My mom owns her home and will return there after rehab, her income per month is 4,100 but she has about 1,900 in bills will she qualify for Medicaid in Maryland. She already used her 100 days of Medicare with a additional 21 days with blue cross. We have no where for her to go.
Being placed in a NH is good. They do provide them with 24/7 care. When they suspect something wrong they call the doctor and the doctor says call the paramedics and then they call me even if it is 2am. My mom does not have assets for us to worry about. I am not aware of the Miller Trust. I will look into it. The only advice I can give you so do your research. There are a lot of homes that accept both. Apply for her.
I don't qualify for benefits because of my income which seems to be above the maximum. I'm 68 and may need help myself.
With regard to podiatry, my mother complained bitterly that the podiatrist didn't trim her toenails. I called and spoke to her. My mother had edema in her feet secondary to chf and the swelling made it dangerous to trim them on that visit. They were trimmed the next week. I was reminded by this of the fact that my grandma, who lived at home with us and also had chf, died of gangrene, due to my aunt's non professional toenail trimming.
But not all accept Medicaid. They do not have to take medicAID. Where I live in New Orleans 2 great ones - Poydras Home & St Anna's don't & won't ever take Medicaid but take medicare & ltc insurance policies. My moms NH in TX took Medicare & Medicaid but would not take any LTC insurance policies for payment. Almost all LTC facilities are private businesses and can determine what their policy will be regarding payment.
I'm offended that you have called the staff at NH "GARBAGE" - working at a NH is a difficult job, most with low pay, high demands & with every minute holding the possibility of an emergency situation.
If so couple of things to think about before you do the medicaid application. Once mom goes into a NH the VA A&A goes away, she then gets $ 90 from VA. Her SS& other retirement will need to get paid to NH minus the small personal needs allowance (varies by state from $35 - $ 105). So at most mom will have about $150 a mo discretionary income which is intended to pay for beauty shoppe, clothing replacement & personal toiletries at the NH & most often the PNA is held in an account in the NH.
Can you pay for all for the home which is in her name? From day 1 of NH and then be able to qualify for exemption or exclusions to the required MERP / estate recovery on her home after mom dies so that you can inheirit the home? If you work, you may not qualify for a caregiver exemption.
Run the #'s on house costs & your income and then make an appointment with an experienced elder law attorney before you do the Medicaid application to see what possible options are out there & within Medicaid compliance for your state.
About the CD, it will likely be viewed as an asset to be spent down. For funeral & burial, those usually are done as a NCV (no cash value) prepaid funeral & burial policy. Funds are fixed for funeral. Problem with the CD is that in theory you could go mañana & cash it out. Also look at the insurance polices, if have any cash value (like they are whole life policies), they will count towards asset limit & usually need to get cashed in if it takes mom over the asset maximum (usually 2K). Medicaid rules are pretty inflexible and precise on $ amounts.
It's all a lot to deal with. One of the experts on this site -Heiser - has a great book that explains the bigger picture of how this works. You May want to get it! Good luck.
So your mom has $ 4,100 each month in income? Really?? It could be that her income is over the medicaid limit for your state. I'd suggest that you look into the income maximum for Medicaid as a first step. Like when I first applied for my mom in TX in 2911 the max was $ 2,064 & now is $ 2,163. Some states have the maximum income at 2k and some are under 2k. The assets max seems to universally be 2k in non-exempt assets. Over these for either income or assets makes mom ineligible. Basically have to be "at need" which means impoverished.
There are things that can be done sometimes for excess income - eg a Miller Trust - but IMHO a Miller needs to be done just right which means having eider law attorney do it. Miller has qualifiers too & income must be a guaranteed benefit. Perchance is mom railroad retirement?
NH Medicaid does not really factor in debt for income. If monthly debt includes payments deducted for Medicare (from her SS check) or a secondary insurer, those can be worked through. But if mom has other debt - credit cards, life insurance payments, mortgage (horror or horrors!!) - once she goes into a NH and onto Medicaid, she will have no - nada - zilch of her income to ever own on those debts ever again. NH Medicaid requires them to do a co-pay or "SOC" (share of cost) of ALL their monthly income to the facility less a small personal needs allowance. The PNA varies by state - for LizDevine parent it's $ 72.80; for my mom it was $ 60. The PNA is the only discretionary income they will ever have again. If the NH charges for cable, phone, well that could eat up the monthly PNA entirely. The SOC for NH seems to come as a total surprise often for family.
If debt needs to be repaid, then family is going to have to pay or the debt gets defaulted on. For moms home, that can get quite complex.
Really look into the income limit as a first. Then try to get a clear picture of moms debt service to see what the fallout would be if she has no income anymore and then look hard to your own purse to see if you can & want to pay her debt. Also realize that if she goes onto Medicaid her exempt asset of a house will become non-exempt upon her death and subject to a recovery attempt by the state.
It's a lot to decide upon. If you can see an atty before you do the Medicaid application to perhaps come up with options as to divesting that's Medicaid compliant. Good luck, you have hard decisions to make.