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My mother needs a nursing home, what happens if she outlives her money?

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If she has considerable funds now, speak with an elder law attorney. She can apply for long term care Medicaid to cover the cost of a nursing home, usually her income all except for a personal needs allowance also goes to the home to assist with payment. Her personal needs funds are for hair cuts, tv, clothing etc. Good luck
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To those who think it's outrageous for someone to request compensation for taking care of a family member: Many people are not in a position to live without a current income. The caregiver is often single and too young to retire, so they don't have a spouse paying the bills or a retirement income coming in. They need to eat like everyone else, and pay for medical care for themselves, and car payments and insurance and toiletries and all the other expenses that everyone has. They are not greedy or money-grubbing; they are in a position where they can't work a paying job due to their family member's needs. It takes a lot of love and commitment to give up a real job to be a caregiver, but it's virtually suicidal to do it if you can't be compensated in some way.

I am not getting paid for taking care of my mother - if she could afford to pay me, I'd rather she pay someone else and let me get on with my life. I'm not saying that's love; it's not. I can afford (barely) to do it for free because I was able to start an early pension, and my employer had an option that pays more before you reach 62 and then less after you can get SS. So I took that. I'm paying my own health insurance through Obamacare, which costs a fortune in my state. I pay out of pocket for my travel expenses (gas, tolls, etc.) to go to my mother's at least once a week, and I don't get reimbursed. Mom can't afford it. But I have no problem with anybody saying they can't stop working to care for a loved one unless they have a substitute source of income. That's most people's reality.
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Many of us are caring for a loved one, just because they have lived a good life and saved....This is their penalty that they were good law-abiding citizens who did it right. Now they have to spend it all before they can get any help. Well when there is another spouse or partner, you CANNOT spend it all. Because the left spouse or partner will need to live once the person dies. We have it all wrong in this Country.
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The care contract is between the elder and caregiver. It has nothing to do with any insurance company. The agreement is to receive x care for y dollars. Maybe penalizing is not the right word. Let me try again. So, you apply for medicaid when the cost of your care needs outweighs your $. Medicaid needs to make sure you are actually impoverished. You can't give your money to your child, claim impoverishment, and get medicaid. They'll check your expenses for the last 5 years to make sure they are valid for lack of a better word. Spending your money on your own care is valid. If you gave your money away in order to qualify, medicaid will impose a "penalty period." Their word, not mine. You will still get medicaid because you have no assets, but you will be ineligible for the number of months they decide relates to the money you "hid" by gifting it. That said, if someone is taking care of you, that's worth money. They should get paid. If they were not doing it, you would have to pay a professional to do it. Litldogtoo, I have to respectfully disagree with you that I can substitute the word taxpayer for medicaid. The government may use my tax money (without my permission) for medicaid, but I have no control whatsoever over what happens after that. So the taxpayer is not in fact penalizing anyone.
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I'm sorry, but I have to ask: Are there 'care contracts' for people who have babies, too? Seems to me some insurance company just got on the bandwagon by figuring out there's money to be made here.

I also have to ask why you believe Medicaid is penalizing anyone? Medicaid is me, i.e., the taxpayer. Substitute the word Medicaid, Medicare, with the word taxpayer, the sentence then become "...the heir that cares for you most without being penalized by the taxpayer'.
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Re: long term care ins. My Dad was fortunate to get a policy in 1998 that cost $1,100 a year and covered 4 years of nursing care at $3,000/month. So he paid in $11,000 and got back $120,000. But they probably don't have policies like that any more.
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Re: care contracts. I think they're a good idea. First of all, being a caregiver is hard work, even (especially) if you love the person. You will likely lose money through days off and missed opportunities for better jobs that your caregiving schedule will not allow. You will also spend your health. That's a fact. Second, and most important, when medicaid does the 5-year look back, they will consider your care expenses a valid expense that they won't penalize you for or try to recoup. Whereas, had you just given monetary gifts to family members to "spend down" your assets, medicaid would consider that "hiding" your money and you would be penalized by months of ineligibility for medicaid. Care contract is the way to go. You're getting the care anyway and "legally" transferring the money to the heir that cares for you most without being penalized by medicaid. Just make sure this is done right. Consult an elder law attorney.
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@Willows - I agree. It's seems as if everyone believes money is the answer to just plain love. Yes, it's a lot of work. And damned it, yes, it's a lot of STRESS. I don't know what the culture has become. Suddenly, I'm old (64) . At some point, those who believe I'm old (the 40 and 20 somethings) will be there, too. It's not a long stretch. Life is short. Very short. We're all planning and making money and progressing in our 'professional lives' but not thinking about the end.

Boy, do I have news for many of you. My mother (92) is currently in a more private layered (from residential to SNF) as a result of being placed there for rehab after which I applied for Medicaid through a consulting firm (the only way to go as far as I'm concerned).

This facility is now renovating and is planning to get rid of many of their Medicaid beds in order to devote the room to their residents. In doing so, they have to relocate their Medicaid patients. There are MANY facilities around here, but all their beds are filled and I mean FILLED. There is a waiting list for those already in NH's.

We're coming to a point where there is going to be a shortage of beds. I'm sure there will be more to come, but our elderly are living way beyond the previous demographic of over 85. Now the largest is over 90 and at some point there will be an oversaturation.

I've gone off the subject but I'd suggest you use a Medicaid consultant or an attorney well versed in Medicaid. You can use your mother's money to do this as you will have to spend it down to purchase funeral plans, etc. They will advise you as to how to best use that money for her along with just how to spend down the money for her).

They are invaluable.
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In addition to background checks for home health care people, do a google search of their name.....I did one, and it was eyeopening, in a bad bad way. I would never have a person who posted photos like she did, care for my mother, yet she was provided through an agency that said it had done all the usual background checks, and this person was also licensed as a home health aide.
Also,these homes distinguish between Medicaid and private pay patients....beware.
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If mom runs out of money do review your options carefully. Look at anything you or your relatives can do to help with finances first. If she gets on Medicaid make sure the visiting Nurses that you use are bonded and check court records and do a thorough background check
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As medicaid laws have changed -get legal advice. My mamma makes $52.00 @ year to much to qualify for any federal aka medicaid . I have her in a private pay facility now but my brother and I will have to finish out paying for her when her money runs out. Don't assume she qualities -as I did. Everyone thinks when the $$runs out the government aid will kick in and I had already started looking for a medicaid facility. Thank goodness for a good attorney who helped us - again don't assume anything or believe what everyone is telling you until you have checked yourself. I had my FL2 forms and all my ducks in a row to have 3 different facilities run her financial information to inform me she doesn't qualify and we are talking modest savings and no other income except SS. Good newsI won't have to worry about a spend down . Good luck and use your local resources for information.
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Re: long term care policies....when we were helping my MIL with her finances, she wanted to, and investigated long term care policies. At her age, one would have cost her nearly $400/mo and ONLY paid out if she went to a nursing home. I don't remember the terms. I just remember, that we told her if she could afford to put out $400/mo, she should just save it somehow, because then, it could be used for ANYTHING, and not just one thing only. We thought putting out that kind of money on the 'chance' that she would need a nursing home someday, was not the right choice. In the end, she had a heart attack, was admitted overnight to a hospital and was dead by morning....with the result that all that money was saved and not wasted. And, now, when I look at what we went through to get my Dad qualified for Medicaid, that people with assets would be better off, enjoying their lives more, in retirement and not worrying so much about leaving an inheritance to family because it will all have to be used up or medical anyhow in the end, unless one dies as my MIL did.....fast and sudden. I don't know if long term care insurance really helps anyone in the end or not. Maybe others have had a more positive experience.
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amott6, That answer is the same as for everyone else. You pay out of pocket, until Medicaid kicks in. I sometimes wonder if those long term care policies are really worth it. They cost a fortune, and once you read the fine print, they rarely cover the whole cost. The one we looked into would have paid out less than half the cost of most facilities around here. So either way your money goes down the drain. And the monthly payments were so far out of our reach, it was ridiculous. Would have cost more than a quarter of our income. As stated above, get an elder care attorney to help you through the process. They seem very expensive, but are so worth it.
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My Assisted Living policy only pays for 5 years. What happens if I outlive that policy?
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Dear Phyllis,
There are some really great comments here and they all add up to one conclusion: you should speak with an elder law attorney in your community. The area of elder law is highly specialized and nuanced. For example, the Medicaid non-exempt asset transfer period which could negatively affect your mother ranges from 30 months to 60 months depending on where you live. This is part of the asset test (or requirement) under Medicaid. There is also an income analysis. If your mother makes too much money, in the eyes of the government, she must pay a "share of cost" for skilled nursing care. One comment here brought up a care contract to get YOU paid for the care you are providing your mother. Care contracts can be highly useful in certain situations. Also, while nursing facilities like to refer to beds as "Medicaid beds", you should know that there is no such thing under the law. A bed is a bed. Nursing facilities will often attempt to limit the number of spaces they have for Medicaid recipients because they get paid less from the government than when a person pays privately.
Besides Medicaid, there may be other benefits available. One example are Veterans benefits. If your mother was in the military or is, perhaps, the widow of a man who was in the military, she may be eligible for VA Aid & Attendance Pension benefits. This could additionally prove extremely helpful.
Fortunately, it sounds like your mother still has part of the assets that she probably worked a lifetime to save. Please do her a favor and call an elder law attorney, so that she may save those remaining assets and not worry about her finances in order to receive the best possible care. If you need help locating a good elder law attorney in your city (or if you just would like to read more about government benefits), you may contact me by visiting: ValleyElderLaw.LA.
Best wishes,
Randall K., Esq.
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Wow, I didn't even know that a person taking care of a elderly loved one could even try to apply for Medicaid for them. My three older siblings has told me that once Momma gets so bad that she needs to be in a home, whatever money she may have in her savings account the home will use that up, and once that is all gone, my siblings told me that they will have to pay for Momma's stay in the home until she dies.

I've learned something new and will have to pass this info on to my older siblings. The saying "you learn something new every day, is very much true". Thank you for enlightening me and so many others about this. I LOVE this newsletter!!! I find it very comforting and extremely helpful!!!
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Someone here urged the daughter to write up a contract and have her mother compensate her for all her work, to which I have to say, "Huh? What in the world???!!!
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Get all your ducks in a row, find out how much money she has now and perhaps file for Medicaid for the future. Maybe you are worrying needlessly about events that have not yet happened.
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I had to help with Dad qualifying for Medicaid for his dementia care in a facility...and am now starting process with my Mom who is still home. As you look for a nursing home, you have to be sure it has Medicare beds and you have to know what their policies are. I always recommend on here, that people consult an elder care attorney, because Medicaid rules are slightly different in different states, but there is always a 5 year look back and if money was used for non eligible reasons, it creates a penalty period whereby Medicaid will not cover no matter what....so it's private pay until that time is up. I believe the penalty period adds up to the amount of money that was not used properly. In most facilities, there are limited Medicaid beds, and, yes, they have current residents on a waiting list for a bed, so it may or could be that she has to go in as a private pay resident and be added to the waiting list. Since my Dad went into Memory Care, I don't know how nursing homes work. If Medicaid approval comes before nursing home placement, it will pay for some home care people to come in, but here in AZ that amounts to about 20 hours/week....so not much assistance. If she needs to be placed in a facility that you do not like or she doesn't like, once she's on Medicaid, she can easily move to any other facility that has a Medicaid bed in your state....but as you are looking, you are always looking for Medicaid certified facilities and you want to say that she is Medicaid pending until she is approved. In AZ, we are checking into moving my Dad, so I also have to find a placement that is covered by the health care company that handles his Medicaid contract too....so a little limited into which facilities I can be considering. Our eldercare attorney had all the financial people and case manager staff in his office to help with paperwork, applications and generally knew staff who did approvals, and knew which facilities were good, bad and ugly too. I believe you could also privately hire social workers or eldercare/geriatric managers to help with the application as well in some places.
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You will spend hundreds of hours "working " for your mom, on top of everything you've already done. Consider asking mom to compensate you. Write up a contract. Your time spent on all the paperwork is Real work.
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WORRY
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Lik everyone has said, get your mom on medicaid. Don't worry, she will be all right.
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Great comments so far. I speak from experience. We spent down to Medicaid $$ floor years ago and it is wise to get help. I used a specialized attorney. I also felt the county DSS worker was most helpful.

Suggest you ask a nursing home with Medicaid beds available to do an FL2 on mom...they'll know what it is.

Grace + Peace,
Bob
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You asked what happens when she runs out of money. This may imply that she needs a nursing home and has money (for now) and you did the math and realized that after so many months (years) she will run out. Even if she has a few hundred thousand dollars...at $9000+ a month, that wont last long. Or she has enough for just a few months...whatever. The main thing is you need to get up to speed on what she needs to qualify for medicaid and prepare. What is allowed to be spent, the 5 year look back, etc. It's a good idea to consult an estate legal practice if you/she can afford it to help you with the application process. There are too many things to do before you apply for Medicaid to protect your mom's (and yours) assets to go into in this short post. Like pre-paying for final expenses for one. So look for a home but get some advice before you apply asap. Some nicer homes like a full pay resident for a few months before the Medicaid kicks in. Good luck and get some advice ASAP.
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Ask the facilities you look at if they have Medicaid beds. If those are limited, someone who is already a resident gets it over a new person coming in. I talked to the financial person at my Mom's facility and she was EXTREMELY helpful with getting Mom's Medicaid app ready and Mom didn't have to go to another facility picked by the system.
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Get her signed up for Medicaid and Medicaid will pay for her nursing home. Get her signed up ASAP because the application process can take months. I think some nursing homes will take your mom if she's in the application phase of signing up for Medicaid but you'll have to check with their social worker. My point is to go ahead and look for a nursing home for your mom while she's being approved for Medicaid and let the nursing homes know that she's in the process of being approved for Medicaid.
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