Friend with Nursing Home Questions

cheerful1_gwJuly 6, 2006

A friend of mine (81 years old) is considering going into a nursing home. She has Medicare; her assets are cash and bonds, which are held jointly with her son. No real estate holdings. She is concerned about what the nursing home can take. She wants her son to inherit as much as possible. She lives in New York State.

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Why does she want to go into a nursing home? A nursing home is usually required by medical conditions. Is she really thinking about a retirement home or assisted living instead? Those are far different facilities.

As for nursing homes, with doctors' orders, medicare covers the first 20 days, and then (I think) $100 or so a day until a total of about 3 months. (Sorry to be vague, my experiences with Mother was a year ago). Then you are on your own to pay the bills until your money is spent.

Real estate,, at least here in CA, is about the only asset that you can shelter.

Your firend needs to talk to lawyer who specializes in Elder Law and Medicare issues. Here's a link to one in California, just so you can see what the scope of the legal specialty is. Heck, email this office and ask for a referral in your firend's area.

But she needs to get real legal advice, and not rely on any info that she gets sceond hand.

Good luck!

Here is a link that might be useful: elder law specialists

    Bookmark   July 6, 2006 at 12:36PM
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You can't shelter real estate here in Kansas. My husband has just been placed and I have talked to a SRS rep and if we had a country home, it would have to be sold. If she has her name on a property with one of the children, SRS can't collect on it until the child sells the home. A lien will probably be placed on it and collected when it is sold.

    Bookmark   July 8, 2006 at 4:24PM
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Best advice is to talk to an Elder Law attorney. And Jonesy, the rep does not necessarily have the right info for you. Seriously, that's like trying to call the IRS for tax info... when tested, a number of callers came up with different answers for the exact same question. I would greatly prefer to believe an attorney instead of a state represpentative when the subject of sheltering money or property comes up.

I'd still like to hear from the OP. Am still thinking that her friend who "wants" to enter a nursing home needs a lot more info.

    Bookmark   July 8, 2006 at 4:39PM
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As long as the bill is being paid monthly in full, the Nursing Home won't care how much money she has when she dies. They will want her Social Security check deposited directly with them and she (or the family) is responsible for the balance of the monthly fee.

The problem is if she applies for State Aid (Medicaid) She will have to spend down her assets before she can qualify. Some States, not all of them, will go after her remaining funds when she dies, if the joint ownship allows it. That's why she really needs to see an attorney to make sure that things are set up to protect the son. There are all sorts of trusts that may be just what she needs.

Medicare only helps in special circumstances for a very short period of time.

    Bookmark   July 8, 2006 at 4:50PM
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Medicare only pays for skilled nursing care (and then only for a short period of time), not custodial care. There is a big difference. Skilled nursing care involves therapy (occupational and physical), amongst other things. Custodial care is simply every day care, which technically (in their eyes) could be provided anywhere, not necessarily a nursing home.

Also, the Medicare patient in a skilled nursing facility is required to show a certain amount of progress within a set period of time, in order for Medicare to continue paying. And even then, the case is reviewed constantly. Trust me, they don't want to pay for anything they don't have to.

The others have advised you well in terms of urging your friend to see an elder care lawyer. But also, does she really need a nursing home? There are other options before that most drastic choice, especially if she only needs minimal assistances with ADL (Activities of Daily Living).

    Bookmark   July 8, 2006 at 4:59PM
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I got the same advice as Jonesy from SRS and it confirmed what my attorney had already told me.

    Bookmark   July 8, 2009 at 4:18PM
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I was part owner of my Mom's home and the SRS rep told me my share of it would be counted as our assets. They couldn't get it until it was sold. My husband died before he qualified for medicaid.

    Bookmark   July 17, 2010 at 11:25PM
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For us, my sons assets could not be more than $2000. Medicare paid the first 100 days after the initial 3 day hospitalization, and then Medicaid picked it up. There are still some charges that mMedicare pay for but mostly it is Medicaid. Because we are now legally his guardians, we have two accountings to do each year, one for the state, and one for the courts because he is an incapacitated person. These accountings are very thorough, and included copies of all bank and tax records.
Thwere are some very nice options if full time skilled nursing is not required. Our son spent time in a family home, that was wonderful. They were a large family and had three paying residents. Unfortunately he got sick and there was fear, he was ocntagious so we placed him in the nursing home. All nursing homes are not the same. Your friend or an agent looking out for her, needs to check the facility out by being there at meals, when they first get the day started, and times when there should be some activities available. If they don't allow you to check it out, cross it off your list. Check the kitchen and the foods served. Do they have a choice of foods? So much to check, but someone needs to be an advocte for her. Residents are so vulnerable, and if it turns out to be a bad situation, it can be overwhelming for her. An advocate can make sure it is going as smooth as possible. Never assume anything either. This got long. Sorry.

    Bookmark   August 25, 2010 at 1:45PM
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Well, I guess I'll put in my two cents worth. Even if it would be 100% possible to somehow, someway pass your life's savings onto your family and friends, I hope you realize that when you do that you will go on government help. That help comes from ME and EVERYONE else in this forum. It is our taxes that will pay for your upkeep. As if there are not enough on 'our payroll' already, but I am more than happy to help people that really have no other way to go but when people take from me to give it to someone that may not even need it makes me very angry. I have worked in a nursing home more years that I care to think about and I've seen it all. One very wealthy woman turned over everything to her family before she came into the home and then when she needed new clothing they refused to get it for her. Takes all kinds.

    Bookmark   November 20, 2010 at 5:00PM
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I agree with lasershow (post above). Makes great points. Also may consider an "adult care home" (some refer to them as adult foster care). 3-4 residence total in a home environment, and very personal care. The adult care home option is VERY popular here in Oregon where they number almost 900 in the Portland area alone.

    Bookmark   January 11, 2011 at 1:07PM
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