Just to recap...My brother 73, living in NH for a year. Was living in his home then became too ill take care of self. Went to hospital, then rehab (did not accept Medicaid) then to current NH. Pays a small monthly fee. Receives SSA and has a small amount saved. He is under the income limit. Does not qualify for Aid and Attendance, income too high.
Applied for Medicaid LTC.
Never got a Medicaid decision for a year. At his last care conference, I asked what was the status of the claim?
He needed dental work and an eye exam. He has a Medicare Advantage plan that pays for some things. I was hoping to have some paid by Medicaid as well.
Regarding the house, his name is not on the deed. Only his deceased spouse is listed as the owner. The house was bought for my nephew. He has died also. My brother never changed the title (I reminded him). Never did anything.
A niece has since moved in with her family. He agreed to it. The house still has a large mortgage. She pays the mortgage but not much else. Has not paid the utilities in the 8 months she has lived there.
The NH business office has said that Medicaid stated that he needs to change the title to his name and sell the house.
She stated that it could take months for this to happen.
He has told the business office and Medicaid that he does not intend to return. Says that he wants to stay where he is.
I am not POA nor his guardian. I do not want to be. He can think for himself and make his decisions.
I am concerned that getting an Elder care attorney would come out of my pocket. I have plans for my funds(work on house, etc..) I would deeply resent paying for an attorney, not for myself but for him!
Tried talking to him last night and he started getting belligerent, I got annoyed.
The truth is, my biggest fear is that he will have to leave the NH and either: go back to his home living with the niece (wife's)-would not be good or come to me..
I emailed the billing office if his claim was denied, will he still be billed, will he be able to remain while this is worked out. No answer yet.
My thought was that he has been there a year. Can a Medicaid claim be pending that long? We are in Pennsylvania.
What are his next steps?
Any thoughts would be appreciated.
I reread ur post and noticed a Will was not mentioned at all. If there was a Will leaving the house to the nephew, even in a life estate for your brother, I think the nephew needed to have it changed over to his name. If he died before his Aunt, it maybe considered part of nephews estate. Unless the Will has a clause concerning if a death incurs. I am rambling here. What needs to happen is someone needs to research who owns the house. Maybe a Title company can do a search.
Another thought, was the house put in trust for the nephew? It seems odd that the house was bought with the nephew in mind and nothing was set up to insure he received it.
There is no will. The property tax is paid through the mortgage. The house was bought with his son in mind who died after his mother.
My brother has requested a copy of the deed from the city(deeds are recorded in the city here).
He contacted the social worker at the NH for assistance or referrals.
He doesn't want to call his niece just yet.
"The NH should be receiving his whole SS. Until Medicaid is approved, he is running a balance at the NH. It won't be cleared until he receives Medicaid."
He is paying 90% of his SSA check. Still. He thought that it would increase in 2022 but it has not. The balance goes into his account. I get the sense that with NH staffing turnover that the billing office did not/is not processing correctly.
"If brother is under the income cap with Medicaid he should be with A&A especially with no assets."
Based on VA eligibility from their website:
If you have no dependents and You don’t qualify for Housebound or Aid and Attendance benefits. …
Your MAPR (Maximum Pension Rate) amount is (in U.S. $) $14,753.
You qualify for Aid and Attendance benefits
Your MAPR is $24,610
His annual income is more than this but still under the monthly income limit for Medicaid in Pennsylvania.
You bring up issues that are food for thought and may come up. This is my 3rd time dealing with a NH but with my mother and brother, there was no property involved. My brother died before the claim was approved.
This situation is completely different than anything I dealt with before. My mother and brother were not able to make decisions.
Thanks for your thoughts.
If your SIL died without a Will she died intestate and owning a house her estate needed to be Probated. Someone may need to become the Administer doing what an Executor would do but with no Will the State determines who gets what. Your brother and his children may have shared as owners of the house. I doubt if he could have changed the deed without proof he or children inherited it. The niece may be paying the Mortgage but she does not own the home. I think someone needs to talk to probate because if I am right, your brother may own at least half the house. (Whoever property tax bill is made out to is the owner)
So the first thing that needs to be done is the niece needs to talk to the Probate Office. Once she finds out what needs to be done, she can then talk to the Medicaid caseworker working on Dads claim. Actually, for now, the house is an exempt asset. Its upon ur brothers death it becomes an asset that Medicaid can recover from and thats a whole different thing. She needs to ask if everything has been received to be able to process his application.
When ur brother went to rehab his Medicare Advantage should have covered the first 20days 100% at least. After that Medicare only pays 50% not sure how MAs work here. There maybe a balance due.
"Pays a small monthly fee."
The NH should be receiving his whole SS. Until Medicaid is approved, he is running a balance at the NH. It won't be cleared until he receives Medicaid.
"Receives SSA and has a small amount saved. He is under the income limit. Does not qualify for Aid and Attendance, income too high."
You cannot receive A&A when you collect Medicaid for ur care in a NH. Medicaid pays more. So I would concentrate on him getting Medicaid. A&A does supply $90 towards the Personal Needs Acct. That can be checked out. If brother is under the income cap with Medicaid he should be with A&A especially with no assets.
POA is usually needed when the person is incompetent and needs to be assigned while competent. Once incompetent your brother cannot assign it. Then its guardianship which is expensive. Or turn the persons care over to the State. He should assign his niece so she can help him. It can be immediate as soon as he signs. Its a tool that his niece will need to do for him since he is in a NH.
Since your brother has a niece she could be his POA. I am 72 and I would not become a POA again. Still for my nephew but he owns nothing has no assets.
Seems you brother is competent at this point so can handle things from the NH. He can call Probate, he can call Medicaid. He should be involved in as much of his care as possible with help from his daughter. Really don't know how he can be expected to pay utilities on a house when he has no money. His SS minus his personal needs money (my state $50) will be used to offset his care. Any money he has left under the 2k (amount allowed in assets in my state) can only be spent on him. So dniece needs to pay those utilities and taxes or she may lose the house. You can lose a house for non-payment of taxes. She should be hiring a lawyer to see what rights she has.
I would not spend my money and I would not bring him into my home not even for a moment. Too many posts like that on the forum and the poster cannot get the person out of their home. If worse comes to worse and he needs 24/7 care the State can take over and become his guardian. You, at 70, do not want to become a caregiver an no matter what a Social Worker says you will not get enough help. I know he is your brother but you can't be expected to clean his mess up.
Cont:
It’s been my understanding that nursing homes are pretty versed and on top of this though, after all they are the ones getting paid and waiting for their money. They would have reviewed the information and scrutinized the details pretty closely before agreeing to do all the work of putting the application in and told him he wouldn’t qualify if they didn’t think he would. In fact they would have made sure there was a way for them to get paid if they weren’t fairly certain he would qualify eventually. As I think about it they have more skin in this game than you so I wouldn’t stress too much about it if they aren’t. I have to assume that if he’s in the nursing home it’s been determined that he isn’t able to live at home alone which means they can’t just send him home unless the niece agrees to take responsibility for his care (she needs to say she can’t) or you agree to take responsibility (you can’t either). It’s not a matter of wanting to or not you just aren’t able to and it wouldn’t be a safe discharge from the facility he’s in, then it’s up to them and the state to make sure he’s in a safe place. It’s actually a good situation because he’s in a NH for LTC so they can’t just put him out on the street I don’t think. Don’t step in to take care of anything but being his health care proxy or POA doesn’t require you to do do anything, just like POA doesn’t require you to take on any financial responsibility, it just gives you the ability to make decisions for him should he be unable. He could end up on all kinds of machines with no quality of life if no one is able or willing to make medical decisions for him. I’m not saying it’s something you should do if you really don’t want to but seems like you kind of filling that roll anyway, Just something to think about.
I would have thought so as well. It has been year. I find it hard to believe that a resident would be allowed to live at the home for a year without Medicaid eligibility.
As for as his niece taking care of him at home, she has grandchildren she's caring for and I feel she got that she wanted ...out of a living situation she wasn't happy in and "keeping the house in the family" (as was put to him) and not letting the house sit empty and vulnerable.
Is she willing to buy? Can she buy? Who knows.
I appreciate the clarification on POA as I thought that once you became POA, you became responsible financially. I do not want the NH nor Medicaid coming for me with huge bills.
This is a mess. Coming here, getting other thoughts based on what others have dealt with is helpful.
Either he gets an attorney(legal aid) or a real estate agent.
As to what this muddy mess with your brother and the house is, who can tell. It is up to him to handle it. I would step away.
I was POA and Trustee for a very "with it" brother who was very cooperative, who had a simple estate, who was just great, and even with all of that it was an enormous job and took a toll.
Let your brother decide who what and when he needs an attorney and let that attorney be paid by HIM, and when there is no way out of this mess but the State to take guardianship if he is no longer competent, LET THE STATE DO IT would be my best advice.
I surely do wish you luck. Keep it to visiting about other stuff because this whole house deal sounds one royal mountain of a mess.
There is no money from him to pay for an attorney.
Perhaps Community Legal Services based on need.
I will take heed to what you said.
"Receives SSA. He is under the income limit."
"Does not qualify for Aid & Attendance, his income is too high."
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He is not on the deed. He does not own the house. His deceased "wife" owned the house, and she must have left a will. Likely stating that her nephew inherits the house.
She did not have a will and they wanted my nephew(their son) to have the house in case of their deaths. He has since died.
You should decide to stay completely out. Right now you say you want out with your lips but you keep inserting yourself with your actions. Stop doing that and let the county take over. If he gets belligerent when you try to help him, then maybe he isn't as competent as you think. Who needs to battle that when you have now power to legally advocate for him? Without you being his PoA or guardian, helping him will be an exercise in futility.
FYI a Medicaid app usually takes 3 months to process for an answer but can differ by state. If he's telling you he got no answer after a year? Hmmm....
"You should decide to stay completely out. Right now you say you want out with your lips but you keep inserting yourself with your actions. Stop doing that and let the county take over. If he gets belligerent when you try to help him, then maybe he isn't as competent as you think. Either way, without you being his PoA or guardian, you have no power unless he assigns you as his PoA and you accept this responsibility."
I needed to hear this.
That was my thought as well. So how can this be an asset?
He is asking for a copy of the deed from the city. He can't remember if the house was property owned with someone else in joint tenancy or tenancy by the entirety.