Are you sure you want to exit? Your progress will be lost.
Who are you caring for?
Which best describes their mobility?
How well are they maintaining their hygiene?
How are they managing their medications?
Does their living environment pose any safety concerns?
Fall risks, spoiled food, or other threats to wellbeing
Are they experiencing any memory loss?
Which best describes your loved one's social life?
Acknowledgment of Disclosures and Authorization
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington. Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services. APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid. We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour. APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment. You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints. Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights. APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.I agree that: A.I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information"). B.APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink. C.APFM may send all communications to me electronically via e-mail or by access to an APFM web site. D.If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records. E.This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year. F.You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
✔
I acknowledge and authorize
✔
I consent to the collection of my consumer health data.*
✔
I consent to the sharing of my consumer health data with qualified home care agencies.*
*If I am consenting on behalf of someone else, I have the proper authorization to do so. By clicking Get My Results, you agree to our Privacy Policy. You also consent to receive calls and texts, which may be autodialed, from us and our customer communities. Your consent is not a condition to using our service. Please visit our Terms of Use. for information about our privacy practices.
Mostly Independent
Your loved one may not require home care or assisted living services at this time. However, continue to monitor their condition for changes and consider occasional in-home care services for help as needed.
Remember, this assessment is not a substitute for professional advice.
Share a few details and we will match you to trusted home care in your area:
Dear Igloo, Yes she is Medicaid pending. Yes, I gave the NH bank statements, insurance policies, funeral contract. What is an award letter? I've already authorized the NH to be the payee. Seemed less complicated to me. The NH did not actually explain that I could send a check. From what you say, leaving the NH and receiving Social Security and pension again is complicated but can be done. If it takes months, I assume they pay retroactively.
Eric - couple of things. Ask about when the biz or accounting office is open for you to sign off to get funds from the PNA. If its Mon - Fri 9-3:30 try to do a trip in to be able to withdraw some funds to spend at Target. Now this does a couple of things - you see what's in the PNA and what other withdrawals are used for & also clearly establishes your continuing involvement & concern in her care.
If this NH has a beauty shop, you want to find out when it's staffed and pay a visit then to have mom placed on the regular appointment list. Again, shows involvement. They cannot add a tip from the PNA, so you may want to tip in advance when you place mom on the regular every Thursday wash & set crowd. It will become a regular social thing for mom to do too. Happiness all around.
Yes they in theory can get better & leave. For those there on rehab, could happen & does. But for the advanced elderly with dementia not realistic IMHO. If you are truly thinking mom will be leaving NH, I'd suggest not having NH become the payee. It will take months to change back to do and you likely will now have to become the representative payee for her SS ( for even more fun in all this, SSA & federal pensions do NOT recognize DPOAs, so have their own rep payee system you will have to report to & do)
So is mom medicaid pending? You say NH did application, right? So what about moms bank statements, awards letters, insurance policies, funeral contracts, etc - did you give them to the NH to accompany the medicaid application?
Igloo, Thank you for this very useful information! In our case the NH is doing the paperwork for Medicaid. We have agreed that the NH will become the payee for Social Security and pension, all of which goes to the NH (This is the co-pay, right?). So far the NH has not been able to have these funds transfertred to them so I have been told that I will eventually have to send the NH a check for the these funds. Once the funds have been transferred we won't have any financial responsibility. That is right, isn't it? It seems most of the patients in the NH are on Medicaid so the NH is very familiar with handling these cases. I am going on intution that they are honest and doing everything properly with respect to the application etc. So far I am impressed with the place and the care. I have not been told anything about guardianship. I have taken and plan to continue to take an active role in my parent's care. I do not want the NH to have control over any important decision making in this respect. I was also told about the PNA but had not thought about its going over $2,000. My understanding also is that Medicaid patients can leave a nursing home if they get better and return to receiving their Social Security and pension. In our case there are no assets other than Social Security and pension, so I can not see any legal complications down the road. The only thing that worries me are the filial responsibility laws that have been mentioned on this forum. The Pittas case, though, seems very unusual and not really applicable to seniors on Medicare / Medicaid. Many thanks for your input. This has been a terribly stressful and upsetting time of life, not even taking into consideration legal and economic aspects.
Eric - so mom is going into a NH Medicaid pending, correct? Assuming that her income & asset situation is all kum-ba-ya for Medicaid in your state, what will happen is that her POA has 2 options on dealing with her co-pay or her "SOC" to the NH. She can have the NH become the payee, so her income goes to the facility OR she can continue to have her income deposited to her checking account from which someone in the family pays the NH her required co-pay each month. The NH cannot make you make them the payee but they will highly encourage it. You don't have to, for my mom I pay the NH her co-pay each month from her checking account & I live in another state.
Did NH tell you about the PNA - personal needs allowance.? It varies by state from $ 35 - 90 a month. Most are $ 60.00. They get to keep that amount each month and it has to be placed into an interest bearing trust account in their name at the NH if the NH deals with their income. For my mom, I set up her trust account @ the NH and have about $ 200 in it to allow her to draw for beauty salon or canteen at the NH. NH sends me a statement every 90 days on it.
Now you have to be cognizant of the monthly build of the PNA. Why? is because if you let it grow beyond 2K, it will take mom over the 2K asset eligibility ceiling for Medicaid. If NH controls the purse, they will buy mom an expensive walker or perhaps a wheelchair to zero balance out her account when it gets close to 2K. If you want to allow it to run this way, fine. I don't and instead I let the PNA build in mom's bank account for a couple of months so that I can go and do a super shopping trip for her and buy pi's, socks, lotions, etc for her.
Now all the states have to have estate recovery in place. This is the MERP program. Upon her death, the state or its outside MERP contractor will send you or whomever is the point person on file with Medicaid for mailings, an "Intent to FIle a Claim (or Lien)" letter, which you have to respond to as to whether or not there is an estate, if probate is to be filed and if there are any exemptions, exclusions or hardships present to offset or set-aside MERP. Even it she has nothing, you need to fill out the questionnaire to essentially close her Medicaid file. If she has nothing, then nothing to get.
Ask the NH if mom's state does an annual renewal. If so, you will need to keep a binder going on all things mom to do the renewal, UNLESS the NH is doing this. Usually the POA needs to sign off on the Medicaid application and renewal as it needs to be someone legally able to do for her. Is the NH becoming her POA or guardian? if you are not going to be active in her stay or life, you might want to set this up to enable the NH to do for her. If in the future, you want to move her to another NH, you won't be able to as you have given NH guardianship.So think carefully on this as it's a big legal step.
For Pittas, it was NOT the state or the federal government seeking payment under “filial responsibility” laws. The case is “HCR vs. Pittas”. Pittas is not the usual elderly momma with dementia in a NH on Medicare & Medicaid, who dies and kids held responsible for payment situation.
For Pittas, the mom, Maryann - who was under 60 - entered a HCR (Healthcare and Retirement Corporation of America) owned facility (Liberty Nursing & Rehab) after an auto accident (two broken legs). She was at Liberty from Sept, 2007 – March, 2008 (6 months / 92K bill). She had medical on her auto insurance and then also applied for Medicaid & was “Medicaid Pending”. She was under 65 so no Medicare. In March, 2008 she left rehab - without settling her 92K bill - & moved to Greece to live with her husband. She did not provide the documentation to Medicaid required before she left the country. Now the son – upon being billed 92K for his mom’s care - took the situation to an arbitration hearing. (I bet arbitration was required to be done as per the admissions contract.) Now in arbitration, it was ruled in the son’s favor. He won but did not file for the arbitration to be binding. HCR wasn’t content with this and HCR appealed the arbitration ruling in son’s favor to a Pennsylvania trial court (judges only, no jury).
From WestLaw: “ As a result, on or about May 12, 2008, HCR instituted a filial support action against Appellant. Pursuant to 23 Pa.C.S.A. § 4603, entitled “Relatives' liability,” HCR sought to hold Appellant liable for the outstanding debt incurred as a result of his mother's treatment and care. The parties submitted the case to arbitration, whereupon a three-member arbitration panel found in favor of Appellant (the son). HCR appealed the arbitration award to trial court. The trial court held a three-day non-jury trial, after which it entered a verdict in favor of HCR in the amount of $92,943.41. Appellant filed post-trial motions, which the trial court denied on January 13, 2011.
In reading the transcripts, my thought is that he & his attorney did a piss poor job for the trial court. He did not substantial his bills; did not provide time line documentation; did not provide address for her in Greece or show attempt to contact her; did not join his father or his sisters to share the support-burden (if he had, his share would have been 23K, this is the biggest error). He did not seem to make an attempt at completing the details & documentation needed for mom’s Medicaid application; or pursuing litigation on the auto accident. HCR just had to show the trial court he had income and bills due. My guess is that he & his legal thought was that he did not have to do anything because he won in arbitration, that was a huge costly mistake.
Most NH bills are not going to be what Pittas was. There is going to be Medicare or other health insurance paying for things; the elder is going to have some $ to pay towards the bill; family is going to make an effort to pay something. If rehab is due to auto accident, your auto policy may pay for some of the costs & if not someone else’s auto insurance is gonna get sued. You are going to complete the Medicaid application. And momma is not going to leave the NH & take a flight to Greece!
BTW HCR was taken private in 2007 with The Carlyle Group ($ 185B in assets under management in 2013) as the majority owner. HCR name changed to HCR ManorCare & had $4B in annual revenues in 2008.
No, you start paying them as soon as the parents move in. They will give you an amount to pay. SOC (share of cost) will be on the admission papers, so pay as you go. The Medicaid application could take a year to be processed.
So if the pension, Social Security money and other assets ARE turned over, there is no problem? In my case the nursing home is doing the application. The Social Sec and pension monies have been deposited to my parent's account this month because the nursing home has not been able to transfer them yet. I will leave them there. The nursing home said that when the Medicaid application has been approved i have to turn over these deposits to the nursing home which I will do. Meanwhile I will not touch this money. Is this the correct procedure?
I think this depends on the law of the state in which the parent resided at the time of death. Some states have filial responsibility laws. They are rarely enforced but that doesn't mean they won't be. forbes/sites/northwesternmutual/2014/02/03/who-will-pay-for-moms-or-dads-nursing-home-bill-filial-support-laws-and-long-term-care/
I don't understand. The MEdicaid application was rejected? So if it was rejected no Medicaid benefits would have been paid. I am speaking of an individual who truly has no assets. When that Medicaid patient dies, can the state come after the children? And what if the children live in a different state?
Yes. See HCR vs. Pittas (Pa. Super. Ct., No. 536 EDA 2011, May 7, 2012) He was ordered to pay $93,000 for his mother's nursing home care. Medicaid had rejected her application, and he was not forthcoming about where all her money went.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
If this NH has a beauty shop, you want to find out when it's staffed and pay a visit then to have mom placed on the regular appointment list. Again, shows involvement. They cannot add a tip from the PNA, so you may want to tip in advance when you place mom on the regular every Thursday wash & set crowd. It will become a regular social thing for mom to do too. Happiness all around.
Yes they in theory can get better & leave. For those there on rehab, could happen & does. But for the advanced elderly with dementia not realistic IMHO. If you are truly thinking mom will be leaving NH, I'd suggest not having NH become the payee. It will take months to change back to do and you likely will now have to become the representative payee for her SS ( for even more fun in all this, SSA & federal pensions do NOT recognize DPOAs, so have their own rep payee system you will have to report to & do)
So is mom medicaid pending? You say NH did application, right? So what about moms bank statements, awards letters, insurance policies, funeral contracts, etc - did you give them to the NH to accompany the medicaid application?
Did NH tell you about the PNA - personal needs allowance.? It varies by state from $ 35 - 90 a month. Most are $ 60.00. They get to keep that amount each month and it has to be placed into an interest bearing trust account in their name at the NH if the NH deals with their income. For my mom, I set up her trust account @ the NH and have about $ 200 in it to allow her to draw for beauty salon or canteen at the NH. NH sends me a statement every 90 days on it.
Now you have to be cognizant of the monthly build of the PNA. Why? is because if you let it grow beyond 2K, it will take mom over the 2K asset eligibility ceiling for Medicaid. If NH controls the purse, they will buy mom an expensive walker or perhaps a wheelchair to zero balance out her account when it gets close to 2K. If you want to allow it to run this way, fine. I don't and instead I let the PNA build in mom's bank account for a couple of months so that I can go and do a super shopping trip for her and buy pi's, socks, lotions, etc for her.
Now all the states have to have estate recovery in place. This is the MERP program. Upon her death, the state or its outside MERP contractor will send you or whomever is the point person on file with Medicaid for mailings, an "Intent to FIle a Claim (or Lien)" letter, which you have to respond to as to whether or not there is an estate, if probate is to be filed and if there are any exemptions, exclusions or hardships present to offset or set-aside MERP. Even it she has nothing, you need to fill out the questionnaire to essentially close her Medicaid file. If she has nothing, then nothing to get.
Ask the NH if mom's state does an annual renewal. If so, you will need to keep a binder going on all things mom to do the renewal, UNLESS the NH is doing this. Usually the POA needs to sign off on the Medicaid application and renewal as it needs to be someone legally able to do for her. Is the NH becoming her POA or guardian? if you are not going to be active in her stay or life, you might want to set this up to enable the NH to do for her. If in the future, you want to move her to another NH, you won't be able to as you have given NH guardianship.So think carefully on this as it's a big legal step.
For Pittas, the mom, Maryann - who was under 60 - entered a HCR (Healthcare and Retirement Corporation of America) owned facility (Liberty Nursing & Rehab) after an auto accident (two broken legs). She was at Liberty from Sept, 2007 – March, 2008 (6 months / 92K bill). She had medical on her auto insurance and then also applied for Medicaid & was “Medicaid Pending”. She was under 65 so no Medicare. In March, 2008 she left rehab - without settling her 92K bill - & moved to Greece to live with her husband. She did not provide the documentation to Medicaid required before she left the country. Now the son – upon being billed 92K for his mom’s care - took the situation to an arbitration hearing. (I bet arbitration was required to be done as per the admissions contract.) Now in arbitration, it was ruled in the son’s favor. He won but did not file for the arbitration to be binding. HCR wasn’t content with this and HCR appealed the arbitration ruling in son’s favor to a Pennsylvania trial court (judges only, no jury).
From WestLaw: “ As a result, on or about May 12, 2008, HCR instituted a filial support action against Appellant. Pursuant to 23 Pa.C.S.A. § 4603, entitled “Relatives' liability,” HCR sought to hold Appellant liable for the outstanding debt incurred as a result of his mother's treatment and care. The parties submitted the case to arbitration, whereupon a three-member arbitration panel found in favor of Appellant (the son). HCR appealed the arbitration award to trial court. The trial court held a three-day non-jury trial, after which it entered a verdict in favor of HCR in the amount of $92,943.41. Appellant filed post-trial motions, which the trial court denied on January 13, 2011.
In reading the transcripts, my thought is that he & his attorney did a piss poor job for the trial court. He did not substantial his bills; did not provide time line documentation; did not provide address for her in Greece or show attempt to contact her; did not join his father or his sisters to share the support-burden (if he had, his share would have been 23K, this is the biggest error). He did not seem to make an attempt at completing the details & documentation needed for mom’s Medicaid application; or pursuing litigation on the auto accident. HCR just had to show the trial court he had income and bills due. My guess is that he & his legal thought was that he did not have to do anything because he won in arbitration, that was a huge costly mistake.
Most NH bills are not going to be what Pittas was. There is going to be Medicare or other health insurance paying for things; the elder is going to have some $ to pay towards the bill; family is going to make an effort to pay something. If rehab is due to auto accident, your auto policy may pay for some of the costs & if not someone else’s auto insurance is gonna get sued. You are going to complete the Medicaid application. And momma is not going to leave the NH & take a flight to Greece!
BTW HCR was taken private in 2007 with The Carlyle Group ($ 185B in assets under management in 2013) as the majority owner. HCR name changed to HCR ManorCare & had $4B in annual revenues in 2008.
forbes/sites/northwesternmutual/2014/02/03/who-will-pay-for-moms-or-dads-nursing-home-bill-filial-support-laws-and-long-term-care/
Medicaid had rejected her application, and he was not forthcoming about where all her money went.