My father is in assisted living, where he's been on spend down for 13 months. At his current spend rate, which won't remain static, he maybe has 10 months, maybe only 8 or less after an upcoming rate increase in January, before his bank account balance is down to zero. Recent interactions with nursing homes' financial assessment departments, while my father's Medicaid application is under review, are leading me to believe that he may be denied Medicaid. His only income is less than $2700 monthly from Social Security. I don't have any room for him, nor can I accommodate his mobility and dementia needs. If push comes to shove, what are my options? Ward of the state? I wouldn't prefer it but there's no way for me to house or support him. What are my options? even if they are not great, I need to know. I can't just leave him on the curb, after all, but I literally have no idea on how to address this if (1) he gets denied Medicaid or (2) he gets accepted, but all the long-term skilled nursing facilities have years long waiting lists? What do I do with him?
Kelliger, read my post below and Ops answers. I live in NJ and our cap for monthy income is just over 2900 a month. This OPs father would only have 2700 a month once he spent down his money for private pay.
In my State you have to be spent down within 90 days of application. Which my Mom was. So for this OP lets say Dad has enough money for 10 months at 10k a month. In my State you would not even apply for Medicaid until the 7th or 8 month in. This would have him spent down within the 90 days allowed. Which is what happened to me. Proved Mom was spent down and Medicaid started the next month.
You need to find out how Conn's Medicaid works. I have heard some states you have to be completely spent down before you apply. Its much easier to get Medicaid once you have private paid. Some States allow income trusts to handle the money that goes over the cap. Medicaid is beneficiary to these trusts. Call your County Social Service office and set up an appt with a Medicaid caseworker to find out what you need to do for your situation.
So speak to a social worker and ask what next steps are if you have someone who needs to be in care, has nothing, and cannot come to your home.
Were you not there he would be managed as a ward of the state. So allow the state to take this one and do understand at that point that you have no input as to his income, placement, expenditures, and the sale of any assets he has.
The one thing YOU NEVER DO IS ALLOW HIM TO BE DISCHARGED TO YOU OR YOUR HOME.
any guidance on how to proceed? Thanks much
Which priority group is Dad in? I just came across that info last month when trying to help get my uncle in another state placed. There are eight groups, Group 5 doesn't require the vet to have a service-connected disability. It can be used if
~ the annual income is below the average income level
~ the veteran receives a pension
~ the veteran is eligible for Medicaid
I can send my notes from a conversation with VA if that would help.
Not all long-term care programs have the years-in criteria like the A&A. For example, to get into the Sgt. John L. Levitow Healthcare Center in Rocky Hill, the criteria is:
~ Honorably discharged from the Armed Forces of the United States (copy of DD-214 is required),
~ be a resident of the State of CT at the time of application for services (proof may be required),
~ ninety (90) days of active duty other than for training purposes.
~ submit an application in advance,
~ submit a report of medical history and physical examination,
~ pass an eligibility check, and
~ have a chronic medical condition or need which requires skilled nursing care or requires 24-hour assistance and supervision with activities of daily living.
It bothers me that the seniormost vets often end up on the State's hands instead of VA. As an elderly acquaintance who served in the Marines said, 'Promises were made to me when I enlisted, I expect them to be kept.'
You will not have to take him in and provide for his care needs in your home, nor will you have to make him a Ward Of The State.
Let me tell you something about these years long waiting lists for a nursing home. It's propaganda. There's always a nursing home with availability. It might not be a high-end place, but he won't be on the street. You can always work from there on finding different placement.
Usually Medicaid doesn't pay for Assisted Living, but good if your father is in one that Medicaid will pay for.
We're in a good state for elder services. If your father goes to the hospital and the AL refuses to take him back because he needs skilled care, the hospital keeps him unti they find a bed for him in a nursing home. Also, nursing homes usually either start the Medicaid application the second a new resident comes through the door, or they get an existing one expediated.
Don't worry so much about this. Your father will not be left on the street in this state and you won't have to move him in with you.
I think you've misunderstood a few things. My father is not on Medicaid. He is on Medicare. Regardless, neither of those programs cover the ASL. He is at the ASL on private pay. The problem is the gap between "spent down" and "on Medicaid". He is spending down at the ASL, being denied entry to nursing homes on private pay, and pending an arduous medicaid process, that the latest nursing home thinks he won't qualify for and used that as the basis for the denial
A couple of suggestions: Was your father ever in the military during time of War? Some "Aid & Attendance" could assist
Have you checked out: Aviva in West Hartford, CT
Maybe you could find him a place in Independent Living (IL) and bring in services for activities of daily living.
Meet with a Social Worker. Sometimes the IL with services brought in could save you $$$ depending upon the health of the loved one.
My State allows Medicaid if a person has been paying privately for at least 2 years in an AL. The AL has to except Medicaid.
You are going to have to see an attorney to see your options regarding this. If you are his POA I would do that at once. Often required when one is "income rich and cash and assets poor".
Good luck. Glad you are thinking ahead.