My mom is on Medicaid in Ohio and we are about to sell her house because we can’t afford 2 sets of bills plus she’s in there long term. It’s only been appraised at $13,500. The nursing home is saying that they can’t switch her to private pay then when the money has been used, switch her back to Medicaid. Anybody been in this situation and know how to manage or spend down that kind of money ? Unless the nursing home is wrong? I was told by the case worker that was what they would do. Have the rules changed in Ohio on this?
You can't just keep it in her account and spend it until it's all gone because each month that the balance is over the limit (probably around $2K), she is not eligible that month for state to pay the Medicaid bed bill.
Definitely needs to talk to the Medicaid worker or an atty.
Keep good concise records
Call Medi-Caid.
I am not in this situation. I would get professional advice.
You do not want BILLS after her death - or even before - due to errors in how finances handled.
Gena
Actually, you are required to report changes in income/resources. Money from sale of house is a new countable resource. House was excluded all this time because a form was signed indicating her desire to return. So not reporting it could result in penalty months where Medicaid won't pay. Social workers at NH should certainly be aware of requirements to report.
You also have the option of going to elder atty to set up trust so that the funds can be used for medical needs and other things mom might need, however atty fees could possibly eat up much of the sale of the house.
You could buy her some cozy winter clothes and a few nice blankets, warm slippers maybe a few pairs, a new summer wardrobe, new shoes and slippers, some snacks she enjoys, buy shelf stable items and buy extra. Does she use a wheel chair? Buy her seat cushions and several lovely covers. How about the in-house beautician? Can you have her hair and nails done, weekly for the month she is flush. Definitely buy the staff at the nursing home pizzas, for all three shifts and enough for everyone. Showing them how much their care of mom means to you can make her caregivers a little less stressed and win her more regard. There are lots of ways to spend a few grand.
I would make this as easy as possible for you. Get a plan together before you have the money in hand, that way it is quick and simple. Order items or go shopping and whatever is left goes to Medicaid. I think you run into a problem when the money shows on a beginning balance, so request the check the 1st day of her statement cycle, this should be no problem, then you have to spend whatever you are buying for her and write a check to Medicaid before the last day of the statement cycle.
Oh, I would buy her a couple of beautiful silk floral arrangements to brighten her room. You could get an extra set and rotate them out.
Anything to help her feel special is a good thing.
Is 13.5 the actual appraisal? Because that # will be quite a bit less after all the real estate and title company fees, keep that in mind.
Not that this is legal advice for you to take any specific action listed herein without actual legal advice from a licensed attorney in your state and one experienced with elder care/Medicaid issues; but worth checking on these potential options:
-- Many states will allow one to "pre-pay" funeral expenses but that may have to be paid before qualifying for Medicaid long term care coverage in your State. I did this w/my mom; we prepaid all her funeral expenses in advance and that took up about $13K of her assets NOT including the burial plot which had been part of a prior family "purchase" years ago. Yikes I know, expensive for burial/funeral and this included no service other than a gravesite service. We live in an expensive urban area on the east coast.
-- My mom's nursing home (and she qualified to Medicaid long term care coverage in our State well over a year ago) will let me to "write an extra check" as needed to the nursing home to "keep her below out State's asset limit." Because there is NOT much of anything to spend my mom's money on (she has dementia and is pretty far along, not like she goes out or does much) AND she gets both a monthly Social Security payment and Federal Employee "annuity payment" (my dad passed away when I was a kid, he worked for the USG and mom never remarried; so she get's his "pension") AND Medicaid only allows my mom to keep about $90.00 but the bank account nevertheless has to remain under a total of $2K; I often have to write an "extra check" to the nursing home just to keep her under the $2K total asset limit. I suppose other states allow this as if there is not much to spend what little money there is on anything, then what to do?
-- Other option (dependent on proper legal advice) is take the funds and tell your State Medicaid Office. She would be "disqualified" for the period of time until which she re-qualifies after the funds are spent down. With the cost of long-term nursing home care it may only take one month of paying privately whereby that $13K in proceeds from the sale of the house are spent down AND THEN she reapplies for State Medicaid long-term care coverage. There was a point last year where my mom may have been in line to inherit some funds from a distant relative and those funds would have put her over our State Medicaid asset limit. Our attorney said, she would just remain where she was at her current nursing home and we would start the spend down process again and, then, re-apply for Medicaid once she had spent down. Good news for us, that relative had a newer Will which did NOT give my mom anything, so this potential issue was all moot. But still good to know in our State the "spend down" process just restarts if your LO comes into some larger funds.
All to say, get with an elder care lawyer licensed in your state w/Medicaid experience. Your LOs nursing home may have some names to suggest. OR contact your area agency on aging for a recommendation for a lawyer. Last option, contact the law schools in your State as many run "pro bono" or low cost "legal aid" programs to help folks with various legal matters when paying a lawyer is out of the question. AND of course you can pay that lawyer with the proceeds of the sale of the property too which may be another way to "get rid" of some of the funds legally.
Whatever you do, be totally transparent in the sale and where you put the proceeds. I have pretty much no experience with Medicaid, but am trying to help a friend work within the Medicaid system. So, I'm learning the hard way. I know she wants a divorce, but says that if she and her hubby split up, they will lose their house as neither can afford it. Putting her half of the house sale in the bank disqualifies her for Medicaid and she'd have to spend that all down before she began the Medicaid runaround all over.
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