What to do when the rent at Dad's memory care facility is raised due to his level of care increasing?

That's interesting that your dad didn't see combat. We were told (along with a friend of mine who was trying to get it for her mom) that they did. You can get it for veterans but not as much as if you did see combat (at least that's what I remember. it's been 7 years so I've slept since then:)) We went through an attny that only worked with veterans.

Pargirl. The VA comment. I just got Aid and Attendance (A&A) for my widowed mom army wife, after 2 1/2 years filing with VA service officers. I turned everything over to Omega Care Planning Council, Raleigh, NC. "Accredited" Experts at getting VA benefits. Yes there is a fee, but a first month income award is nothing to pay compared to getting "0" income for 2 1/2 yrs, and then the settlement took only 6 months! Dad was a veteran. He does NOT have to have been in combat to receive A&A. He just has to have been serving in the military during a war era. He did thru Vietnam and Korea.

igloo572: I understand. I don't know if it's a trend or not.

with dementia, he can qualify for Medicaid. Pay the facility with his portion and Medicaid fills in the rest of the fees. Since dementia is a terminal illness, he can expect care until he passes.

Llama - my mom did not have LTC policy, so never a consideration.
My post was more geared to my experience that my moms NH chose not to take LTC insurance for payment. And if this is a trend, it's going to make investing in this type of insurance product less attractive as they run a risk for being able to easily use.

igloo572: Did you think of cashing out the LTC and giving it for payment (partial or not) to the NH?

llama - regarding LTC insurance, I have no idea if this is a trend, but my mothers NH would not take at all any LTC policies. Payment was private pay, Medicare or Medicaid. Signs as to this posted in entry, elevator and admissions office. What the business office told me was that in the past they did take LTC policies but there was always ALWAYS something in dealing with LTC insurers that meant delays, refiling, more details wanted, payments clawed back. Since each LTC insurer had its own payment and contract, they each have their own reporting and documentation forms; each insurer could have different formats for information on care provided in addition to the ICD standard codes; different forms on staffing (even wanting professional registration/level; one even wanted CE status on staff)…. all of which required time by the NH. That there seemed to be a pattern of always needing another piece of paperwork submitted which delayed settling an account by weeks if not months. Just not worth it for this NH which was part of a small group (it was my mom's 2nd NH and was really a great facility imo). They put this policy in place before ICD-10 roll-out as they figured it was going to be even more of a nightmare to deal with.

I'd bet that this situation is common for a lot of smaller facilities or in-home care companies. If a facility or home-health agency can easily fill a bed or have clients on private pay, Medicare & Medicaid, then taking LTC insurance with the extra time needed to get paid just doesn't make sense for a business. If this is a trend, a lot of folks having LTC polices are not going to be able to use their policy easily.

While it's too late for "dad" here, piece of advice I give everyone is to put into your investment portfolio long-term care.

Lileva- as you can see by the answers so far, how to deal with the costs of care are very much interdependent on what your state has for priority of how it spends it's Medicaid $$$.

Your going to need to find out just what programs Medicaid pays for and how easy it will be for dad to qualify to be eligibile and what the open medicaid bed status is Dads state & his city. It's like 60-70% of those in a NH are on Medicaid.

My take on all this is if they live long enough - unless they are generationally wealthy- they will flat run out of $ & family will run out of caregiving ability and they will end up applying for medicaid to pay for thier NH. Avoiding the eventual is only going to make you as DPOA just loco, so get them eligible for a Medicaud NH bed.

If where dad is currently does NOT participate in Medicaid, then you need to find a new facility that does and that will take him as "Medicaid Pending". That excess income that dad gets needs to be looked into being reset by a Miller Trust, (like Babalou suggested!) so he is under Medicaid financial limits. I've found that most facilities are not ever going to bring up miller trust as its viewed as legal & financial advise so outside of thier "expertise" combined with wanting to keep as many residents private pay as its more profitable, even if it means the residents kids pay. You cannot overlook the profit motive of facilities esoecially of they aren't keen on Medicaid participation. If dads state really tends to limit Medicaid to NH / skilled nursing care, then you are going to get his medical chart to start showing "need" for skilled nursing. If his current facility is all "dad doesn't need skilled care", then you are just going to have to do this on your own. It can be done, I moved my mom from private pay IL to a "medicaid pending" NH and totally bypassed the AL stage. It can be done, yeah its work but once they are in a NH and on medicaid, its all done from that point on......put a bow on it! Otherwise it's just a band-aid that will constantly be needing to be dealt with IMO. If you find you need to do this, & his current place isnt helpful, I'd suggest you find a couple of NH that take Medicaid that you like and then have dad become a patient of the MD that is the medical director of the NH. For my moms gerontogy group, all the docs also were medical directors of several NH & all still saw patients in their regular practice. It took about 6 mos of every 3 - 5 weeks of visits to build moms chart to show "need" (for those at home, IL, AL they likely wont have the fat medical chart that a hospital discharge to a NH for rehab does, so it needs to be done). mDs who are medical directors of a NH know how a chart needs to read to pass a review by medicaid. The visit she had a bad H&H labs, 10% weight loss and a couple of other things, her doc wrote the orders for "skilled nursing" needed & I moved her from IL to a NH within weeks. If my mom had needed a miller to be done (she didn't as she was abt $ 1,900 in mo income so under the $ 2,064 income limit the year she applied), I'd have met with an elder law atty to set a Miller up during this period. Miller is pretty straightforward but the sticky is the different income sources more than likely have their own paperwork hell to get into a Miller, so it's not a DIY but needs legal to do. If for some reason your dads income isn't "guaranteed" so can't qualify to be in a Miller, the atty might be able to have the income amortized for review by Medicaid so dad stays under the income limits. This little tidbit I had to do for my mom as she had a dividend that paid once a year & in theory would take her just right over $ 2,064 for that month only, but once it was amortized over 12 months not an issue.

Worrying every week, month, day of just how dads care is going to be paid, will be beyond stressful. Emotionally it doesn't leave time to just enjoy being with your parent. You need to find a solution. If you can get him into a Medicaid bed and get his excess income dealt with, do it! Your local Agency on Aging should have lists of all care facilities and which take Medicaid. This site has list of elder law attys by state too. Good luck.

Btw most excellent insight from Joanne's & Vicksky!!

Wonderful advice from Joannes!

Check with your state health dept....to determine if Memory Care is considered A.L. licensure. In Arizona, where I live, Memory Care facilitities are licensed as Assisted Living, and the State Health Dept or website for A.L. licensure, or Medicaid website, will send out a list of all facilities in your town, or area that are licensed with Medicaid and take Memory Care/dementia residents. In AZ, there are many that are small homes, who will take all Memory Care residents and do accept Medicaid. I saw great care for my Dad when he was in a licensed Memory Care facility versus a nursing home that had a separate wing for those with dementia. In Arizona, Memory Care is a flat fee that covers everything....and where my Mom is now living in Assisted Living, her care needs fees are about $1200/mo and her total monthly bill is $4100, with $2600 being base rent. That's pretty much the same for all the places around here for 75 miles. When my Mom has to go into their Memory Care wing, her rate will be $5100/mo, but never with any added on fees for the rest of her life. Memory Care in AZ is mandated to have 3 staff for every 15 residents...but I found, when looking at smaller homes, they were often licensed only for 10 residents, and would still have 3 on days and evenings....so a better staffing. Less on night times, but many residents do sleep well at night. Also, some places here, have the caregivers doing laundry, room cleaning and cooking, while other places, like where my Mom is, have housekeeping and kitchen staff in addition to caregivers, so they aren't so busy with other duties. Just giving you other ideas to consider.

What state are you in. We specilize in finding small homes for seniors like the one my mother lives in. In michigan they are adult family homes and they provide 24/7 care to end of life. They have visiting doc, nurse, foot doc, physical therapy. They manage medications and do personal care. All the ladies that live in moms home have dementia. Every state has such homes. We can help you find out what your state has.

Re: rate increasing for higher level of care. Yes, it happens- - need more care, have to pay more. This is normal, need to plan for it. Please spend a few hundred in meetinf with an elder care lawyer, get all dadspaperwork together and make a plan now- - dont just apply for Medicaid, dont go giving stuff away and dont sell anything yet. If you sell below market value (wink wink) they will penalize dad. Lots of considerations, all your answers cannot come from an online discussion-- at this point you need personalized, professional lawyer help, who knows the Medicaid system in your particular state. Good luck, I hope you find a competent lawyer.

1RareFind wrote, "If anything is promised to specific individuals, you may want to get those items to those specific people and help your dad with the help of a lawyer to make any changes to his will that are appropriate" which is absolutely what should not be done. If there are items of enough value or easy enough to sell, fact check--they still belong to dad, and as HIS assets, these should NOT be given to heirs now, while dad could be using proceeds from their sale to pay his current needs. This is exactly what Medicaid would expect, and actually they will deny paying his care if, for example, he had a piano worth 2,000 or a 10,000 car or a shotgun collection worth 15,000. Please do not make the mistake of gifting items (valuable items) before death. These are in many cases the senior's only way to provide for their needs, and most seniors would rather see their stuff go towards their food & shelter, when facedwith a possible Medicaid look-back penalty. Its not harsh, it's the rules, same for everyone, if you have assets they must go towards your cares.

Someone mentioned his will but his will has no bearing on anything until he passes away. If you have to sell his belongings to pay for memory care, then thats what you have to do. It doesn't matter if he had planned to leave his shot gun to someone or his furniture to someone else. His needs come first while he is living. But all of that may not be an issue. First you need to price other facilities. Compare what you are getting for your money. Do this right away as you may neex to put your name on a waiting list. Some lists can be a couple of years long. Also if your father is in a private room, move him to a semi private room. You will surely save money that way and may not need to move him. Make sure to fully check out any new facility you may be interested in. It may be cheaper, but you want to make sure they are taking proper care of their clients. Check online, check with BBB, check with the state, check with your neurologist. Also if you have a doctor who comes to the facility to see your dad, ask this doctor about other facilities. If he/she goes to one facility, then they are probably going to several. What state are you in?

Ooops, I am not reading very well today. I am so sorry! Please ignore me here.

Also, the more care he needs the cost will go up (at least that was the way it was in my mom's case). We sold the house, got rid of all cd's, savings, etc. and set up a trust. Also, my dad was a veteran (has to have been in combat) so we were able to get VA benefits for him and my mom. With their SS, Teacher Retirement, VA, Annuity, we were able to make ends meet. We were very luck in the fact that my mom insisted on getting long term care insurance while she worked. It ran out about 6 mos. ago but it was a God send while it lasted. She just passed away 6 weeks ago so we don't have that worry anymore :( Now I just need to take care of 94 year old dad. Good luck and God Bless.

I'm confused, is LW father in an apartment or a facility? Does the father have dementia? I thought father had his faculties and was living in an apartment with the rent increasing (as it always does).

1RareFined

It's not price gouging if increases are written in any agreement/contract signed, unfortunately.

What does it say in the contract/agreement you and/or he signed?

It sounds to me like some price gouging is going on and it needs reported. There should be an agency for tenants rights when renting, I would definitely inquire there for starters. Another option is to report the price gouging to the local BBB in that specific area where it's going on. You could also move him to another facility. You want to be very careful not to start shelling out any money from your own pocket, this will break you as well as it's breaking him. You don't want to be in the poor house over this.

Someone here mentioned liquidating his assets or renting out his home if he owns one. Renting out the home is a very good idea but it would have to be cleared of his belongings. Before getting rid of any of his belongings though, make sure that none of those belongings are willed to other potential errors airlines heirs. If anything is promised to specific individuals, you may want to get those items to those specific people and help your dad with the help of a lawyer to make any changes to his will that are appropriate. If he's incompetent, Then he can't change his will and his will will have to stand. Items that are promised in the will to specific individuals will need to be protected and saved for them. You can't just go and overturned someone's will if it was made out when the person was of sound mind but now they're not. I definitely do your homework and check very carefully to see if anything he owns is mentioned in his will if he has one because this is his last will and testament when he passes on and his wishes should be honored.

As for his rental situation, you may want to get him on Medicaid. Normally nursing homes take the whole check of the intake, leaving them a small allowance each month. I'm not sure what the set up is in your case, but this one is particularly surprising since they haven't taken his whole check as facilities normally do. This sounds more to me like an assisted living than a memory care facility because assisted-living won't take your whole check like a nursing facility will

Memory care facilities are not required to have a social worker or someone there to help you make ends meet. Nor is a boarding home style arrange a chouce for memory care. Most memory care facilities do not take Medicaid. Some do, very few, so you will have to look around. I had to find a new facility ti move my mkm to when her rent went up. See if you can find a not for profit one. They maybe more willing ti work with your financial ability to pay. You can contact APlace For Mom to see if they can help. But i found them to only give my name out to a few facilities whi now call me constantly and they told me to look online for a list of facilities, which i already knew to do. There are some memory care facilities that are very small and in homes. Those are usually cheaper and have lower patient to caretaker ratios which is good. I dont know what kind of mentsl stimulation they offer tnough or if they have enough caretakers thete. I would never leave my mom with a place that only had one caretaker ar a time because there is no one else thete to make sure everything is on the up and up. If he was VA, see if you can apply for aid and attendance help. That takes a good year though, so better get busy with it. I do believe your only option is to find a new place or sell assets to subsidize his income.

There is a 'board and care' here, rooms in a lovely old house with shared bathrooms. It's about $2000 something a month, paid out of their social security, but the residents get three meals a day and there is always someone in the house in case of emergencies. They don't accept Medicaid. No personal care, no health care, no medications - I guess you could say it's like an old fashioned boarding house.

Have u looked into adult foster homes, some states call them different things. My mom lives in one here in michigan. She pays 3000 a month. Some are as low as 2500 a month. If you would like more information private message me and i will try and find out what your state has available. They can be a wonderful option for dementia clients.

The facility is required to have a benefits person to help you make ends meet. If Dad has a house, rent it out. We did that for mom, it really helped. If he has assets, start liquidating them.

You need to find out if his facility accepts Medicaid. If so, with the assistance of an elder care attorney, you can set up a Miller Trust. But first, I would talk to the social worker at the facility. She may have some other ideas.