We need to get my boyfriend's mother into assisted living. Does anyone know of any programs that help cover the cost of AL in Texas?

Medicaid has nothing to do with work credits. Medicaid is all “need based” and what that need is dependent on the program. Medicaid is a huge program, from those Happy tTeeth vans sent to elementary schools to loaning out breast pumps to new moms on WIC to paying for long term care in a NH.

I’d like to backtrack on your situation, I actually have concerns if she could ever even get a AL bed paid for by Medicaid in TX. LTC Medicaid is geared to be paid for those needing skilled nursing care services which means as a resident in a NH. For a bed in an AL that is a bed on a waiver program, it’s a diversion of some of the $ that otherwise would be spent at a NH. Most states do NOT even do AL waiver programs, so AL is totally private pay. TX does have AL diversion waivers but the # of beds are beyond super low and the criteria to be in one is very very narrow. A good well run AL usually can easily fill a room with a private pay elder they don’t need to bother dealing with state Medicaid regulations.

If she is basically all ok on her ADLs and needs just a bit of help in her day, and its more about medication management being done for her, that’s not enough. Medication management is a surcharge onto an AL bill, it’s nothing special. Did this AL guarantee to you she would meet the at need medical criteria get a Medicaid AL bed? Or did they more imply that they have AL Medicaid bed; that they participate in a Medicaid waiver program?

Medical “at need” is just as important as the financial part. But imo it’s way way harder to get done as you r dependent on her old MD, old hospital record, the nursing & medical staff at a facility to do things, get work ups and labs done that clearly show medical need. I just don’t see an AL having the medical staff to do this in house if she needs to have her medical at need reviewed.

My moms tiered community was IL to AL to NH & w a end stage hospice wing, and it had a few AL Medicaid beds. The AL Medicaid beds all had a waiting list from existing residents and were basically a way station in their AL till a Medicaid bed opened up in the NH part. There was no risk medically as they were really ready for a NH bed. But on paper the facility appeared to have AL Medicaid beds. Reality was totally different.

5 yr lookback is kinda the standard nationally used for assessing if they are “at need” financially. Some states can opt to do less (CA does) or do only 3 if they have been in IL or AL for 2 full years prior. Once an application red flagged imo they r toast on getting into another facility without having an experienced elder law attorney shepherding her future application. If y’all did not know about the car & land, could there be other “gifts”??? Look in detail on all her checks and cash withdrawals as State may want an accounting / receipt. There is someone on this forum doing LTC Medicaid application as I write this and it’s all items over $200 within the recent past for the Aunts application.

She has not 1 but two gifting transfer penalties against her right now. The land and the car and gifted to different relatives, right?
Both are recorded in courthouse / state records database. No real way around them unless she could have been taken advantage of by her relatives and she is willing to contact APS and file charges against each them and then it turns into a law enforcement and DA issue… it will get ugly. Did anyone explain just how the penalty gets determined and placed?

An update: I had talked to my boyfriend and he finally called the assisted living facility that he has been trying to get his mom into. They told him because of the fact there is a car in her name and she had property in her name that she is a risk. She won't qualify for Medicaid through them until 2024.

The property that was in her name now belongs to her brother. But apparently, in the state of Texas, there is a five-year window. Although she no longer owns the property, it could still disqualify her from Medicaid since it hasn't been five years yet. And I guess that facility isn't willing to risk taking her in since there is a chance she might not qualify for Medicaid.

He told me the social worker is trying to find other places but the problem is the Medicaid standards for Texas.

It all comes down to money. She can't pay for assisted living because she doesn't get enough social security and has no savings. But can't get Medicaid because of assets she no longer owns. It's very frustrating.

We had to use social security in TX for my BIL, they were great to work with, the hospital gave us 3 places to look at, and we picked one. They wanted his finances. We gave them bank statements. We cashed in his CD of 5 K and gave that to the NH for the first month. He did own a travel trailer he lived in and a $500 truck, we sold both for very little. Other than that social security and Medicaid took over until he turned 65. We were open and honest, he had no other funds. If there was property, there needs to be a paper trail or the family will have to give the property back. there is a 5-year look back. There is a huge paper trail on the interweb, they will search if they are going to have to payout. Call the NH you are looking at, they have people that can guide you. We used an ombudsman when things got messy and wanted to move my BIL out. There are resources, unfortunately, it takes time. Be prepared.

Here’s what you do. You (or your boyfriend) tell the hospice social worker I’m sorry, I have to work to pay the bills and I don’t have the ability or means to safely take care of mom. Either they provide more help or they can call the state and have the state take guardianship of her. There is only so much you can do. If she’s out of the house now in the facility, you refuse to take her home. If she’s still in the house you tell the SW that you’ve done all you can do as far as taking care of her and helping with the Medicaid application, but at this point the state needs to step in because you can’t safely take care of her anymore. If you really want her out you need to firm, strong and persistent, and the state needs to know mom is not safe there anymore, not from abuse but from the inability to receive the care she needs because you (boyfriend) can’t be there because of other responsibilities.

LilyMoon

Here is a resource for you to explore options for your BFs mom. Good luck with finding services that will help.

http://www.aacog.com/108/Bexar-Area-Agency-on-Aging

Here's a good article that may clarify things for you:

https://www.nolo.com/legal-encyclopedia/when-medicaid-texas-will-pay-nursing-home-assisted-living-home-health-care.html

I think you are a bit confused. Medicaid doesn't have anything to quarters worked. Do you mean she didn't qualify for Medicare? What program is paying for Hospice?
The woman at assisted living is not your best advisor here. A good written explanation of what has happened to the car and property backed up by the appropriate paperwork (title transfer, impound bill, etc. ) would probably dismiss those concerns. And are you sure Medicaid is going to actually pay for assisted living? It doesn't usually do that unless there is some special waiver program run by the state.