Retirement Home Question (1 Viewer)

[Steeler]

There is talk of potentially moving my Mom into a retirement community/home/whatever but she doesn't have enough savings/income to qualify for anything decent... she'd be in a govt program and I really don't want her to have to go there.

But I have some questions about the ability for someone to be grandfathered into a nicer facility when their money runs out.  First I guess I need to ask if that is even a thing?  I thought there was some kind of criteria or whatever... like if the person has enough money to stay in a facility for 2 years (or whatever) they wouldn't be kicked out when their savings was depleted... is that a thing?  For example if my Mom had 240K and the 2 year criteria was correct she could stay in a facility that cost 10K per year for the rest of her life.  If so, what are the guidelines around their savings, the length of time they have to pay in full, etc.  Could my siblings and I give her the 240K up front (hypothetically, we can't afford to do this) or would that not be allowed because it's not "her" money? 

I'm just trying to understand the barriers to getting her into a nicer place.

 

[El Floppo]

black dot... but mostly, good luck and support for you and your mom.

 

[CletiusMaximus]

There is talk of potentially moving my Mom into a retirement community/home/whatever but she doesn't have enough savings/income to qualify for anything decent... she'd be in a govt program and I really don't want her to have to go there.

But I have some questions about the ability for someone to be grandfathered into a nicer facility when their money runs out.  First I guess I need to ask if that is even a thing?  I thought there was some kind of criteria or whatever... like if the person has enough money to stay in a facility for 2 years (or whatever) they wouldn't be kicked out when their savings was depleted... is that a thing?  For example if my Mom had 240K and the 2 year criteria was correct she could stay in a facility that cost 10K per year for the rest of her life.  If so, what are the guidelines around their savings, the length of time they have to pay in full, etc.  Could my siblings and I give her the 240K up front (hypothetically, we can't afford to do this) or would that not be allowed because it's not "her" money? 

I'm just trying to understand the barriers to getting her into a nicer place.

The short answer is that many retirement home systems will accept Medicaid once the money runs out, even though that means they have to accept a lower monthly payment. In my experience with my mom about 10 years ago, if she is able to pay the normal rate for a year or longer, many if not most homes will not kick her out when she switches to Medicaid. These homes are mostly all owned by large conglomerates now, so of course they are completely profit-driven, so it helps to do a bit of legwork up front. This is a topic they are all comfortable discussing up front with you so there should be no surprises.

Secondly, you can consult with an Elder Law professional and get some advice and do some planning - financial planning, legal planning, finding the right home, etc. Obviously, the sooner you get started the better. This is such a hot area - for legal professionals and others over the past 10 years or so - that there are many very skilled, helpful professionals out there but also no shortage of charlatans, so make sure you get a good referral and you understand the fee structure and what you're getting going into it. Most nursing/retirement homes will also provide assistance in this area but I would not trust their advice.

I've got lots of other thoughts on this topic but don't want to stray from your main question.  The main thing for me is that my sister, my step-dad and I worked together and decided that our mother's safety and comfort was the main goal. I recommend you determine what your main goal is and stick to that, don't be swayed by bells and whistles and never let anyone put any guilt on you for any decision you make in this process.

 

[TLEF316]

My mom is going through this right now with my grandmother. She's been in a memory care facility (she has Alzheimer's. Now at the point where she has no idea who anybody is) for like 4 years and the $$ is about to run out (money that she inherited from her long time "gentleman friend". God bless that guy. Can't imagine where she'd be without him).  She also now probably (we're not doing an invasive procedure to officially diagnose) has fairly late stage pancreatic cancer.  Would be surprising if she lasted another year. But she's 97...so what can ya do.

Long story short, she's technically in hospice care now (which basically means she has a hospital bed, increased supervision and a specialized nurse visiting a few times a week to monitor her condition) but the expectation is that she'll be able to continue to live there until she passes, even if medicaid ends up paying for the back end.

I'm not sure about the exact rules, but I know that they're basically doing a full forensic review of her financials(as well as her medical history)  going back at least 6 or 7 years. We paid for 24/7 live-in care givers for a couple of years before moving her into the facility, and my mom made the mistake of paying those folks in cash/paypal. So that's causing issues now since we can't document a lot of those expenses. Same deal with groceries and other bills. My mom paid for a lot of stuff in cash and then just reimbursed herself by transferring $$ of out of my grandma's account to hers (she's power of attorney for a while). No good. 

We're running into roadblocks on the medical end, as her previous doctor wont officially confirm that she required 24/7 care 5+ years ago (since she's no longer a patient). Big headache.

So my suggestion (not sure what the exact rules are in terms of time frames)......document EVERYTHING. Dont pay for ANYTHING yourself (if you're gonna have your mom "reimburse you"). And if you can afford it, get an attorney who specializes in this stuff to walk you through it like you're a 5 year old.

When the time comes for my mom (she's 65 and in good health, but you never know) its gonna be my responsibility (She's single and I'm the oldest and by far most reliable of her 3 sons). I will be taking VERY good notes and crossing every T to make sure I dont F this up.

 

[Steeler]

Follow up question - can anyone recommend a particular medical alert necklace company?  I've done some research today and would consider Medical Guardian as my first choice right now, but wanted some feedback/suggestions/recommendations.

Thanks.

Edit: I originally said Life Alert as the first choice but the next few things I read talked about their drawbacks much more... also they don't appear to have a set price that is easy to determine... which doesn't seem right. 

 

[bushdocda]

Good stuff from @CletiusMaximus above.  I do not have experience with rental senior living offerings so can’t help much with them and how they work regarding financial criteria.  I can offer a bit on entrance deposit  communities. 
This will depend on the facility, contract offerings and the financial criteria for incoming residents. At a refundable deposit, fee for service CCRC with full continuum of care, the financial criteria will account for the length of stay including the likelihood of needing higher cost skilled care at some point in the stay. Benevolent care can be available if assets and income are exhausted over the length of stay.  

You could be a guarantor for the deposit or monthly potentially if you and fam need to help out. The would allow the assets or monthly $ you’d be contractually vouching to be counted to her financial qualifying criteria.

If you can’t get straight answers on these questions from a provider, I would not engage with them.

 

[Harry Frogfish]

For example if my Mom had 240K and the 2 year criteria was correct she could stay in a facility that cost 10K per year for the rest of her life.  If so, what are the guidelines around their savings, the length of time they have to pay in full, etc. 

10K per YEAR?  I am in no way trying to be insensitive here and I understand, this stuff is very difficult, but are you serious with that?  

Where is your Mom going to be put, in good care, at 850 bucks a MONTH?  Antarctica?

ETA that is $27 a DAY (24 hours).  So, a little over a buck an hour.  Do you and your family really understand the level of care that will get her?  She will be another number, at best.  Again, no offense, I mean that sincerely, this stuff can be absolutely brutal, but you will get what you pay for.  And this is your Mom.

I wish you and your loved ones nothing but the best.  That said, quality caregiving isn't a minimum wage job that many are wont to think, for some reason (until they do it themselves).  And unless you or your family are willing to do it yourself, then bargain-shopping is what it is.  And you have to ask yourselves, is this the time/person to do it?

Very difficult situation, hope the family can agree on what's best for your Mom, but as you can see from my comments, you not only risk not ending up saving money in the long run -- there are problems that can come from minimalist care -- you may end up with regret.  There is no price for that.

 

[brun]

I'm fuzzy on the details because it was a while back and I don't know your mom's situation, but I hope this is somewhat helpful. 

After my mom had a stroke, from which she never returned to baseline, we needed to find her a facility. The most desirable ones usually have waiting lists. Medicare and her Advantage plan paid for about 3 months in a skilled nursing care bed. After that we paid out of pocket from her savings. About $14k a month. After that it was time to apply for Medicaid. These facilities have a fixed/approved number of Medicaid beds. I could be wrong but don't think being an existing resident in a facility guarantees that a Medicaid bed will be available.

IIRC the financial assessment for Medicaid eligibility goes back at least 5 years. Big amounts,  I forget the actual threshold, that have been gifted from her will need to be returned. I believe her max wealth to qualify was $3k. Once on Medicaid nearly all her income just went straight to the facility from which she got some small amount of spending $$ per month.

After my dad died my mom lived very frugally so she could pass on as much as possible to her children and grandchildren. Of course that never happened because her assets were never protected for that purpose. She would have been just as well off if she spent it all at the casinos or getting her hair done.

Good luck.

 

[gianmarco]

10K per YEAR?  I am in no way trying to be insensitive here and I understand, this stuff is very difficult, but are you serious with that?  

Where is your Mom going to be put, in good care, at 850 bucks a MONTH?  Antarctica?

ETA that is $27 a DAY (24 hours).  So, a little over a buck an hour.  Do you and your family really understand the level of care that will get her?  She will be another number, at best.  Again, no offense, I mean that sincerely, this stuff can be absolutely brutal, but you will get what you pay for.  And this is your Mom.

I wish you and your loved ones nothing but the best.  That said, quality caregiving isn't a minimum wage job that many are wont to think, for some reason (until they do it themselves).  And unless you or your family are willing to do it yourself, then bargain-shopping is what it is.  And you have to ask yourselves, is this the time/person to do it?

Very difficult situation, hope the family can agree on what's best for your Mom, but as you can see from my comments, you not only risk not ending up saving money in the long run -- there are problems that can come from minimalist care -- you may end up with regret.  There is no price for that.

Pretty sure he meant $10K/month, hence the $240K for 2 year calculation.

 

[Steeler]

10K per YEAR?  I am in no way trying to be insensitive here and I understand, this stuff is very difficult, but are you serious with that?  

Where is your Mom going to be put, in good care, at 850 bucks a MONTH?  Antarctica?

ETA that is $27 a DAY (24 hours).  So, a little over a buck an hour.  Do you and your family really understand the level of care that will get her?  She will be another number, at best.  Again, no offense, I mean that sincerely, this stuff can be absolutely brutal, but you will get what you pay for.  And this is your Mom.

I wish you and your loved ones nothing but the best.  That said, quality caregiving isn't a minimum wage job that many are wont to think, for some reason (until they do it themselves).  And unless you or your family are willing to do it yourself, then bargain-shopping is what it is.  And you have to ask yourselves, is this the time/person to do it?

Very difficult situation, hope the family can agree on what's best for your Mom, but as you can see from my comments, you not only risk not ending up saving money in the long run -- there are problems that can come from minimalist care -- you may end up with regret.  There is no price for that.

I appreciate your response, but 10K per year was clearly me misspeaking, I meant 10K per month:  For example if my Mom had 240K and the 2 year criteria was correct she could stay in a facility that cost 10K per year month for the rest of her life.

 

[Chris B.]

But I have some questions about the ability for someone to be grandfathered into a nicer facility when their money runs out.  First I guess I need to ask if that is even a thing?  I thought there was some kind of criteria or whatever... like if the person has enough money to stay in a facility for 2 years (or whatever) they wouldn't be kicked out when their savings was depleted... is that a thing? 

Can I ask what state your mom is in?

But to answer your questions, yes it's a thing. We looked into a memory care community for my FIL last summer and found an outstanding one. After the initial screening of the family's finances they can admit the individual and should their money run out, the facility will keep them on for the remainder of their life. The community's founding family/benefactor has a massive fund to make sure no community members are ever expelled for finances. We didn't end up placing my FIL there cuz we actually found an even better community elsewhere. But these places do exists and some are so nice I'd be happy to go there myself in a few decades.

 

[Steeler]

Can I ask what state your mom is in?

Pennsylvania.

 

[Mrs. Rannous]

We're running into roadblocks on the medical end, as her previous doctor wont officially confirm that she required 24/7 care 5+ years ago (since she's no longer a patient). Big headache.

Frankly, I'd be giving this AH a big legal headache.  The fact that she is no longer his patient is irrelevant.  If she was his patient then, he can report on her condition then.  No excuses.

 

[Mrs. Rannous]

I haven't tried these guys myself, but they may be able to better answer your questions and point you to resources.

 

[Senor Schmutzig]

Follow up question - can anyone recommend a particular medical alert necklace company? I've done some research today and would consider Medical Guardian as my first choice right now, but wanted some feedback/suggestions/recommendations.

Thanks.

Edit: I originally said Life Alert as the first choice but the next few things I read talked about their drawbacks much more... also they don't appear to have a set price that is easy to determine... which doesn't seem right.

@Steeler - Did you ever settle on one? My mom has been asking about the possibility of getting one of these for herself recently, so I'm starting to look at options. My father passed away in November, so she is living by herself now. We are about an hour away but since my dad fell a few times and she wasn't able to help him (he was a large man), it has her thinking about this and freaking out if it happens to her.

 

[Steeler]

Follow up question - can anyone recommend a particular medical alert necklace company? I've done some research today and would consider Medical Guardian as my first choice right now, but wanted some feedback/suggestions/recommendations.

Thanks.

Edit: I originally said Life Alert as the first choice but the next few things I read talked about their drawbacks much more... also they don't appear to have a set price that is easy to determine... which doesn't seem right.

@Steeler - Did you ever settle on one? My mom has been asking about the possibility of getting one of these for herself recently, so I'm starting to look at options. My father passed away in November, so she is living by herself now. We are about an hour away but since my dad fell a few times and she wasn't able to help him (he was a large man), it has her thinking about this and freaking out if it happens to her.

We never got one of these for my Mom. She's now living in a retirement home with an alarm/alert system in her appartment. Being around peers and joining in the activities has been really good for her.

Sorry I couldn't help. I hope you find something that works for your Mom.

 

[Parrothead]

Can I ask what state your mom is in?

Pennsylvania.

Make sure you take out the maximum (17K i believe) and pre-pay all funeral expenses. A funeral director (or your lawyer if you have one) will walk you through -and this money is a legit spend down expense that will not be taken by the home/ Medicaid. Once the funeral is paid for, you get a check from the funeral home for what is leftover- tax free.

 

[Mookie]

Follow up question - can anyone recommend a particular medical alert necklace company? I've done some research today and would consider Medical Guardian as my first choice right now, but wanted some feedback/suggestions/recommendations.

Thanks.

Edit: I originally said Life Alert as the first choice but the next few things I read talked about their drawbacks much more... also they don't appear to have a set price that is easy to determine... which doesn't seem right.

@Steeler - Did you ever settle on one? My mom has been asking about the possibility of getting one of these for herself recently, so I'm starting to look at options. My father passed away in November, so she is living by herself now. We are about an hour away but since my dad fell a few times and she wasn't able to help him (he was a large man), it has her thinking about this and freaking out if it happens to her.

My mother passed away a few years ago, but I was looking into this right before she died as she lived alone and was starting to slow down. She was resistant about the stigma that comes with a Life Alert bracelet or necklace and was fiercely independent, telling me she would never wear one of those "ridiculous" things. I was going to buy her an Apple watch as it has a lot of the same features, and would make her look tech savvy even if she wasn't. Haven't looked into it since. Good luck.

 

[jamny]

Follow up question - can anyone recommend a particular medical alert necklace company? I've done some research today and would consider Medical Guardian as my first choice right now, but wanted some feedback/suggestions/recommendations.

Thanks.

Edit: I originally said Life Alert as the first choice but the next few things I read talked about their drawbacks much more... also they don't appear to have a set price that is easy to determine... which doesn't seem right.

@Steeler - Did you ever settle on one? My mom has been asking about the possibility of getting one of these for herself recently, so I'm starting to look at options. My father passed away in November, so she is living by herself now. We are about an hour away but since my dad fell a few times and she wasn't able to help him (he was a large man), it has her thinking about this and freaking out if it happens to her.

My mother passed away a few years ago, but I was looking into this right before she died as she lived alone and was starting to slow down. She was resistant about the stigma that comes with a Life Alert bracelet or necklace and was fiercely independent, telling me she would never wear one of those "ridiculous" things. I was going to buy her an Apple watch as it has a lot of the same features, and would make her look tech savvy even if she wasn't. Haven't looked into it since. Good luck.

We bought one for my MiL that didn't have a monthly fee. It came with a watchband and 2 necklace buttons (one she keeps in the shower) and will call up to like 4 numbers, one at a time. Bare bones setup but has already helped. I can find out the name if you want.

 

[General Malaise]

Follow up question - can anyone recommend a particular medical alert necklace company? I've done some research today and would consider Medical Guardian as my first choice right now, but wanted some feedback/suggestions/recommendations.

Thanks.

Edit: I originally said Life Alert as the first choice but the next few things I read talked about their drawbacks much more... also they don't appear to have a set price that is easy to determine... which doesn't seem right.

@Steeler - Did you ever settle on one? My mom has been asking about the possibility of getting one of these for herself recently, so I'm starting to look at options. My father passed away in November, so she is living by herself now. We are about an hour away but since my dad fell a few times and she wasn't able to help him (he was a large man), it has her thinking about this and freaking out if it happens to her.

My mother passed away a few years ago, but I was looking into this right before she died as she lived alone and was starting to slow down. She was resistant about the stigma that comes with a Life Alert bracelet or necklace and was fiercely independent, telling me she would never wear one of those "ridiculous" things. I was going to buy her an Apple watch as it has a lot of the same features, and would make her look tech savvy even if she wasn't. Haven't looked into it since. Good luck.

We bought one for my MiL that didn't have a monthly fee. It came with a watchband and 2 necklace buttons (one she keeps in the shower) and will call up to like 4 numbers, one at a time. Bare bones setup but has already helped. I can find out the name if you want.

I'd like that name too, GB. Thanks.

 

[SayChowda]

@Senor Schmutzig - Same as @Steeler, when my mother moved into assisted living, they provided their own necklace thing with their own version of life alert.

What we did in the few months leading up to assisted living is we got my mother a lanyard thing so she could wear a cell phone, very basic functionality, in a pouch hanging around her neck. So, if she traveled from one room to another, i.e. the kitchen or bathroom, the phone would be on her.

 

[jamny]

Follow up question - can anyone recommend a particular medical alert necklace company? I've done some research today and would consider Medical Guardian as my first choice right now, but wanted some feedback/suggestions/recommendations.

Thanks.

Edit: I originally said Life Alert as the first choice but the next few things I read talked about their drawbacks much more... also they don't appear to have a set price that is easy to determine... which doesn't seem right.

@Steeler - Did you ever settle on one? My mom has been asking about the possibility of getting one of these for herself recently, so I'm starting to look at options. My father passed away in November, so she is living by herself now. We are about an hour away but since my dad fell a few times and she wasn't able to help him (he was a large man), it has her thinking about this and freaking out if it happens to her.

My mother passed away a few years ago, but I was looking into this right before she died as she lived alone and was starting to slow down. She was resistant about the stigma that comes with a Life Alert bracelet or necklace and was fiercely independent, telling me she would never wear one of those "ridiculous" things. I was going to buy her an Apple watch as it has a lot of the same features, and would make her look tech savvy even if she wasn't. Haven't looked into it since. Good luck.

We bought one for my MiL that didn't have a monthly fee. It came with a watchband and 2 necklace buttons (one she keeps in the shower) and will call up to like 4 numbers, one at a time. Bare bones setup but has already helped. I can find out the name if you want.

I'd like that name too, GB. Thanks.

This was the one. We got it because you can use it with a landline. It says there a Bluetooth adapter that you can buy separately. I guess it was only 1 wrist and one necklace. It's really a kind of "better than nothing" device but it has worked so far. A negative is that unless they are near the phone, it might be tough to hear them so you'll only know the button was pressed.
Link

 

[Chadstroma]

The one thing I can add to this discussion.

For those who really want to stay in the home (most people will feel strongly about this I think). A route that can be researched would be a reverse mortgage. If they own their home, then this can be a way to finance extra assistance from just help around the house like a housekeeper to light medical assistance like a HHA or CNA to more help needed like a RN.

My sister's boyfriend reached out to me not long ago about the options on this as his Mom's health was declining and she absolutely refused to leave her home. I went through the reverse mortgage option with him and it was a really good fit for what she wanted and the resources that she had. It ended up that her health was declining even quicker than anticipated with her unfortunately passing not long after we first discussed it.

If anyone is interested, I can go into it in a little more detail. It can be a good tool for a number of elderly people but it is important to understand it in it's fullness and work with someone that is reputable.

 

[bcat01]

The one thing I can add to this discussion.

For those who really want to stay in the home (most people will feel strongly about this I think). A route that can be researched would be a reverse mortgage. If they own their home, then this can be a way to finance extra assistance from just help around the house like a housekeeper to light medical assistance like a HHA or CNA to more help needed like a RN.

My sister's boyfriend reached out to me not long ago about the options on this as his Mom's health was declining and she absolutely refused to leave her home. I went through the reverse mortgage option with him and it was a really good fit for what she wanted and the resources that she had. It ended up that her health was declining even quicker than anticipated with her unfortunately passing not long after we first discussed it.

If anyone is interested, I can go into it in a little more detail. It can be a good tool for a number of elderly people but it is important to understand it in it's fullness and work with someone that is reputable.

I would just call Tom Selleck.