Have an appeal hearing coming up over penalties. I have nothing more to give them so I can't see how an appeal is going to change anything. What happens then - do NH's just evict them? My dad is completely dependent for everything and in a wheelchair. I have stairs here and no one to help me lift/bathe/change. He also requires sedation some evenings because of aggressive behavior. That's what prevented me from moving into his house full time - he sometimes thought I was a partner and if I didnt respond as one to advances, he would get ugly.
You need a letter from the medical director @ the NH as to dad's status and that he needs 24/7 care or death will happen to take to the hearing.
You need to show some fiduciary duty too…..like that you have done whatever to have dad pay in a timely manner his co-pay (or his SOC - share of cost in Medicaid speak) to the NH from him SS & retirement income. Also do a sheet showing how you pay for his extras ( those $ 100 items you mentioned) & again in a a timely manner. Take some photos of dad & seriously he needs to look pitiful in the shots. Waivers on transfer penalties are done, there's a couple on this site in the past who have gotten them but you need someone to be your ally in the presentation as you are just going to be too emotional and flustered. You want to look presentable at the hearing but nothing expensive and sensible flat shoes and no dangling or moving jewelry (think Penny's rather than Macy's)
You know ward of the state situations sometimes are for the best - the court appointed guardian doesn't want family to be out of their life (unless there was abuse) but family need to realize that the guardian is in charge. Often court appointed is done because family cannot due to their own medical issues or due to military deployment. And if the situation can change, then sometimes the guardian will ask the court for a review & release of their status so the elder goes back to family oversight. If you can show PTSD or whatever else of your own medical situation & your spouses death so it's bolsters your case that what happened was not for your gain but just done in overwhelming panic.
About the payment rate, if you want dad to stay in this NH & it seems that this NH really likes dad (like his care plan is easy for them to accomplish), they often will negotiate down what is due to be what Medicaid would reimburse them with a smallish surcharge. Also I'd look to see IF dad could qualify for hospice - hospice is paid for by Medicare and although it does not pay for their room & board costs at the NH, it does provide for extra nursing staff to come in and provide care for dad. This can be a huge plus for the NH as it takes all the care responsibility off of their staff and shared now with hospice. My mom was on hospice for 18 months and really the hospice staff (3 X a week for an aide & RN once a week) worked well with NH staff…mom was never clearer or had better care of her bedding due to hospice being there to help out. Plus hospice provided for a specialized mattress and gerichair & geribathing chair, which made it easier for all to care for her.
About the "not very nice places", the guardian can often get things done in short order & faster than family ever would. If the guardian has other clients at the facility, they are going to do whatever to keep the guardian (and not have a report sent to the state as to delinquencies) happy so the elder benefits. You could find that dad being a ward, gives you the opportunity to spend time with dad but without worry about how things are being paid or reported. Good luck & try to keep an even keel.
Often the copay comes as a total unexpected to family. If the elder has monthly expenses (mortgage, house ownership costs, insurance premiums, CC debt, etc) someone in the family has to pay for all if they want to keep whatever going. This is kinda why it's so very important to do a spend-down where it does the best long view good for the elder. Like paying for dental work or burial policy is better than paying off a CC. If they have a mortgage (horrors!) all this is especially sticky as there is no $ to pay mortgage and if property doesn't sell immediately, it goes into foreclosure. But whatever their situation, copay has to be paid to facility.
When I started with the elder care lawyer, I couldn't think (stress, exhaustion make my ADD horrible since the brain surgery). When I first saw him I said not interested in asset preservation, he's head spun. I was adamant that I didn't need anything else - my dad helped me enough to get us to that point - his response was "well let's dont be dying on any swords here". That's what they do, I get it but my only concern was getting my dad's medicaid approved. When my sister was still involved, she discussed with me getting the house put in my name. Making the house my permanent address so a clock would start running by the time anything happened to him. She said as long as I lived there 2 years we would get around capital gains taxes. I did that in April 2011 (which it turns out, IL didnt officially implement the Fed rules until Jan 2012 - the one thing I did get from the lawyer). I had a quick claim deed signed and notarized 4/11. After I realized my sister wasn't going to lift a finger, I never filed it and tore it up in 2013. I would never have cut her out completely, because it wasn't my money but I sure didn't have to do a thing so that she could get hers any sooner. I would have let the State have it before her. What I learned about the rules, is if I HAD done it then before the rules changed - I'd be sitting on the house with no problems. The penalty back then started running from the time of the transfer. After Jan 2012, the penalty didn't start running until the time of application. The ONLY regret I have about the house is I didn't have it together emotional to make it presentable for sale and let the attorney rush thru an auction "as is". It was paid for. It sold for about $40,000. The buy put in another $10,000 updates and sold it for 90. I hate that if I had enough energy to do that - I could have given the nursing home more. I just didn't understand pennying everything to death - like out of that $8000 - he instructed me to pay a full month and then gave me a number of days for the other. I just paid the whole thing, it was senseless not to - no matter what - let it apply to the balance.
We bought a transport chair for his car so that I could take him to an osteo dr and follow up oncology appts. I can't get him or that thing in and out of my car. Other than that - the NH provides him a chair. I pay for his monthly supplies approx $100/mo. We bought some clothes, not many out of the house proceeds, but going forward I have no problem supplying whatever he needs. The car is over the value of allowable so I'm selling it - what comes with that is I'm withdrawing any follow up appts of any kinds - it's the only way you're allowed to keep the car. That was a hard decision to make - He had cancer surg at the start of this and now I'm just discontinuing - I can't get him in and out of my car. I guess the osteo doc is not necessary since he's in a chair - he had almost no cartilage left in his knees and the doc was shocked he was still walking. I didn't realize just how much I was "propping" my dad up in a lot of way so when he went into the NH and I was no longer doing for him - I was shocked at his dependency and it tears me up.
what would I do without my condo - I would rent a small apt somewhere. I want to do that anyway - the plan for this place was to be here for when my husband needed AL - he didn't make it thru that plan. I KNOW it would be good for me to get out of here but I've been too depressed just to pack it all up and not just pitch it all. Seeing that place across the street is just a reminder.
Nobody has ever said anything to me about a co-pay and I don't see on the bills that there is any other monies being applied to his care. We have a balance of about $49,000 over 2 years now.
I'm not sure what I'm going to do if they start shuffling him around esp if it's not somewhere I can get to him easily. He's about 15 mins away from me now. I get sick every time I go to my mailbox. When they finally gave me some determination, that they wouldn't pay until 11/2016. Initially I started think - okay, I can take out all of my living room furniture and put in a hospital bed, etc. Just drove my nuts trying to figure out a way I could it - feeling like I can't was a blow. It doesn't happen often but aside from the problem with bathing/toileting him - sometimes he acts aggressively and they sedate him. That would be impossible for me. The doctors just keep giving me pills. They're watching me pretty closely right now - I didn't do it purposely but drank on top of some of the meds - pretty heavily. Ended up an hour away from here in freezing weather in my pj's, no shoes and no coat. Fortunately to a friend I trust. Been there a ton of times, and glad the neighbors knew me because I knocked on the wrong door initially. Didn't know that or that I was even there until I woke up the next day. My friend said I passed out sitting on his toilet and when he got me up - he said I just cried for an hour before I went back to sleep. Lucky I didn't kill anybody getting there and that realization knocked some sense into me. Every rejection/denial/setback just gets worse because it's just been SO damn long since I had a life when I didn't wake up with some concern or another over my dad. I haven't restarted living my own life and just having trouble getting started.
We had a lot of unusual problems - like a stalker lady. She's lucky to be alive. Crazy woman even got in my dad's house 5 days after he was in the NH. The upside for me, probably the saving grace, I gave my dad's last couple years some joy. I hate seeing someone so brilliant as he was so gone. He would literally eat glue if you put it in front of him. At the Thanksgiving dinner they had sprinkled silk leaves on the table - he tried eating them. I haven't learned how to "step away" from it. Thanks for listening.
except, get it, you bought the chair - and then beyond that you still have the house proceeds money - that you're using to pay the $100/mo. supplies bill - not out of your money, like I somehow thought and not out of his personal allowance money he's allowed to keep for that purpose? so you're trying now to provide for his needs out of the house allowance money - after - you've applied to Medicaid - and put him in the nh? - yea, hm....not sure I understand about the car - you could keep it to take him to appts.? but you're selling it to put on the nursing home bill? or you were in order to keep the money that you're now being told you can't keep anyway? so then why go ahead and sell the car, especially if that means you can't get him to his appts. and especially if that means he can't get there at all - will they transport him? or at least call an ambulance?
and you're not saying you'd give the nh what you made off selling your condo, are you?
are the bills not showing his income - I'm sure he "is" getting at least SS, right? - being applied to the nh? if not, I'd sure check into that
and as far as being shuffled my friend was concerned about that as well - they had some issues with her mom and they ended up sending her about a couple hours away but it was only temporarily and happened to be right when she was going that way anyway so that worked but then when time for her to be discharged from there it had been long enough (which isn't long, is it) that they didn't have a place to take her back where she'd been so were going to have to place her a hour away but she asked for just a little more time and something happened that she was able to get her back but, yes, I do understand, that, I guess, is the bad part of all this, isn't it..she's got her mom about that close, too. But sounds like in your case it might not be a bad idea for them to move him about an hour away, say, close to your friends, and you sell your condo to get away from your dad's house that's not his anymore and he's not there and move there as well - that sound like a plan? But, yes, Emerald, I can certainly understand what you're actually going through with your dad - it liked to have killed me seeing mine like that - honestly, I wish, in many ways, he hadn't even had his last couple years - what exactly are you saying you're discontinuing regarding your dad's cancer?
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