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If your talking Rehab where Medicare has been paying for her to have Physical Therapy, that is short-term. Medicare pays 100% for the first 20 days, only 50% for the next 80, Grandmom being responsible for the other 50% unless her secondary insurance pays. There is no eviction from rehab. Medicare determines if the patient has hit a plateau or cannot be helped because not cooperative or like your GM dementia is so sever she cannot remember the excercises or help in her PT.
For now her house is an exempt asset if not sold. I suggest you tell the SW that GM needs to be transferred to LTC. Where I live, Rehab and LTC are one and the same. So an easy transfer. Then if the Medicaid application has not gotten started do it. Make sure someone is in contact with the SW at all times. There are certain documents Medicaid requires. You must produce them ASAP. In my State you only have 90 days to spend down any money and get them info they need. The faster you get things to Medicaid the faster she will get it. While this is going on, GM will be asked by the facility for her SS and any pension to offset the cost of her care. Make sure you are cc'd in any email sent tovthe caseworker. I was able to send most of my proof thru email.
For GM to be released at this point is an "unsafe discharge" they can't do. No one to care for her at home and she is 24/7 care. Only one person should be dealing with the SW and the facility and that is the POA or guardian.
LSS….. that RM is debt that she owes but she does not have to worry on repaying as they will acquire the house and sell it.
if someone is living at the house, unless it was her spouse at the time of the RM or themselves were a signatory onto the RM, they have no say in all this and they will have to move once the RM company calls the lending in and due. On RMs between the $ paid to gran and the interest and fees attached, could be way more than the property is worth.
if your Uncle is living there and somehow thinking he’s going to continue to live there, that is NOT HAPPENING unless he all on his own has the ability to pay in cash for the entire $ due on the RM and usually paid in full 90 days. If Uncle thinks he’s going to put it up for sale and determine how it gets sold, that is NOT HAPPENING as the RM totally controls what happens on the property once the owner (grandma) moves out or dies. The RM holds securitized interest on property, they do not need to bother with what Uncle or others want to do. Most RM allow the owner to be away from the home for 6 months to maybe a year but if the owner cannot document a reasonable likelihood to return home, the RM will call in loan. But whatever the case, all property costs (taxes, insurance) while she is away must continue be paid by grannie, otherwise the RM can call in the loan. RM holds the upper hand in all this. Like if she did not pay property taxes, loan can be called in; if the roof needs to be repaired or replaced and she doesn’t get this done in 30-60 days, loan can be called in. RM controls what happens.
My guess is that 3 things are going on
- that Uncle has said to the staff that he’s needing grannies SS income for her home and grannie won’t be doing the required copay for her (to be allowed to shift from a Medicare paid rehab patient to a LTC custodial care resident at the NH that is filing for LTC Medicaid program). This program requires her to turn over her SS$ to the NH every month except for a small $50/$75 a month personal needs allowance that is out into an account at the NH. So the facility is totally not wanting to deal with this.
- 2 And if she has not paid any health insurance copay bill that possibly has happened while she’s in rehab, the facility really won’t want to deal with any future problems with her.
- 3. that her home has a RM on it was not known to the facility. That they thought she would be a resident who had house sale $ to be able to private pay and do a spend down till eligible for LTC Medicaid. Then they found out she has a RM; and they know that she will get zero-nada-none of that house sale $ as it’s all going to repay her outstanding RM.
So what happens next, if you don’t come and get her, or Uncle doesn’t come and take her back to her home with the RM on it, then what likely to happen is the NH will call EMS to take her to the ER/ED and then they reuse to take her back. The hospital discharge planner will be calling you and uncle to come and get her.
As long as that is the case they CANNOT MAKE AN UNSAFE DISCHARGE. Know that. They are desperate to get one of you to take on temporary guardianship. Then she is off their dance card and on yours.
Which of you feels able to address this mess, because I can sure tell you that I wouldn't be willing or able. (I would allow the state to assume guardianship.)
The reverse mortgage means, as you say, that the home must be sold. Whatever resources are left after the sale and the reverse mortgage being paid off will go to support the in-facility care of grandmother.
Meanwhile you have
A) medicaid saying she makes too much money with her mortage
B) all facilities refusing her because she hasn't ENOUGH money.
C) a reverse mortgage money demanding sale of home
D) a bunch of creditors lined up like hungry sharks.
Do YOU want to deal with all this? I sure wouldn't.
Do any of the family feel competent to work through this financial and legal mess AND to take on responsibility for her discharge to them or their home?
I sure wouldn't. And I say that after being POA and Trustee for my brother.
You say this is a "rehab". Rehabs don't typically keep patients. But they cannot also discharge them to home without someone to care for them. If no one is legally liable to accept her in discharge they cannot simply send her home. That is why these social workers are so desperate to get one of you to take responsibility. They will promise you supportive help and let me assure you, you will GET NONE.
This is all very murky waters about which we cannot have all the facts. You have an elder who "no one wants to assume responsibility for" who is in rehab and being discharged from rehab. As I said she has fallen in the chasm of having too much money for Medicaid and too little for LTC.
You say "no one wants to be legally liable". DANG RIGHT!!!!! I would not want to be either, because this all sounds like quite the impossible situation.
Tell the social worker that the state may need to take on guardianship; that the family does not feel competent to do so.
See an elder law attorney now with all the facts in this case. Find out how to allow the state to take on guardianship. Do know that once they do, they make ALL legal, medical and financial decisions that grandmother isn't competent to make. You simple are down to visiting granddaughter/son.
So sorry. This would be a horrific mess to take on imho. At least to say there's no way I would be competent to do so, and for that reason I would refuse any responsibility in this matter. Just keep repeating to them that no one wishes to take on this legally complicated mess, nor is competent to, and that it's all sadly in their hands, and remind them that they cannot legally make an unsafe discharge of a 97 year old to her own home alone.