Medicaid & Nursing Homes

[yoyoma51]

My father is currently at a nursing home after having a couple of strokes. He may have to reside there for his remaining years (he is 75). My mom died in 1999 and he has not remarried. He does not own a home.

Currently, Medicare is paying as he is there for rehab. Between Medicare and his supplement insurance, he will not have much out of pocket expense for about 60 more days.

He has about $60k in funds and receives about $1300/month from Social Security.

If he does have to stay in the nursing home, Medicaid will begin to pay after he uses up all (or almost all) his money (the home is $6k/month).

My question/observation is this:

How screwed up is it that he can't give the little money he has to his kids and his church? Medicaid will go back 5 years and seize any gifts. It is too late to form any kind trust.

He really wants his three boys to have his money, but that's not allowed. HOWEVER, he COULD go to Vegas for a weekend, gamble it all away and THEN be Medicaid eligible.

THAT'S NUTS! Ceasar's Palace can have it, but his church or children CAN'T.

Thanks for reading. Needed to vent.

[chpxiii]

When you start passing down money it helps to build wealth. And we can't have the masses starting to build wealth in this country.

[Minnymouth]

Unfortunately nursing homes are NOT CHEAP, and if the person has ANY ASSETS AT ALL, they are liquidated and used to pay for the patients care until they are exhausted.

The only way to prevent this from happening is to have previous trust funds set up that are untouchable.

Yes, all of us would like to pass down our things/assets/money to our children.... but this day and time it is not feasible possible to do that most of the time.

$6,000 a month for room and board is a great expense for keeping an elderly person. SUPPOSEDLY, this is for round the clock care....... don't bet your life on it or theirs!!!

The care that most get is not VALUED at $6,000 a month......BELIEVE ME!!!!

As most of you know, I kept my mom at home (bedridden stroke victim) for 4 years. I worked every day and had a sitter come in while I worked. Now the sitters didn't work 3 shifts - ONLY ONE - while I worked. Then mom was under my care the rest of the time, including weekends.

Sitter expenses alone came between $12,000 and $14,000 a year...... a lot less than $6000 a month for a nursing home.

There was nothing that they would have done, that I couldn't do myself at home.

Most people do not want to be BOTHERED with taking care of an elderly parent..... their own lives are disrupted, and put on hold while they do. They don't want the added expense or the responsibility.

Families are not like they used to be where you took care of family members at home if you could.

Now days many parents won't even care for their handicapped children that they might have.....

Most attitudes are "I have a Life to Live of my Own"....... and NOTHING is going to get in my way of doing it........

What a shame........ that our lives have come to this point in our society.....

Often the elderly need care that can't be given in the home, this is understandable..... but there are lots of things that can be done at home now that do not require full medical supervision. But as before, most people don't want to be bothered with all of it....

Personally, I was not going to pay a nursing home $6,000 a month to bath my mom, watch her eat and sleep every day.....
Kind of expensive room rent , don't you think???

Care-giving is not meant for a lot of people, but a lot won't even try..... Sad..... It's amazing what you can do when you put forth the effort.....

Its stressfull, financially hard, time consuming, emotionally upsetting, and really works on your nerves (especially if you work outside of the home also).

But it is also so very REWARDING...... long serious talks with a parent, lots of laughing (even about the situation).... and the bonding that is irreplacable......

In life you do what you have to do, do what you think you can do, and hope you can do the things that you've never done......

And you don't know where you stand till you try!!!

[Flamingo]

My father is currently at a nursing home after having a couple of strokes. He may have to reside there for his remaining years (he is 75). My mom died in 1999 and he has not remarried. He does not own a home.

Currently, Medicare is paying as he is there for rehab. Between Medicare and his supplement insurance, he will not have much out of pocket expense for about 60 more days.

He has about $60k in funds and receives about $1300/month from Social Security.

If he does have to stay in the nursing home, Medicaid will begin to pay after he uses up all (or almost all) his money (the home is $6k/month).

My question/observation is this:

How screwed up is it that he can't give the little money he has to his kids and his church? Medicaid will go back 5 years and seize any gifts. It is too late to form any kind trust.

He really wants his three boys to have his money, but that's not allowed. HOWEVER, he COULD go to Vegas for a weekend, gamble it all away and THEN be Medicaid eligible.

THAT'S NUTS! Ceasar's Palace can have it, but his church or children CAN'T.

Thanks for reading. Needed to vent.

Been in your shoes so vent away - you deserve and need it. To qualify a senior for Medicaid, you have to spend down their assets to $2,000. Many of us boomers are finding out, or have found out the hard way as you, that there is a 5 year window to save their assets - used to be 3 but was changed in 2/06 to five years. What that means is you and your senior parents have to preplan in the event a nursing home is in their future and they do not have long term care insurance. Certain trusts can prevent loss of assets; an elder law attorney and/or estate planning attorney can be of assistance to anyone who may face this issue. My dad died in 1983; my mother resided in her home by herself with our constant assistance for her needs until she became very ill and collapsed in 2003. She could not return home and we needed to put her in nursing care. Medicare covered the nursing home for 3 months; after that it was all private pay. Our last name is not "Getty" or "Hilton" so we had to investigate Medicaid. We had to sell her home and turn over her assets and SS check to the nursing home. Many people do not realize nursing homes run at least $6500 per month, some much higher. Medicaid allows $40 per month for the senior's incidentals and clothing.

May I suggest speaking with the counselors at the nursing home who can give you all the help and informaton you will need to get you through this. I know how difficult and overwhelming it can be and how quickly your parents' life savings can be eaten up by health costs for their care. As the undertaker told us when my mother passed away this past summer after 4 years in a nursing facility with excellent care, "You come into this world with nothing and you leave with nothing." How true.

[Granny]

Minny,

Well said. I too took care of my mom for 4 years after a stroke. Didn't ever consider putting her in any home except mine. Those were the best 4 years we ever had.

There was a short period of time before she died that I was taking care of 4 generations (while working). Sure it was difficult, but the rewards were astronomical.

You are so right, you do what you have to do. I remember when I learned I was pregnant with my last child. I thought "Oh well, it will be ok, I'll be 42 when this one turns 18, that won't be old, I'll still have a chance to have my own life." Then mom got sick, then came to grand-babies that I am raising.

Hard work raising them, you bet it is, especially since one was exposed to heavy alcohol use. But I wouldn't trade the life I have now for the life I was going to have for anything in the world. How boring that life would be!

[Flamingo]

Minny,

Well said. I too took care of my mom for 4 years after a stroke. Didn't ever consider putting her in any home except mine. Those were the best 4 years we ever had.

There was a short period of time before she died that I was taking care of 4 generations (while working). Sure it was difficult, but the rewards were astronomical.

You are so right, you do what you have to do. I remember when I learned I was pregnant with my last child. I thought "Oh well, it will be ok, I'll be 42 when this one turns 18, that won't be old, I'll still have a chance to have my own life." Then mom got sick, then came to grand-babies that I am raising.

Hard work raising them, you bet it is, especially since one was exposed to heavy alcohol use. But I wouldn't trade the life I have now for the life I was going to have for anything in the world. How boring that life would be!

Be thankful you were able to take them home. We unfortunately could not due to medical orders. If we went against those orders, we could have been incited for elder abuse inasmuch as she was not terminal but needed 24 hour medical supervision and monitoring. Also we were advised that many people try to take their elders home when they should be placed in a proper nursing facility since the family wants to prevent Medicaid from getting the elder's house or assets if there are no funds to cover the nursing facility or long-term care insurance. We found out things that would make your hair stand on end. If the elder is not terminal and needs care that cannot be provided or approved in a house setting, and you cannot provide round the clock monitoring if needed, you can face elder abuse charges. Things have changed with the population aging as it is and it's best to protect yourself and the seniors in your life. Get a good consultation with an elder care lawyer or estate planning lawyer in advance. It's a hard lesson learned by many way too late.

[rrockinggramma]

I am currently dealing with this situation. My mom is 85 (86 Jan 11) and is finally considering going into an independent living center. We recently took away her car and it has been devasting for her. She is doing pretty good but is getting more foggy by the day. However, she just redid her will and her estate. Her attorney told us (she has a trust set up?) that when the time comes they can work around the laws and get medicaid to pay without her losing all of her assets. So maybe an elder law attorney could give some free consultations and see if there is a way around keeping some the OP's money?

[Flamingo]

I am currently dealing with this situation. My mom is 85 (86 Jan 11) and is finally considering going into an independent living center. We recently took away her car and it has been devasting for her. She is doing pretty good but is getting more foggy by the day. However, she just redid her will and her estate. Her attorney told us (she has a trust set up?) that when the time comes they can work around the laws and get medicaid to pay without her losing all of her assets. So maybe an elder law attorney could give some free consultations and see if there is a way around keeping some the OP's money?

To the OP - RockingGramma rocks and is right - The key is the trust situation set up in advance along with that five year window when items are changed as to names. Laws have recently changed as to that so contact an elder care/estate planning lawyer and get some good advice. They may not give free consultations for that (ours was $75 but $75 well spent for some great advice on certain things we were not aware of) but it will help you in the long run if not at this moment.

Best of luck to you and to your family.

[Minnymouth]

A friend of my mom's lived in assisted living quarters for years before she passed away. It was hard for her to adjust, but eventually she called it "home". These can be great for parents that still want to be on their on but yet need to be checked on throughout the day.

One of my neighbors converted her garage into a cute apartment for her mother. Her mom still drives, so she comes and goes as she pleases, yet her daughter is close by if she wants to "check" on mom.

And yes, if you have older parents, IT'S TIME to take them and help them protect their assets if they have them. You should consider this if your in your 20's even.... Death has "no age limit"!!

Society has "it's hand out" and believe me, they will confiscate it if at all possible........

Medicare is PAID WELL, for taking care of the elderly and the person that pays $6,000 a month is NOT TAKEN CARE OF ANY BETTER...... (A friend of mine can vouch for that - his dad's care cost $6,000 a month for 3 years....) Thank goodness they had protected some of his assets years earlier that he had put in trust funds for his grandchildren... Fortunately, being wealthy they could afford the $6,000 a month for his care..... His dad required 24 hour care with machines...... so he was unable to keep him at home any longer.

Help them get that paperwork in order, wills, trust funds, final wishes, etc...... before anything happens..... In fact, do your own also.........save your children a lot of grief and loss.....

[Minnymouth]

There is a "sticky" under this section of the forum that helps people "know" what they need to do, what they need to sign, etc to help their families thru all this....

[tinroofrusted]

Absolutely NO COMMENT on this.

I am afraid I would step on some toes seriously.

Above all else, if you are older, make sure to have your wishes in writing. Mine will be absolutely NO out of home placement......

[CindyLou]

Nursing homes can be a great place for elders that need around the clock care if the right one is chosen AND if there is a amost DAILY presence from the family. Both of my grandmothers were very well taken care of with much participation from family members. If the family is there then the nursing home workers will make sure that everything is done correctly. Sad, but true.

[BKOnce]

Instead of paying them $6K to run a business into their pockets, just open a business for yourself. Use that 6K to remodel your home or build additional room in house, hire a part-time sitter like Minni said, so the initial investment cost of $72,000 ($6X12) in first year will be paid off sooner than said. Next years, NO part-time sitters should make $6K salary request anyway!

[Minnymouth]

Cindylynnsmith,

You are absolutely RIGHT..... family presence is VERY IMPORTANT... when a parent is in a nursing home. If the patient has no visitors, or once a month visitors, THEY WILL IGNORE these patients often and neglect their care.

Not only nursing homes do this, but also hospitals and rehab centers.

My mother was in my care for 4 years - no bed sores..... She went to the hospital for one week and came out with 2 bed sores. THAT'S NEGLECT............. I RAISED HOLY HELL at the hospital....

I also raised HELL with the rehab center who put her on PROZAC and turned her into a screaming maniac for a few days. My mom was a quiet Christain woman trying to regain her mobility, who with a few days of taking prozac turned into a cussing, raging, combative woman that lashed out at everyone.

HeHe..... they thought because they didn't post the Prozac on her chart, nobody would know.... As her caregiver I demanded the medicine records to see what she was taking, and demanded she be took off it RIGHT THEN or I would sue!! Within 24 hours she was her old self again.

Even as a stroke patient she never suffered from depression, etc.

How can a stroke victim rehabiliate themselves in rehab if they are taking an anti-depressant like Prozac??? It makes them sleepy and droozy when they are not WILD on it!!!!

No offsense to you that are in the medical field, BUT, it is a wise thing to CHECK ALL MEDS that your parents take, demand their medicine charts if you have power of attorney.... KNOW WHAT THEIR TAKING......

Much of the medicines prescribed for the elderly are not needed. Its a money making thing in the nursing homes, etc. Also, its a way of keeping them sedated so they don't have to be bothered with them.....

When I brought my mom home she was sedated, couldn't feed herself, etc. I confronted her doctors over her meds and took her off a great deal of the meds they were poking down her throat. Within 3 days she was her normal, laughing self and with a week she was feeding herself. She went from 8-10 prescriptions to only 3 that she really needed. Thus eliminating all the "side effects" of all the meds being mixed together.....

She was in her "right mind" for the next 4 years till her death.....she just couldn't walk after the second set of strokes.

Yes, there are some GREAT Doctors and Nurses in the medical field who are very compassionate, and due the best job they know how for their patients.............THEN there are those that just "draw a paycheck" from week to week. After a while in the medical field, pain and suffering means nothing to them, and the neglect of a patient means even less!!

SOOOOO, for your own peace of mind, and for the "good care" that you want for your loved ones, followup on their care, and their meds. Be involved with "what the doctors and nurses do"....

Be the "spokesman" for your parents if they can't!!!!

[BKOnce]

Once, there was I think a TV show like CSI, where director of nursing homes killed/drugged/injected a patience because she is trouble or so sick that taking all expensive resources, and the director had to eliminate her to lower their business costs down !

Yes, it's true, so everything is all about business & business survival ! Nothing else matters.. all are just sick dogs & cats to them!