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By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington. Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services. APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid. We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour. APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment. You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints. Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights. APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.I agree that: A.I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information"). B.APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink. C.APFM may send all communications to me electronically via e-mail or by access to an APFM web site. D.If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records. E.This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year. F.You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
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Mostly Independent
Your loved one may not require home care or assisted living services at this time. However, continue to monitor their condition for changes and consider occasional in-home care services for help as needed.
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NH (aka skilled nursing facility/SNF or long term care/LTC) is paid for 3 ways: 1) private pay by either the elder or their family; 2) from LTC insurance; or 3) by qualifying for Medicaid.
Medicaid rules determined by each state & are state specific even though it is a federal & state program. Medicaid is needs-based. You are expected to spend your assets first and foremost before the state will pay. There are things you can do to reduce assets but these need to be done by someone qualified to do this that will pass your state's review. An certified elder law attorney is best.
For NH Medicaid eligibility, an individual must show that: 1) are 65+ (can be younger if qualified disability), 2) medical condition requires skilled level of nursing care, 3) monthly income at or below their states max (about 2K), This is the “income test”– how much $ do you make. TX is $2,094. 4) all countable assets are at or below 2K This is the “asset test” – how much $ do you own. 5) not gifted away anything of value during 5yr look-back period.
If you do, could be a “transfer penalty” when items are gifted. Penalty different for each state as it’s based on each state’s NH reimbursement rate. For Texas, it is $ 142.92 a day rate (2011).
Look-back is 5 yrs. Most states require 3 – 6 mo. of financials with initial Medicaid application. Can require more financials if something pique’s interest. Financials are bank statements, social security and retirement statements, insurance policies, etc. Your assets are subject to MERP (estate recovery) after death.
ASSETS: All assets are counted, unless the assets fall within the short list of "noncountable" assets: - personal possessions, - a vehicle (some states have a limit on the value) - their principal residence, provided it is in the same state in which the individual is applying for coverage & the house may be kept with no equity limit if the "community spouse" lives there; otherwise the equity limit is 500K (750K in some states) - prepaid funeral (irrevocable, NCV, usually 10K max) - small amount of life insurance (usually $1,500 & NCV) All other assets (savings, stocks, whole life, rental property) are counted.Must “spend down” to get below their states maximum to qualify.
The financials are what most folks focus on. But remember that they also need to medically qualify for needing skilled care for Medicaid.
My mother was just granted a permanent residence card or green card. She is 75 years old now. Never worked here. She will be staying with me and my family here in Florida. She has no social security pension or no source of income. Would she qualify for a medicaid or medicare benefits?
Pri - At 75 your mom is still young and I'd look into getting her naturalized so that she can become a citizen. Not being a citizen is kinda a sticky situation to be in and get federal or state supported care or programs. There are lots of community based organizations who do citizenship classes in other languages too.
Until recently this hasn't been a issue but is so now. At my mom's NH, there actually have been issues with ladies who were war brides and never became citizens and so get ineligible for state Medicaid but can get VA aid & attendance. In speaking with one of their kids, it has been a real nightmare of paperwork as they have dementia too far gone to go and do the citizenship classe & test to be naturalized. My mom lives in a big city with a huge military presence so this situation is not unique and the NH knows how to deal with this issue. But I doubt that other places would be able to work through it. Good luck.
how do we get Mom on Medicaid? How do we get help paying for 24 hour care in home for her as well? We have 24 hour care now and trying to spend down her $$, she doesn't own a home and does not have a car , gets Social security. All annuities cashed in already and all life ins. policies to help pay for homecare. Do we apply now for Medicaid?? Where do we go?
CHristie - I think the issue you are going to have is keeping mom @ home. Most states (who administer Medicaid - which is a joint federal and state program) have Medicaid designed to be for elders who are at a NH rather than for paying for at home care. The concept behind this is that a NH as a facility will have the range of equipment & skilled (& vetted) professionals - social workers, rehab, PT, OT, etc - that someone "working" or helping mom with ADL's in your home could not. Medicaid requires the medical need for skilled nursing, if they are living at home (or in IL) it's kinda hard to validate and document the medical need for skilled care.
The NH or facility is usually the one who submits the Medicaid application on your elders behalf along with their NH bill to the state. BUT the family or responsible party fills out and submits the elders individual Medicaid application to the NH along with the financial documentation required. The NH will give you a 1 or 2 page list of the documents needed - my mom's list was 1 page and her documents ended up being over 100 pages, while my MIL NH list was 2 pages but her documents were maybe 40 pages. Both NH were in TX but each approached it differently. The NH usually does an initial look over of what your submit and I think bases whether or not they accept your elder as "Medicaid Pending" for payment by looking at their financials. NH has an assigned state caseworker for that facility and you do not deal with them unless there is a specific issue with your elders application. My mom was in IL for a couple of years before NH, so her banking showed a clear & consistent pattern via automated payment of how the vast majority of her monthly income was spent. The caseworker may ask to see documentation or receipts on checks if they were not written to a business.
For at home care paid for by Medicaid, you would need to see if your state even does this via a waiver and how the waiver for this is structured. My mom is in TX in a NH and on Medicaid - her state has a very small and limited elder waiver program for nonNH situations and the waiting list is long. In TX it's much easier to get them into a NH than getting a waiver.Waivers tend to be called "community based services" and I'd suggest you contact your local Area on Aging to see what your state & your community provides. This site has a drop down list for AoA by state. Good luck and keep a sense of humor, you'll need it.
My dad sold his home and lived with my brother. The money from the home was put into savings in my brothers name. My brother got sick and used some of the money for medical bills. My dad now needs assisted living. Will my brother have to pay back the money before my dad can get medicaid?
@generous: how long ago did your dad sell the house? In NY state, the typical look-back period for applying for long term care Medicaid is five years; meaning that financial transactions your dad made (including the sale of the house) over the last five years will be looked at. This may vary depending on the state he lives in. Per chance, was the house ever put into a life estate?
Hmm...the money from the sale of the house (including what was already spent) most likely is going to be considered an asset of your dad's. These funds are probably going to count as available funds for payment of costs at the assisted living facility, *before* your dad is eligible to apply for Medicaid. If your dad's monthly income happens to cover the cost of monthly rent at assisted living, a facility might be able to accept him based on his ability to pay privately without worrying about what he has in assets. But if in the next four years he needed to apply for Medicaid, the asset transfer could still be an issue. Your best bet is to contact an eldercare attorney to be sure.
Generous - If your elder needs to apply for Medicaid between now and 2018, the sale of the house and what it sold or transferred for will be found out and there likely will be a transfer penalty attached to his Medicaid status. For hard assets, like a home or a car, the documentation of sale or transfer is recorded by the local assessor and in turn dovetails into the state's system. This information is just keystrokes away from being found out.
The transfer penalty is kinda sticky in that there can be exemptions to value of assets or the assessed value is higher than what the reality of selling the property is (so there is a whole fair market value issue to deal with), so if he applies for Medicaid, you will need an elder care attorney to sort the penalty out and possibly represent you in an appeal.
How the transfer penalty works is based on your states Medicaid NH reinbursement rate. My mom is in TX and TX rate is about $ 143.00 a day, which is pitiful low. This is kinda how it works: house valued & or sold at $200K; and 1/2 of the $ Dad is using to private pay for AL and 1/2 went to brother which brother has totally spent. Dad's AL uses up 95K and now Dad is in a NH @ 5K a mo. and about to qualify for Medicaid. Dad stays in the NH but is Medicaid Pending. All looks good for qualifying as his assets (100K) have been spent on AL and now on NH. Dad has no more assets. But about 3 - 6 months later, the asset sale or transfer of the house, will come up when the state does the routine search on the application. Then you or whomever signed dad into the NH, will get a transfer penalty letter from the state with the amount needed to be private pay before Medicaid will pay. The NH gets the letter also. So if the penalty is 100K and if you are in Texas, it is roughly 700 days that someone needs to private pay @ the NH. This is a total panic situation 4 u & an awful situation to place your elder in.
The transfer penalty is such that the individual still qualifies for Medicaid but is ineligible for Medicaid's payment to the NH during the penalty period. Confused - yes; confusing - hell yes. Penalty set on each states' management of Medicaid, each state has it's own formula as to how they figure out the day rate and if it is set by the start of the month or exact date of transfer etc. It's a hot mess to figure out. Realistically you'll need someone legal to deal with this if it becomes an issue.
All my mothers retirement she receives from my dads death is taken out for private insurance. She has nothing and lives with me. I want to get her on medicade so she can get more income from the retirement. The private insurance doesn't pay for much anyway. Why should she pay if she qualifies for medicade?
My mother has been taking care of my grandfather for quite some time now. He fell and broke his hip. I need information on how to apply for her to be paid as his care giver. They reside in Miami. Thanks
Has anyone had the experience of transferring a parent from one state to another NH. The parent has Medicaid coverage in the home state. We are just starting on the transfer process and if anyone has tips, please share. Thanks so much.
How do I get medicaid for both of my parents. Mother had a stroke, and dad is total blind. still leave in their home, but it is in home equality. need help leave in Dallas, Texas
My grandmother lives in an assisted living facility in Rockwall, TX. She is about to run out of money in the near future and we need to get her qualified for medicaid. Her monthly income is only $1200. We don't know where to start.
I am caring for my mother in my home, she gets only 752.00 Soc Sec. owns nothing, no car, no savings. Now she is very ill and I will need to transfer her to a NH at some point. Can I apply for medicaid on her behalf, or does the NH have to do that. She already qualified for help on prescriptions. Living in Texas
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
Medicaid rules determined by each state & are state specific even though it is a federal & state program. Medicaid is needs-based. You are expected to spend your assets first and foremost before the state will pay. There are things you can do to reduce assets but these need to be done by someone qualified to do this that will pass your state's review. An certified elder law attorney is best.
For NH Medicaid eligibility, an individual must show that:
1) are 65+ (can be younger if qualified disability),
2) medical condition requires skilled level of nursing care,
3) monthly income at or below their states max (about 2K),
This is the “income test”– how much $ do you make. TX is $2,094.
4) all countable assets are at or below 2K
This is the “asset test” – how much $ do you own.
5) not gifted away anything of value during 5yr look-back period.
If you do, could be a “transfer penalty” when items are gifted. Penalty different for each state as it’s based on each state’s NH reimbursement rate. For Texas, it is $ 142.92 a day rate (2011).
Look-back is 5 yrs. Most states require 3 – 6 mo. of financials with initial Medicaid application. Can require more financials if something pique’s interest. Financials are bank statements, social security and retirement statements, insurance policies, etc. Your assets are subject to MERP (estate recovery) after death.
ASSETS: All assets are counted, unless the assets fall within the short list of "noncountable" assets:
- personal possessions,
- a vehicle (some states have a limit on the value)
- their principal residence, provided it is in the same state in which the individual is applying for coverage & the house may be kept with no equity limit if the "community spouse" lives there; otherwise the equity limit is 500K (750K in some states)
- prepaid funeral (irrevocable, NCV, usually 10K max)
- small amount of life insurance (usually $1,500 & NCV)
All other assets (savings, stocks, whole life, rental property) are counted.Must “spend down” to get below their states maximum to qualify.
The financials are what most folks focus on. But remember that they also need to medically qualify for needing skilled care for Medicaid.
Until recently this hasn't been a issue but is so now. At my mom's NH, there actually have been issues with ladies who were war brides and never became citizens and so get ineligible for state Medicaid but can get VA aid & attendance. In speaking with one of their kids, it has been a real nightmare of paperwork as they have dementia too far gone to go and do the citizenship classe & test to be naturalized. My mom lives in a big city with a huge military presence so this situation is not unique and the NH knows how to deal with this issue. But I doubt that other places would be able to work through it. Good luck.
The NH or facility is usually the one who submits the Medicaid application on your elders behalf along with their NH bill to the state. BUT the family or responsible party fills out and submits the elders individual Medicaid application to the NH along with the financial documentation required. The NH will give you a 1 or 2 page list of the documents needed - my mom's list was 1 page and her documents ended up being over 100 pages, while my MIL NH list was 2 pages but her documents were maybe 40 pages. Both NH were in TX but each approached it differently. The NH usually does an initial look over of what your submit and I think bases whether or not they accept your elder as "Medicaid Pending" for payment by looking at their financials. NH has an assigned state caseworker for that facility and you do not deal with them unless there is a specific issue with your elders application. My mom was in IL for a couple of years before NH, so her banking showed a clear & consistent pattern via automated payment of how the vast majority of her monthly income was spent. The caseworker may ask to see documentation or receipts on checks if they were not written to a business.
For at home care paid for by Medicaid, you would need to see if your state even does this via a waiver and how the waiver for this is structured. My mom is in TX in a NH and on Medicaid - her state has a very small and limited elder waiver program for nonNH situations and the waiting list is long. In TX it's much easier to get them into a NH than getting a waiver.Waivers tend to be called "community based services" and I'd suggest you contact your local Area on Aging to see what your state & your community provides. This site has a drop down list for AoA by state. Good luck and keep a sense of humor, you'll need it.
The transfer penalty is kinda sticky in that there can be exemptions to value of assets or the assessed value is higher than what the reality of selling the property is (so there is a whole fair market value issue to deal with), so if he applies for Medicaid, you will need an elder care attorney to sort the penalty out and possibly represent you in an appeal.
How the transfer penalty works is based on your states Medicaid NH reinbursement rate. My mom is in TX and TX rate is about $ 143.00 a day, which is pitiful low. This is kinda how it works: house valued & or sold at $200K; and 1/2 of the $ Dad is using to private pay for AL and 1/2 went to brother which brother has totally spent. Dad's AL uses up 95K and now Dad is in a NH @ 5K a mo. and about to qualify for Medicaid. Dad stays in the NH but is Medicaid Pending. All looks good for qualifying as his assets (100K) have been spent on AL and now on NH. Dad has no more assets. But about 3 - 6 months later, the asset sale or transfer of the house, will come up when the state does the routine search on the application. Then you or whomever signed dad into the NH, will get a transfer penalty letter from the state with the amount needed to be private pay before Medicaid will pay. The NH gets the letter also. So if the penalty is 100K and if you are in Texas, it is roughly 700 days that someone needs to private pay @ the NH.
This is a total panic situation 4 u & an awful situation to place your elder in.
The transfer penalty is such that the individual still qualifies for Medicaid but is ineligible for Medicaid's payment to the NH during the penalty period. Confused - yes; confusing - hell yes. Penalty set on each states' management of Medicaid, each state has it's own formula as to how they figure out the day rate and if it is set by the start of the month or exact date of transfer etc. It's a hot mess to figure out.
Realistically you'll need someone legal to deal with this if it becomes an issue.