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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.
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When our health care system became for profit...by heavens, the investor class demanded money regardless of the harm inflicted! Capitalism is a lousy way to deliver health care. Over the last 40 years the investor class (top 10%) has devised more and more ways (thru their wholy owned subsiderary ... the government) to strip the accumulated wealth from the middle and lower classes. And...even better...convinced voters that "yeah! Hey..you don't get any help till all your life long savings has been transferred into the pockets of the top 10%... even though taxes are no longer paid fairly by everyone...so.... Geez we have to keep those poor 10% at the top from paying for any of this!" Tax burden on 1960 was fairly shoulder by everyone, now...even the middle class is calling for the family blood ... to make up for the top 10% getting wealthier and wealthier. Who do you think owns all that stock in healthcare aproviders and service? Not you and me! How did they ever convince everyone that families have to be impoverished? But..yeah..let's all keep paying them more and more because hey..they need it..right? Hey, for profit healthcare is making the top richer every year...and everyone else...........
A transfer penalty is placed that although they are approved for Medicaid as they are now poor, they are ineligible for Medicaid to pay till the penalty period of time has passed. The penalty starts on the day of the Medicaid application and not the date of the transfer(s).
It's all a math problem. The likely scenario is that when the NH Medicaid application and the supporting documentation is turned in, the caseworker assigned will enter the awards letters #'s (their income) in and then look to see their living situation for prior 5 years. So if they still have their home or are in IL or AL, then realistically they should have funds gone. There's probably a whole algorithm with variables that is used. But if they have been living with family with no legally done caregiver & or rental agreements and are down to $ 1,200 well in the words of the handsome & talented Ricky Richardo… Lucy you have some splaining to do. Say mom got $2K a mo income (from SS & retirement) and lived with her son. That's 120K in income plus a quick scan of real property records shows mom sold her home for $ 235K in 2013. So where did 355K go? There was gifting and it's gonna show up. Lets say it's 250k...
The math problem has a "Diversion Penalty Divisor". Each state manages its Medicaid program uniquely but within an overall federal guideline. So each state will have a set amount that it pays the NH for daily room & board. Like for my mom in 2015 it was around $ 158 a day, this is the DPD. So 250K gifting in a state that pays $ 58 r&B is 1,582 days of ineligibility. That over 4 years.
Now mom is already in a NH when the ineligibility notice comes down. The NH gets the notice too. Family have stark choices: private pay for all the time she has been there and going forward OR move her back home. OR if family ignores all this, the NH will ask the court to place mom as an emergency ward of the state & it will be done. Court appointed guardian now determines all, pays the NH from mom's income & assets and can move her to another facility. That NH bill is still there and they will turn it over to collections.
Waivers can be done but imo you will need to hire an atty to shepherd the appeal and negotiate with the NH and the state. If a family member stole from the elder, you'd need to have a police report done. If they had dementia and didn't know what they were doing, you'd need supporting documentation on this. If they gave money to their church, it could get a waiver. In the application, it's pretty upfront about penalties. The DPOA has a required fiduciary duty to the elder and they could be held responsible.
Really applying for Medicaid means the state has an all-access pass to their entire financial life.
They are not exactly "denied" Medicaid. Rather there is a penalty period during which they are not eligible for the program. The length of the period depends on how much they gave away. They will have to come up with a way to self-pay for the nursing home until the period is up.
If the money was given to family or close friends, they may decide to give money back for the purpose of paying for that penalty payment. However, this is no requirement that they do so.
This is a common situation here. Unscrupulous children or grandchildren talk the elder out of money, and then the responsible person finds out that the gifts disqualify the elder from Medicaid eligibility.
And then it's all on the responsible person. So the elder usually ends up living with the responsible person. I'm sure it is very unlikely that the unscrupulous ones ever pay back the money.
Medicaid is available only to people who are financially eligible. To prevent people from scamming the system and giving their money to family members so they are suddenly eligible Medicaid came up with rules about gifting. If you had enough money to care for yourself and you gave it away, don't come to us expecting tax money.
Well, all right. But in the case you describe, KatieKate, grandma was not trying to scam the system. She was just behaving as a loving grandmother, expecting to get the money back. She did not foresee the accident that would prevent grandchild from paying her back.
And in the case of my support group person, the loved one wasn't trying to scam the system, but was irrationally giving away money to charities because of her dementia.
I understand why Medicaid has the rules, but, gosh, they sure to present a hardship to lots of people who were not trying to cheat.
ok...which is it? Does the elder need to be somewhere else during the penalty period? Or... does the elder need to be in a NH racking up debt during the penality period?
So..just say grandma helped grandson pay for education in Germany. Grandson had an unfortunate accident. Now, grandma needs to be in NH.. let us say, the amount of money was equal to one year in the NH...
Does grandma stay with grandsons parents (her son and daughter in law...or someone else) for the penality period (one year) ...or does grandma go into the NH and rack up a year of debt till medicaid takes over? OR, does grandma just live on the street for the remainder of her days? There isn't any other answer. That money is not coming back.
The thing is that so much can change in 5 years. My dad went from traveling, to needing NH because of AD in 5 years. My mom went from using her walker to visit with family at a wedding reception, to being in a wheelchair fulltime at a NH in 5 years. Neither ever expected to need every cent of their assets for care, and I can see them giving money to the grandkids for education (had they had the financial resources to do so). So it has to be a terrible situation when their generosity comes back on them (and ultimately their adult children).
That's at least partly because there has been a significant change in the definitions of poverty.
If you get sidetracked into believing that societal problems are the fault of fat cats pocketing everybody's money and going tee hee hee about it you ignore much more substantial issues: namely, how the expectations for individuals are going to be met by a society's resources, taken as a whole. For decades western governments have been doing it with smoke and mirrors - borrowing money so that they can pretend to their electorates that they can have all of the desiderata without being obliged to pay for them. Eventually, as one charmingly tactful economist I heard put it: "these guarantees cease to be credible."
So now, a member of our affluent societies is encouraged to expect: good primary, secondary and tertiary education fulfilling, well-paid employment stable prices home ownership or protected tenancy employment rights protecting a healthy work-life balance affordable comprehensive health care a guaranteed minimum standard of living regardless of means or ability to pay for it protected access to key utilities including clean water and heating/air conditioning general living standards rising from generation to generation indefinitely a long and enjoyable retirement the right to accumulate and bequeath wealth high quality health and social care throughout a lengthy old age.
And that's not even counting expensive stuff like national and civic security, or consumer safeguards in the finance industry, or energy and environmental policy.
These are all fine aspirations for a prosperous society with continuously improving productivity (which in our case, both sides of the Atlantic, we have not got). But expectations? Not until we can balance the books, which we can't, not even if the fat cats are hung upside in public and shaken until the money falls out of their pockets. We are in much deeper trouble than that would solve.
We have borrowed too much for too long. It is the end of the line of credit. Time to decide which really are the essentials of civilisation, and which are luxuries we would do better without.
By the way, that's not necessarily a bad thing. It won't do us any harm to have our minds concentrated on what really matters.
Once you turn 65 you had better consider all your assets as eligible for forfeiture to Medicaid. Do not spend a penny on a birthday present or helping a family member. All your assets belong to the 10% investor class. If you fail to keep all your assets to pay for outrageous inflated healthcare prices (inflated beyond anything reasonable)....well...you could be on the street if you ever need anything back from society. That same society you worked your whole life and played by the rules..paid your taxes. Healthcare is not an entitlement..it is a basic human right. And, in the end..must surrender it all to the greed of the investors in healthcare.
Healthcare is NOT and entitlement! It is A basic human right. I think far too many people got snookered into believing that "those people"...(you know the welfare queens) were taking all the benefits and we were all paying. Turns out the vast majority of "those people" are ordinary people like us and our parents.....middle class.
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.
Over the last 40 years the investor class (top 10%) has devised more and more ways (thru their wholy owned subsiderary ... the government) to strip the accumulated wealth from the middle and lower classes.
And...even better...convinced voters that "yeah! Hey..you don't get any help till all your life long savings has been transferred into the pockets of the top 10%... even though taxes are no longer paid fairly by everyone...so.... Geez we have to keep those poor 10% at the top from paying for any of this!" Tax burden on 1960 was fairly shoulder by everyone, now...even the middle class is calling for the family blood ... to make up for the top 10% getting wealthier and wealthier. Who do you think owns all that stock in healthcare aproviders and service? Not you and me! How did they ever convince everyone that families have to be impoverished? But..yeah..let's all keep paying them more and more because hey..they need it..right? Hey, for profit healthcare is making the top richer every year...and everyone else...........
Ok...got that out of my system.
It's all a math problem. The likely scenario is that when the NH Medicaid application and the supporting documentation is turned in, the caseworker assigned will enter the awards letters #'s (their income) in and then look to see their living situation for prior 5 years. So if they still have their home or are in IL or AL, then realistically they should have funds gone. There's probably a whole algorithm with variables that is used. But if they have been living with family with no legally done caregiver & or rental agreements and are down to $ 1,200 well in the words of the handsome & talented Ricky Richardo… Lucy you have some splaining to do. Say mom got $2K a mo income (from SS & retirement) and lived with her son. That's 120K in income plus a quick scan of real property records shows mom sold her home for $ 235K in 2013. So where did 355K go? There was gifting and it's gonna show up. Lets say it's 250k...
The math problem has a "Diversion Penalty Divisor". Each state manages its Medicaid program uniquely but within an overall federal guideline. So each state will have a set amount that it pays the NH for daily room & board. Like for my mom in 2015 it was around $ 158 a day, this is the DPD.
So 250K gifting in a state that pays $ 58 r&B is 1,582 days of ineligibility. That over 4 years.
Now mom is already in a NH when the ineligibility notice comes down. The NH gets the notice too. Family have stark choices: private pay for all the time she has been there and going forward OR move her back home. OR if family ignores all this, the NH will ask the court to place mom as an emergency ward of the state & it will be done. Court appointed guardian now determines all, pays the NH from mom's income & assets and can move her to another facility. That NH bill is still there and they will turn it over to collections.
Waivers can be done but imo you will need to hire an atty to shepherd the appeal and negotiate with the NH and the state. If a family member stole from the elder, you'd need to have a police report done. If they had dementia and didn't know what they were doing, you'd need supporting documentation on this. If they gave money to their church, it could get a waiver. In the application, it's pretty upfront about penalties. The DPOA has a required fiduciary duty to the elder and they could be held responsible.
Really applying for Medicaid means the state has an all-access pass to their entire financial life.
If the money was given to family or close friends, they may decide to give money back for the purpose of paying for that penalty payment. However, this is no requirement that they do so.
And then it's all on the responsible person. So the elder usually ends up living with the responsible person. I'm sure it is very unlikely that the unscrupulous ones ever pay back the money.
So unfair!
Well, all right. But in the case you describe, KatieKate, grandma was not trying to scam the system. She was just behaving as a loving grandmother, expecting to get the money back. She did not foresee the accident that would prevent grandchild from paying her back.
And in the case of my support group person, the loved one wasn't trying to scam the system, but was irrationally giving away money to charities because of her dementia.
I understand why Medicaid has the rules, but, gosh, they sure to present a hardship to lots of people who were not trying to cheat.
So..just say grandma helped grandson pay for education in Germany. Grandson had an unfortunate accident. Now, grandma needs to be in NH.. let us say, the amount of money was equal to one year in the NH...
Does grandma stay with grandsons parents (her son and daughter in law...or someone else) for the penality period (one year) ...or does grandma go into the NH and rack up a year of debt till medicaid takes over? OR, does grandma just live on the street for the remainder of her days? There isn't any other answer. That money is not coming back.
Is there an expert here that can enlighten us?
If you get sidetracked into believing that societal problems are the fault of fat cats pocketing everybody's money and going tee hee hee about it you ignore much more substantial issues: namely, how the expectations for individuals are going to be met by a society's resources, taken as a whole. For decades western governments have been doing it with smoke and mirrors - borrowing money so that they can pretend to their electorates that they can have all of the desiderata without being obliged to pay for them. Eventually, as one charmingly tactful economist I heard put it: "these guarantees cease to be credible."
So now, a member of our affluent societies is encouraged to expect:
good primary, secondary and tertiary education
fulfilling, well-paid employment
stable prices
home ownership or protected tenancy
employment rights protecting a healthy work-life balance
affordable comprehensive health care
a guaranteed minimum standard of living regardless of means or ability to pay for it
protected access to key utilities including clean water and heating/air conditioning
general living standards rising from generation to generation indefinitely
a long and enjoyable retirement
the right to accumulate and bequeath wealth
high quality health and social care throughout a lengthy old age.
And that's not even counting expensive stuff like national and civic security, or consumer safeguards in the finance industry, or energy and environmental policy.
These are all fine aspirations for a prosperous society with continuously improving productivity (which in our case, both sides of the Atlantic, we have not got). But expectations? Not until we can balance the books, which we can't, not even if the fat cats are hung upside in public and shaken until the money falls out of their pockets. We are in much deeper trouble than that would solve.
We have borrowed too much for too long. It is the end of the line of credit. Time to decide which really are the essentials of civilisation, and which are luxuries we would do better without.
By the way, that's not necessarily a bad thing. It won't do us any harm to have our minds concentrated on what really matters.
Once you turn 65 you had better consider all your assets as eligible for forfeiture to Medicaid. Do not spend a penny on a birthday present or helping a family member. All your assets belong to the 10% investor class. If you fail to keep all your assets to pay for outrageous inflated healthcare prices (inflated beyond anything reasonable)....well...you could be on the street if you ever need anything back from society. That same society you worked your whole life and played by the rules..paid your taxes. Healthcare is not an entitlement..it is a basic human right. And, in the end..must surrender it all to the greed of the investors in healthcare.
Healthcare is NOT and entitlement! It is A basic human right. I think far too many people got snookered into believing that "those people"...(you know the welfare queens) were taking all the benefits and we were all paying. Turns out the vast majority of "those people" are ordinary people like us and our parents.....middle class.
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