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Between social security and a small pension my MIL earns too much for Medicaid (around $1,500/month). She has no assets (cash or otherwise) except a condo she owns worth about $160K, where her grandaughter and great-grandchild live rent-free (they pay the taxes, maintenance, condo fee, etc.) She is getting worse by the day and a nursing home is the next step. My guess is that we're going to be about $5K a month short of the monthly cost .... my MIL really wanted to leave the condo to her grandchildren, but that may be impossible. Do we have to sell the condo to make the payments? What happens if she outlasts the proceeds from the condo? Is there anything we can do to get help from Medicaid? Thx in advance for any suggestions ... I know many in this community are facing similar challenges.

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Her first stop needs to be a certified Eldercare attorney who is familiar with Medicaid in her state. She can get a pooled income trust to get around the "overage " in income, for example.
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Thank you for your response .... so you think we should have her enrolled in Medicaid BEFORE we decide on a Nursing Home?
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You need to consult a lawyer first about how to get her qualified i.e. get her income under the limit. A home is a noncountable asset, meaning that it doesn't count against the dollar limit on assets. Medicaid will put a lien on it, but selling it right now is probably not the best idea.

She also needs to be Medically in need of skilled nursing. Does her doctor say that's the level of care she needs? Or is she in need of Assisted Living? They are very different levels of care.

You can request a "needs assessment " through your local Area Agency on Aging, or her doctor can order one.

Why does she ( Or anyone) think she needs Nursing Home Care?
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She's 84 and has Alzheimer's .... she refuses to bathe and is combative. She cut herself rather badly and takes the gauze/band-aids off as soon as she is alone. I had not thought about obtaining a "needs assessment"; I'll ask her Doctor about that. And I will hold off on taking the steps toward selling the condo until I learn more. Thanks again.
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She may need Memory Care which is a specialized kind of Assisted Living. Most folks with Dementia don't need nursing home care unless they've got a slew of medical issues as well.

If she should happen to fall, become I'll or otherwise end up in a hospital, you'll have the services of the discharge unit at the hospital who will be tasked with finding her a placement if they determine that she can't live without full time supervision.

She CAN be admitted to a Nursing Home (If that's what she needs) " Medicaid Pending".

Have you had her evaluated for meds by a geriatric psychiatrist? Sometimes meds can help with the agitation and aggression.
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If your MIL is single, her house is a countable asset unless she is planning to return to it. If her granddaughter has been taking care of grandma for two years in that house or granddaughter is disabled, then other rules may apply. Overall, elders have saved money to pay for their old age, not to enrich their descendants while the taxpayer pays for their nursing care.
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Thank you all for taking the time to share your thoughts; this has been extremely helpful.
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My Mom made 1700 a month with SS. No extra cash. A house worth maybe $70K and she got Medicaid. I think the problem is the condo. People living there should be paying rent, probably. The condo could be sold for her care. You need to go back and find out why she was turned down. A Medicaid approved application only last 60 days. You must have Mom set up in a nursing home by then.
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In many states the nursing home will be taking her oension an social security and that will no longer be considered her income so check with your attorney on that because that generally takes care of the income situation for qualifications
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Definitely do NOT sell the condo yet! In some states, it is possible to create a deed that will allow transfer to children (or others) without becoming subject to the state's recoupment (reimbursement) requirements.
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She cannot be approved for Medicaid until she has incurred the cost of the medical care, at least not in my state. Normally you would have care ordered by a doctor and then she would be put in a nursing home with a status of Medicaid pending. The nursing home will normally apply for Medicaid for you. As for the condo, I would speak to a lawyer about that. Your mother in law does not earn too much for Medicaid. $1500 a month is nothing compared to the cost of a nursing home or assisted living. Good luck!
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Contact the Nursing Home and speak with the person in accounting and they will give you forms to fill out and also tell you what will be affected.

For my dad, they would have gotten his home but I've been advised that the NH doesn't actually take the home, Medicaid/Medicare does, to recoup some of the expenses. They were very open and honest with me. It's a good starting point.
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The Medicaid applicant is allowed $2K in countable assets. The applicant must be prepared for the 5 year lookback period, which entails pulling up bank records up to 5 years back.
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The Assisted living/Memory Care apartment I found for two friends of mine with memory and frontal temporal dementia issues told me that after 18 months of regular payments, they would accept public financing. They explained they also cover all the care needs up to the point of death, so they never needed to leave. The wife lasted 5 months there before passing after she could not longer swallow. Hospice attended to her the last 3 weeks or so, at no cost to them. The husband continues to live there and gets good care. A doctor visits him once a month, they adjust his meds as his needs change, they provide his meds at appropriate times and he walks to the dining room 3 times a day for meals that are adjusted to their needs. I am so impressed with this place--they do everything "right." I used their savings and cash assets and long term care insurance to help pay for this. I am in the process of getting their town home sold and that money goes right to his savings account. The retirement income covers about 1/3 the cost each month. Once my friend becomes poor enough, I can file for veteran benefits to help. At around $8,000 a month, we can do this for 2-3 more years before getting to that point. I am also the executor of his estate and know what his intent is if there is any money left. He is in good physical health, so it is likely he will out live the IRA assets and money from the sale of his town home and then the public funding issue will be there. I am keeping all the bills and paying everything by check, so there is a good paper trail. All the money coming in goes directly to the checking and savings account. I don't have to account to anyone in my role as his POA, but am behaving as though I do or will have to account for his money and expenditures. Good luck with this path. Good questions and advice has been given here. I just wanted to share how this has worked for me in the care of my friends--it's gone really smoothly and I have gotten great advice along the way.
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I don't think you will be able to enroll her in Medicaid before she goes to a nursing home. Medicaid covers medical expenses that she cannot afford. If she hasn't incurred expenses, her application will be denied and she would have to apply again once she actually had medical bills over her monthly state Medicaid income allowance.
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And in my state, there are a few kinds of Medicaid. Chronic care, which covers nursing home long term care and community Medicaid that covers home care. You can only apply for chronic care if you are already in a nursing home. Otherwise you can only apply for community Medicaid if you are still at home.
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