There have been some comments about assisted living homes and communities and I thought I would start a thread pertaining to pros and cons of them. Marsh and his wife live in one in Maine. Some of them have Cottages. Here is one near Huntington, WV owned by my niece and nephew. You can call them for questions, costs, etc. for comparison. http://www.midlandmeadows.com/
There are plans from a local NH Facility to greatly expand with cottages, apartments, Drug Store, Movie Theatre, Grocery pending their getting funding in place. They are located in a rural area with plenty of building sites. Plans are for it to be self-contained and sounds like something very Senior Friendly. This would be the NH I would use if I have to place DH. There may already be similar facilities in other areas but not in ours. Not sure how this economy will effect his plans.
I wrote this somewhere in another thread, but it belongs here, so here it is.
Every State is different, and every retirement home is different. Prices, what Medicaid or LTC will pay towards it, services, EVERYTHING is different from State to State and facility to facility. There are independent living facilities, assisted living facilities, and nursing homes. The level of care is different in all of them. You will need to do a lot of research on all of these issues for your own particular State.
Here are two retirement villages near us - one in Bloomington, IL and one in Normal, IL. The two towns are truly twin cities. I'm not always sure where the dividing line is.
http://www.westminstervillageinc.com/ This one has independent living in duplexes and apartments, assisted living apartments, and a nursing home.
The next place has its websites on different pages. They have the same things as the other plus a secure dementia unit.
The duplexes and supportive living places at this village are new and don't have have many pictures on line. Supportive living means that the state helps with costs for low income seniors
Something that's nice about the way these are set up is that if you are in one level of care and need to move to a different level (e.g. move from assisted living to dementia unit) your name is automatically put at the top of the waiting list.
The one we are in has cottages (which you buy), independent living apartments, and assisted living apartments. My wife and I are in an independent living apartment. This means that I do all of her care unless an emergency develops, in which case I can press a button, or pull a cord, and one of the nurses from assisted living will come check on us. Unfortunately, there is no nursing home or dementia unit in this facility.
I have given some thought about moving into and independent living apartment that is close by. They do have a nursing home that takes alz. patients. But what happens when his time comes to go and I have sold our home and I don't want to live there. All my children are in NW Florida and that is where I would go. If I understand it right when and if all the money is gone and he needs to go on Medicaid I would still have a house and a car and some funds to live on. I really need to talk to an eldercare lawyer but we do not have one here. So much to think about and I believe I'll just take a nap.
Good question Bama. If DH goes on medicade and funds are divided with the other spouse retaining $110,000. aprox. plus the house and 1 car. Say the DH has to be in there 5 years and then dies. Does the survivor keep the house and car or the sale of them if she wants to move someplace else. Or can Medicade step in and seize the house and car for unpaid NH costs.
In my situation Bama, as I understand it I think I have to live in the house but I would like to know about later.
Some of you might get some useful information by visiting http://www.emeritus.com/locations/Show-Community.aspx/Silverleaf-Manor, which is the place where my DW's two AD sisters have lived in Assisted Living apartments in Meridian, MS, for the past four plus years. One of the sisters occupies an "alcove apartment" and the other occupies a one bedroom apartment. If you navigate around the site some, you can take a virtual tour, which will show you what the two different apartments look like. I know that the alcove apartment (including three meals, housekeeping, etc.) cost $2250 per month four years ago and has now increased to $2570 -- reflecting only about 3% per year inflation. And if you navigate more, you can find similar facilities operated by the same parent company in most states. Nancy, I see that they have two in Austin, TX, and they provide the means for you to contact them for further info if you're interested. Another interesting thing I ran across by navigating around on the site was lots of helpful information about financial assistance available, including some specific info about qualifying for and payouts available to Veterans and Veteran's Spouses through the Aids and Assistance program. Most of the locations seem to have Alzheimer's and Memory Care options, and while my DW's sisters haven't needed to avail themselves of those services yet, it's comforting to know that they're available if and when. We've visited the place many times (I even recognize lots of the seniors in the photos!) and have been well satisfied with the services.
I am wondering the same thing. The house is in both our names and was included in a living trust. Sometimes I wonder why we did the Living Trust becuse we certainly don't have a lot of money. We were living in Florida at the time and attended a seminar for seniors and got carried away. It did get all the living wills and all the power of attornies that we might need set up and that was a good thing. I just never had to worry about financial things and now I am having to take a crash course. Sure wish I was smarter.
Every state has different laws regarding medicaid placing a lien on your house and then being able to take it at the death of the spouse to pay for care they received. In Kentucky they cannot do this - at least right now.
its my understaning that when a recipient signs up for medicaide you are giving the state permission to 'estate recovery' at death. now having a spouse living in the home will avoid that being executed, but i was under the assumption when the SPOUSE dies or becomes unable to live int he the primary home then they can exexute the lein to recover. i dont know about moving after death either. i would think at the sale of the home you would have to repay medicaide what they were owed -not sure about this though at all! i dont think you get off scott free for all the yrs of medical care. somewhere they will get their money be sure. maybe after YOU the spouse dies..we sure need Jane to give her advice here! an estate as far as i know for medicaide recovery of their monies means a home or car, etc. or only property /real estate that goes to probate court after death. the rest isnt eligible. this is only conjecture i dont know one way or another. divvi
My dad lived in Oregon. When he died, my stepmom could still live in the house as long as she wanted to. She sold it before she died which at the time of sale, Medicaid took their money and the balance was distributed amongst the 4 of his 7 children he left it to in his will. (I and a brother and sister by his first marriage were left out. In his will he worded it as 'to the children Charlotte, Darrell and Margarite I leave my love is a legal wording to disown those children - according to the attorney I consulted about contesting the will. He said there was not enough to worry about contesting and my siblings will not tell me how much they received).
He is 86 and hopefully we will not get to that problem. It is my understanding that with a Living Will we will not be going through probate court. I don't know why I am worring about this problem I may go before he does and it want be my problem. I have always said I was going to live to be 104 so I am not in any hurry to leave this world. Even with all our problems we get up everyday to a beautiful world with sun, rain,trees ,birds, flowers and Chocolate icecream. Who could ask for anything more and our neighborhood is having a yard sale Saturday and I can go shopping. Life is good. I must be tired because I always get silly. This has been a rambling post and it's time to close it.
To clarify in Kentucky: House owned jointly by both spouses. Spouse can live in home - however, when spouse dies (his name on deed), medicaid MAY (NOT SHALL), can recover his portion. When medicaid spouse dies - then that becomes an asset - which may be recovered. If house is transferred from medicaid spouse to other spouse then mediaid spouse has no interest in the house - so not an asset. Medicaid consultant suggested he sign title to house to me solely while he can still do this. I determined not to do this right now, because if something happened to me first - it would all be his asset and would be used by medicaid. Just going to take my chances on this one.
ugh. just had a thought of 'what-ifs", DH under medicaide, in a nursing home, DH dies unexpectedly after 4yrs..
spouse wants to move out of primary home after DH death and has signed a contract with buyer,
medicade leins on the home sale with 'estate recovery' for reimbursement of NH costs,
at closing, medicaide gets paid first! out of proceeds, and the value of care owed to medicare is 380k after 4yrs.. MORE than the sale of the house-so medicare gets all monies from sale??
so spouse gets no monies to move and now has nowhere to go... hummmm....!
divvi, are both spouse on the deed? Jointly? If so, only his portion of the proceeds would go to medicaid (as his asset). Surviving spouse would get her share of proceeds. I think.....
well i know thats why someone will come back and say thats why we see 'elderlaw atty' to prepare for this...
i wonder how many have been surprised by this actually happening! well first off a title company SHOULD find the medicaide lein placed on the primary home when the person signed on to medicaide. but see they would find that out after a buyer was already involved and probably earnest money put down on the house to buy it.. yikes..!
we all know medicaide isnt going to give us anything for 'free' esp thousands and thousands of unpaid medical bills..
vickie not if the mediciade bill IS MORE than the house is worth or sold for..ugh.. think about it.! there would be no money left. unless of course you live in million dr home .
i just dont know for sure. but like you say if his half of sale is only 75k and the medicaide bill is 400k.. they just settle for the 75k?? and not go after more?
and with the laws changing so often so medicaide keeps ahead of what the elderlaw attys have told us to do. they go back and try to undo what we've done with new laws.. sigh..i think new laws are in effect now or since 2006? i dont have this worry as my DH will never qualify for medicaide or va! but its a good question to know at any rate..divvi
Isn't it ODD that something like Medicaid is so darned hard to understand. The booklets are written like IRS handbooks and my befuddled brain can't follow. If you call them three times, you'll get three answers. We need to find one person who is truly an expert to help in this regard.
Joan, this would be an EXCELLENT blog or side bar item. With bullet points outlining basic facts, qualifications and caveats. All of us would benefit from this. NancyB
Trouble is, Nancy, IT IS DIFFERENT FROM ONE STATE TO ANOTHER. ALL OVER THE MAP!!! Whereas Medicare is NOT, Medicaid depends on state money as well as federal money, and it's just as different as, say, unemployment benefits or minimum wage, etc. There are certain constants, but it is so complicated, that's why we always recommend elderlaw attorneys who know their own state laws.
Nancy B, this would be difficult for Joan since every state has different regulations and laws regarding Medicaid. Every state has a Medicaid website which spells out the basics. However, I think most would need to consult with an elderlaw attorney or a medicaid consultant to get specific details on your individual situation. For sure --it is complicated.
i found out a few things -when you sign up for medicaide there is a form 8001 that is about the Estate Recovery after death. they tell you about it, but even if you DONT sign it doesnt release you from recovery..haha.(gotcha!).if the medicaide reciepient dies and there is a spouse living in the home 'some' states can file a TEFRA lein on the home to try to collect after the other spouse in the house dies. if there is no lein or your state doesnt file a lein then 'usually' medicaide does nothing to recoup.. notice i said usually..haha if the other spouse at some point needs medicaide too then the home will go to pay medicaide bills for that spouse after death. as we know sooooo many different rules for each state -i didnt see anything with regards to selling or moving.. maybe someone else who IS qualified in this territory can let us know... with things properly executed of course by a VERY good elderlaw atty is the way to avoid much of this mess! almost makes me glad we dont qualify..haha.. divvi
We have an Investigative Reporter on one of our local TV news stations. He once interviewed a young woman who was trying to get her mother's insurance money to pay off the Funeral Home and other outstanding expenses. They were reporting that Medicaid (Tx) had put a "freeze" on her insurance and other assets until they reviewed what was due them. Apparently it had been going on quite awhile when she went to the TV station to air her problem. Her situation was simply that it had been almost a year and they hadn't gotten to her mother's file. Interest charges were building up and the poor daughter was desperate for help. Supposedly, whoever the Inv. Reporter contacted at the Medicaide office said they'd "get right on it". I hope they did. It gets so darned frustrating.
.. and I wonder if the VA benefits vary from state to state, too. And can people move from a restrictive state to a less restrictive one (say, retire to Maine, or NC, or FL) and have all the rules change immediately? And then there's our daughter who lives with us and might someday be MY caregiver.. so can SHE inherit the house without a lien being taken on it? she qualifies as a caregiver child.
if you move to another state it starts all over with their requirments. i was reading that some states have more 'beds ' for medicaide reciepients and it could prove beneficial to move after looking into it. every state has its own stuff. period! ugh! and yes briegull if your daughter cares for you and it passes to her then its the same story all over again i would think til SHE dies or needs medicaide... isnt it just extremely too complicated? they dont want us to know all the info -they need the loopholes to get repaid any way they can. alot of people dont realize that an insurance policy that has any 'accrued value' is up for grabs for medicaide recovery too...its just way too much to keep up with.. divvi
I know there is a 3 year window that the government looks to when determining (validity of?) ownership. That keeps me from transferring everything to my son today and filing tomorrow for special assistance that looks to net worth. BUT, I'm thinking that if your home title was place into, say, "The Briegall Family Trust", with your daughter as Trustee,...and the three year window came and went...if the house wouldn't be protected within the Trust. I think this is a legimitate question. Surely someone has a son/daughter who is a lawyer and would give a more or less general answer to this. My cousin is a lawyer (teaches law in a Law School) and he is soooooooo reluctant to give opinions on legal issues. It's a CYA thing with him... Wasn't it Abe Lincoln who said , "A Lawyer's Knowledge Is His Stock In Trade" and that discourages them from giving out 'free advice'. :-)
imohr i read that part you listed abut WV about medicade and home.. i would definately ask an elder law if you should have the home in your name alone and not in both. its saying notice...haha again..'GENERALLY, there will be no lein placed against the home until the living spouse who remains in the home dies'...the generally, is what gets me..i think you would be ok but i would consult about the names on the deed to be sure...divvi.
I think it would. My elderlaw attorney is suggest a "Qualified Personal Residence Trust", in which I set the trust up for a certain number of years - such as 3. If I am still alive at the end of that period, the property transfers to my heirs. If I still want to live there I have to pay "fair market" rent. If I die before the end of the trust period, the property reverts back into my estate as though there never was a trust. That's why you should pick a short period of time. The advantage of paying rent is that it moves more of you assets to your heirs without going through your estate, thus saving taxes.
nancy there was a huge topic here about medicaide but that was a while back when Jane our medicare/medicaide/ expert gave us all super advice. but times have changed again and new laws so maybe alot of that isnt valid anymore?? each state does it own stuff it seems. there are all kinds of 'trusts' to look into. you HAVE to get expert advice from a super elderlaw in YOUR state only or it could be a huge screwup. and someone whos up and up on the daily changes! thats the catch. generic answers dont apply at all to this medicaide topic...this we know. divvi
But, didn't it say WV opted to take the simplest option and not file a lien to recover? My brain just won't wrap around all that. My Elder lawyer, 5 years ago had us change all of our Real Estate Deeds to different ownership wordings and I can't remember for sure but it is not the way people generally have their property titled. There was a reason for that but I can't remember what it was. Something to the effect that if he dies half of the value goes into the _____family trust and not to me.
I am afraid to transfer funds and property to family members because you never know when a divorce or lawsuit will come into play with them and you might lose it that way. With 2 out of 3 children been divorced, I think I will take my chances with Medicade.
I don't have a recent lawyer or I would e-mail him and ask. Any of you seen one recently you can e-mail the question for your state. I am sorry Marsh, your situation just won't wrap around my poor brain. Do you think Maine won't take a lein on your home if your wife is on Medicade and you have initiated the trust you mentioned above? You probally won't be in the Medicade situation nor will I but I would like to know.
i think its important to speak with an eldercare atty on a yrly basis these days. laws change and what you did 5-10yrs ago may not be valid anymore.
i believe marsh is talking about a trust to move his home into to avoid probate thus avoiding any recovery from medicade. he nor his wife would be owners of the property but would 'rent' from the trust . but that couldnt be eligible until the 3yrs have gone by after the setup, right marsh? but there is probably a lookback period 5yrs for medicaide for the trust too? maybe i am wrong
I tried to have our wills updated 5 years ago but he couldn't pass the lawyer's test that he understood about the trust so even though the lawyer had made a few minor changes (that he agreed weren't all that important) and rewrote our Wills he would not go ahead with having DH sign his. So, DH cannot make changes in his. After he passes I will have mine checked out again. I did check with a third lawyer last year and he advised, under the circumstances leaving things as is. This is just all too difficult. Over the past 20 years I have consulted with 4 Lawyers specializing in Elder/Trust situations and I don't think I know any more now than when I started. I would love having someone explain it to me in simple English language that the average person could understand.
well this is the last post for me on this topic too, i am drained just thinking about it all. to make things more dicey i read medicade was looking into trying to get into the contents of some of the trusts...ie-rewriting laws to accomodate the invalidity of doing some of them... sigh..who knows. divvi