I think grandma would qualify for a skilled nursing facility based on her issues. Are there any other options?

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I think grandma would qualify for a skilled nursing facility based on her issues. Are there any other options?

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Hi! My grandmother in living in an Independant Living facility about 10 miles from me. Her money will run out in about a year if she sells off things and spends down to the last dime. After that, I am unsure of any other options aside from SNF. I have 2 year old tiwns and no space and my brother lives in a one bedroom apartment and works full time. Neither of us are in a position to take her in. After she runs out of money, she will only have SS at about 1200 monthly. She is disabled and gets around on a motorized scooter, can usually transfer well, diabetic, uncontrolled hypertention, CHF, CKD stage 4, urinary incontinent, among other ailments. I used to take her to appointments, but they got out of hand, usually 2-4 appointments a week. I think she would qualify for SNF based on her issues. Are there any other options? Her meds exceed her SS check when she is the donut hole, so I dn't see how she could afford to live anywwhere that SNF with Medicaid. If SNF is our only option, I will need to read the best way to do this, so that she doesn't get evicted and become homeless. Any insight would be great. I will try to read through more threads on here, but it is hard with 2 little ones. Thanks for any input.

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Sorry, I think this is posted in the wrong topic.

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Posting here works - I'm sure you'll get helpful replies. You didn't mention your grandmothers cognitive level - any signs of dementia? Also, it would be helpful to know just a bit about her personality- is she stubborn? Independent? Easygoing? etc. Is your grandmother still capable of reasoning and understanding her financial future?

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Hi, my grandmother's cognition is great. She is 73. Other than fullishly spending her retirement and not being proactive with any of her finances, she thinks very well. She is easy going, but very lazy. She doesn't really believe in doing anything for herself that somebody else will do for her. She is concerned about her finances and asking my brother and I for help because she knows that she will be out of money soon. She also drops hints about us putting a bed for her in my (already crowded) twins room or my brother getting a 2 bedroom apartment. Sadly, she needs more care than either of us can provide. I wouldn't really say that she is stubborn. She is very dependant - needs someone nearby when showering, help with shoes, changing bed daily, laundry, all meals, making up meds, all shopping, all medical appointments, taking care of her dogs, etc. She has a late model SUV with power lift for her chair, but cannot drive. Not only is she dangerus, but once the scooter is loaded, she has no way of getting to the drivers seat, thank goodness! Hope this helps more. She can be an absolute delight to be with, but challlenging because of her incessant needs.

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I am reading through some posts on here, and it sure is overwhelming. If she needs to apply to Medicaid months before she needs it, bt has to have less than $200 in assets, how does that work? Her apartment is not going to let her live there rent free! I am so overwhelmed.

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I not sure if it's a typo or you've got some bad information but I'm pretty sure the amount allowed for retained assets and receiving Medicaid is $2,000 not $200. But as you describe things it does sound as if a snf is your only answer - plus it truly sounds as if grandmother would medically qualify, even if she is on the younger side for this type of placement - but it is a required factor - snf being prescribed by her doctor. As the process does take some time your are correct in thinking it's something you and grandmother should be looking into now. As far as getting grandmother to agree to it - really, what option does she have? If grandmother is as sharp as you say then she ought to be able to see the necessity and reasoning of this tough decision. Start looking around now for a place as many facilities require a period of self pay before they'll accept Medicaid- and grandmother may have to move sooner rather than later. Be prepared for your grandmother to kick up a fuss and get a bit mean and nasty about it all but stick to your guns - you didn't create your grandmother financial problems and you shouldn't have to pay for it - figuratively or literally.

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Hi Rainmom, thanks for your response. It is going to be tough. She has two dogs that are her babies and giving them up is going to be super hard, especially as the person most likely to take them lives far away so she'll likely not see them again. I am going to start acting as soon as I can. One thing that concerns me is her paying lots of money to under the table help over the last decade with nothing in writing. She has two bank accouns and had set up a special trust for Medicaid qualification when my grandfatehr was alive, so not sure how they are titled and which money she paid from to know if this will be a problem or not. She also has a small life insurance that I guess she'll have to cash out. If I call the nusing homes do I ask how long they have to be self-pay before they will do the filing? Is that something that I don't mention?

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42twinsmom - trust me, the person(s) you talk to will bring up the financial requirements. Also, some facilities require proof that you can self-pay for X amount of time at the point of admission - which is where having grandmothers assets pulled together and available is important - this is a good way to spend down the assets to the allowable Medicaid amount. In my mothers case the NH we chose required proof of three years worth of available self-pay funds - not all require such a lengthy amount but my moms place was self-pay all the way - they didn't take Medicaid - some places only require a few months then allow the person to stay "medicaid pending" - then take Medicaid funds thereafter. You might want to consider using some of grandmothers funds to hire an eldercare attorney that has experienced with Medicaid qualifications and trusts.

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Hi 42twinsmom, I just read your post and see it was from 12 days ago, but wanted to reply, nonetheless. I wondered, is your grandma on dialysis? You noted she is diabetic, has uncontrolled HTN and CHF among other ailments and that she requires 2-4 trips a week to seek medical care. Is her urinary incontinence managed by herself? Does she know she needs to urinate but can't get there, or is her urine free flowing without her realization that it is occurring? Is she frequently requiring hospitalization for her illnesses? These are important questions to answer for yourself on behalf of her long term well being and placement in an appropriate facility. It sounds to me, from what you have stated that she most certainly fits the criteria for skilled care nursing. If she is frequently hospitalized, a three day stay or longer is one of the triggers for Medicare funded skilled nursing care. It would cover her stay in a snf for her first 20 days there, then she would need to cover a co-insurance amount up to under $200 per day for another (I think, not sure) 120 days, after which she would need to pay as a private payor, unless she had other insurance coverage. It sounds like now is the time to start making inquiries into sonf as they are often for profit and would like to earn income for care provided until it was time for Medicaid to pick up the tab. Having the preparatory discussions ongoing in advance of your grandma running out of her available cash, would in my estimation, be the wise and proactive way of dealing with this future reality. Case managers in the hospital setting, at her healthcare providers, and/or at prospective skilled care facilities should be able to guide you through the process - especially if you continue your proactive approach to her care - which, by the way, you should be commended for. But based on the multiple medical diagnoses which you listed, I think it is without question that your loved one is eligible to live and be cared for in a skilled facility.

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Please, please follow the excellent suggestions that have been provided here. Keep us updated! In reading through your posts, what jumped out loud and clear to me is that your grandmother expects you (or your brother; but probably moreso you) will jump in to fill the gap. Beware of any "temporary" solutions, such as letting her move in with you temporarily. Temporary can very easily become permanent. You are NOT responsible for your grandmother's poor financial decisionmaking.

If I may ask, are there any other relatives? Why is your grandmother's health and welfare falling to you and your brother?

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I think grandma would qualify for a skilled nursing facility based on her issues. Are there any other options?

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