Something like the spousal impoverishment law. My father entered a skilled nursing facility upon a hospital discharge for rehab before coming home. His health issues worsened and he had to remain in the facility with a medicaid pending status. The initial Medicaid application was made while he was at home by direction of his social worker who saw he needed far more home care.
Thankfully the Medicaid was granted, and I (disabled adult daughter/caregiver) was informed by the nursing facility Medicaid liaison I would definitely qualify for MMMNA in lieu of a spouse (we lost my mother 8 years ago) as my father is the primary income for our household and my disability began before the age of 22.
I'm now being told I by the nursing facility I have two options. Leave my father in the facility which will require all of his income paid to them. I do understand this, but was told we would be able to divert some of his income so I would not be left impoverished and be able to have our home to bring dad back to. I cannot keep the household going on only my disability income. Their other suggestion was to clear our belongings out of our home, which we only rent and do not own, and ask a friend or family member if I can move in with them. Our intention was always to bring him home, but due to caregiving for him my own health has deteriorated to the extent of needing two separate emergency operations on top of trying to deal with multiple sclerosis. I can barely take care of myself at this point and haven't been able to move forward with any surgery in trying to settle his care and financial issues first. Our hope was to get my health under control enough to bring him home and care for him as I have done for the last six years.
The nursing facility has set a discharge of my father due to non payment of patient liability. Non payment was due to me never being informed of the determined liability or any deductions, never able to apply for MMMNA or similar possible deductions. The first notice of any liability was a bill sent in late August for the months of July and August for an amount of a liability higher than my father's income. Our combined incomes are necessary to pay the monthly household bills. The facility will now not even speak about deductions for my father's liability amount, not even the personal needs allowance or insurance premiums required by law. The administrator was quite blunt in his feeling about MMMNA or any similar protections for family. That income could be diverted to me and I could "blow it" however I wanted. All I want is my father to receive proper care, to survive paying our bills while I regain enough of my own health in order to bring dad home. Instead I am facing becoming homeless or bringing him home and being unable to care for either of us. We have previously had home health aids for him thankfully, but it isn't enough anymore especially if I were recovering from surgery, he needs 24/7 monitoring, has had numerous falls and can do nothing on his own.
I just find it preposterous that if I were a spouse there would be no issue and there are also laws that would help if we owned our home, but there is nothing for any other family members who lived with and cared for the patient who goes into a facility. So many of us give up our lives, health, jobs to care for our loved ones and face these issues. And not for personal gain, I stand to inherit no home or savings, everything is depleted. It is done out of love and this is the result?
Any help, advice, suggestions would be greatly appreciated. I have researched and talked to everyone I can think of, but everything is a dead end or brick wall. I have not contacted an elder law attorney simply because I cannot afford to.
Also I wanted to add some information that was suggested to me (because of my surgical need being considered an emergency) and might help someone else.
A social worker with our local senior center suggested because he could qualify for Hospice care they could take over his care and Medicare would cover his costs which would please the NF as their payment. And dad wouldn't need to be uprooted and moved, which is so difficult for neurological patients especially. She said she's seen this done many times and it wouldn't be a set amount of time, it would all depend on his condition.
While we are not at DNR status, by my father's choice, this wouldn't really work for us, but I thought it may be of help to someone else.
I'm hoping that going forward, you can get your own health issues under control and make plans for your own future.
Kixxybaby and BUCKEYEPRIDE my prayers are with you, I am so sorry. It's truly devastating to see and experience not only the illness our loved ones suffer, but also the greed and disinterest in anything aside from the bottom line, too prevalent in the medical community. Thank God there are those special doctors, nurses and aides that truly do care.
As for this thing called "get a job" to supplement my income. I am quite familiar with the concept and would love to, however I lost that ability many years ago due to multiple sclerosis. A small home business of my own had to be given up when dad got sick, I could not keep up with both. That is why I remained in my family's home caring for my father for the last six years. 24/7 around the clock alone. There are few family members left, they are elderly themselves and I am an only child. With only 5 hours divided twice a week of respite, enough time for grocery shopping, and against all advice of family, friends and doctors. I chose this, to do all I could with my own physical limitations, do not think it's been easy. And before dad got sick himself, he and I did the same during the three years my mother was ill before we lost her.
I have spent the last 11 years of my life being a caregiver. I have sacrificed much including my own heath. But I would change nothing. We each do what is right for us and in my family you take care of each other. Out of love. Out of respect. No, we aren't always prepared for what's to come and don't always plan accordingly. Many fall into that trap, not knowing or dreaming such circumstances could come. But I will not be shamed or made to feel lesser because of this situation. Yes, obviously mistakes were made, but I can look myself in the mirror and know I did not let them down.
And I have had many doctors say that my dedication and care for both of my parents has been exemplary, above and beyond. That they lived longer because of my care. I'm not praising myself, I still feel I fail every day, that's exactly why I posted, I didn't want to miss anything or do anything wrong. But to be admonished or accused?
Taking care of my own, being prideful, simply not wanting to be a burden and ask for help sooner was apparently my downfall. I can do it, we're okay and a smile are my normal responses. Many of the responses I received here are a good example of why I have tried to do it all on my own and never ask for help. Many didn't even read what I wrote correctly and the advice given wasn't even applicable. And others responded not even understanding the laws themselves. Of course I have contacted an Ombudsman already who is now prepared to represent us, along with Proseniors. I have researched and learned as much as I can on my own, even the medicaid liaison said I had a good grasp on this information. I was, and am, trying to protect my father, our home and myself. And no, we do not own our home, we only rent it. When I refer to our home I mean the place we have lived for years, our memories are here, where my mother lived with us and went through her own illness, this is "home" to my father and where he wants to return. This isn't simply about me or housing, this is for him. Also misunderstood by some, I am on disability and do receive Social Security. Subsidized housing and whatever else it will take to survive after my father is gone has always been in my mind. But that's for later, he's my focus now.
And he will remain my focus as long he lives and chooses to live. In her last days my mother said she was tired and ready, so we broke our hearts, signed the DNR and let her go while we held her in our arms. I will do the same for him, whenever and whatever he chooses.
As an update on my situation I spoke with the NF social worker today and they do see there is an issue with personal needs allowance, medical premiums (due to the possibility of a hospitalization that will not be covered by institutional medicaid) and other deductions have not yet been dealt with in my father's case.
The initial patient liability evaluation by the NF medicaid liaison for my father was approximately $700 per month, not the current $2000 plus.Yes, there are deductions, family allowances, asset and income protection that vary for nearly every patient and their families.
While everything varies state to state and many medicaid laws changed on July 1 of this year, I am adding a link that may be useful to some. It is for my state, but perhaps it will help others to find information regarding their own states and situations. http://codes.ohio.gov/oac/5160:1-3-04.3v1
While it doesn't apply to everyone who responded, some clearly need to think before they type. And do some research of your own before you condemn and hurt others with misinformation and ignorance.
Call your local or state OMBUDSMAN (google it). They will protect your loved one from any unfortunate discharge. Because the NH was unable to find another Nursing Home to take her they were forced to keep my Mom, but I am going to be homeless now. I have no equity in my home, but I fear they will still process foreclosure on my home out of spite since they told me they would. My OMBUDSMAN advised me NOT to agree to take my Mom if they tried to discharge her. She said they have seen where a NH will wait in a van with a families loved one and then put the resident on the family members front door and leave. Just the thought of that to anybody is repulsive. But, when it comes down to it, it is ALL ABOUT THE MONEY! I love most of the people who care for her in the NH, the nurses and aids, they are overworked, shorthanded and underpaid, but Management is all about the Money!!
Please call your OMBUDSMAN NOW!!!.
I am the one who should be suing them for neglect. My Mom fell on her face broke her nose and had a brain bleed, they were Medically restraining her with over kill on the medication and had to send her to a facility to detox her. While she was there I noticed finger print bruising all over her legs from the NH. I have NO ENERGY to pursue that option.