What happens if mom runs out of funds at private AL before qualifying for Medicaid assistance? Does she get discharged to family?

It sounds like it was only $1400 a month which you could report as she was paying rent to your sister while living there. What state was she living in at the time and what state is she living in now?

No money being paid to AL? They'll probably start discharge process making sure to follow state law. If Medicaid application has been submitted, then they'll probably suspend the discharge process.

I'd say the first question can be answered by the AL facility. Do they have a paydown program? If not, Mom will have to move. Maybe you already know this answer.
When I researched AL facilites for my in-laws, my first question was: If my folks run out of money, do you have a paydown program? Paydown means that once they've been self pay for a period of time (in our area usually 24 months, but I've heard of 36), they'll get to stay when they go on medicaid. Some said, no, they'd have to move. Those were immediately off my list.
Whether or not, you can find out in your county who to contact to start the "Medicaid long term care" application. Get that started, yesterday. You will find out of the theft is considered money that has to be paid back. It won't be the first time they've heard of relatives stealing from their clients. On the other hand, it wouldn't be the first time someone has tried to say the money was stolen when it was actually given. If they say it requires a police report, you have you answer. You could then verify with an elder law atty familiar with Medicaid long term care rules. They might call them selves elder law but if they just write wills and trusts, they might not know more than you've already found out. Good luck with it all.

Tajann: Retain an elder law attorney and make sure that the attorney knows that there was $18,000 of monies involved, even though some of it was "rent." Nonetheless, APS should be notified.

Elder care lawyer for sure.

However, some ALs that are private pay, have a few rooms that are available if funds should run low that they will allocate to Medicaid funded residents.

I am not sure if your Mom is already in the AL or going to be in the AL. If you are already in the AL and the relationship that you have with them is good, and if your Mom is well behaved, then I would suggest you talk to the AL

However, if you don't feel comfortable about asking this question to the AL, you can either have the elder care lawyer talk to them, or get counselling assistance from your state/county's LTCOP organization and see if that facility has a few rooms that take Medicaid patients.

I wish you best of luck on your journey.

As advised on this forum, speak with an eldercare attorney. The funds were stolen from your mom.

You are doing the right thing by speaking to an elder law attorney. The elder law attorney will guide you through the process. Make sure you have all records of how your mother’s money was spent as Medicaid will need these records. My daughter works for Medicaid of New Jersey and she expects to receive these records in a timely fashion. I’m sure the attorney will explain all of this to you.

You are headed in the right direction by getting an Elder Care Lawyer. If you can,check their references and website. Be aware, it may not be cheap, but the cost is well worth every penny they charge.

I wish everyone would be aware to start planning ahead of time for loved ones or even themselves. Longterm Care insurance is great, but it too has a time limitation on it. So, we/they may never need a nursing home, but no one can predict the future.

In addition to getting the elder care lawyer, I highly recommend a book (just $20 from Barnes and Nobels), called "How to Protect Your Life Savings from Nursing Homes", by Joshua Rae. It's a quick, easy read of 87 pages with information specifically relating to the individual states as an appendix, and he shares a website for other questions you might have.

It's not really the nursing homes, it's more the various governments (State, Local, and Federal) who look at taking your loved ones hard earned assets. I've been through this for 3 elderly relatives, and I couldn't have protected my own health without the help of the Elder Care Law firm guiding me through the maze.

good idea meet with a elder lawyer.

If it really truly is only $7K, I’d ask the atty to send a certified letter to Sissy to try to get her to send you a check for the money. Basically a 10 day demand letter. Do you think that would do it?

Mom doesn’t have the $, that’s why she’s filing for LTC Medicaid waiver.
But do you have the money to write a check for the AL bill or ability to put this on a credit card? Because the AL bill is going to have to be paid one way or another. I think you best off doing this and NOT causing any issues for moms Medicaid waiver application. AL placement has way less safeguards as the AL can discharge her “to the street” “to a shelter”. It is not a NH so does not have the requirement for a safe and secure environment that a skilled nursing facility has for a mandatory “like 2 like” placement. The ALs rarely do that as it’s bad public relations but they will call EMS and send her off to the ER and then refuse to take her back. & then can bill storage for her clothing, tv, etc Really you don’t want to go there if you can help it.

Also I would highly suggest that you asap run a credit check from the big 3 on mom. Like do it now online. Just to make sure that happy hands niece did not open up a credit card or do any other borrowing using grannies SS# & credit history while your mom was living in an other state with your Sister and her family. You want this search done before you meet with the attorney. Cause if there was other stuff done, it changes the whole trajectory of this drama. & post an update, ok!

There may be a penalty of no payment for a couple of months. Wait for the lawyer response. Perhaps you can "suggest" to sister that she will have to take care of mom 24/7 for the time of no coverage. My response is just to scare her into knowing the consequences.
And yes you can file a police report on behalf of mom. She does not need to do it. When I filed on behalf of my mom and her boyfriend who was being scammed, the police reports came to me, the filer

I have more questions than answers - do you have POA / Healthcare Proxy? Ask attorney about all legal issues. Depending on where you live and the facility a spend down approach should work. Likely some kind of report may be needed - I’d ask attorney and a Medicaid eligibility specialist at the local agency on aging or at the receiving AL. The receiving AL has incentive to work with you to get mom eligible - perhaps the stolen funds could be considered “lost” since mom doesn’t want to press charges. Elder care lawyer is a great first step. As others have noted, make it clear your place is not an option (perhaps for health reasons?)

Your last line is critical and most important....that you "are meeting with an Elder Law Attorney". Do not miss nor delay this appointment!

Mom may not want to pursue charges but this may prevent her from Medicaid for maybe 5 years. This would be considered a "gift". You might not have any choice but to go after the funds.
I also hope that this particular facility accepts Medicaid or you will have to look for another place and many/most places want "Private Pay" for sometimes 2 to 3 years before Medicaid kicks in.

Is anyone POA for Finances?
Is mom competent?

I think that if your mom’s mind is still very good, you might have a frank discussion about what hard things will happen next. The theft needs to be dealt with. Then an attorney, not mom, confronts sister. If mom won’t agree to this, you will need to take the reins, as people above have posted.

Not pursuing charges against family sounds all well and good until you have to deal with the severe consequences for doing so. They ripped mom off. They are trash. Perhaps a good talk about what happens next to mom because of the trash sister will wake mom up. But I am sure mom is feeling like a victim already, and just wants it to go away.

I agree the threat of prosecution may be enough to get some repayment. Again, if mom can shift the blame for a lawsuit onto the lawyer and Medicaid, and essentially be able to say there was nothing she could do, it might be easier for her to agree to prosecution.

Mom is no no doubt counting on your goodness and strong sense of responsibility, and is counting on you taking her in. You may need to—but be careful. Best of luck!

Then ask mom how she expects to cover her costs of the AL facility if she will not pursue charges. She doesn't want to do anything unpleasant, but she sure has no problem dumping her problems in your lap.

This may be considered gifting. This needs to be reported as Elder Abuse and theft with the evidence you have and there MUST BE police reports. That will be the only way that Medicaid won't likely consider this gifting.

As to what happens? In your particular facility it is time for a face-to-face and heart-to-heart talk about all the particulars in this case. My advice would be NEVER to say to ANYONE any mention of "discharge to our home". Once that happens all of THIS nightmare will look like a good dream.

Your Mom is going to need to file charges on the stolen money. There has to be a police report out there. Her rent, there should have been a contract written up, witnessed and notarized maybe even by a lawyer. Not sure if Moms word is good enough that it was for rent.

I just edited my post. I saw by your last one you are planning on sending Mom to a facility that takes Medicaid. So making any deals with the AL is not really on the table. So yes, they can ask Mom to leave if she can't pay. So, its either you paying for her care in the AL or taking her home with you. This is a good question for the lawyer. Can Mom be placed in a facility with medicaid pending? For me, Mom had 20k. She was going from an AL to LTC. I placed her in LTC and she paid for May and June. I started the Medicaid application in April so facility aware that Mom was going on Medicaid. I got all the paperwork to the caseworker by June and Medicaid started July1st. Better you place them when they have money then when they don't.

Good thing ur seeing an Elder Lawyer, good luck.

Meet with the AL director and explain the situation. There is a decent chance they will cut her a break. Medicaid also may pay retroactively, so they may keep her as Medicaid pending. Worst case scenario is if they decide to discharge her, then it will be up to you how you want to proceed. You can take her in, or if you really don't want to do that, you could then contact APS and let them intervene. You can tell them what happened, and it is possible they will open up an investigation on your sister and niece. I wouldn't expect that to get very far though as the amount you described comes to about $1300 a month, which is nothing much. Mom should be expected to pay something towards rent and food while living with them, no?

Yes, consult an elder attorney. If there ends up being a Medicaid penalty period because of this, don't you be the one to take your mother home or return the missing money. Put it on Mom's oldest daughter's shoulders to either repay the money or take her mother in.

It might be worth checking what changes if M pursues the theft of her funds. It wasn’t a gift or a deliberate ‘spend down’. This may affect when the Medicaid waiver cuts in, which is an answer to “the money is gone so what difference does it make”, though you still have to cope with “it’s family”. And it is not unknown for money to magically re-appear when prosecutions are imminent.

I hope that your legal appointment can deal with all this. Best wishes, Margaret