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In my experience only, not as a general statement, when an elderly person is approved for Medicaid, the person must "spend down" assets to $2,000.
In the matter of the home, Medicaid will place a lien against the home, but not sell it. When the person is deceased, a claim will be made for the funds advanced by Medicaid. If a family member wishes to retain the home, they can make arrangements to pay what is owed. Sometimes, that isn't an unmanageable figure, depending on how long the person lived.
In addition, Medicaid isn't paying the entire nursing home bill - the patient's Social Security check will revert to the facility and Medicaid will pay the amount not covered by the SS.
(The patient is allowed a small part of the check monthly for personal items)
A Social Worker can guide you and tell you if you need to speak to an attorney. Good luck.
In my experience only, not as a general statement, when an elderly person is approved for Medicaid, the person must "spend down" assets to $2,000.
In the matter of the home, Medicaid will place a lien against the home, but not sell it. When the person is deceased, a claim will be made for the funds advanced by Medicaid. If a family member wishes to retain the home, they can make arrangements to pay what is owed. Sometimes, that isn't an unmanageable figure, depending on how long the person lived.
In addition, Medicaid isn't paying the entire nursing home bill - the patient's Social Security check will revert to the facility and Medicaid will pay the amount not covered by the SS.
(The patient is allowed a small part of the check monthly for personal items)
A Social Worker can guide you and tell you if you need to speak to an attorney. Good luck.
This is not the way it works in Florida, so posters please check your own state's regulations and an elder law attorney from your state (or that of your parent).
I worked in an IRF, intensive rehab facility and we generally found that people with dementia or serious cognitive decline could not do the program. If they are not doing the rehab, which is exercise type treatment, then Medicare may say they aren't qualified for IRF. If mom only has dementia type issue and not a health issue, Medicare will likely not pay for her to stay in a hospital nor be sent to a step down medical facility such as you are asking about. See if there is any kind of non-profit in your area that guides family's of seniors down this road into a proper placement. If your mom is accepted by a memory care facility, an assisted living or nursing home type place that is specialized for memory care, the facility will advise you about payment and if she qualifies for any programs like Medicaid in your state. Each state does Medicaid differently as the money flows in block amounts from the feds to the states and the states set their own rules. Some facilities will help patients apply for Medicaid, etc. Some will not. Medicaid beds are hard to find in some areas, and sometimes are not the best facilities. If she is qualified for Medicaid, it is possible to get her a certain amount of paid caregiver help in her home. In my state, that can't be your relative being paid. In my state, the highest amount of a caregiver time is 40 hours per week. This is very stressful and hard for families to go through. There is little safety net for older adults in the USA and it will get worse as we all age out. The cost of LTC has skyrocketed over 20 years, gone up higher than inflation and higher than medical costs have gone up. I wish you the best.
Yes, my mon is on Medicaid now in an assisted living. She gets her SS check plus a small pension direct deposited into her own account that I have POA for. Every year, Medicaid determines how much toward the assisted living bill my mother has to pay based on her income, minus $110 a month that she is allowed to keep. They send me a letter informing me of the amount, based on the form I fill out each year to re-qualify her. This year we owe the assisted living $1707.00 a month. The assisted living sends me a $9,000.00+ bill, and I send them $1707.00 from her account. So, no one is really taking it, I am using her SS check to pay her rent at the assisted living.
If there is no POA, the check goes right to the home, and they open an account for the resident for the monthly amount the resident is allowed to keep. The resident can spend it how they want. If it is someone with dementia, the home will have to use it to buy something for the resident before the account exceeds $2,000, because Medicaid patients can't have more than $2000 in assets (the Covid stimulus payments are not counted, however). So they'll buy the resident clothes, a power wheelchair or whatever is appropriate that they can use.
My mother has a similar arrangement in memory care. She ran out of money last November and shifted from private pay at $9k/month to a half price licensed room that is part of a cash assistance program. Her income is too high to qualify for Medicaid so I have to redirect $1,700/month to a pooled trust. The trust deducts a $100 administrative fee and pays the rest through to the memory care facility. The state pays a chunk. I write the check from my mother’s account to cover the difference. She no longer pays the Medicare premium so her Social Security check got bigger. Medicare picked up most of her Rx co-pays so her pharmacy bill went from $150+/month to almost nothing. I’m now in a position where I have to figure out how to spend the excess money so her balance doesn’t go over $2,000. I’m in the process of replacing her wardrobe. After I do that, I may have to call the state social services and reduce her cash assistance.
My mother has a similar arrangement in memory care. She ran out of money last November and shifted from private pay at $9k/month to a half price licensed room that is part of a cash assistance program. Her income is too high to qualify for Medicaid so I have to redirect $1,700/month to a pooled trust. The trust deducts a $100 administrative fee and pays the rest through to the memory care facility. The state pays a chunk. I write the check from my mother’s account to cover the difference. She no longer pays the Medicare premium so her Social Security check got bigger. Medicare picked up most of her Rx co-pays so her pharmacy bill went from $150+/month to almost nothing. I’m now in a position where I have to figure out how to spend the excess money so her balance doesn’t go over $2,000. I’m in the process of replacing her wardrobe. After I do that, I may have to call the state social services and reduce her cash assistance.
Get her a lift recliner too if she doesn’t already have one. You can also if you think she’d benefit from more 1-1 help or company, use it to hire a private aide or companion from an agency to spend a few hours a week with her.
Get her a lift recliner too if she doesn’t already have one. You can also if you think she’d benefit from more 1-1 help or company, use it to hire a private aide or companion from an agency to spend a few hours a week with her.
Great ideas. Some elderly enjoy those life-like cats or dogs that are electronic. They move, respond to being petted, meow or bark. I have known elders with dementia who really thought that they were live pets
Here are more ideas if you need to spend down each month to stay under $2,000 in savings. If your loved one has everything that she needs personally, you can check to see if the facility could use something for the common room that could benefit your loved one as well as others. Perhaps things such as a dementia friendly clock or CD player or extra puzzles and games or a subscription to magazines or the local newspaper. When my late husband was in a facility I ordered the daily newspaper for him and several of the other residents enjoyed reading it also. He also kept his CD player in the common room (mostly because he would forget it there), but other residents or staff would sometimes listen to his CDs and he was very happy to share.
At one small facility (only four residents) I ordered easy crafts from Oriental Trader for everyone to do (obviously with the permission and involvement from the staff) mostly because my husband would get bored and especially enjoyed doing crafts and other projects. They have many easy kits or crafts suitable for all levels of dementia and/or preschoolers. Even the most physically challenged can do, and enjoy, the crafts.
(hand over hand).
Maybe you would be allowed to get something like a bird feeder or flower boxes for outside of your loved ones window. Or, a big fish tank or birds (in cages) for the common areas. Of course, don't do anything that would add to extra work for the staff unless they and management agree.
I write the check from my mother’s account to cover the difference. She no longer pays the Medicare premium so her Social Security check got bigger. Medicare picked up most of her Rx co-pays so her pharmacy bill went from $150+/month to almost nothing.
Curious -- are you referencing the Medicare Part B premium? If so, does that mean that she receives 100% of her care through the facility and its providers?
Curious -- are you referencing the Medicare Part B premium? If so, does that mean that she receives 100% of her care through the facility and its providers?
Just trying to understand...thanks.
Yep. Part B premium. For unknown reasons, she didn’t file for Medicare until age 75 so her premium was ~ $280/month. It’s now zero with Medicaid covering the premium instead of a small Social Security survivor benefit. The premium was double what it should have been. I have no idea how that happened. She has gold plated supplemental insurance from her Massachusetts college prof retirement benefits so she uses that for medical and Rx. In a half dozen years with hospitalizations, I’ve never seen a co-pay. Her Rx is through that same system but Medicaid now covers what the private insurance doesn’t. Her private premium is ~$50/month deducted from her state pension. I could only dream of a benefit like that.
Unless she is ejected to the hospital, 100% of her care is in-house. A geriatric practice affiliated with one of the three large local hospitals covers two large CCRC in town and they’re in the memory care building weekly with at least a nurse practitioner and usually a specialist geriatric physician and geriatric psychiatrist to look at meds. It’s a one stop shop. Totally different from when she was in assisted living elsewhere and I had to get her to any doctor appointment. With COVID-19 where I’m locked out, it’s been a godsend. Fortunately, they haven’t needed to send her to the hospital in the last year.
I had to move my mother 100 miles to another state to find a facility like this. She was in Newport RI and there’s nothing like this CCRC and memory care facility in Rhode Island. All I saw was assisted living facilities that had added a lockdown wing and some extra CNA staff. No on-site medical care. The slightest thing goes wrong and they’re off in an ambulance.
Get her a lift recliner too if she doesn’t already have one. You can also if you think she’d benefit from more 1-1 help or company, use it to hire a private aide or companion from an agency to spend a few hours a week with her.
Good point. It would be good to pay staff to walk her around. She is now very sedentary and the staff is fully occupied with bathing, dressing, feeding, etc. I haven’t been allowed in the facility since COVID so I haven’t seen her new, smaller room. I’ll see if a lift chair will fit.
Good point. It would be good to pay staff to walk her around. She is now very sedentary and the staff is fully occupied with bathing, dressing, feeding, etc. I haven’t been allowed in the facility since COVID so I haven’t seen her new, smaller room. I’ll see if a lift chair will fit.
Do they have plans to open up to visiting family members soon? Is it possible for them to wheel her outside for a visit?
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