The social service director at the nursing facility should be helping you file for Medicaid for your mother's stay. The letter of intent, by law, should be a 30 day notice. But here's the rub, the facility cannot discharge your mother unless they can ensure that she is going to a "safe and healthy" environment. Please contact the Ombudsman Supervisor for that facility and allow them to help you with this issue. The Ombudsman's contact info should be displayed in the facility (this is law).
She has not applied for medicaid. I need to do that. The problem is that she has real estate that has not sold and I've been advised that Medicaid won't pay until her assets are below $2000.
Well unfortunately, probably your options are limited - 1. what is the status on the rental property? has there been any interest in a sale? what is it's DOM (days on market)? What is the Realtor telling you as far as interest in the property. If - heaven forbid - you are doing this as FSBO, you need to asap find a Realtor to get it on a MLS service. I don't know how other states deal with this but for TX Medicaid, if the applicant has a home & wants to sell it (instead of keeping it as an Medicaid exempt asset), it needs to be a done by a Realtor and be a viable, genuine listing on the real estate market. FSBO just won't cut it. If it truly is rental property, then it has to be sold for Medicaid rules.
Now there could be the option that mom makes the rental property to be her homestead, and that could make it an exempt asset. Would that be at all feasible?
2. So how has she been paying for her care up to now? and how much is she short each month? Can you or other family pay the difference? Is the property actually producing income to pay towards her care?
3. I would apply for Medicaid for her - even if you know she will be denied. She needs to apply for Medicaid, so that she can be considered "Medicaid Pending" by the NH (as it buys you a couple of months to sort things out). If the rental is up for sale, that should be taken into account by Medicaid and there may be a lien placed on the property so that the state gets the funds from the sale in order for her to qualify. Now during this period of time, she will need to do her co-pay to the NH aka her "SOC" share of cost in Medicaid speak. The SOC will be whatever monthly income she gets each month. It has to be all the income she gets less a small monthly needs allowance ($ 35 - 90 a month depending on the state). The SOC has to be paid too. So if mom's SS is paying for things for the rental property or for her personal homestead or anything else, that $ will no longer be there anymore. Her monthly income has to be paid to the NH the minute she applies for Medicaid. Now if she has to do this, will there be financial problems with the rental property or other items??? if so, then you need to call a family meeting to see who can float funds to pay for things on the property till they go to act of sale. it needs to be clear (legally) that any $$ fronted by family is a bridge loan to mom and has to be reimbursed from the proceeds of the sale too. There may be some hard choices that have to be done. If family does not have the resources to help out, property may need to go into foreclosure or to tax sale. That is a hard reality.
4. All this doesn't solve the past due to the NH but does buy you some time IF the NH is willing to work with you. The NH needs to get paid something or needs to have someone within the family sign off on a payment contract. If you can do this, then the NH will probably be ok. But if you can't, then they can continue to do whatever to have her moved out. So what is the NH telling you? Do they want to keep mom there or do they really want her out ? If mom doesn't pay, who signed off to be financially responsible for mom? You really need to keep the lines of communication open with the NH. At my mom's NH # 1, there was a resident who's son just refused to deal with the bill. Medicaid declined to pay as he had sold her home after mom had been OK'd by Medicaid, did not report it and then house sale $ was not used in her spend-down or for her care. What they did was make the lady an emergency ward of the state, so the state took over her care and they moved the lady to another NH in another county that satisfied the "safe & healthy environment" required that Patts44 mentioned. The son was not aware of the move either and he did not have to be told as mom was now a ward of the state. It was some kinda ugly - I was there seeing my mom when he was there and the police was called to escort him out. The NH probably went after him personally for the debt too. This is pretty dramatic but if you are just up against the wall and there is just flat no $ out there, her becoming a ward of the state can happen. Now everything she owns then comes under the state's rules and she will have a temporary guardian named. Your & other family;s role is secondary in all this too. You probably don't want it to come down to this but keep it in mind as an option if need be.
Lastly, you can have move move back to your home or another family members home and provide the caregiving for her till she is fully eligible for Medicaid.
Please contact the Ombudsman Supervisor for that facility and allow them to help you with this issue. The Ombudsman's contact info should be displayed in the facility (this is law).
1. what is the status on the rental property? has there been any interest in a sale? what is it's DOM (days on market)? What is the Realtor telling you as far as interest in the property. If - heaven forbid - you are doing this as FSBO, you need to asap find a Realtor to get it on a MLS service. I don't know how other states deal with this but for TX Medicaid, if the applicant has a home & wants to sell it (instead of keeping it as an Medicaid exempt asset), it needs to be a done by a Realtor and be a viable, genuine listing on the real estate market. FSBO just won't cut it. If it truly is rental property, then it has to be sold for Medicaid rules.
Now there could be the option that mom makes the rental property to be her homestead, and that could make it an exempt asset. Would that be at all feasible?
2. So how has she been paying for her care up to now? and how much is she short each month? Can you or other family pay the difference? Is the property actually producing income to pay towards her care?
3. I would apply for Medicaid for her - even if you know she will be denied. She needs to apply for Medicaid, so that she can be considered "Medicaid Pending" by the NH (as it buys you a couple of months to sort things out). If the rental is up for sale, that should be taken into account by Medicaid and there may be a lien placed on the property so that the state gets the funds from the sale in order for her to qualify. Now during this period of time, she will need to do her co-pay to the NH aka her "SOC" share of cost in Medicaid speak. The SOC will be whatever monthly income she gets each month. It has to be all the income she gets less a small monthly needs allowance ($ 35 - 90 a month depending on the state). The SOC has to be paid too. So if mom's SS is paying for things for the rental property or for her personal homestead or anything else, that $ will no longer be there anymore. Her monthly income has to be paid to the NH the minute she applies for Medicaid. Now if she has to do this, will there be financial problems with the rental property or other items??? if so, then you need to call a family meeting to see who can float funds to pay for things on the property till they go to act of sale. it needs to be clear (legally) that any $$ fronted by family is a bridge loan to mom and has to be reimbursed from the proceeds of the sale too. There may be some hard choices that have to be done. If family does not have the resources to help out, property may need to go into foreclosure or to tax sale. That is a hard reality.
4. All this doesn't solve the past due to the NH but does buy you some time IF the NH is willing to work with you. The NH needs to get paid something or needs to have someone within the family sign off on a payment contract. If you can do this, then the NH will probably be ok. But if you can't, then they can continue to do whatever to have her moved out. So what is the NH telling you? Do they want to keep mom there or do they really want her out ? If mom doesn't pay, who signed off to be financially responsible for mom? You really need to keep the lines of communication open with the NH. At my mom's NH # 1, there was a resident who's son just refused to deal with the bill. Medicaid declined to pay as he had sold her home after mom had been OK'd by Medicaid, did not report it and then house sale $ was not used in her spend-down or for her care. What they did was make the lady an emergency ward of the state, so the state took over her care and they moved the lady to another NH in another county that satisfied the "safe & healthy environment" required that Patts44 mentioned. The son was not aware of the move either and he did not have to be told as mom was now a ward of the state. It was some kinda ugly - I was there seeing my mom when he was there and the police was called to escort him out. The NH probably went after him personally for the debt too. This is pretty dramatic but if you are just up against the wall and there is just flat no $ out there, her becoming a ward of the state can happen. Now everything she owns then comes under the state's rules and she will have a temporary guardian named. Your & other family;s role is secondary in all this too. You probably don't want it to come down to this but keep it in mind as an option if need be.
Lastly, you can have move move back to your home or another family members home and provide the caregiving for her till she is fully eligible for Medicaid.