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I liked the answer helpful answer CETUD PrettyinDixie gave 9 hours ago. I would like to know where the clock could be obtained, just in case push comes to shove for survival of my dear husband. I have a nanny cam here in my own home for my sweetie, but the clock sounds like a winner in a place that one cannot be at all times. Does it record things so you can go back and check at any given time slot? Thanks. Joylee
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CETUD, can you see it from your home thru that clock, thats fantastic! I have 3 friends with spouses in nursing homes, and when they buzz, no one comes. They all mess themselves because they get no help. They are paying over 14k a month for this, insane!
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They (the Nurses and CNA's) act like they are entitled to your cash and therefore will report you to Medicaid if you use your money for anything other than your parents or family members in their care. In Illinois some of the Adult Protective Agents actually will remove a Power of Atty. to gain control of your loved ones assets and leave the family without a dime all in the name of claiming abuse that never happened. If you inherit belongings from your parent or loved one make sure that they sign an Irrevocable trust stating that the state cannot come in and Seize their belongings which you are to inherit. The nurses can sometimes phony home health records because a patient calls in sick and does not want them at the house, they the nurses can then in turn take these files to the local Adult proctective Association Advocate and work with getting a caretaker out of the house they the nurses can claim they have not been to the residence when they have all in the name of money. They can blame a sibling and say that they took the file to the Adult Protective Agency. So be careful, get a good lawyer, get an Irrevocable trust signed, and tell the nurses if they only have two years of education, and the Certified Nurses Assistant only has several months of education to back off because they are not entitled to any more money other than the money they make due to their education and make it stick.
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In addition to my previous post...if VA benefits are a consideration then you would want the Elder Law Attorney to be VA accredited. VA and Medicaid have different rules and therefore you would want the overall planning to address both.
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The answer is "it depends." Medicaid is a needs based benefit and eligibility is required. An elder law attorney who is also VA Accredited is a good start.
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My Mom is in a facility where the Medicaid Coordinator told me that Medicaid in that state WILL investigate anything over $300 but they CAN investigate ANYTHING. In addition to differences between states, there are differences among and between the employees who work for those agencies. I've worked for a government investigating agency and I can tell you that some bureaucrats are more into power trips than others, some are more rigorous in doing their jobs than others and some are lazier and less competent than others. It's a crap shoot who you'll get. BUT, based on my experience with another agency, it's more likely that the investigators who are looking for potential fraud (e.g. "hiding" assets with family) are going to be more interested in checks to family members or other private individuals, checks for cash, checks for goods or services that seem "odd" for the elder such as for college tuition, day care or diaper services, "big ticket" computer/electronics items, checks for big amounts to grocery stores when the elder lives in a meals-provided assisted living facility, car payments, etc. Think about it! If you were trying to prove that your mother (who doesn't drive, has dentures, and owns her own home) was spending money/giving money on, in your view, a sleezy nephew, what would YOU be looking for? $300 ATM withdrawals, a $2200 check to a dentist you never heard of and a $125 debit at Brooks Brothers or would you be concerned about $100 to the hairdresser she's gone to for years, a check for $6000 for burial insurance and monthly grocery bills -- of whatever amount -- that have hardly changed over the course of the last 2 years? Think like a detective! The people who work for Medicaid are spending my money and yours. They do not want to protect YOUR "inheritance"; they DO want to insure that money that has been spent by the applicant has been for his or her personal needs. That doesn't mean he or she couldn't have taken a $10,000 cruise 4 years ago -- but it MAY mean s/he will suffer a penalty when s/he applies for Medicaid today for the $10,000 s/he spent for YOUR ticket on the cruise. The frustrating thing is, of course, that 4 years ago neither she nor you had any idea she was going to have to go into an $8000 a month nursing home for 6 more years of life. I'm just beginning this process myself but in this last example I would sure argue -- if it were true -- that my father's doctor advised such a nice trip and that my Dad couldn't/wouldn't travel alone and that I paid for my own off-shore excursions, etc. I think that these rules don't mean that the applicant can't spend anything significant for other than basic food, shelter, and health care; I THINK they mean that you may have to explain and justify expenditures that are not obviously, on their face, for the individual's personal care. Documentation can be the very best explanation but in the absence of such you may have to work a little harder. I expect lawyers who specialize in this sort of professional service know just how to do it. So get one -- sooner rather than later!
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thanks for input. I am in MD and was told by the elder law lawyer that anything over $500 may be investigated. We use cash alot for odds and ends so I often cash a check for $200 or $300 every month so I hope it will not be looked into :(
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People are allowed to spend money on their own care. I would do a care contract, including amount for room and board and track everything. You should be fine. Of course, if you think medicaid is in your future, speak to an elder law attorney as soon as possible.
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I am the gardian an conservitor and the court granted me 500.00 $ a month to care for mom with dad living with us so the money spent also goes towards bills and we buy all things need for there care and food
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I think that the most helpful answers here address the DIFFERENCES in investigating the "look back" period and determining Medicaid eligibility FROM STATE TO STATE, as well as the advice to immediately engage the services of an attorney experienced in exactly this area of law. Most of them are not; do not settle for one that isn't! If you are considering changing your state of residence to a state that recognizes gay marriage, be aware that that state undoubtedly also has different rules for Medicaid than your current home state. Moving a person who is on Medicaid from one state to another starts the whole process over again. If you are thinking of relocating, you should also get legal advice on whether it would be prudent to do so -- and have your parent establish residency there -- PRIOR to first making application for Medicaid for either/both parent. You have some challenging things with which to deal and I wish you the very best in finding happiness and in caring for your loved ones as well. Angels watch over you on your journey.
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Brit - on under $500, not necessarily. A lot of how a review is done depends on your state (as medicaid is managed uniquely by each state) & how the NH does its own review to decide IF they will take a potential resident as "medicaid pending" which a NH can or cannot allow.

On the latter, for my late MIL, well her NH kept wanting details & info as to checks mil had written to her caregivers - now what she was doing were ck for $70-100 for liquor runs - but no receipts kept or found & atop that caregiver was paid by state program (mil was legally blind). mil actually died before being approved by Medicaid as NH review & their submission of mil's application was for months and then mil got hospitalized due to sepsis & then went to an in-facility hospice (Medicare). She was approved retroactively. But literally mil application was held up over checks under $100.00.

On the other, many states use a pretty simple formula as to what resources should be available and if they aren't there, then the application is flagged for review. Remember in the Medicaid application you have to provide awards letters, so it is known to the penny what their income is. They have to provide details on their living situation (still in their home, in AL or IL, living with family); info on their savings, investments, etc. So if mom gets $1800 a mo income from SS & retirement and lives with family in their home and had a savings account with 30k 5 years ago AND now has only 1k to her name......well her $$$ has gone somewhere.....After all mom had $ 108,000.00 in income plus that 30k in savings, so she should have funds to private pay for a while for her NH. Family would need to have a legal caregiver agreement or rental agreement in place not to have a possible issue surface. you need to be able to show a plausible "pattern of spending" of just where mom's 138large went. If their in IL or AL or still have their home, then it makes sense as to where $$ went. But otherwise IMHO you have to be very careful & do whatever legally to protect both your elder & yourself from the overarching purview of the state.
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It is my understanding that Medicaid will only be looking back at money you have spent over $500 every month that you cannot show a need to have used.
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Cetude....I find your statement that "If you don't visit your loved one like daily the staff will abuse, neglect or mistreat your loved one" to be extremely offensive & abhorrently inaccurate. I spent 7 of my 28 years in nursing working in nursing homes, either as staff or as per diem relief, and I NEVER saw any of the PURPOSEFUL abuse, neglect or mistreatment that you're insinuating. If a resident didn't get changed the instant they soiled themselves, it wasn't for a wanton desire to neglect or make them suffer, it was due to a workload issue. Everyone on this board expresses how difficult & draining it is to care for 1 or 2 loved ones at home. Try being responsible for 50 residents on a wing with just yourself and, depending on the shift, anywhere from 1 to 6 aides. People here, myself included, struggle with 1:1 or 2:1 care...try a 6:1 ratio (or greater), all while dealing with interruptions from physician rounds, sick calls, phone calls from family or family that wants to stand at the unit desk & verbally berate you for 20 min for something stupid like they found that another resident's socks had inadvertantly gotten put in their mom or dad's drawer. (Yes, that is a real event) I had a family chew me out, in front of everyone in the building, on a daily basis because we hadn't successfully gotten Mom to walk the halls on her own. We busted a$$ for 2 months using 2 assists trying to get this woman ambulating under her own steam to find out that Mom hadn't walked for the 2 previous years! The family's expectation was that, now that she was in a nursing home, we would be able to turn back the hands of time & make Mom the independent & self-sufficient woman she used to be! Just because they're family doesn't mean their goals are always realistic!

Yes, there are homes that do a better job than others....partly due to wage structure & partly due to staffing levels. It's a fact of life, places that pay better attract more experienced, more motivated staff. We like to see nurses as selfless individuals who care for everyone...and, by in large, we are...but the truth is, everyone needs to earn enough to survive, so wages do matter. Staffing levels pretty much go in the same category. Being a nurse...and especially being a CNA...is an incredibly physical job. Lifting & turning a full-grown adult who, often, can't help in any way or, worse yet, fights you the whole time, isn't easy...and we often have to do this on our own. Th is is one reason why there's not a nurse alive that doesn't have a bad back! Homes with low staffing levels will see high turn-over because no one wants to risk injurying the people they care for...or themselves. A severe injury can end a career & that nurse's earning capability so, yeah, she's gonna go where the staffing levels provide sufficient help.

The last year that I worked in a nursing home I worked 11-7 on an Alzheimer's unit & it was just me & ONE aide to deal with 36 wandering, confused & combative residents. That's an 18 resident to 1 caregiver ratio! So, yeah, I find your idiotic comment to be incredibly insulting.
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I agree that you need a very experienced NAELA certifed attorney. Look for the most experienced attorney in your area.
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CETUD - - - To avoid the neglect - well, not avoid, but to be aware - I have put a nanny cam in my mothers room. She has beginning of dementia, so for a while she is fine, then not so...no one knows it is there, not even her. It is a clock.
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You have a lot to deal with my heart goes out to you.If your father was in the military at one point your mother as his spouse could be eligible for compensation from the VA for some of her long term care cost.It take awhile and a lot of forms but well worth a try.If eligible please go see the VA now they will explain everything.
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cetude I sort of know where youare coming from BUT in the UK we have a audit system that cetifies and rates care homes and nursing homes and I always would advise check on their status and visit them. If when you walk in the door you can smell urine or worse walk away immediately. If you are met immediately by someone and they are happy to sow you round even thought you didnt make an appointment then I think you may be on to a winner.

Don't fall for the appointment trick - its easy to clean up once in a while it is keeping it fantastic ALL the time that counts. if you ring and they want 3 days notice then alarm bells are already ringing. If you say I want to come round in 30 minutes and they say can you make that an hour because we need to focus on teas/drug rounds then even better.
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The sad thing about nursing homes is that the stress does not end there. If you don't visit your loved one like daily the staff will abuse, neglect or mistreat your loved one. A single CNA has like a whole hall of very needy patients. Medical technology keeps people alive a lot longer, but the elderly are treated like garbage once they get old. If the nursing homes feeds and keep your loved one clean without bedsores they are doing a great job due to the huge amounts of patients they have. I hope I don't live that long.
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If bad comes to worse, and you are desperate - you can get your loved one hospitalized; after 3 days in the hospital, Medicare will pay up to 100 days nursing home care for rehab. Meanwhile you can try to get your parent on Medicaid which you may need an Eldercare attorney. However, if your parent is showing decline (and many do decline after they are in the nursing home, especially if you don't visit them often they REALLY get bad off because the staff will either neglect or abuse them), you can get your loved one on hospice, which Medicare will pay for. However, even Medicare is losing money so they had many cuts. It's awful no matter what you do.
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I echo the excellent advice of everyone who has chimed in. Please see an elder law attorney asap. As was mentioned, the law isn't necessarily fair, but it is the law. You need expert legal help to sort this out.
Take care,
Carol
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Id be tempted to put a rental agreement in place and back date it - yes I know that's illegal. The only issue is that you would be expected to pay tax on that so its not a win win situation. the bonus is that you could then increase the rental as long as you aren't being ridiculous of course. After all why should they live with you free of charge - they had to pay for things in their previous domicile
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I'd say you're in a much better position if mom and dad wrote checks directly . . . For your mortgage...utilities...food. The problem you have is that Medicaid may consider everything they paid directly to YOU as a gift.

It's not fair necessarily, but it'd the way it is. Too bad you didn't take Igloo's excellent advice months ago. An Elder Law attorney. And the only thing worse than your not having DONE that is to let ONE MORE DAY GO BY without an appointment. Don't think you can afford it? Well...that advise your parents CAN pay for. Call asap.
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They can assess penalties if you don't have a caregiver contract prior to getting the money. Of course those would be really nice if you knew about them ahead of time and not only find out about it at the time of medicaid application. I didn't know. Was solely responsible for my dad for 3 years - no way I could do that full time and work; or not go bankrupt or lose my home. We have been fighting with the State of Illinois (one of the most broke in the country) for 2 years now. So far the nursing home hasn't kicked him out. We can meet half of the monthly $4,700. There is such a thing here as an undue hardship waiver when they assess penalties - but so far - that's been denied also. The criteria for it are without the care he's receiving he would be at risk of health, life, shelter, food, clothing. It's apparently not enough that my dad can't do any of his own activities of daily living, can no longer put together intelligible sentences and most days a spoon is complicated for him. I coudln't take that back on by myself and my house is not set up for it. Ask them if they care.
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You really are best served by seeing an elder law attorney as you have 2 different issues to be concerned about: possible transfer penalty issues AND your dad being a "community spouse" when & if your mom goes into a NH and needs to apply for Medicaid to pay. These are kinda two very different issues but both affect your mom's eligibility for Medicaid and what dad does (or does not need to do) as far as keeping his assets to whatever your state has for CS.

CS can get somewhat complex as their financials has a fixed date (aka "Snapshot" date) that everything is set from, in a way it is less flexible for couples to do after application Medicaid planning even though there is a community spouse situation. Really you need good legal & I'd suggest you get one who is NAELA certified.
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