no difference. You're missing something.

Further, if she has a monthly income of $3,500 and can get Medicaid-qualified to only exempt seven months, I'm betting you can work a deal with a nursing home. $3,500 is probably more than Medicaid pays them.
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