My mother was in Assisted Living for 3-1/2 years, self pay. She became quite ill and needed to move to the nursing facility. She has depleted her funds. Any suggestions?

I don't think she can collect aid and attendance from VA and also qualify for Medicaid. Someone that knows more than me will come along.

We are preparing to set up a Millers Trust for my Mother in Law. She also receives VA benefits and we've been told that her VA benefits and Social Security will go into the trust and payments for the nursing home will be taken out of the trust. The social worker at the nursing home told us that there would be approximately $90 a month left in the trust for her to use for personal things.
See if her nursing home has a social worker who can help you with the process. My brother in law is handling this as he lives in the same town as her. If we need to hire an attorney we will use some of her remaining funds to do so.
It's sad that this process is such "a secret" and people aren't aware of the trust. I read about it on this site months ago and immediately called BIL and told him to talk to the social worker about it so that we could be ready when her funds run out.

How about this! My daughter got another letter today saying her Medicaid is approved! Now which letter do we believe? My daughter has a call into Medicaid to question the status. Also found out that with the QIT or Miller Trust, what we do is put any income into the trust which is above the Medicaid limit and put the State as the beneficiary. Then she qualifies for Medicaid. Her Social Security And Veterans benefit, plus a small pension amount is paid to the nursing home as we have been doing and Medicaid pays the rest. I am hoping this is the correct information. It seems that my daughter already made a QIT trust but maybe hadn't put enough into it to qualify my Mom for Medicaid. Really she is only about $65 over the limit, so that is the amount that goes into the trust every month. The rest of her income goes to the Nursing Home. I am still waiting for confirmation on all this. I'm praying this is true as I live in a condo with no room for her, nor can I care for her with my own health not so good. I thank you all soooooo much for all the encouragement! Taking care of aging parents is quite a job and I can say I will have no regrets when my Mom passes. I have done every single thing I can do to care for her, visit her, etc. I will let you know the outcome! On another note, my Mom has developed tumors in her chest. She was diagnosed with lung cancer three years ago but has had literally no symptoms until now. I just pray God takes her home quickly as I don't want her to suffer. So hard to watch her go downhill. Life is hard but God is good!

I have been reading about the Miller Trust. Does anyone know how much it costs to set one up?

Gloria, you can give up Veterans benefits to get her qualified, but check with an elder law attorney before you make ANY changes. I am not at all sure relinquishing VA is necessary, haven't dealt with that myself.

It has been said here before that you can't receive A&A and Medicaid too. Both are government. Did u file thru the home or go to an office? If thru the home, maybe you should go in person. Take all Moms info. Copies of latest Bank statement showing electronic deposits made by SS and VA. Any life insurance policies. Also mentioned on this site, employer policies don't count since employer pays into them. Ask them all ur questions. Then if not satisfied, see a lawyer.
Actually, the finance officer or Social Worker at the home should know about A&A and if it can be used for LTC.

The ineligiblity is probably due to a solvable math problem.
Your Mom between her SS, her teacher pension & the A&A.... when added up, is taking her above whatever her state has set as the monthly income limit for LTC Medicaid. Like for my late mom the mo income max was $2,064; my mom got $900 SS and 1k from dads retirement so under $2064 but if she had a teachers retirement of $500, she would have been at $ 2400 so $336 over the income limit & so ineligible for Medicaid. So she would have needed to do a Miller Trust to deal with the $336 overage so qualify for Medicaid.

I’d bet your mom’s situation is somewhat along these lines. BUT her overage is coming from the $1,100 VA A&A. As it’s VA it’s totally fixable but not via a Miller. Instead Mom can file to get the A&A “suspended”. Suspended rather than relinquished.  Once that happens, VA switches to paying her just a $90 a mo personal needs stipend. The $1100 a mo stops, so no more counting as income. The VA personal needs $90 will be extra $ for her to each mo AND will be in addition to a personal needs allowance that her states Medicaid program allows her to keep. For my mom the PNA was $60 a mo, so if dad had been a vet (instead he was a federal civil servant), mom would have had both $60 & $90 a mo as fun $$ each month.

My understanding is that A&A as a source of $ works fab for living at home or IL or AL or while in spend-down mode as between thier savings, retirement $, SS, & VAs A&A there’s enough $ to cover costs of care. But once they move into a NH with its cost from 5k - 15k a mo, there likely isn’t enough $$$ to cover NH costs. But if they go onto Medicaid, it will cover thier NH room&board costs totally. So they suspended VA A&A (as double dipping now not allowed) and apply instead for Medicaid. Comprende?

The sticky in this is that the Medicaid caseworker isn’t factoring in what happens once A&A is suspended. Ditto for billing at the NH. I’d try to get with the SW at the NH to see if they know of a at-no-charge VA benefits counselor. Get them to help your mom bridge the application / suspension. There’s gonna be a total butt-rash lag time between the months VA still paying A&A and Medicaid eligibility. VA should eventually claw back the $$$ paid, so don’t spend it or pay the NH the $1100. NH should just be getting paid mom’s required copay or SOC (share of cost) that is based on what her SS & pensions pay to her, & this figure based on her annual “awards letters” which she received in November that states to the penny what she’s getting paid for 2018. Like for my mom, she basically had a monthly copay of $1840 a mo to the NH ($1k + $900 - $60 personal needs allowance) which I paid by check to the NH from her checking account and built each mo by her PNA. Personally I’d caution against letting the facility become the direct deposit payee for moms incomes sources as there is going to be accounting issues till all smoothed out plus it allows you to use her VA$90 and state monthly PNA $ more as you determine. 

There’s quite a few posts on this site over in the VA Q&As on dealing with this.
Make yourself a fresh pot of coffee or favorite adult beverage and jot down notes to ask the SW at the NH. 😉.

Another thought, could the facility left out any health status information of mom needing skilled nursing care on her Medicaid application??? For LTC NH Medicaid, they have to be “at need” both financial and medical.

There’s huge emphasis on the $$ aspect on Medicaid but they have to show need for skilled nursing care for NH Medicaid as well. If part of health history, ICD codes/diagnosis, even RXs are left off the medical part of the application, it may not pass Medicaid eligibility review. Medical is facility responsibility.

Gloria - oh so glad for you!!! Remember there probably will be a renewal to be done. So you / your daughter get a binder going with mom’s bank statements, awards letters and anything else financial so the renewal can be done easily & quickly next year.

All of you are a blessing to me! And thanks for the heads up on the renewal, though I don’t think she will last till next year as she has lung cancer and tumors are showing up in her chest.