My boyfriend's stepfather died in November of 2020. His younger brother lived with their mom for two months but ended up telling her that he couldn't take care of her and left. After that, my boyfriend's mom as well as his family began pushing him to take her in and take care of her.
April 10th she will have been with us for a year. The past few months my boyfriend has been trying to get her into assisted but it's just been roadblocks.
She's low-income and her only source of income is social security. She doesn't have Medicaid and it doesn't seem like she can get it as every time she has applied she is denied for not having enough work credits.
Hospice is involved as well but they don't help much. A nurse comes once a week to check on her. For the most part, they just keep bugging my boyfriend and demanding he do more.
The social worker with hospice found an assisted living facility that my boyfriend has been trying to get her into. He was originally told they would take her in right away if she said yes. She said yes and then they told him all the papers he needed to give them. They also told him his mom needs to be living in an assisted living facility to even be approved for Medicaid.
He finally got together all the papers they needed a few weeks ago and turned them in. A week later they called him and mentioned to him about a car that is in her name and some property that was given to her.
She doesn't drive and hasn't for years. It was the car her husband drove and for some reason they put it in her name as well as his. She doesn't have the car because my boyfriend's younger brother took it. The brother got pulled over last year and the car was impounded because he didn't have insurance. And She had property that was given to her by her grandparents but she signed it over to her brother years ago. The woman at the assisted living facility said both of these will count against her when applying for Medicaid. My boyfriend hasn't heard from the facility for about a week so we're not sure if they will approve her being there or not now.
He works a lot and has kids. He is always busy and having to take care of her is draining him. The family doesn't help at all. And it is a nightmare having her live with us.
She wants to be waited on hand and foot but she also wants to be in charge and be woman of the house.
He has been trying and trying to get her into assisted living but like I said, keeps running into roadblocks. We can't afford to pay for her to be in there and family won't help.
We live in Texas. I've been trying to find any programs that would help cover the cost but have been unable to find any. Does anyone know of any programs that help cover the cost of assisted living in Texas? I would appreciate any help.
The woman at assisted living is not your best advisor here. A good written explanation of what has happened to the car and property backed up by the appropriate paperwork (title transfer, impound bill, etc. ) would probably dismiss those concerns. And are you sure Medicaid is going to actually pay for assisted living? It doesn't usually do that unless there is some special waiver program run by the state.
She has applied for Medicaid twice and both times they have denied her saying she doesn't have enough work credits. That doesn't make sense to me either but it's what it says in their letters for the reason of denying her. I know it has to do with Medicare so I'm not sure why Medicaid keeps denying her stating it is because of work credits.
I know he told the worker at the assisted living facility that the car was impounded. His mom doesn't have the title. They believe it was in the glovebox in the car. My boyfriend didn't even know his mom's name was on the car too. There is a lot he doesn't know because this was all pushed onto him since no one else wanted to take care of her. And I don't know anything about the property that was given to her. I didn't know there was property in her name at all until recently. I just know she signed it over to her brother years ago.
I’d like to backtrack on your situation, I actually have concerns if she could ever even get a AL bed paid for by Medicaid in TX. LTC Medicaid is geared to be paid for those needing skilled nursing care services which means as a resident in a NH. For a bed in an AL that is a bed on a waiver program, it’s a diversion of some of the $ that otherwise would be spent at a NH. Most states do NOT even do AL waiver programs, so AL is totally private pay. TX does have AL diversion waivers but the # of beds are beyond super low and the criteria to be in one is very very narrow. A good well run AL usually can easily fill a room with a private pay elder they don’t need to bother dealing with state Medicaid regulations.
If she is basically all ok on her ADLs and needs just a bit of help in her day, and its more about medication management being done for her, that’s not enough. Medication management is a surcharge onto an AL bill, it’s nothing special. Did this AL guarantee to you she would meet the at need medical criteria get a Medicaid AL bed? Or did they more imply that they have AL Medicaid bed; that they participate in a Medicaid waiver program?
Medical “at need” is just as important as the financial part. But imo it’s way way harder to get done as you r dependent on her old MD, old hospital record, the nursing & medical staff at a facility to do things, get work ups and labs done that clearly show medical need. I just don’t see an AL having the medical staff to do this in house if she needs to have her medical at need reviewed.
My moms tiered community was IL to AL to NH & w a end stage hospice wing, and it had a few AL Medicaid beds. The AL Medicaid beds all had a waiting list from existing residents and were basically a way station in their AL till a Medicaid bed opened up in the NH part. There was no risk medically as they were really ready for a NH bed. But on paper the facility appeared to have AL Medicaid beds. Reality was totally different.
5 yr lookback is kinda the standard nationally used for assessing if they are “at need” financially. Some states can opt to do less (CA does) or do only 3 if they have been in IL or AL for 2 full years prior. Once an application red flagged imo they r toast on getting into another facility without having an experienced elder law attorney shepherding her future application. If y’all did not know about the car & land, could there be other “gifts”??? Look in detail on all her checks and cash withdrawals as State may want an accounting / receipt. There is someone on this forum doing LTC Medicaid application as I write this and it’s all items over $200 within the recent past for the Aunts application.
She has not 1 but two gifting transfer penalties against her right now. The land and the car and gifted to different relatives, right?
Both are recorded in courthouse / state records database. No real way around them unless she could have been taken advantage of by her relatives and she is willing to contact APS and file charges against each them and then it turns into a law enforcement and DA issue… it will get ugly. Did anyone explain just how the penalty gets determined and placed?
https://www.nolo.com/legal-encyclopedia/when-medicaid-texas-will-pay-nursing-home-assisted-living-home-health-care.html
Here is a resource for you to explore options for your BFs mom. Good luck with finding services that will help.
http://www.aacog.com/108/Bexar-Area-Agency-on-Aging
The property that was in her name now belongs to her brother. But apparently, in the state of Texas, there is a five-year window. Although she no longer owns the property, it could still disqualify her from Medicaid since it hasn't been five years yet. And I guess that facility isn't willing to risk taking her in since there is a chance she might not qualify for Medicaid.
He told me the social worker is trying to find other places but the problem is the Medicaid standards for Texas.
It all comes down to money. She can't pay for assisted living because she doesn't get enough social security and has no savings. But can't get Medicaid because of assets she no longer owns. It's very frustrating.