My mother receives Social Security and 2 pensions. The facility only takes her Social Security. Her two pensions still go to her checking account, along with a $90.00 monthly veteran's benefit (which is supposedly protected from Medicaid). She pays the facility by check each month for her "rent."
She recently received a payout from an investment she finally closed out. That amounted to, approximately, $2,600.00. The head nurse took her to the bank and told my mother that if she deposited the check in her own account, Medicaid would see it and take it. The nurse promised my mother that she would see to it that she would get a nicer room on the Rehab floor and other nice amenities is my mother would "trust her" to take the money and keep it safe for her in her personal bank. My mom cashed the check and gave the nurse the cash to put into her savings account. The nurse then took my mother shopping and told her to buy shoes, that she would pay for them. Mom didn't really even like the shoes she was told to buy, but she did take them back to the facility. They still haven't been worn.
A few months later, when my mother asked the nurse to give her money back to her, (in front of a friend of my mother's) the nurse gave part of it back and told my mother that my mother had spend the rest. This was not the truth. The nurse never gave any money back to my mother and if the nurse did use any of the money for my mother, it would have only been for the money she spent on the shoes she made Mom purchase.
We called and State Ombudsman who questioned Mom and then the nurse. The nurse, at first was very apologetic, even crying and begging Mom not to report her. She told my mother that she would return the money to her. She was worried that she would be fired from her job.
Apparently, after this, she spoke to her superior, where the story changed. I believe that it was determined that since Mom had given her cash, there was no paper trail. Without a paper trail, it was like it "never happened." That is what the Ombudsman heard when he spoke with the nurse and her superior. This facility is breaking the law. They have covered a theft and they are not following Medicaid protocol, by not taking al of my mother's income and having her write a check to them for the amount they say she owes each month. Who knows what figures they have reported as her income for Medicaid purposes?
I don't have any POA or authority. My mother is quite difficult to deal with. I need some answers and some direction in this matter. I want her to move from this facility. It has the lowest rating in the county. She can't even eat the food the quality is so poor. The toilet in her room is continually backing up. She and her roommate must throw their used toilet tissue in the waste basket. That is so unhealthy (and disgusting)!
I know I have offered up a lot of information, but I am really in need of advice and answers about what can be done about the Medicaid issue, which I think is illegal, the blatant theft of my mother's money, and the unhealthy conditions that she and others at the facility live with on a daily basis. Please help me with any information you can give me. It would be greatly appreciated.
With respect to the nurse's behavior, whereas your mother consented to the "gift", theft may be difficult to prove if your mother had cognitive capacity at the time. This incident may, however, be considered "exploitation" which is also a criminal offense. I suggest contacting Adult Protective Services http://www.state.nj.us/humanservices/doas/services/aps/ with respect to this and the other matters relating to your mother's and other resident's care.
Regarding Medicaid eligibility, the liquidation of the $2,600 investment, and income:
1. If the the $2,600 is reported to DHS, which it should be, your mother would technically be ineligible for Medicaid in the month of receipt. Whether she would be ineligible for the full month or for portion of the month will depend on the character of the "investment".
2. If it was an IRA or other retirement plan distribution, it would be counted as income in the month of receipt and she would be ineligible for the entire month and there is no cure.
3. If it was not income, this can probably be cured if the funds are recovered and paid to the nursing home as patient responsibility. Fortunately, ineligibility penalties with respect to assets are calculated fractionally and ultimately there should be no problem as DHS would cover the balance of the month.
3. In any event, and given the circumstances, I am sure the nursing home will have no problem covering any shortfall for the month in question. If that fails, I am sure a hardship exemption through DHS will be possible.
4. As far as monthly payment is concerned, a Medicaid recipient is not obligated to have income sent directly to the facility. As long as all of your mother's gross monthly income is paid towards her cost of care (less $35 for personal needs) it does not matter if it goes to her checking account first. You are correct that the $90 VA Pension is not considered a resource and is not payable towards her cost of care. She is free to use it for her personal needs in addition to the $35.
5. Since it seems you were not involved in the Medicaid application process I would verify that her gross income (not counting the $90 VA Pension) is under the NJ income cap of $2,199. If it is over the income cap you must immediately have a Qualified Income Trust established and funded so as not to jeopardize eligibility.
6. Lastly, you may want to give strong consideration to having yourself (or another) appointed as a guardian for your mother.
Who DOES have PoA?