Need some help. Dont know what to do.

[rcrush]

About 6 months ago my mom died and my dad had to go live in a nursing home. He had a stroke a couple of years ago and from what I'm told he will not be able to live on his own. My dad is retired military and had all his medical care taken care of or thats what I assumed. I get a call today from the home and they said that Tricare and Medicare were running out and I would have to have $30,000 a year so he can live there. I was dumb enough to believe that retired military get medical care for life. My moms life insurance was $30,000 so thats enough to cover 1 year of the home I guess. I would have to sell the house and everything else to make sure he could get taken care of. But what happends when all that money runs out? They said he would pretty much have to be dirt poor to qualify for medicaid. So I guess that once all our savings is eaten away he can go on medicaid but theres got to be a better way. I mean I could probably swing it if my parents didnt have massive credit card debt that I was using their insurance money to pay off.

Is it even possible to get some kind of Nursing Home Insurance at this point?

[babylonsister]

1. Here's a kick; I hope someone with more knowledge than I

have can help you. My uncle was in the same position about 10 years ago. It's not easy.

Are there any nearby VA facilities?

[rcrush]

2. I have no idea

I was never the one in the family that dealt with this stuff but now it seems I'm the only one left that can or will do anything. I will have to ask someone if VA can help cause I sure as hell hope so.

[babylonsister]

3. I suggest you also post your questions in the VA forum here:

http://www.democraticunderground.com/discuss/duboard.php?az=show_topics&forum=259

[drmeow]

4. Try calling one of these organizations

to find out what your options are:

http://www.tamus.edu/benefits/publications/brochures/elder.pdf

[Mike 03]

5. Kick. I wish I knew how to help. I hope an attorney sees your post.

I have some vague recollection of there being a legal document that, upon execution, can protect a home from having to be sold, or from creditors or lienholders, in a situation such as you have described, at least in some states. I'll look around and see if I can find out what it was or what it is called or if it could apply in this situation.

[babylonsister]

6. There's a bunch of links here:

this site is very good for helping vets...

http://www.vawatchdog.org/va%20links%20ez%20guide.htm

[Phoebe Loosinhouse]

7. You really need to talk to someone who is knowledgeable about Medicare

and nursing homes in your state. Believe it or not, the ground rules differ from state to state.

Medicare also has different rules and guidelines for coverage of short-term versus long term care. I believe that I have heard of people being checked out of their nursing homes to stay with family to interrupt a stay so that they will qualify later once again under short term care guidelines. When I say this, this is not a scam . This is people following the legal guidelines of what is and isn't allowed. Many nursing homes have ombudspeople on their staff to help guide you through the complexities of all the rules. By the way, $30,000 is incredibly cheap for nursing home care in my neck of the woods.

Does your Dad get a military pension? Does he get Social Security? How much will they contribute towards his care? Many people with military retirements will NEVER qualify for Medicare because their retirement incomes will always be higher than Medicare guidelines.

You can also look into VA nursing homes and see if he qualifies. Some are horror stories and some are perfectly fine - you have to investigate

If someone is going to go into long term, uninterrupted care, I think they do require the person to spend down their assets to almost nothing.

You really need to see an attorney and get advice for the best options for your Dad - remember, in the state your Dad is in.

Was your Mom's insurance left to your Dad? If it was, then, yes you probably do have to spend it on his care, but at least that might buy you time to sell off his possessions (with his consent and knowledge, of course) and sell his home and get another few years of coverage.

[Midlodemocrat]

8. You need to liquidate all his assets and pay for the nursing home

out of those. When those run out, he will qualify for Medicaid. Because his spouse is deceased, he does not get to keep his property while being on Medicaid.

And, no, he can't get nursing home insurance at this point.

Once he goes on Medicaid, he can never be kicked out of the nursing home unless CMS decides to essentially shut the home down. If it's a good home, that won't happen.

[snappyturtle]

9. The day my father died the financial administrator of the hospital called my mother

and I into her office. She was brutal. My dad had SAMBA (Special Agents Mutual Benefit Association)government, insurance. They said it was running out and wanted to know if Mom would sell the farm....literally?

I was unaware it would run out too.He was 92 and never seriously ill until he went into the hospital!
My mother was frantic as was I and then the adm. told us Dad had signed a paper that there were to be no extraordinary efforts made to keep him alive. He died less than 12 hours later...he knew of the pressures coming. I figured we'd have to come up with some home care help.

When I worked in a nursing home I learned of patients that had to sell everything to stay there.

It's an awful place to be in...I feel so for you. :hug:

[rcrush]

10. Ugh

Thanks for all the replies. Pretty much confirms what I thought I would have to do. I was named Power of Attorney for my dad because he is not able to make decisions for himself according to the doctor. I'm waiting for the lawyer who drew up the will to contact me but this whole process is just so ridiculous to me.

[snappyturtle]

14. I was blown away by it. The system makes no sense to me and this is why.

My husband has a friend who is or was a trust fund baby. He and his brother went through millions of their parents' money. They half heartedly tried to start up businesses, clubs,restaurants,used car dealerships, et.al. They both ended up in drugs.....like the cocaine sort. All their businesses failed big time. This guy has never earnestly worked although he had a B.S. from U of T and at one time a realtor license, which he never used but he did go to federal prison for drug trafficking! Anyway, his health is awful. Diabetes, Hep. C and totally weak. Can barely walk or stand...poor circulation and yet he applied for disability and got that although it's only six hundred a month and when he recently became ill from a nelected skin infection, the local hospital took him in for a week and is providing daily follow-up treatments! I DON'T GET IT! Not that I want to see anyone suffer but here's a guy that has never worked, never bought insurance (when he could afford it) and never contributed one diddly to society even though he had every advantage and HE gets a free ride. He has no living relatives except some distant cousins. I get so angry when I hear the WORKING poor are looking for handouts!

I hate to admit how much we've contributed to try to get him on the right track...a lot of money and time. He seems to be doing better but he's 58 years old and I don't know how he plans to support himself. This is a bone of contention in our house until a just a few days ago when mr. snappy landed a good building job because the last two years we were barely surviving.

I wish you the best of luck.

[rcrush]

11. Thats what I was always told

(I was unaware it would run out too.He was 92 and never seriously ill until he went into the hospital!)

Exactly I mean I was told all my life that if you served the military that you would be taken care of for life. As far as your medical care was concerned anyway. But I'm finding out that its only up until it gets expensive then you are on your own.

[snappyturtle]

19. Unfortunately, yep. nt

[tkmorris]

12. You need a lawyer/financial adviser NOW

It is possible for him to qualify for Medicaid, but to do so he will have to be, on paper, as "dirt poor" as the nursing home admin implied. You seem to have some control of his assets, which is helpful, but the main problem is that they are still his assets. I am thinking that he needs to turn over those assets to family (tax-free gifts) or something similar, but a good advisor will know the specific ins and outs and literally save you thousands. Don't be cheap on the advice and then pay huge money to the nursing home, get the help now.

[Phoebe Loosinhouse]

15. Medicare is totally onto gifting assets to family members and they

have mega rules about it and a "look-back" period, which I can't remember if it is 3 or 6 years. For every x amount of assets a person gifts, it adds x amount of months to the time they would NOT qualify.

[EFerrari]

13. I would get someone besides the nursing home to advise you.

They have a conflict of interest here.

[TahitiNut]

16. As the "assisted living" caregiver for my mother for the past 5+ years, ...

... I welcome you to the wonderful world of American health care for senior citizens. It's a horror ... and the under-40 crowd can't be bothered. (Boy, do THEY have a shock coming!)

Find your county social service agencies ... and get advice from a social service worker there. The problem ISN'T that there's nobody to help ... it's FINDING them. It's NOT made easy since the whole system is set up on ADVERSARIAL assumptions ... advocacy on opposite sides of potential lawsuits as well as the adversarial assumptions inherent in bureaucratic agency relationships with their clients.

While I'm an intellectual supporter of a political dialectic, the slide into an all-is-adversarial notion pervading our social systems (with "zero-sum" thinking) is incredibly toxic.

[kiva]

17. Some very good advice on this thread.

As someone suggested, please do contact the VA about the feasibility of finding space in one of their facilities, though it may not be the best solution for you. When this happened with my father, the closest VA nursing home was over an hour away from where my mother lived, plus had a substantial waiting list, so wasn't a workable option. There was a VA hospital nearby, but they had no nursing home facility.

A bit of advice--after my mother's stroke, she too could no longer live independently. After a great deal of searching (mostly by my wonderful SIL) we found a very good assisted living home. We had rejected several homes that included both assisted living and traditional nursing home facilities, mostly because these places tend to be less aesthetically attractive--the institutional smell and appearance are (not surprisingly) more evident, and we thought she would do better in a more pleasant setting. What we didn't consider was what would happen when her mental state deteriorated to the point where she could no longer function in the assisted living setting. It was, to put it bluntly, a nightmare to move her--she was confused by the move, and convinced that people at the nursing home were trying to kill her. If we had it to do over, we would have definitely chose a facility that would have allowed her to move into a different wing and still see the same familiar people and rooms.

Also, do make sure you get information about any extra charges for services. The monthly fee for the assisted living place almost doubled during the three years my mom was there, mostly because of charges for things like assisting her in the bath, extra cleaning services, and other extra care she needed as her condition deteriorated. You have my sympathy, this is a difficult time. :hug:

[Blue Diadem]

18. If I were you, I'd speak with someone from the VA.

Here's a link to their Geriatric and extended care programs and services.

http://www1.va.gov/GeriatricsSHG/page.cfm?pg=63

[snappyturtle]

20. Maybe this sounds devious...may not be legal..I don't know but how about

if you have your mother's life insurance to pay for a year that in the MEANTIME, since you have power of attorney, that you get the house somehow put in your name? Is that possible? Legal beagles..answer please.

[rcrush]

21. I dont know

I asked the lawyer if there would be an easier way to pay all his bills since right now I have to go to the bank and ask for cashiers checks for all his bills. They wont even let me use any money to pay my rent. Everyone I have to deal with I believe is in the business of making shit complicated.

[kiva]

22. Unfortunatly the financial powers that be have taken

care of this, and most (maybe all?) states have pretty definite restrictions about transferring assets. In my family's case, we had put my parents' house in all of our names (mom, dad, three kids) a year or so before my father's condition became too severe. Three years later we sold the house, and my mother's portion had to be spent before most assistance was available, and we barely made the cutoff. We paid for a few hours of legal advice, and it was well worth the expense.

[snappyturtle]

23. Dad died in 2002 so the memory of the particulars that never came to be

because of his death are a bit vague. I do remember some reference to what you have said. It makes sense from the others involved, that they wouldn't make it easy! Thanks.

[kiva]

25. You're welcome, and good luck! n/t

[A HERETIC I AM]

24. Depending on the size of his estate, you may have several options.

1st, you need to know how much everything in his estate is worth. What is the total value of all his assets (house, securities**, cars, antiques, collectibles, etc.) if they were to be liquidated tomorrow?

2nd, What are his total liabilities? You mentioned credit card debt. What else is there?

If the total of his estate after settling all obligations is substantial - say $500,000 or more, there may be a way to leverage those funds in such a way as to not have it all be gone by the time he passes away or at least guarantee there will be an income stream as long as he lives.

You most definitely need an Attorney and a qualified Financial Advisor. There are various ways to preserve wealth in a situation like this if done properly. Properly titling the assets in a Trust or vehicles such as a Charitable Remainder Trust for instance. Perhaps a "Life with Period Certain" immediate annuity. If he needs $30,000 now to stay in the facility and he has had a stroke, he could likely live quite a while but have a deteriorating condition that could push the annual care expenses up into the 6 figure range. The problem with using assets to fund ongoing expenses is how much the money can yield. 5% is perfectly and safely doable. 7% can be done too. Much higher than that and the risk of loss or reduction of principal becomes much greater. There are Closed End Funds out there right now yielding up to and over 15% but they aren't anything I would buy my mom.


Your situation clearly illustrates the value of a properly sized Long Term Care Insurance policy.

You have my sympathies for you and your fathers situation.

See an Attorney.

** On edit to add this ** You need to ask him SPECIFICALLY if he has any stock certificates stashed in a safe deposit box somewhere or in the house. Many of your fathers generation do. Many, many children of deceased parents find stock and bond certificates hidden in their homes or in one or more safe deposit boxes. Had they known they were there beforehand, the funds could have alleviated much hardship. You never know. Maybe he has 500,000 shares of some stock he paid $.10/share for 45 years ago that is worth a considerable sum now.

[McCamy Taylor]

26. Tricare and Medicare cant "run out". He needs to qualify for Medicaid, too.

But to do that, he only has to go through his savings, not his childrens' savings. In some places he is allowed to keep his home. Have you contacted Medicaid?