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My father is in assisted living, where he's been on spend down for 13 months. At his current spend rate, which won't remain static, he maybe has 10 months, maybe only 8 or less after an upcoming rate increase in January, before his bank account balance is down to zero. Recent interactions with nursing homes' financial assessment departments, while my father's Medicaid application is under review, are leading me to believe that he may be denied Medicaid. His only income is less than $2700 monthly from Social Security. I don't have any room for him, nor can I accommodate his mobility and dementia needs. If push comes to shove, what are my options? Ward of the state? I wouldn't prefer it but there's no way for me to house or support him. What are my options? even if they are not great, I need to know. I can't just leave him on the curb, after all, but I literally have no idea on how to address this if (1) he gets denied Medicaid or (2) he gets accepted, but all the long-term skilled nursing facilities have years long waiting lists? What do I do with him?

Just checking on the VA front because things are so hard to find there. If you've talked with Social Work at your nearest VA facility and have exhausted all resources there, I apologize for being redundant.

Which priority group is Dad in? I just came across that info last month when trying to help get my uncle in another state placed. There are eight groups, Group 5 doesn't require the vet to have a service-connected disability. It can be used if
~ the annual income is below the average income level
~ the veteran receives a pension
~ the veteran is eligible for Medicaid

I can send my notes from a conversation with VA if that would help.

Not all long-term care programs have the years-in criteria like the A&A. For example, to get into the Sgt. John L. Levitow Healthcare Center in Rocky Hill, the criteria is:

~ Honorably discharged from the Armed Forces of the United States (copy of DD-214 is required),
~ be a resident of the State of CT at the time of application for services (proof may be required),
~ ninety (90) days of active duty other than for training purposes.
~ submit an application in advance,
~ submit a report of medical history and physical examination,
~ pass an eligibility check, and
~ have a chronic medical condition or need which requires skilled nursing care or requires 24-hour assistance and supervision with activities of daily living.

It bothers me that the seniormost vets often end up on the State's hands instead of VA. As an elderly acquaintance who served in the Marines said, 'Promises were made to me when I enlisted, I expect them to be kept.'
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Reply to ravensdottir
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I'm in Connecticut too. Your father will not be turned down for Medicaid if all of his unprotected assets have been spent-down and he's already in Long Term Care.

You will not have to take him in and provide for his care needs in your home, nor will you have to make him a Ward Of The State.

Let me tell you something about these years long waiting lists for a nursing home. It's propaganda. There's always a nursing home with availability. It might not be a high-end place, but he won't be on the street. You can always work from there on finding different placement.

Usually Medicaid doesn't pay for Assisted Living, but good if your father is in one that Medicaid will pay for.

We're in a good state for elder services. If your father goes to the hospital and the AL refuses to take him back because he needs skilled care, the hospital keeps him unti they find a bed for him in a nursing home. Also, nursing homes usually either start the Medicaid application the second a new resident comes through the door, or they get an existing one expediated.

Don't worry so much about this. Your father will not be left on the street in this state and you won't have to move him in with you.
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willothewisp Oct 26, 2024
Hi

I think you've misunderstood a few things. My father is not on Medicaid. He is on Medicare. Regardless, neither of those programs cover the ASL. He is at the ASL on private pay. The problem is the gap between "spent down" and "on Medicaid". He is spending down at the ASL, being denied entry to nursing homes on private pay, and pending an arduous medicaid process, that the latest nursing home thinks he won't qualify for and used that as the basis for the denial
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Good Afternoon,

A couple of suggestions: Was your father ever in the military during time of War? Some "Aid & Attendance" could assist


Have you checked out: Aviva in West Hartford, CT

Maybe you could find him a place in Independent Living (IL) and bring in services for activities of daily living.

Meet with a Social Worker. Sometimes the IL with services brought in could save you $$$ depending upon the health of the loved one.
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willothewisp Oct 26, 2024
Thanks for the reply but he can't afford IL. Nor is he independent. About the only thing he can legit do unassisted is eat and get dressed. And dressing is a chore. He was in the military but not during war. He is on spend down. The plan was spend down, then medicaid and then long term skilled nursing but both are proving near impossible - hence the post
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What I did was take the 20k Mom had and placed her in Long-term care on private pay that took Medicaid. This gave me time to apply and do what needed to be done for Medicaid. The 20k paid for May and June. June I confirmed that Mom was spent down and and all info needed received. Medicaid started paying July 1st. It will be so much easier to get Dad placed if you can pay privately.

My State allows Medicaid if a person has been paying privately for at least 2 years in an AL. The AL has to except Medicaid.
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willothewisp Oct 26, 2024
I can but the only nursing home that had a bed available, said they felt that he'd be denied medicaid, so they denied him a bed. They apparently have a Magic 8-ball, and basically predict whether he'd be accepted or denied and if their ball says "outlook not so good", then they revoke the available bed. I wish I were joking, This literally just happened 2 days ago, with my active medicaid application already under review.
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Connecticut is a good state for elder care and Medicaid. I live here as well. Rest easy, he will qualify for LTC Medicaid, or nursing home Medicaid if he medically needs it, and you in no way will have to house or support him. I was in your shoes 5 or 6 years ago with the same fears, and those fears were not realized. Just make sure you do not sign any paperwork stating you will take financial responsibility for him. Hire an elder attorney (with his money, if you have POA) if possible. If not possible, don't worry, it will still work out. If you can't find an open bed at a nursing home that will take him under Medicaid pending by the time he has to leave AL, make sure you contact and emphasize to the facility social worker well beforehand that you are unable to take him once the money runs out. If the SW is not really helpful (and don't be surprised if she isn't), you must call the State's Medicaid office, the ombudsman, and APS if necessary to help you. They will step in and find a safe place for him. Many of the NH's here are quite good, or at least better than the popular conceived notion of them. My father was wonderfully taken care of the last years of his life.
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willothewisp Oct 26, 2024
This is seems encouraging, thank you. I wish I shared your optimism. And you are correct - she's not helpful. I work in business. I am accustomed to questions that I ask, or that are being asked of me, are in good faith, in search of the answer to whatever the question is. She seems to take every question that I ask as if I am searching for holes in whatever it is we are discussing, when in fact, I am seeking understanding so that I can do whatever is necessary, correctly, quickly, the first time. Its like I am dealing with a high school student. Its like I have to hand hold her and placate her insecurities and defense mechanisms just to get an answer. Its insane
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I think if income monthly is too high to qualify for Medicaid you will be forced to do a Miller Trust or a Q.I.T. (qualified income trust) in which his SS. is put away in a trust account (Usually the state is the beneficiary) and his pension then, not being enough, will allow him to qualify for Medicaid.

You are going to have to see an attorney to see your options regarding this. If you are his POA I would do that at once. Often required when one is "income rich and cash and assets poor".

Good luck. Glad you are thinking ahead.
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willothewisp Oct 24, 2024
Thank you. I am POA and will start looking into this now too. It never seems to end. I just want to make sure he is cared for. Its terrible that its come to this but that's why I am posting here - searching for answers from those who may have been down this road, or simply have the knowledge. I thought I was planning ahead, but this all fell in my lap and now its basically my problem to solve and I am just lost, which is just due to lack of even knowing sometimes what to ask.
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