They are ages 89 and 90. They have paid 7 years on a 20 year Mortgage. One has Alzheimer's the other heart disease. Their health needs are at the point where they need to move to a nursing home or assisted living facility. What steps need to be taken to do this ? Grandson is only living relative and also needs POA, along with what else to help out ?
An estate planner and/or Medicaid-competent elder law attorney would be the best bet for this family to find out what their best options really are. Grammy, assisted living and skilled nursing are two very different things, particularly from a Medicaid point of view. You need some assessment of their level of care needs to help determine what will be possible, and how they can stay together presuming that is desired. Some facilities will do this for you before anyone commits to a move there, or there may be a geriatric evaluation with social service help available in your community. Area Agency on Aging or something with a hospital with a comprehensive program would be possible resources.
In reply to this above,
Sure as long as theres Millions of dollars of assets to play with.But,the money that is being used to pay the house payments could be going to healthcare.If your elderly would ever apply or need Medicaid?The POA will be asked with wonders why all those house payments was made while they was in the nurcing home.Not only the nurcing home will be asking why?So will Medicaid.The POA maybe required to pay all of that back in the end.Same example,why pay the house Phone bill or house Cable bill if their in a nurcing home?Why pay the electric bill or gas bill when by rights the home should be winterized .
To help answer your questions with the best truth with advice I will say this,
You explained above that the grandson in the only family member willing to to help.
Because,the American Dream is gone.The grandson will be force by the nurcing home to sell their home,car,life policies as we call assets.Every asset must be sold.In order for this to happen requires "Guardenship".Also,requires to spend thier funds down to nothing.If the grandson don't spend the money down?The nurcing home will.Tell the grandson to start repairing the home for resale using their assets to do so.If the elderly's are Millionairs?They have no worries.If not?They will be forced to spend their assets in order to apply for Medicaid.In other words,I hope the family had a Will/Trust created 5 yrs ago.With that 5 yrs expired I see no issues saving their assets to go to the family .Medicaid goes back 5 yrs so don't try to gift any money to a family member or friend.The nurcing home and Medicaid will drain their assets to a prun.They don't just go after the home,accounts.They also,go after the items in the home.Requires a assement of their belongings in the home.A forced auction is required to sell everything they ever owned in life.Sad it is to see their life savings to be sold.Also,sad to see how much nurcing home take and still able to sleep at nite lol.
A assisted living facility is the best idea because,their not with Medicaid but will require full pay out of pocket cost.If they was a Vet.VA pays $1,100 for assisted living.VA only pays $80 for nurcing homes.Remember,Medcare only pays up to 80 days.After 21 days it goes 80/20.After 80 is full pay.Rare to see a nurcing home let a elderly max out their 80 days.Avoid nurcing homes to avoid Medicaid.
One more thing,
If you rent the house out the nurcing home can't touch it.Because,that is income as the house is making money .Avoid becoming a POA and Avoid nurcing homes at all cost unless you want to see the elderly drained fast.Good luck.
Sec. 1917. [42 U.S.C. 1396p] (a)(1)
B) in the case of a lien on an individual’s home under subsection (a)(1)(B), when—
(i) no sibling of the individual (who was residing in the individual’s home for a period of at least one year immediately before the date of the individual’s admission to the medical institution), and
(ii) no son or daughter of the individual (who was residing in the individual’s home for a period of at least two years immediately before the date of the individual’s admission to the medical institution, and who establishes to the satisfaction of the State that he or she provided care to such individual which permitted such individual to reside at home rather than in an institution),
is lawfully residing in such home who has lawfully resided in such home on a continuous basis since the date of the individual’s admission to the medical institution.
§ 32.1-327. Claim against indigent's estate for payments made.