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I've had to move my mom out of her condo after dad passed away. So she went to Assisted Living for about a year and started having problems with deep vein thrombosis. It has kept her going from assisted living to the hospital to rehab and back to assisted living, only to go through the same thing again in 2 weeks. The facility said they could no longer accept her in their facility because she required a 2 lift assist and their state law forbids that as their aides are not certified in lifting a resident in and out of bed. Anyway I ended up putting her in a nursing home and have needed to make several trips to the nursing home to make sure things were going well. I have 2 questions. First: Her savings is almost gone and preparing for Medicaid in PA. What amount of liquid assets can legally be set aside so I can take care of her mounting copays coming in for hospital and rehab stays, also various doctor copays. Second: As her POA, am I entitled to receive some form of compensation for the hours I spent at home filling out paperwork and spending time on the phone on her behalf. I have not taken any money out except for reimbursement for getting her adult pullups for incontinence and other medicinal purchases.


Would be so grateful for some help. Thank you in advance.

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If your mother is medically eligible for Medicaid now, why would you wait until all of her assets are spent down before preparing to apply? Talk with an elder law attorney in your state now, and learn how excess countable assets can be set aside for supplemental needs so your mother can be financially eligible sooner, rather than later.

And, Yes, you can be paid for your work, but if you want your mother to be eligible for Medicaid your compensation must comply with the Medicaid regulations in your state.

Talking with an elder law attorney in your state is a first step toward the results you are looking for your mother's care and your peace of mind.
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We2AreUnchained Aug 2018
Thank you for your reply. I was told in PA the liquid assets cannot be over $2,000.00. My mother doesn't have but $3,000.00 right now but I've been told that they want her SS, Pension, and VA stipend, and she has to have a prepaid funeral and all Retirement funds, IRA's, 401(k) or Annuity. She has 3 annuities and once cashed out she will have right at $25,000.00. I'm beginning to realize that the Business Manager may only be talking about what they want, not what Medicaid requires. So that's the battle for next week.

I don't even care about being paid as a POA. I'm just trying to legally find a way to spend down her assets without (quite honestly) giving it all to the nursing home. That may sound unfair, I don't know.
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Your mom's money can definitely be put toward her medical expenses. That's what it's there for.

As POA, you aren't prohibited from reimbursing yourself for your time and work on your mom's behalf. However, I would encourage you to keep meticulous financial records especially if there are other siblings. Siblings have a way of popping up when you least expect it and demanding to know where the parent's money is going. This destroys families.

Do some research and find out what representatives are paid and for what kind of work. Document your research as well. Document everything.
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We2AreUnchained Aug 2018
Thank you for your reply. I hear what you are saying about siblings. They are saying they don't want to do the things that I have to do for her, but I agree that money can bring out the best and the worst in families. I do keep very exact reports of her bills and what ever is being reimbursed. So I am not worried about that.
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If you are looking at Mom being on Medicaid eventually, I wouldn't pay myself at this point. In th estate of NJ you are allowed 2k in the bank. If insurance policies have a cash in value, they need to be cashed in unless provided by an employer. You can use this on any of Moms money to prepay her funeral. I would use the bills to help spend down Moms money for Medicaid. Once u file you only have so long to spend down, like 60 days I think.
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Unless your POA document specifically says so or you have a written contract with your mother to be paid by her for being her caretaker, no. Medicaid is going to have a 5 year look back into her finances and if they find sizable amounts of money gone, they are going to know where to and why. Keep receipts for things you get reimbursed for. Why can't you pay for those things with her checks since you are her POA?
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We2AreUnchained Aug 2018
Thank you for your reply. I pay everything through bill pay. When I am picking up things like her adult underwear or miscellaneous items for hygiene I do it with a credit card that is empty and only used for her needs. Then I pay the card off each month through bill pay and I have a receipt for the purchase and also for the credit card.
I don't have checks since I only use the bill pay. It's a much easier way for me to keep track of what I have to spend for her care.
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Have you had your Medicaid meeting with a Medicaid case worker yet? PA may be different but I’m in NY and as soon as I had the appointment she became Medicaid Pending and they told me to stop paying anything for mom, and there was even a 3 month look back from that date that would be covered. They told me to just let the bills pile up, making sure to give them copies of everything. I brought all the bills I had at that time to the meeting, and emailed all new ones until the final determination. Hospital, rehab, ambulance, dentist, copays etc. It was all accounted for in the final disposition, when her share of cost was calculated.

I cant speak to the question of getting paid for your time. Looking back the paperwork really wasn’t that much, after gathering the info for the application.
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We2AreUnchained Aug 2018
I haven't spoken with Medicaid at all because the business manager at the nursing home handed me a pile of forms to fill out and said that she will take care of Medicaid for me and she would also take care of getting her monthly income to be direct deposited into the nursing home account and listed with her name. I'm not wanting this to happen, and I'm not finding any information to support my feelings of not trusting the business manager and Medicaid.
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I don’t know why you would have to go through the NH business manager instead of dealing with Medicaid directly. I specifically did not want moms SS and pension paid directly to the NH as I wanted to make sure both were being deposited monthly. Then I write a check to the NH. This was after my friend’s mom was mistakenly flagged as deceased by her pension plan who stopped paying the NH. Of course my friend didn’t know this until the NH wanted to evict her for owning $60K. It took her a long time to get it fixed. So for the time it takes to check her checking balance and send an echeck, to me it’s worth it. My Medicaid caseworker was very helpful and I trusted her more than I would have the business office to know the rules. Moms application was quite simple however, no house to sell or huge bank accounts. If your mom has a large estate and holdings you probably should see a lawyer familiar with Medicaid however.
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We2AreUnchained Aug 2018
Thank you. That's one of the main reasons I'd rather have the control. Sometimes I think I must be a control freak, but on the other hand, I have read horror stories about nursing homes with financial mistakes such as yours with your mom. My mom does not have a large estate at all. I sold her condo right away and have used up nearly all of it when she was in assisted living. Then when she had to go to a nursing home, I had to use a large chunk of her money to get her into the NH. I know that other NH's have a much higher cost than the one in my mother's area, but I can tell you this, $11,880.00 really took a huge bite out of her liquid assets. I am in the process of cashing out her 3 annuities because I am told all of it has to be spent down to the NH along with her VA pension money from my dad's WWII service and her little pension from when she worked and her social security. Well thank you for your suggestion. I am going to look into a Medicaid agent to give me the best direction to follow.
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