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A bath lady comes once a week, Everything else I do. Buy the groceries, wash his clothes, etc.

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You are in a tough position and BLESS you.

I agree with others that the best thing to do, if you can afford it, is to see an elder law attorney who specializes in Medicaid planning. Check out naela.org to get some names in your area. Alternatively, I recommend contacting a P.A.C.E. provider in your area, if there is one. Hopefully, your brother will qualify through Medicaid (they will figure it out) or he can afford it outside of Medicaid.

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https://www.medicare.gov/sign-up-change-plans/different-types-of-medicare-health-plans/pace
https://www.medicare.gov/plan-compare/#/pace?year=2023&lang=en
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Whatever you pay for out of his SSI check for him. List it all. If he needs 24/7 care, I'm sure his entire check is going toward his care. You may be kicking in a little too. Keep a separate list of things that you buy for him out of your pocket. Don't comingle his money with anyone else. Don't withdraw all his money when deposited to his account and put it in your acct. Use check, credit, debit card to pay for things out of his account each month. Easiest way to keep a record.

Usually when they look at expenses coming out of his bank account, they are looking for whole check deposited and then withdrawn. Or possibly a large amt pulled out of his money each month. Those can be investigated as gifts to someone else.

Just let his money go in his account and use the check ledger to write down each expense out of his money. Whatever he needs will be ok - supplies, food, maybe where he paid a provider at a drs office or someone that came to the home.
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BigSister84: Perhaps you should retain an elder law attorney.
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Depending on your state you may be able to be paid for his care up to a certain amount but it might help to speak to a social worker and/or an attorney versed in Medicaid law. His supplies and such should be prescribed by a doctor so reimbursement can occur, again a social worker can guide you.
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Call Medicaid. They should have a list or clearly defined information to provide.
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Confer with Elder Law attorney and/ or with a qualified licensed Social Worker. You need specific professional assistance to navigate this situation.
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I'm very sorry to learn about your brother's situation. See a Medicaid specialist and eldercare attorney who knows the very complex rules that exist in your residential state, as every single penny must be counted for the lookback period to spend down to Medicaid level.

For myself as former banker, I like crunching numbers, so I will keep all bank transactions and receipts for 30 months lookback period in CA State. Although I am just 67 and very active, no one ever knows what can happen to land one into expensive care at home or a facility: be it fall injuries or a sudden illness.
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Sorry but if the number in your name is your age, maybe its time for brother to go into Longterm care. Caregiving is hard for someone 20 yrs younger than you. Of course ur exhausted. When he was in Rehab you could have had him transferred to LTC and start the Medicaid process.
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If he is paying you..that is an acceptable expense
If he is paying "room and board" that is an acceptable expense
clothing, personal items (soap, toothbrush, hair cuts, )
Medical expenses, including medications both Rx and OTC
Medicaid rep would be able to give you more detailed info
If he is paying you for your care you should have an agreement or contract.
Document everything.
Save all receipts.
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Talk to Medicaid. Do you have a caregiver agreement? A room and board agreement?
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BigSister84 Dec 2022
No I do not have a caregiver agreement. He has lived with me most of his life and has always had mental issues. But refused any kind of treatment.5 years ago he was diagnosed with Alzheimer’s and put on meds. Ended up in hosp then nursing home for 2 weeks. That is when I became a caregiver. Got a poa and took over everything for him I have kept most receipts. But in the beginning everything was so crazy
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