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My mother needs a nursing home, what happens if she outlives her money?

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Get her signed up for Medicaid and Medicaid will pay for her nursing home. Get her signed up ASAP because the application process can take months. I think some nursing homes will take your mom if she's in the application phase of signing up for Medicaid but you'll have to check with their social worker. My point is to go ahead and look for a nursing home for your mom while she's being approved for Medicaid and let the nursing homes know that she's in the process of being approved for Medicaid.
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You asked what happens when she runs out of money. This may imply that she needs a nursing home and has money (for now) and you did the math and realized that after so many months (years) she will run out. Even if she has a few hundred thousand dollars...at $9000+ a month, that wont last long. Or she has enough for just a few months...whatever. The main thing is you need to get up to speed on what she needs to qualify for medicaid and prepare. What is allowed to be spent, the 5 year look back, etc. It's a good idea to consult an estate legal practice if you/she can afford it to help you with the application process. There are too many things to do before you apply for Medicaid to protect your mom's (and yours) assets to go into in this short post. Like pre-paying for final expenses for one. So look for a home but get some advice before you apply asap. Some nicer homes like a full pay resident for a few months before the Medicaid kicks in. Good luck and get some advice ASAP.
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Someone here urged the daughter to write up a contract and have her mother compensate her for all her work, to which I have to say, "Huh? What in the world???!!!
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Dear Phyllis,
There are some really great comments here and they all add up to one conclusion: you should speak with an elder law attorney in your community. The area of elder law is highly specialized and nuanced. For example, the Medicaid non-exempt asset transfer period which could negatively affect your mother ranges from 30 months to 60 months depending on where you live. This is part of the asset test (or requirement) under Medicaid. There is also an income analysis. If your mother makes too much money, in the eyes of the government, she must pay a "share of cost" for skilled nursing care. One comment here brought up a care contract to get YOU paid for the care you are providing your mother. Care contracts can be highly useful in certain situations. Also, while nursing facilities like to refer to beds as "Medicaid beds", you should know that there is no such thing under the law. A bed is a bed. Nursing facilities will often attempt to limit the number of spaces they have for Medicaid recipients because they get paid less from the government than when a person pays privately.
Besides Medicaid, there may be other benefits available. One example are Veterans benefits. If your mother was in the military or is, perhaps, the widow of a man who was in the military, she may be eligible for VA Aid & Attendance Pension benefits. This could additionally prove extremely helpful.
Fortunately, it sounds like your mother still has part of the assets that she probably worked a lifetime to save. Please do her a favor and call an elder law attorney, so that she may save those remaining assets and not worry about her finances in order to receive the best possible care. If you need help locating a good elder law attorney in your city (or if you just would like to read more about government benefits), you may contact me by visiting: ValleyElderLaw.LA.
Best wishes,
Randall K., Esq.
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As medicaid laws have changed -get legal advice. My mamma makes $52.00 @ year to much to qualify for any federal aka medicaid . I have her in a private pay facility now but my brother and I will have to finish out paying for her when her money runs out. Don't assume she qualities -as I did. Everyone thinks when the $$runs out the government aid will kick in and I had already started looking for a medicaid facility. Thank goodness for a good attorney who helped us - again don't assume anything or believe what everyone is telling you until you have checked yourself. I had my FL2 forms and all my ducks in a row to have 3 different facilities run her financial information to inform me she doesn't qualify and we are talking modest savings and no other income except SS. Good newsI won't have to worry about a spend down . Good luck and use your local resources for information.
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Ask the facilities you look at if they have Medicaid beds. If those are limited, someone who is already a resident gets it over a new person coming in. I talked to the financial person at my Mom's facility and she was EXTREMELY helpful with getting Mom's Medicaid app ready and Mom didn't have to go to another facility picked by the system.
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Great comments so far. I speak from experience. We spent down to Medicaid $$ floor years ago and it is wise to get help. I used a specialized attorney. I also felt the county DSS worker was most helpful.

Suggest you ask a nursing home with Medicaid beds available to do an FL2 on mom...they'll know what it is.

Grace + Peace,
Bob
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I had to help with Dad qualifying for Medicaid for his dementia care in a facility...and am now starting process with my Mom who is still home. As you look for a nursing home, you have to be sure it has Medicare beds and you have to know what their policies are. I always recommend on here, that people consult an elder care attorney, because Medicaid rules are slightly different in different states, but there is always a 5 year look back and if money was used for non eligible reasons, it creates a penalty period whereby Medicaid will not cover no matter what....so it's private pay until that time is up. I believe the penalty period adds up to the amount of money that was not used properly. In most facilities, there are limited Medicaid beds, and, yes, they have current residents on a waiting list for a bed, so it may or could be that she has to go in as a private pay resident and be added to the waiting list. Since my Dad went into Memory Care, I don't know how nursing homes work. If Medicaid approval comes before nursing home placement, it will pay for some home care people to come in, but here in AZ that amounts to about 20 hours/week....so not much assistance. If she needs to be placed in a facility that you do not like or she doesn't like, once she's on Medicaid, she can easily move to any other facility that has a Medicaid bed in your state....but as you are looking, you are always looking for Medicaid certified facilities and you want to say that she is Medicaid pending until she is approved. In AZ, we are checking into moving my Dad, so I also have to find a placement that is covered by the health care company that handles his Medicaid contract too....so a little limited into which facilities I can be considering. Our eldercare attorney had all the financial people and case manager staff in his office to help with paperwork, applications and generally knew staff who did approvals, and knew which facilities were good, bad and ugly too. I believe you could also privately hire social workers or eldercare/geriatric managers to help with the application as well in some places.
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amott6, That answer is the same as for everyone else. You pay out of pocket, until Medicaid kicks in. I sometimes wonder if those long term care policies are really worth it. They cost a fortune, and once you read the fine print, they rarely cover the whole cost. The one we looked into would have paid out less than half the cost of most facilities around here. So either way your money goes down the drain. And the monthly payments were so far out of our reach, it was ridiculous. Would have cost more than a quarter of our income. As stated above, get an elder care attorney to help you through the process. They seem very expensive, but are so worth it.
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@Willows - I agree. It's seems as if everyone believes money is the answer to just plain love. Yes, it's a lot of work. And damned it, yes, it's a lot of STRESS. I don't know what the culture has become. Suddenly, I'm old (64) . At some point, those who believe I'm old (the 40 and 20 somethings) will be there, too. It's not a long stretch. Life is short. Very short. We're all planning and making money and progressing in our 'professional lives' but not thinking about the end.

Boy, do I have news for many of you. My mother (92) is currently in a more private layered (from residential to SNF) as a result of being placed there for rehab after which I applied for Medicaid through a consulting firm (the only way to go as far as I'm concerned).

This facility is now renovating and is planning to get rid of many of their Medicaid beds in order to devote the room to their residents. In doing so, they have to relocate their Medicaid patients. There are MANY facilities around here, but all their beds are filled and I mean FILLED. There is a waiting list for those already in NH's.

We're coming to a point where there is going to be a shortage of beds. I'm sure there will be more to come, but our elderly are living way beyond the previous demographic of over 85. Now the largest is over 90 and at some point there will be an oversaturation.

I've gone off the subject but I'd suggest you use a Medicaid consultant or an attorney well versed in Medicaid. You can use your mother's money to do this as you will have to spend it down to purchase funeral plans, etc. They will advise you as to how to best use that money for her along with just how to spend down the money for her).

They are invaluable.
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