First Steps After Entering a Nursing Home

Overwhelming” is probably the best word to describe how you feel when a loved one has been admitted to a nursing home. Whether it is for rehabilitation after an unexpected event like a stroke or the result of advanced dementia there are some questions you should have the answer to in order to avoid problems down the road.

Find out if it is a Medicaid facility

Not every nursing home is a medicaid participating facility and if the nursing home your loved one is in is not in the Medicaid program then Medicaid will not provide payment to them, you will be private pay.

Find out if it is a Medicaid bed

Once your loved one is in a Medicaid participating nursing home your work is not done. They need to be in a bed classified for Medicaid patients. Not every room or bed in a nursing home is a Medicaid bed, it is usually a modest percentage of the total beds available. Just as before, if your loved one is in a Medicaid nursing home but not in a Medicaid bed then their expenses will not be eligible for Medicaid payment.

Gather all financial information

In order to evaluate your loved one’s potential Medicaid eligibility I will need to have an accurate picture of their finances, including assets and income details. Without knowing what they have and what their income is it is virtually impossible to know if they are or are not Medicaid eligible and what asset protection options may be available.

Find out who has legal authority and is your POA good enough

If the Medicaid applicant is not able to act for themselves due to their medical condition or reduced mental capacity then only the person they named in a valid Power of Attorney or appointed Guardian by a court can act for them.

If they already have a Power of Attorney you need to know how much power they gave to the person they want to act for them. A generic power of attorney is usually sufficient for routine transactions, but if your goal is asset protection you will probably need a broader Power of Attorney.

Review their eligibility for nursing home Medicaid.

There are a lot of criteria for Medicaid eligibility which I can’t run through the long list here. But two of the most important and easiest to verify are income and asset eligibility. If they don’t pass either one of those tests then the other criteria doesn’t matter because they will be denied anyway.

If your loved one is over the gross monthly income limit for the program they need benefits from then make sure you have their Miller Trust ready before the deadline passes.

If your loved one has resources over the amount they are allowed to have and qualify for Medicaid then investigate if a Woodlands Medicaid Lawyer can help them protect their assets.

Decide if you want to protect assets or spend everything

Once you have completed everything above, then you need to decide if your loved one would want to protect their life savings from endless nursing home bills or if they want to spend everything they have on nursing home bills. This is a personal choice and there is no right or wrong answer, but it is a choice.

Avoid making costly mistakes.

If your goal is Medicaid eligibility you better have a plan for how to get there without making any mistakes along the way. If you are spending money that belongs to the Medicaid applicant make sure you are not creating a penalty. If you are buying a car or performing a transaction with their house you better know all the consequences of the action you are contemplating. And last but not least, you better know your target date for the beginning of Medicaid benefits and what you need to do in order to make sure they are eligible on that date. The thousands of dollars in un-covered nursing home bills, evictions, and responsible party lawsuits all follow after making a mistake with the Medicaid beginning date.

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