My Mom can't afford a rehab/nursing home, will Medicaid pay?

You didnt say if she is expected to stay at the NH permanently, so i am guessing that is the case. Your mom will have to sell her house and sign an agreement that all money received will pay the nursing home. Once done, Medicaid (not Medicare) will cover her stay, long term. She is allowes to keep ONLY $2,000 worth of assets total and will be allocated an amount of $72.80 personal needs to spend monthly. Sorry to be so blunt, but basically every penny your mom has will go to the NH. You should complete the Medicaid apolication asap.

It also depends if anyone lives in the home. Did she live alone or have a spouse? If there is a spouse or defendant child that has to have the home to live in then they can't make her sell it. And it's sad to say but the nursing homes that do take Medicaid are not the nice ones .

Pardon the typos. So sorry, but that is the way the system is set up. I worked as a BOM in a NH, so i know how difficult this is for families and emotional. Medicaid will have to know and have proof of any pensions, life insurance, and social security income per month. You are allowed to keep a prepaid burial plan and once in a while, assets that can not be liquidated. You as the family, will have to do all of the legwork to get this stuff, so dont waste your money paying a Medicaid specialist, they are a ripoff. You can enroll mom yourself, also please ask mom to assign you as POA. Again, sorry, but I do know this is very hard. Best, hope this helps

Yes that is true, if someone ia living in the house, i was assuming it was just mom.

Check reviews on area nursing homes. If the home is BOTH a rehab and NH, the payer mix should in theory keep the home in businesd and profitable. Word of advise: Out of the blue, ask to see the toenails of a resident with no involved family or friends. If they look like claws, there may be neglect and no dignity for the residents staying there...run, find mom a better place. Research, research, research and ask questions.

Twilight - what are you thinking that moms situation will be? If mom is returning to her home, then how & why do you see medicaid coming into this? OR are you thinking that mom may not return home & need to stay in a facility with Medicaid paying for the NH?

So your mom has $ 4,100 each month in income? Really?? It could be that her income is over the medicaid limit for your state. I'd suggest that you look into the income maximum for Medicaid as a first step. Like when I first applied for my mom in TX in 2911 the max was $ 2,064 & now is $ 2,163. Some states have the maximum income at 2k and some are under 2k. The assets max seems to universally be 2k in non-exempt assets. Over these for either income or assets makes mom ineligible. Basically have to be "at need" which means impoverished.

There are things that can be done sometimes for excess income - eg a Miller Trust - but IMHO a Miller needs to be done just right which means having eider law attorney do it. Miller has qualifiers too & income must be a guaranteed benefit. Perchance is mom railroad retirement?

NH Medicaid does not really factor in debt for income. If monthly debt includes payments deducted for Medicare (from her SS check) or a secondary insurer, those can be worked through. But if mom has other debt - credit cards, life insurance payments, mortgage (horror or horrors!!) - once she goes into a NH and onto Medicaid, she will have no - nada - zilch of her income to ever own on those debts ever again. NH Medicaid requires them to do a co-pay or "SOC" (share of cost) of ALL their monthly income to the facility less a small personal needs allowance. The PNA varies by state - for LizDevine parent it's $ 72.80; for my mom it was $ 60. The PNA is the only discretionary income they will ever have again. If the NH charges for cable, phone, well that could eat up the monthly PNA entirely. The SOC for NH seems to come as a total surprise often for family.

If debt needs to be repaid, then family is going to have to pay or the debt gets defaulted on. For moms home, that can get quite complex.

Really look into the income limit as a first. Then try to get a clear picture of moms debt service to see what the fallout would be if she has no income anymore and then look hard to your own purse to see if you can & want to pay her debt. Also realize that if she goes onto Medicaid her exempt asset of a house will become non-exempt upon her death and subject to a recovery attempt by the state.

It's a lot to decide upon. If you can see an atty before you do the Medicaid application to perhaps come up with options as to divesting that's Medicaid compliant. Good luck, you have hard decisions to make.

From the research and home visits I did, I learned that the resident can/will be self pay until about 6 months before the money runs out. Yep, the process takes at least long. At that time, either the NH or the family/lawyer will start the medicaid process. At most of the homes I toured, the care is exactly the same (assisted living is a bit different). The medicaid payers are usually in double rooms, but they can start out in a single. In three of the places, I learned that if the resident has dementia, it is better to start them out in the room they will live in right off the bat. This is to prevent confusion and fear later on. The two I really liked are rehab/long term care homes.

My mom has a CD that has both my name and hers on it (only $5k) which we plan to use for burial expenses when time comes coupled with a couple of small insurance policies. She is 92 and currently we make it ok with her at home although we must have someone with her at all times. She receives small SS and VA Aid which she pays to me and I in turn use to pay others as needed to stay with her while I work. Will it make any difference that the CD has my name on it should she require nursing home care as we would definitely have to apply for Medicaid as she has no other assets. Thanks for any advice

Happy - so your caregiving for mom for free in your non-job time; her SS or other income is needed to enable the both of you to live at the house; the VA A&A is fully being spent on caregivers & it's looking like mom is going to need a higher level of care in a NH. Is that about the situation?

If so couple of things to think about before you do the medicaid application. Once mom goes into a NH the VA A&A goes away, she then gets $ 90 from VA. Her SS& other retirement will need to get paid to NH minus the small personal needs allowance (varies by state from $35 - $ 105). So at most mom will have about $150 a mo discretionary income which is intended to pay for beauty shoppe, clothing replacement & personal toiletries at the NH & most often the PNA is held in an account in the NH.
Can you pay for all for the home which is in her name? From day 1 of NH and then be able to qualify for exemption or exclusions to the required MERP / estate recovery on her home after mom dies so that you can inheirit the home? If you work, you may not qualify for a caregiver exemption.

Run the #'s on house costs & your income and then make an appointment with an experienced elder law attorney before you do the Medicaid application to see what possible options are out there & within Medicaid compliance for your state.

About the CD, it will likely be viewed as an asset to be spent down. For funeral & burial, those usually are done as a NCV (no cash value) prepaid funeral & burial policy. Funds are fixed for funeral. Problem with the CD is that in theory you could go mañana & cash it out. Also look at the insurance polices, if have any cash value (like they are whole life policies), they will count towards asset limit & usually need to get cashed in if it takes mom over the asset maximum (usually 2K). Medicaid rules are pretty inflexible and precise on $ amounts.

It's all a lot to deal with. One of the experts on this site -Heiser - has a great book that explains the bigger picture of how this works. You May want to get it! Good luck.

Igloo mentions a good idea. Our elder law attorney says a Miller Trust is the way to go for my wife when she needs a NH. Her income is around $4,000 per month. In Florida her Gross income will be her paid through the trust to the nh. Medicaid will pay the balance.

All nursing homes accept medicaid. They have to. Nursing home care, as deficient as it is, costs $12,000 a month. I don't know anyone who can or would be willing to sustain that year after year. That being said, nursing homes prefer to accept people who come in with their own funds. If you are already on medicaid, most admissions people will think of a stupid way to tell you there are no beds, or your loved one is not appropriate for the home. But some will not. You just have to take a chance. My mother was admitted to a private room already on medicaid, and allowed to stay. I want to underscore that even after you put your loved one in a nursing home you have to make sure they're bathed, underwear changed and feet taken care of. I look at my mom's feet every time I come. The first time I thought to do this, which is why I started, I found red and brown pus coming from under her toenail. The staff acted stupid and useless. The podiatrist they sent put on bacitracin and a bandaid and sprinkled some antifungal powder into her shoe. Came back for one follow up and never returned. I have been taking care of her feet myself. Salt water soaks, washing with soap, changing socks, peroxide and bacitracin when necessary. Yes, the medical care and medical "professionals" found in a nursing home are garbage, but if you need a lifeline, a decent nursing home, as bad as they are, is a life saver.

Christine - almost all long term care facilites accept mediCARE.
But not all accept Medicaid. They do not have to take medicAID. Where I live in New Orleans 2 great ones - Poydras Home & St Anna's don't & won't ever take Medicaid but take medicare & ltc insurance policies. My moms NH in TX took Medicare & Medicaid but would not take any LTC insurance policies for payment. Almost all LTC facilities are private businesses and can determine what their policy will be regarding payment.

I'm offended that you have called the staff at NH "GARBAGE" - working at a NH is a difficult job, most with low pay, high demands & with every minute holding the possibility of an emergency situation.

igloo, you're right that I should not have said the medical staff is garbage. I apologize for that. That remark, and the medicaid remark, was based solely on my experience with my mom and my friends' parents in NY nursing homes. I will underscore, however, that the medical care received in most nursing homes is sadly below par and that family needs to be very involved.

Christine, the staff at my mother's NH are some of the sweetest, most loving folks I've ever met. They are not "garbage".

With regard to podiatry, my mother complained bitterly that the podiatrist didn't trim her toenails. I called and spoke to her. My mother had edema in her feet secondary to chf and the swelling made it dangerous to trim them on that visit. They were trimmed the next week. I was reminded by this of the fact that my grandma, who lived at home with us and also had chf, died of gangrene, due to my aunt's non professional toenail trimming.

My mom is in a NH. She was living alone in her own apartment when she fell. The hospital would not release her to go back to her apartment. They told us she needed to be in a skilled nursing facility. I started researching and going on tours to different homes to look for myself. I did find one that accepted medicare/medicaid. Mom is 88 with dementia and is allergic to almost everything including dust. I looked for cleanliness, asked the other residents how they felt about the place and how they were being treated before I made my decision. My sister and I had POA's before. She's doing as best as can be expected for her age.

Being placed in a NH is good. They do provide them with 24/7 care. When they suspect something wrong they call the doctor and the doctor says call the paramedics and then they call me even if it is 2am. My mom does not have assets for us to worry about. I am not aware of the Miller Trust. I will look into it. The only advice I can give you so do your research. There are a lot of homes that accept both. Apply for her.
I don't qualify for benefits because of my income which seems to be above the maximum. I'm 68 and may need help myself.

Twright: She is allowed to own only $2, 000 in assets if she applies for Medicaid.