Very OT Medicare and stuff

I am trying to help an old couple we know. Her husband was in nursing home for his 100 days or whatever it is. Time is up and he is being transferred to another home and he will be charged his pension and social security, leaving her with zilch. Could he go home for week or so and start another 100 days? How does this work? Nobody will talk to me since I am not related. Can wife stop this from happening? Please any help appreciated. They are both 75 years old. Somebody told her to get a job. She is capable of taking care of him at home.

dave, Where your neighbor is.....
Medicare Only pays for SKILLED NURSING not Custodial Nursing! Skilled means 24/7 skilled care.
Custodial means there is someone around on a 24/7 basis but they are not skilled ie Dr., Nurse, etc.
There are clauses that allow your friend to go home and come back after a time, and Medicare will pick up the tab but ,,,,,You are talking about jumping through specific hoops at specific times, Like threading a needle. If he can remain at home for a time that will be the best.
BUT I will tell you that your Neighbors will need to start making prep for a Custodial Care Nursing Home, Now this is where the hard decisions will have to be made.
At $4000/month average cost how will they pay for his care, use pensions and SS payments. sign over their home to be used as collaterial against the debt. Sell off land or other property. If this is done what about the Mrs. Are their tax consequence.
Is your state a "Community Property" state, Then each spouse is entitaled to 1/2 of the whole. That may be a way to approach this problem. Simply split the estate in 1/2 and go from there.
Hope this helps, Call me if you like. 512-577-3837
Later,
John A.

They may not talk to you about that specific case because of the overblown privacy rules. But, they should be able to tell you what the rules are. If I remember right there was a federal law passed a few years ago that prevents the care of one spouse taking everything. But, you have to talk to the right people. Also, if she has a Social Security record, she might be able to receive Social Security based on her own work record, if she has one. Usually whether she receives her own or her husbands depends on which is greater -- if this does work, she will get less income, since apparantly she is on her husbands.

You need to find an attorney that specializes in "elder law". The laws vary from state to state.

I'm sure rules vary by state, But if they have property (ie land, homes, etc.), it might be time to get their name off the deeds. In my state the nursing home can take everything in order to cover costs. Many farms had to be sold to cover debts. Sold at auction to the highest bidder, then alot of times all the cash went straight to the nursing home leaving sons, daughters and family members with nothing. Its sad to see the family farm disappear that way. Some were farms that were in the same name since they were settled on over 100 years ago.

The 100 day period begins over again after 6 months if the one receiving skilled care leaves the facility for home or one such as assisted living and does not need skilled care for the 6 month period.

Got to your local social service agency and find out the Medicaid rules specific to your area. To qualify for benefits here, one has to spend down their assets and can have the following: A car-- It can be a $500 clunker or a Rolls Royce, $2000 in monetary assets, checking, or a savings account, and can keep the house and any property directly adjacent to the house. My mom has a house on a 1 acre lot and 17 acres of farmland on a separate deed adjoining her home lot, and she can keep that all. The problems that arise are that her spouse or heirs will have to keep up the property and pay bills accordingly to maintain this asset level. The sick one will have no income as her social security will go to the nursing home. So, it can be left up to the POAs as to how to manage the assets. The kids could in reality pay for all the sick one's bills which would protect his or her asset base and not put him or her on Medicaid. I have a cousin and her husband doing that now. She was deeded some out of state property and faces the "lookback" provisions of the law. In order to protect her ability to keep the land, she is paying her mom"s bills. She will spend less money than ifn she had to buy the property on the open market.

My Mom has been in and out of both types of facilities for almost 2 years.

Be careful about re-titling property and assets. There is a 5 year lookback, and Medicaid and social services will come and get their money even if they wait until after a sick one has passed away. I have heard horror stories about that.

Have wills, POAs, and health care POAs in place. Do not do anything based upon what friends or medical folks tell you. Go to social services and get the rules, then go to an attorney if necessary.

The truth is that we all should do estate planning much earlier than we do to help avoid the 5 year rule and such situations as this.

These are some of the things I have learned over the last 2 years. Your experiences may differ. I am my mom's POA and Health Care POA. I am still learning. Good Luck. It becomes difficult at times.

Dave, Seems to me the key statement is "she is capable of taking care of him at home". This may be a situation where Home Health Care can provide some intermittent care at home (if he has "traditional" Medicare and a "skilled service" is needed). Wife can ask for an assessment to be done by a Medicare Home Health Agency. Home Health services are paid by Medicare. If he does not have Medicare -payment would be out of pocket.

Thanks so much all. I found out today both are on Social security and Medicaid. This man had his 100 days in nursing home and was told to leave. He is now in another home and his wife was told to kick over his SS check or goodbye. Lady says local bank has control of assets. Must be time for lawyer. I will keep trying, too. Thanks again.

Supposed to say Medicare, Blue Cross, and Medicaid. No kids, no relatives.

I think your $4000 avg cost is low. My grandmother had that much cost 10 years ago.

Spook, You are right! I will bet you and she are on the East or West Coast region or surenough larger Metro area, like Chicago, Detroit, Atlanta
That $4000 figure will work most anywhere in Texas except the larger metros ie D/FW, Houston
Later,
John A

When my dad was in nursing home they not only got his Social Security check but he had to pay the difference in thier monthly charge and amount of check , about $2000. As long as he had the money to pay I think that is the way it should be. Back a few years ago you could give all your assets away and then let taxpayers pick up nursing home charge but that does not work now. Someone has to pay the charges as they are not in business to lose money.

You can still do it, BUT.....It all has to be in someone elses name, other than your spouses, for a minumum of 5 years. Going through that right now with my grandmother. Fortunately, she transferred EVRYTHING she had over to my mother and uncle in 2001. Only problem is that at the TAX OFFICE its all still in my grandmothers name.Mom is having to prove that it was all changed legally back in 01, just a county screw up. Granny is having he SS check, and some other things she had go to the nursing home, and paying an additional grand a month. She could have gone to a nursing home not quite as nice and been able to save the grand, but she is VERY happy where shes at now, and she has the money.