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Old 09-14-2017, 04:03 PM
 
20,664 posts, read 16,694,604 times
Reputation: 38849

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Quote:
Originally Posted by MadManofBethesda View Post
This is the type of facility in which you could end up:

Hurricane Irma aftermath: Hollywood nursing home where 5 died has troubled past | Miami Herald

I urge you to read the article and see the list of prior complaints/infractions at this facility. Now I'm sure not all Medicaid facilities are this bad, but why risk it if you don't have to?
Regardless of their past infractions (all nursing homes have infractions, every one), I am not convinced these deaths are totally the fault of the home or even more their fault than the county. They had been calling Florida Power and Light over and over saying it was life and death and no one came, they got canned and scripted responses. The way they prioritized, the hospital across the street was a "priority" to get power back, while the nursing home was not. They seemed to do the best they could, they had the residents in the hallways, with fans and portable air conditioners. But without electricity, people dependent on oxygen are going to be in trouble.

I saw an interview (by phone) from a patient's daughter from the home. Her mom is currently one of those in the hospital with respiratory distress. She said she is there every single day and that her mom got good care. She said she called Florida Power and Light herself as did other family members and begged them but she said they just told her they'd take care of it and said it sounded like the person was "reading from a script".

I also would not assume for a second that this home has a lot of Medicaid beds. It is a rehab facility as well and doesn't look at all like a Medicaid facility looks, it looks pretty and expensive to me. Level of care has absolutely not one thing to do with whether a place costs a lot or not. I work in all sorts of homes, and some of the worst I have seen care-wise were also the most beautiful and expensive. Some of the best in terms of care are the smaller religious-affiliated facilities, and they have plenty of Medicaid residents.

Most people who spend down enter a facility while they still have some money, and then continue to live in the same home once they've spent down and are on Medicaid. It would be foolish to spend down first because you won't have any choices. My mom is in an assisted living facility that has a policy stating you can stay and live there on Medicaid only after you've paid privately for 18 months. Now she gets a bill for over $10,000 a month (she didn't private pay that much, she was more independent until recently and her care level was lower) and I have to send them $1100 a month, with Medicaid filling the gaps (I don't think they get the entire bill amount though).

I also don't think anyone plans to enter a nursing home period let alone plans to spend down. The reality is people end up spending down like it or not once they start needing health care services, whether at home or in a home. 24 hour home care costs $75,000 a year, ALFs and nursing homes in the 10's of thousands...no matter how well I "plan" I have no ability to pay that for long. And long term care insurance only pays a portion, and not forever. My mom has been in her ALF for 4-5 years now, and is healthy aside from leg problems and will probably live another 5-10 years. Who an afford that without Medicaid?
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Old 09-14-2017, 04:17 PM
 
Location: Philadelphia/South Jersey area
2,886 posts, read 1,412,752 times
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I don't know anyone who would do this. I know plenty of people who are not purchasing LTci as they don't feel like it's a good deal (I'm included after a horrible experience with Genworth) but we do have long term care contingencies.

So there is a whole world in between purchasing long term care insurance and medicaid.

If you go to early retirement.org you will find quite a number of folks on those forums that donot have LTCi but as I said they are definitely not going to spend down to go on medicaid.


There are also quite a number of people who are becoming inventive with alternatives to nursing homes. We are doing this with my MIL. we sold her house, downsized her and put her in a condo. Between her investments, proceeds from sale of house and social security we pay two health home care aides to take care of her in house. cost us no where near the numbers kicked around here. she is 85 and has parkinson
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Old 09-14-2017, 05:14 PM
 
10,604 posts, read 14,229,316 times
Reputation: 17208
Quote:
Originally Posted by Lastfire View Post
Well, I may be one of the "fools" addressed in this thread. My DH developed dementia at a very early age....long before retirement age. So here we are 14 yrs later and DH has absolutely no medical issues. He will probably outlive me by 10 yrs. So long term care in a memory unit will be $80k per year for 10 yrs....guess he will end up in a medicaid facility. Does that mean we are stupid? Or that we should have divorced (49+yrs) or that I should somehow become super old lady and handle this 235 lb dementia man? Those of you who have had breaks in life go your way, good for you. But sometimes we fools need a little help from the "old U.S. government."
Nobody used the word fool or even a euphemism for it.

What are you even mad about (pertaining to this thread - not life) ?

And it doesn't even SOUND like you're "spending down" your assets to get him on Medicaid and you don't have to do that ANYWAY.

My suggestion is you move to a state with more generous taxpayer funded resources like Ohio. And I'd be looking for a faith based organization that's been around for a long time. They do exist. Sometimes in places you wouldn't think of like Tupelo MS. Right down the street from the largest community hospital in the country.

Then of course in OH, or the other top ten heroin states, you'll be competing with all the heroin addicts and their families who ALSO feel it's the taxpayer's responsibility to shoulder the burden of their idiot family members who thought putting a needle in their arm was a good idea. Because they need "help". I mean it's only about 40 years since all of America mocked Nancy Reagan for saying "Just say no to drugs".

How about all the charities for children and taxpayer funded programs?? They're never ending. NOW they want free post high school education. And we're not even allowed to limit the types of food on the free govt food programs because it's "mean" to refuse to pay for soda and crap. Remember 2012 was all about free birth control. Championed by a THIRTY YEAR OLD IVY LEAGUE LAW STUDENT who was "suffering" having to pay for her own birth control? And she was actually applauded for that foolishness.

It never ceases to amaze me that the wealthy seniors in my FL county spend ALL their free time and money on charities "for the children" even though we pay for birth control now, AND free meals 365 days per year for the little angels. Not a DIME for seniors. Weird.

With 90 million citizens out of the workforce there's only so much of other people's money to go around. *shrug* Your guess is as good as mine what's going to happen with all the cognitively compromised Boomers let alone the massive amount of autism spectrum people growing by leaps and bounds.

Yes it would have helped YOU to have your own LTC policy when you were young enough to qualify. Water under the bridge now.

Last edited by runswithscissors; 09-14-2017 at 05:26 PM..
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Old 09-14-2017, 05:19 PM
 
Location: Central Massachusetts
4,800 posts, read 4,858,884 times
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I for one am not going to panic and start spending money just to protect assets. The assets we have are for us to use either taking trips or tripping the light fantastic in a nursing home. I promised my wife and she back that for better or worse, in sickness and in health we would care for and love each other. I will do whatever it takes to ensure my wife is taken care of. She will do the same. We do not need some insurance to do that. In fact I am sure that when push comes to shove we will do it because it has to be done. Well done eliza61nyc. That is how we feel as well.
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Old 09-14-2017, 06:40 PM
 
20,664 posts, read 16,694,604 times
Reputation: 38849
Quote:
Originally Posted by eliza61nyc View Post
I don't know anyone who would do this. I know plenty of people who are not purchasing LTci as they don't feel like it's a good deal (I'm included after a horrible experience with Genworth) but we do have long term care contingencies.

So there is a whole world in between purchasing long term care insurance and medicaid.

If you go to early retirement.org you will find quite a number of folks on those forums that donot have LTCi but as I said they are definitely not going to spend down to go on medicaid.


There are also quite a number of people who are becoming inventive with alternatives to nursing homes. We are doing this with my MIL. we sold her house, downsized her and put her in a condo. Between her investments, proceeds from sale of house and social security we pay two health home care aides to take care of her in house. cost us no where near the numbers kicked around here. she is 85 and has parkinson
2 aides even 8 hours a day is very different cost-wise from a live-in, which is $75000 or more via an agency. That is what my mom would need.
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Old 09-14-2017, 07:40 PM
 
Location: Columbia SC
9,018 posts, read 7,778,187 times
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Family having a situation now. Placing their mother (99 years of age) in a care facility. The facility said $7,400.00 per month and if the family could pay for one year (not in advance) then they would accept whatever Medicaid paid after that. Is this a common practice?
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Old 09-14-2017, 07:45 PM
 
Location: Philadelphia/South Jersey area
2,886 posts, read 1,412,752 times
Reputation: 10129
Quote:
Originally Posted by oldsoldier1976 View Post
I for one am not going to panic and start spending money just to protect assets. The assets we have are for us to use either taking trips or tripping the light fantastic in a nursing home. I promised my wife and she back that for better or worse, in sickness and in health we would care for and love each other. I will do whatever it takes to ensure my wife is taken care of. She will do the same. We do not need some insurance to do that. In fact I am sure that when push comes to shove we will do it because it has to be done. Well done eliza61nyc. That is how we feel as well.
I've always found that really strange, lol people scream about the need to "save" for retirement or when they get old and then say they don't want to use their money to take care of themselves?? go figure?

Now I realize that this is not the situation op was describing but many folks do have a very doable plan sans LTCi. Also nothing is final, I get together with my FA every quarter and twice a year we reevaluate. when I hit 58 or 60 I may feel ltc insurance is something I want.

God willing by the time I get old enough for a nursing home, i won't be spending like I do know so if i need it to live independently I'm good with that. I know there are many factors.
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Old 09-14-2017, 07:48 PM
 
Location: Philadelphia/South Jersey area
2,886 posts, read 1,412,752 times
Reputation: 10129
what will be interesting is whats going to happen as more and more adults live longer and longer. people already claim most Americans aren't saving for retirement. so if they aren't saving for retirement and we're living longer and nursing homes aren't taking medicaid, what will happen??
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Old 09-14-2017, 08:02 PM
 
Location: Central IL
15,253 posts, read 8,568,509 times
Reputation: 35698
Quote:
Originally Posted by MadManofBethesda View Post
Nobody is calling you a fool. In fact, the title of this thread and the question that I posed at the end of my OP specifically exempts people in your circumstances. This thread is directed at people who have a choice to purchase LTCi, but instead have made a conscious decision to spend down their money to qualify for Medicaid rather than purchase LTCi. Hence my question, why risk ending up in a subpar facility if you don't have to?

You (and others who can't purchase LTCi for health or money reasons) obviously don't have a choice to make. Please don't go looking for slights where none was intended.
Because I'm not so sure that even if I shell out for an LTCi policy that it will ultimately protect me! Who can wait until they are 75 to pay the rates? So you start in your 50's and hope your rates don't get doubled more than once or twice.

Then you hope that there are no loopholes in the policy once you try to start collecting. These can be complicated policies, ones that laypeople have much less experience with than your typical auto or homeowner's policies. If I could easily afford a policy I'd feel better taking such chances - but to lay out so much money and still have "things" happen would be pretty bad. Frankly, I've had 3 female relatives spend years in nursing homes - private pay to begin with and then on Medicaid after their money finally ran out - maybe they just got lucky with the facilities they were in?
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Old 09-14-2017, 09:49 PM
 
Location: Florida -
8,769 posts, read 10,867,395 times
Reputation: 16653
I don't know if the real issue is people spending down to qualify for Medicaid OR of people not planning and saving enough for their healthcare ... and expecting others to pay for them.

Yes, I know that some people work and save -- and still get caught with healthcare expenses they cannot afford. They should be helped. But, some spend their entire lives being supported by 'the system' and also make no plans for their own care in their old age.

A big part of this problem started when the politicians started pandering for votes by calling welfare an "entitlement" instead of charity. Some responded by concluding, "I'm entitled to be supported by others, whether I work or not" ... which gradually evolved into a generational sense of entitlement.
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