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Mom needs an atty to deal with her 2 situations: 40K transfer penalty and the absent but still legally married Husband. & as you are still her POA that means you need to find one & asap.

That she is going into a hospital for care is beyond great as those costs should be covered by Medicare and whatever she has for her secondary health insurance. You want her hospitalized on MediCARE for as long as feasible, as that pushes off her having to deal with filing for LTC Medicaid custodial care in a SNF or NH. Keep your ears open if it should be suggested that she moves out from being a “patient” in a hospital to becoming a “resident” in a skilled nursing care facility aka a NH. Patient in a hospital is MediCARE; resident is private pay, LTC insurance or Medicaid in a facility. You don’t want to trigger her filing for LTC Medicaid till there is a plan as per the new attorney as that 40K gifting will surface.

Im actually concerned abt the old husband…. If they are married, even though estranged:
1. his own financials & details on all property ownership will be needed for mom’s Medicaid filing. Medicaid is “at need” both medically and financially. What he has for income and assets will matter. I’m guessing he will not be at all willing to do this or will do major foot dragging to ever be responsive. Medicaid is very time sensitive so no response in 10-30 days, application closed for noncompliance. If he owns a home, as they are married, it will be subject to however y’all’s State does Medicaid estate recovery. Attorney needs to deal with this and legally segregate them.
AND
2. Hubs could himself file for a capture of some of her monthly income (her SS that goes into that bank account you have access to). They are still married, he is still a spouse. LTC Medicaid has a waiver that spouses can file for, it’s called CSRA or MMNA. Think of it as like old school alimony for the non-NH spouse. It’s $ the community spouse (CS in Medicaid speak) can file to have go to them to enable them to live in their community. Like if mom gets $1500 a mo SS and he can show he needs $1200 of that for his own living in the community costs, he gets $1200 and mom is left with $300 a mo at the most available as a required by Medicaid copay to the NH. NH will not exactly be thrilled to find that an originally anticipated $1500 copay from mom as a new resident is now going to be just $300.
To me, you want the attorney to decisively find a way to cleave off that old estranged hubs from being able to ever have any way or claim to your moms income. Otherwise he’s going to get involved every year when her SS payout changes. & mom will need his updated info every year for her own Medicaid LTC renewal. It will be beyond a buttrash to deal with him on this imo. Again atty need to deal,with this and decisively. Not a DIY.

Ya know “in theory” a NH that has Medicaid beds should not care what the applicants / new resident income & therefore their copay is. But that’s in-my-experience not what happens. My mom had 2 mo income’s and was right below the LTC Medicaid income maximum. NHs I looked at were positively giddy over moms income as it would mean a nice guaranteed $$$ copay. Their gonna be pissed to find they have to deal with a CS who can draw off $$$ every month from a residents income.
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SamTheManager Nov 2022
Don't you think this would qualify as abandonment? Like, the husband has been gone for so many years and they tried to get in touch with him to serve him papers and can't find him? They will likely need to make a good faith attempt to reach him, well documented and if they can't do that, they likely can have a divorce proceeding begin. It might go quite quickly if the entirety of the circumstances are made known to the relevant authorities. People can't be allowed to hold other people's lives up by moving away and not making contact for years and years.
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I want you to see an elder law attorney with these questions. Find one that you can pay an hourly fee for. You will likely not need more than an hour, but to go the wrong way on this could greatly harm your Mom, and perhaps even you. You need to explore making a contract for care, how to keep full records that can pass muster, and you need to explore being POA on accounts rather than melding assets which can cause all sorts of problems in future. There are some things that there is no substitute for. Legal questions need an attorney and medical questions often require a doctor. Do get help so that the "opinions" of others don't cause you to run into trouble in future. I surely do wish you good luck.
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I would consult a elder attorney for advice since she is still Legally married and he / she can help you with the medicaid process and documents . No you dont Have to Pick her up after her respite care - tell the case manager and social worker " That You are Unable to care for her 24/ 7 and that she needs round the clock care and you can Not provide that . That she is a Fall risk , wanders and physically overpowers you . " That is all you have to say . Get your Own Private social worker or therapist to help from this trauma . It sounds Like you have done More then enough . Once we are at that breaking point our Own health and sanity Must take priority . No you can't do it anymore and that is a very healthy response . Take care of yourself .
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Co-mingling Moms money with yours is a problem. SS should always be kept in a separate account. I think as payee its required. My nephew gets a Government annuity from his deceased mothers pension. As a Government employee, she never paid into SS. The annuity works just like SS, he gets raises every year. I am payee and that annuity has to be in an acct of its own.

Its not just the 40k you may have problems with, it will be hard for Medicaid to separate what is hers from yours. Medicaid requires 5 yrs of bank statements. If you had kept her money separate, her bank statement would show the money going in and out. So hope you have kept good records. And u can't pay yourself unless there was an agreement between u and Mom, written would have been the best thing.

If Medicaid questions the 40k there will be a penalty. There is a formula for how long. Either someone pays privately for the penalty period or you care for her during the penalty period.

You may have to take Mom back into your home. If that will be an impossibility, then you may have to allow the State to become Guardian. They will be able to work thru the red tape to get her placed. You will have no say in her care or where she is placed. You maybe able to request a place close by. They will do all the Medicaid work. Maybe requesting certain info from you.

I know, I really have made things look worse but this is how it may go. The reason why an elder lawyer is needed. I think under the circumstances, allowing the State to take over her care may be the best thing. Be aware, her SS will also go to the State to offset the cost of her care.

Its a shame there is not a book of do and don't for Caregivers. Most of what I wrote was learned from this forum. Because of this, I was able to go to Medicaid with information under my belt. I was so lucky that my Mom was a good record keeper. She had at least 5 yrs of bank statements in her file drawer. My Moms lawyer who wrote up her Will and POA told me to get her name off my nephews acct because Medicaid would look at it as hers, until I proved differently. She was 80 at the time. Medicaid was needed at 89.

I am so sorry you are going through all of this.
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ShannonEgen Nov 2022
Thank you for your honest reply. To clarify, her SS goes into an account with her name and mine each month, but I transfer it into another account from there. No other money besides her SS has ever gone into her account, so statements from that account will show only her own money. I have no problem giving up POA. I don't want this responsibility anymore. I don't want to be in any kind of legal trouble myself though. I do realize her SS will go to care regardless of circumstances. I never knew about ANY of these issues until about a year ago. I had no idea about any of it, the rules of Medicaid and that we had to have a care agreement, etc. I would have done things differently if I had known.
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Shannon, check into board and care homes.

My dad was in the donut hole of to much SS and not getting enough to pay for help or a facility. I was directed to board and care homes and he was able to self pay and have enough left over to pay some bills.

I would get them monthly numbers together for her SS and make a spread sheet showing her share of costs, personal expenses and the small amount left over to pay you for care. This should be done pronto.

Tge 40k only has 6 months to move out of the look back period, for your sanity, just try to do the best you can until then. That's what I would do.

Best of luck finding the best solution for this situation. It is so difficult finding out what we didn't know years ago and dealing with the fallout from that.

Great big warm hug! It will work out and you will be okay.
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ShannonEgen Nov 2022
Thank you so much for the encouragement. Yes, if I had known these things 5+ years ago, I would have done things differently. I had no idea we were doing anything wrong or that would be a problem now. It seems like we'll be stuck until June, unfortunately. I do have a consultation set up with an elder law attorney but the first one they had available is a month from now.
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Please find the funds to have a consultation with an Elder Care attorney on this matter, it's the only sane thing to do. If you place mom, you may have to pay out of pocket for her rent until Medicaid kicks in since she gifted you $40k 4.5 years ago. The attorney can guide you on your responsibilities to your mother since your state is a filial one. Also about you comingling her funds with yours and how to disentangle yourself from that situation.

Please don't mention feeling violent tendencies toward your mother bc such verbiage can work against you. We here understand and empathize with burn out and compassion fatigue, but not everyone does. Most people don't even understand dementia, never mind the toll it takes on the caregiver!

Ask the attorney about resigning your POA and having the state assume the care for your mother. See if it's legal to do that in Indiana. It's very important to get sound legal advice from a pro now rather than opinions from forum users on the internet. This is way too huge an issue to leave anything to chance....make sure you are armed with all the facts moving forward so you are fully protected.

I hope you can get mom placed at once, and that you'll be able to relax and take your own health and peace of mind back. Sending you a hug and a prayer for a good resolution to all of this chaos. My mother was 95 when she died in Feb from advanced dementia and heart issues. I know the horrible pain of all this, and she wasn't even living with me but in Memory Care Assisted Living. And it still tore me apart having to deal with her every day.
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ShannonEgen Nov 2022
Thank you for your response and advice. I know we'll need an attorney, there's just no way around it. There are only two certified elder law attorneys near us, so hopefully one of them will at least offer a free consultation or maybe a payment plan. I'm sorry for your loss of your mom and all you went through with her.
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Your post is heartbreaking. I’m truly sorry for your experience and can feel the absolute exhaustion. Yours is a real cautionary tale for so many who come to this site with wonderful intentions and ultimately find the reality of dementia caregiving to be far more than ever imaginable. I hope you’ll immediately tell the hospital social worker that you cannot and will not continue and to find mom a suitable new home, one where she’s safe and has professional care. And then I hope you’ll heal and find peace. You’ve been a blessing to your mother, now be one to yourself
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ShannonEgen Nov 2022
Thank you for the kind words and for understanding. It's not easy for me to admit my true feelings about all of this. I'm not proud of how I feel, but this is no longer safe for multiple reasons. My concern and confusion is surrounding the concept of just "dumping her at a hospital". Are there really no legal/criminal consequences for taking here there and then refusing to pick her up? I just find it hard to believe that I/we wouldn't be in some kind of trouble for that, especially knowing she can't get medicaid for another 6-8 months and that we've been spending (on her and as a "fee" for care/rent) her SS money. She has none saved up. I just feel like we're going to be liable for something somewhere. Am I wrong?
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You need to work with elder law Atty & start touring skilled nursing facilities nearby. They can help minimize the loss of $$$ to Medicaid & nursing home. Have her go to a facility of your choice after psych stay. I know from experience..my mother has been having nonstop talking/screaming for 24 hr straight…but at least she don’t walk/wander. The facility will put ankle bracelet on her. .hugs 🤗
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ShannonEgen Nov 2022
I'm sorry you're going through something similar. We can't afford an attorney. A consultation maybe, but not ongoing. What we're worried about is being financially responsible for her somehow. If she has a 6 month penalty period but needs care now, who pays? Her SS obviously won't cover it. How would this work? Can't we be accused of elder abuse/abandonment if we just refuse to bring her home from the psych hospital?
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What does the elder care attorney you consulted back in January say you should do?

Consider resigning your POA and turning her care over to the State of Indiana.

Indiana is a filial obligation state, but I don’t see states bring those laws to bear except in situations where the adult child is flush with funds.

I think you should be speaking with the discharge planners at the psych hospital about "unsafe discharge" and where she should reside next.
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ShannonEgen Nov 2022
I never consulted one. We can't afford it but make too much to qualify for free legal help. We definitely don't have a lot of money, in fact, we're check to check and considering filing bankruptcy. If we say that it would be an unsafe discharge, do we have to prove that in some way, and if so, how? It's not considered abandonment?
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ShannonEgen, welcome to the forum. The answer is "yes", you can refuse to bring home your Mom from the hospital.

Find the Hospital Social Worker and explain that you can no longer care for your Mom. This is not uncommon to refuse. The Discharge Coordinator might try to convince you to bring Mom home, but stand your ground.

Other writers on this forum will give you more information and their experiences.
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ShannonEgen Nov 2022
Thank you for your quick response. I'm wondering though, where does the money for placement come from if Medicaid has a penalty period? How do we get around that? She gifted me $40k 4 1/2 years ago. She has no other assets. I meant to mention that in my post. No car, no savings, no pension, zero.
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