What to do when the rent at Dad's memory care facility is raised due to his level of care increasing?

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Dad only has $240.00 left between his current rent and what he brings in from his pension and Social Security. The last level of care increase was $700.00. I don't know what to do with Dad if the rent is more than he makes. Unfortunately, hus pension and Social Security combined are more than the monthly maximum allowed with all of the assistance programs I have looked into. Perhaps you would be able to give me some guidance. Thank you.

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That's interesting that your dad didn't see combat. We were told (along with a friend of mine who was trying to get it for her mom) that they did. You can get it for veterans but not as much as if you did see combat (at least that's what I remember. it's been 7 years so I've slept since then:)) We went through an attny that only worked with veterans.
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Pargirl. The VA comment. I just got Aid and Attendance (A&A) for my widowed mom army wife, after 2 1/2 years filing with VA service officers. I turned everything over to Omega Care Planning Council, Raleigh, NC. "Accredited" Experts at getting VA benefits. Yes there is a fee, but a first month income award is nothing to pay compared to getting "0" income for 2 1/2 yrs, and then the settlement took only 6 months! Dad was a veteran. He does NOT have to have been in combat to receive A&A. He just has to have been serving in the military during a war era. He did thru Vietnam and Korea.
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igloo572: I understand. I don't know if it's a trend or not.
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with dementia, he can qualify for Medicaid. Pay the facility with his portion and Medicaid fills in the rest of the fees. Since dementia is a terminal illness, he can expect care until he passes.
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Llama - my mom did not have LTC policy, so never a consideration.
My post was more geared to my experience that my moms NH chose not to take LTC insurance for payment. And if this is a trend, it's going to make investing in this type of insurance product less attractive as they run a risk for being able to easily use.
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igloo572: Did you think of cashing out the LTC and giving it for payment (partial or not) to the NH?
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llama - regarding LTC insurance, I have no idea if this is a trend, but my mothers NH would not take at all any LTC policies. Payment was private pay, Medicare or Medicaid. Signs as to this posted in entry, elevator and admissions office. What the business office told me was that in the past they did take LTC policies but there was always ALWAYS something in dealing with LTC insurers that meant delays, refiling, more details wanted, payments clawed back. Since each LTC insurer had its own payment and contract, they each have their own reporting and documentation forms; each insurer could have different formats for information on care provided in addition to the ICD standard codes; different forms on staffing (even wanting professional registration/level; one even wanted CE status on staff)…. all of which required time by the NH. That there seemed to be a pattern of always needing another piece of paperwork submitted which delayed settling an account by weeks if not months. Just not worth it for this NH which was part of a small group (it was my mom's 2nd NH and was really a great facility imo). They put this policy in place before ICD-10 roll-out as they figured it was going to be even more of a nightmare to deal with.

I'd bet that this situation is common for a lot of smaller facilities or in-home care companies. If a facility or home-health agency can easily fill a bed or have clients on private pay, Medicare & Medicaid, then taking LTC insurance with the extra time needed to get paid just doesn't make sense for a business. If this is a trend, a lot of folks having LTC polices are not going to be able to use their policy easily.
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While it's too late for "dad" here, piece of advice I give everyone is to put into your investment portfolio long-term care.
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Lileva- as you can see by the answers so far, how to deal with the costs of care are very much interdependent on what your state has for priority of how it spends it's Medicaid $$$.

Your going to need to find out just what programs Medicaid pays for and how easy it will be for dad to qualify to be eligibile and what the open medicaid bed status is Dads state & his city. It's like 60-70% of those in a NH are on Medicaid.

My take on all this is if they live long enough - unless they are generationally wealthy- they will flat run out of $ & family will run out of caregiving ability and they will end up applying for medicaid to pay for thier NH. Avoiding the eventual is only going to make you as DPOA just loco, so get them eligible for a Medicaud NH bed.

If where dad is currently does NOT participate in Medicaid, then you need to find a new facility that does and that will take him as "Medicaid Pending". That excess income that dad gets needs to be looked into being reset by a Miller Trust, (like Babalou suggested!) so he is under Medicaid financial limits. I've found that most facilities are not ever going to bring up miller trust as its viewed as legal & financial advise so outside of thier "expertise" combined with wanting to keep as many residents private pay as its more profitable, even if it means the residents kids pay. You cannot overlook the profit motive of facilities esoecially of they aren't keen on Medicaid participation. If dads state really tends to limit Medicaid to NH / skilled nursing care, then you are going to get his medical chart to start showing "need" for skilled nursing. If his current facility is all "dad doesn't need skilled care", then you are just going to have to do this on your own. It can be done, I moved my mom from private pay IL to a "medicaid pending" NH and totally bypassed the AL stage. It can be done, yeah its work but once they are in a NH and on medicaid, its all done from that point on......put a bow on it! Otherwise it's just a band-aid that will constantly be needing to be dealt with IMO. If you find you need to do this, & his current place isnt helpful, I'd suggest you find a couple of NH that take Medicaid that you like and then have dad become a patient of the MD that is the medical director of the NH. For my moms gerontogy group, all the docs also were medical directors of several NH & all still saw patients in their regular practice. It took about 6 mos of every 3 - 5 weeks of visits to build moms chart to show "need" (for those at home, IL, AL they likely wont have the fat medical chart that a hospital discharge to a NH for rehab does, so it needs to be done). mDs who are medical directors of a NH know how a chart needs to read to pass a review by medicaid. The visit she had a bad H&H labs, 10% weight loss and a couple of other things, her doc wrote the orders for "skilled nursing" needed & I moved her from IL to a NH within weeks. If my mom had needed a miller to be done (she didn't as she was abt $ 1,900 in mo income so under the $ 2,064 income limit the year she applied), I'd have met with an elder law atty to set a Miller up during this period. Miller is pretty straightforward but the sticky is the different income sources more than likely have their own paperwork hell to get into a Miller, so it's not a DIY but needs legal to do. If for some reason your dads income isn't "guaranteed" so can't qualify to be in a Miller, the atty might be able to have the income amortized for review by Medicaid so dad stays under the income limits. This little tidbit I had to do for my mom as she had a dividend that paid once a year & in theory would take her just right over $ 2,064 for that month only, but once it was amortized over 12 months not an issue.

Worrying every week, month, day of just how dads care is going to be paid, will be beyond stressful. Emotionally it doesn't leave time to just enjoy being with your parent. You need to find a solution. If you can get him into a Medicaid bed and get his excess income dealt with, do it! Your local Agency on Aging should have lists of all care facilities and which take Medicaid. This site has list of elder law attys by state too. Good luck.

Btw most excellent insight from Joanne's & Vicksky!!
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Wonderful advice from Joannes!
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