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We need to find placement that will accept Medicaid after a few months of private pay. He has moderate Alzheimer's. He lives with his 97 year old girlfriend. He has been quite disturbed when she was in rehab for 6 weeks.
Don’t expect calm and rational decisions from your dad. His dementia means it’s time to make the best choices for him. I hope you or someone else close has POA for medical and financial decisions. You’ll have to find an appropriate place for him and let him know not far ahead of time of the move. I wish you both peace
Depending on the severity of his dementia, that will determine when you should talk to him and at what level.
Lives with his 97 yo gf? Wow. Is the house his or hers? Not your problem, but, wondering what will happen to her when he leaves? Are you going to reach out to her family to give them a heads up? Complicated.....
Any idea if any, and I mean any, of their finances are at all commingled? OR If each of their individual mo income is needed to keep their household afloat? AND for payments on where they live, are either paying on debts or monthly bills in the others name…. Like water bill in her name but he pays it or gives her $ to pay the bill. AND Do they or have they presented themselves as married? So they might actually be common law?
Personally I’d suggest that you like ASAP start to go through his finances to see what it looks like for commingling and transfers. And start documentation on what was done going back to if you can to 2016. At 97 he’s is likely to be a LTC Medicaid application and it will want 5 full years of lookback on his financials. Any commingled or transfers can be considered gifting and rationale for ineligibility by Medicaid. Your going to have to unthread all this to show that it’s not & in detail. The sooner you start the easier to get beyond this. If she too has dementia then your going to need to work w her family / POA to get access to her finances as well. You can get thru this but start early and keep yourself organized to keep your sanity & your stress lower.
Also since this is related to his recent calling you almost every nite asking about “his papers”, something is triggering this. Just spitballing here…. but I wouldn’t be surprised if the gfs 6 weeks in rehab is now causing bills & phone calls for payment & OR someone is asking for information as to his role in the households finances OR his financial responsibility to her as the gf needs $ to pay the balance due &/or she is having Medicaid applied for & Medicaid is asking for paperwork & she too has dementia…
if all this rehab / LTC Medicaid maze is new to you, this site has a ton of articles as to what’s what and more importantly what’s not!
fwiw if gf went into a NH for rehab and it was after a hospitalization, that 6 week rehab stay was a MediCARE paid benefit at 100% for 20/21 days (abt 3 weeks). MediCARE not MedicAID. But should she show she needed to stay in MediCARE rehab past the initial 100% MediCARE days she can & up to 100 days but at 80% MediCARE with 20% copay balance. If it’s 3 weeks that’s (I think) abt 5k owed if she is on original Medicare with Part B. If she has a better secondary health insurance for Part B to her Original Medicare (like BCBS), they usually pay the 20% entirely otherwise it’s ends up private pay. The NH seem not to get all huffy on folks in rehab in the copay stage as the MediCARE rehab benefit pays way more $$$ - like 2x - 4x - what MedicAID LTC pays for daily room&board as a resident. (NH is making bank from Medicare rehab). But what NH tend to do if it’s looking like there’s no for sure insurer paying or if the person could end up staying at the NH (go from rehab patient to long term care resident) is to proactively file for Medicaid for the person. Often the elder does not at all understand wtf is going on so agrees to the Medicaid filing. If any of this happened, there will be letters & invoices from NH, Medicaid sent to her home address. Plus Statements from CMS that detail what services they (MediCARE) paid for & what her as the “insured” is responsible for. I’d suggest that you go over for a visit and get your detective hat on to find paperwork & take it all to a Fed Ex Office type of place and xerox all. It may be that dad is feeling he has to pay this bills and hence his need for “papers”.
if she was on a MediCARE Advantage plan, well those are kinda notorious for not paying very well for rehab as Advantage plans require the providers / vendors to be “in network” and it’s usually only docs & services affiliated with the big hospital & it’s clinics. So that NH will be totally out of network, won’t be 5K but way way more $ she owes.
Also did dad pick her up from the rehab? If so there was discharge & other paperwork to sign her out. I’d try to find that. You want to look to see if He may have without realizing it signed off for financial responsibility for her as he took her home. Once you get a better idea of what’s happening with their finances, you kinda imo want to approach her family as to the next steps for both of them. If their $ & assets has been commingled in anyway, it’s gonna need to be unthreaded in order for either of them to become eligible for Medicaid. Good luck.
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.
Lives with his 97 yo gf? Wow. Is the house his or hers? Not your problem, but, wondering what will happen to her when he leaves? Are you going to reach out to her family to give them a heads up? Complicated.....
OR
If each of their individual mo income is needed to keep their household afloat?
AND
for payments on where they live, are either paying on debts or monthly bills in the others name…. Like water bill in her name but he pays it or gives her $ to pay the bill.
AND
Do they or have they presented themselves as married? So they might actually be common law?
Personally I’d suggest that you like ASAP start to go through his finances to see what it looks like for commingling and transfers. And start documentation on what was done going back to if you can to 2016. At 97 he’s is likely to be a LTC Medicaid application and it will want 5 full years of lookback on his financials. Any commingled or transfers can be considered gifting and rationale for ineligibility by Medicaid. Your going to have to unthread all this to show that it’s not & in detail. The sooner you start the easier to get beyond this. If she too has dementia then your going to need to work w her family / POA to get access to her finances as well. You can get thru this but start early and keep yourself organized to keep your sanity & your stress lower.
Just spitballing here…. but I wouldn’t be surprised if the gfs 6 weeks in rehab is now causing bills & phone calls for payment & OR someone is asking for information as to his role in the households finances OR his financial responsibility to her as the gf needs $ to pay the balance due &/or she is having Medicaid applied for & Medicaid is asking for paperwork & she too has dementia…
if all this rehab / LTC Medicaid maze is new to you, this site has a ton of articles as to what’s what and more importantly what’s not!
fwiw if gf went into a NH for rehab and it was after a hospitalization, that 6 week rehab stay was a MediCARE paid benefit at 100% for 20/21 days (abt 3 weeks). MediCARE not MedicAID. But should she show she needed to stay in MediCARE rehab past the initial 100% MediCARE days she can & up to 100 days but at 80% MediCARE with 20% copay balance. If it’s 3 weeks that’s (I think) abt 5k owed if she is on original Medicare with Part B. If she has a better secondary health insurance for Part B to her Original Medicare (like BCBS), they usually pay the 20% entirely otherwise it’s ends up private pay. The NH seem not to get all huffy on folks in rehab in the copay stage as the MediCARE rehab benefit pays way more $$$ - like 2x - 4x - what MedicAID LTC pays for daily room&board as a resident. (NH is making bank from Medicare rehab). But what NH tend to do if it’s looking like there’s no for sure insurer paying or if the person could end up staying at the NH (go from rehab patient to long term care resident) is to proactively file for Medicaid for the person. Often the elder does not at all understand wtf is going on so agrees to the Medicaid filing. If any of this happened, there will be letters & invoices from NH, Medicaid sent to her home address. Plus Statements from CMS that detail what services they (MediCARE) paid for & what her as the “insured” is responsible for. I’d suggest that you go over for a visit and get your detective hat on to find paperwork & take it all to a Fed Ex Office type of place and xerox all. It may be that dad is feeling he has to pay this bills and hence his need for “papers”.
if she was on a MediCARE Advantage plan, well those are kinda notorious for not paying very well for rehab as Advantage plans require the providers / vendors to be “in network” and it’s usually only docs & services affiliated with the big hospital & it’s clinics. So that NH will be totally out of network, won’t be 5K but way way more $ she owes.
Also did dad pick her up from the rehab? If so there was discharge & other paperwork to sign her out. I’d try to find that. You want to look to see if He may have without realizing it signed off for financial responsibility for her as he took her home. Once you get a better idea of what’s happening with their finances, you kinda imo want to approach her family as to the next steps for both of them. If their $ & assets has been commingled in anyway, it’s gonna need to be unthreaded in order for either of them to become eligible for Medicaid. Good luck.