Can your elder be put out of a nursing home while she is waiting for her house to sell?

Understand your concern for your mother and her money situation, but don't sell her house. The house is the answer to your financial problems. Let the house be the resource that supports your mother in the care facility. Rent it out. If you don't want to manage it, hire a property manager. If the house is rented properly, you will be able to support your mother in a luxury care facility and have some money left over.

The home is an exempt resource so she should be able to apply for Medicaid immediately. Her Social Security and VA will go to the n.h. and Medicaid will pick up the difference. Once the house is sold, all that money will be countable, so she will be disqualified from Medicaid until she either spends it down by paying the nursing home (private pay) or otherwise protects it by purchasing exempt assets, converting it to a Medicaid annuity, etc. (discussed in my book). Good luck!

To answer your question can they 'throw her out' the answer is NO. They will bully you that they can but they cannot throw her out. They might move her to another facility but that is rare and still it would be a 'like' facility. But you won't have a choice. Just check on her as often as you can if you don't like the facility until you can make other arrangements when medicaid kicks in.

Who signed for responsible party at move-in to the NH? It should have been Mom. If it was leave things alone...you are not responsible. If you signed find a good elder law attorney in your area. There are things they can do to help you with this situation.

Did you consider a reverse mortgage on the home? If it generates enough money each month it might cover the cost of a live in aide so your mother can spend her remaining days in her home

My dad's skilled nursing waited while we sorted out a Medicaid appeal. There was a brief private pay period that they were pretty patient with also, while other finances were sorted out. I paid part of one of Mom's bills there, after she didn't progress in post-acute rehab but needed a little time to find a suitable assisted living, with cash we found stashed in a tea pot and they got a kick out of that...so did Mom.

The home being an exempt asset ceases to apply once the person has no intention of living in it again. I was told they go by the person's expressed intention, even if it seems impossible that it would ever happen.

PW - ? for you, do you know exactly why mom's Medicaid app was denied? Every state manages Medicaid uniquely so it's different regulations and qualifiers. I've dealt with TX & LA and to a lesser degree FL, and none of these decline because an elder lives with family. The decline will be due to 2 things - 1. that the elder does not show in their medical history the need for skilled nursing care (often happens when they are at home as most NH admits comes from a hospital stay so those have a fat medical file while the at home ones just don't) & 2. that the elder does not meet the financial requirements for impoverishment in your state under its Medicaid rules. Like my mom had to have income under $ 2,094 & non exempt assets under 2K. If either had been over she would have not qualified for the financial part of Medicaid review. So what was it for your mom?

The answer will make a difference - imho - in how to approach Medicaid.

Now about the NH "kicking her out", the NH seem to do a review of the details in the Medicaid application to determine IF they will accept a resident as "Medicaid Pending". If so, then the elder's monthly income will suffice as their payment to the NH (like their SS, retirement check) and there is no private pay difference required. Medicaid Pending is pretty standard approach by NH's as like 70% of stays are Medicaid. Now your mom's NH is NOT doing this, correct? If so, they are going to expect someone (probably you) to be totally financially responsible for the full bill and at whatever their private pay rate is. You need to carefully read the contract for admission and how it was signed. At 5K - 15K a mo for a NH, you probably cannot pay this debt if they or their collection agent comes after you. You need to make sure that you are not held responsible for it. Personally I would look for another NH that will accept her Medicaid Pending.

If she is in a NH that accepts her as a Medicaid Pending resident, then she has some protections under Medicaid rules and they cannot kick her to the curb. But for private pay, they can and often they will do after whomever signed the admit to be fully financially responsible in order for her to stay there. You need to carefully speak with admissions at the NH as to what they expect in payment. It's a lot to deal with, I would suggest you take a friend or younger family member to the meeting with you and take notes & record the conversation on their phone.

So mom has continued to own a house for like 6 years while she was living with you? How has the expenses on the house (taxes, insurance, etc) been paid? If you or other family has been shelling out on it, then you all need to have some sort of contract in place that is an agreement to be reimbursed for these costs from the eventual proceeds of the sale of the home. Otherwise every penny from the sale will be mom's assets have to be used as a "spend-down" before Medicaid will pay. But at least mom will be able to private pay for her stay if need be.

Medicaid deals with elders owning a home and applying all the time. For TX, the home has to be listed with a Realtor with a 6 mo contract to be OK for Medicaid to make her eligible for care. No For Sale by Owner and no selling it privately at less than Fair Market Value. Has to be an open market sale. If it sells for below that tax assessor value, it's OK as long as it was listed with Realtor and an open sale. You can ask for a diversion of their co-pay to the NH for home costs for utilities or other minor items needed to have it on the market (yard maintenance), but state does not have to do this. If they do you have to document to the penny, what the diversion paid for.

Again NH take them all the time as Medicaid Pending and they own their home. Their home by & large is viewed as an exempt asset for Medicaid. They are allowed to have exempt a home and a car. They can continue to own their home and be on Medicaid till they die. Now they won't have any of their own income to pay for things on the house, so family will have to pay for everything on the house, but they can continue to own it. Some states have removed this exemption if they have end stage cancer but most states are pro-property rights.

Medicaid is for people who have very little money or assets. The system has a long look back to prevent people from "dumping" assets on family/friends to avoid private pay. If the patient's spouse is alive, he/she is allowed to stay in the house, own one car and a small savings account. Your Mom's house should be sold and you will need to use the proceeds to pay for the nursing home until she qualifies for Medicaid. It's a long, sad process. Hang in there.

I faced a somewhat similiar situation: My mother needed Medicaid, but her income made her ineligible. She too owned a home, so I had to have a Miller's Trust document generated in order to "spend-down" her assets in order to make my mom's income become Medicade eligible (ie. My advice is that you should seek advice from an Elder Care Lawyer). Now we have been approved for Community Based Medicade (this process took ~1-1.5yr to get Medicade approval; there is a waiting list). Community Based Medicade provides care-provider services in the home. Also, as a side-note, I was told that Community Based Medicade pays for Residental Care (ie. Personal Care Homes) for those Residental Care Homes that accept Medicade as payment. This is another alternative for you to consider (ie. instead of a Nursing Home....)
My mother suffers from advanced Alz (Diabetes and HBP), and her health is deteriorating. She was recently hospitalized, then referred to a nursing home (ie. NH) for continued rehabilitation.
There are several key learnings here:
(1) You must be in a hospital for 72 "consecutive" hours before Medicare will pay for Skilled Nursing Home, after which Medicare will pay 100% for 20 days. After 20 days, if you have a secondary (co-insurance), Medicare will pay 40-60% (? - I can't quite remember) for 80 more days and co-insurance will pay a portion of the remaining balance, and you will pay the remainder.
(2) "As SOON" as your mother is admitted into the Skilled Nursing Home, apply for Traditional Medicaid which covers Skilled Nursing Home Care. I was told that it takes ~45 days for Medicade to review your application, so plan/budget that you may have to pay out-of pocket for some NH expenses until she is approved for Medicaid.
(3)With the private pay cost of a "decent" NH exceeding $4500/month, you should begin searching for: (a) A good/ acceptable Nursing Home that accepts Medicade. (b) Once found, ask that NH if they accept "Medicade-Pending" patients. If you are successful in locating a NH that accepts Medicade-Pending Patients (and that has a bed available), they may work with you to admit your mother until she recieves Medicade approval.
My advice is the 1st seek advice from an Elder Care Lawyer or call your City's/County's Lawyer's Referral Hotline (ie. this should be a free service). I was able to call around and get a lot of my questions answered by phone, then pay $500 out of pocket for the actual Miller's Trust document to be generated. Then only thing required is to apply for Medicade.....
Hope my story helps you....

I think they can. The question is, "Will they?" I think if you show a conscientious effort to sell her home, the answer is "No, they won't." They may lien the house or some-such. But the carrot of her being private pay for months on end will be incentive for them to wait. Private pay is more lucrative for nursing homes than Medicaid.

Be very forthright in your efforts to sell her home. Hopefully, you already have it listed with a Realtor or plan to do so within thirty days maximum. Be prepared to lower the price by $5K to $10K at regular intervals until it's sold. Now is NOT the time to "test the market".

Remember, if you're trying to get too much money for the house, it won't sell. And the only ones who are going to suffer for it not selling are your mom and YOU...since Medicaid, once the house is sold and the money is exhausted, will pick up the cost of her care regardless.

Area Agencies on Aging have elder law attorneys you can talk to. They may be able to help in this area of Medicaid.
As you said, residence in her house may be a sticking point.
If sent to an NH from the hospital as it has been said - Medicare coverage for 90 days but not necessarily 100%.
You really need to talk to an expert.

i NEVER stay on topic . the obama administration is planning to remove medical debt from individual credit ratings because medical debt is keeping too many people from being eligible for loans that could make the economy move forward ..
after observing the intense work that NH does each shift with patients with varying degrees of illness and mobility impairments , the rather large staff , nurse , doc on duty 24 hrs , the constant meal preperation , etc , i no longer think that their rates are all that outrageous .. they furnish meds for that cost also , up to and including hospice care .

my aunt applied for medicaid and was accepted to NH . her only asset is a pretty worn out shack on a couple of acres . aps told me that a simple for sale sign in front of the house would get her into NH for now , the home doesnt even have to be listed with a realtor . this may not answer your question but its what was required of edna and pia . the shack will never qualify for a bank loan . im guessing the state will sieze and auction it off at a point . i was told family could buy it at a reduced rate below market value if family wanted the home but they couldnt buy it for , like , one dollar .. in indiana it appears that the state will give family opportunity to keep it if possible . pia's family doesnt want it , they wanted to get the cash for it later -- so badly that they denied edna the doc visit she needed so she wouldnt be placed in NH ..
i know , TMI . but stuff this crazy actually happens .

The nursing home will probally want about 2 years of self pay before she goes on Medicaid. Depends on how you deal with the nuring home. If she goes into the hospital for something like 3 days or nights, for some illness she medicare will pick up, gee I don't remember but 100% of nuring home up till the time runs out. Think it is 60 days. Have to double check. Very hard situation. sorry.