What to do with mom's house and bills since I put her into a nursing home?

Sprentice - ok so the stumbling block for Medicaid is that mom’s monthly income is too high for whatever Medicaid limit your state has set.

This is a totally fixable problem for Medicaid.
Again 2 part process - mom needs to get her assets to under 2k. I’d drain her bank accounts of assets by paying for an elder law atty (to do a Miller) and if funds left then paying forward on the utilities on the house or house insurance. So that takes care of 2k asset limit restrictions. Then her monthly income (which is over Medicaid maximum) is dealt with by a Miller Trust that the atty sets up.

Your mom to me basically has a math problem for Medicaid & Miller solves it. Say mom gets SS of $1200 a mo, a pension of 1k and teachers retirement of $300. So a whopping $2500 a mo. BUT Medicaid has monthly income max at $2150. Mom is $ 350.00 over the limit for Medicaid but not enough (peals of laughter) to ever pay for a NH. The atty does a Miller that becomes the payee for all income so mom gets “paid” the allowable max income but the Miller keeps the overage $$. Voila! Mom qualifies for Medicaid.

Miller kinda varies by state in what happens with overage. Most have it so that all income goes to NH as moms required under Medicaid copay or SOC (share of cost). But other states actually have extra $ go to a Trust which reverts to state upon death as state is beneficiary. Atty will know what’s what.

Mom can be BOTH on Medicare paid Hospice and on Medicaid while in the NH. My mom was for 18 long, l....o.....n..g months. I’d bet once your mom is more on an imposed regime of care & dialysis in the NH she’ll be much better. My experience with my mom was that the NH really really loves residents that are Hospice as Hospice means extra hands coming in to help nurse, bathe, feed, caregive etc. Plus Hospice moves in speciality equipment like Geri bathing chairs, pneumatic beds, orders special nutionals. All things that make their stay at the NH more optimum.

Also Hospice has grief management as a part of Hospice benefit.

Fair enough.

If you were a CNA at the NH where your mother now is, do you not know anybody on the admin side there who could give you advice about how to make the paperwork more manageable?

Just suppose you were to resign your POA, and then your sister as designated alternative were in turn to resign her POA, so that your mother effectively didn't have an appointed person... I wonder what would happen then. Could be the NH would apply for guardianship? But that is the kind of question that somebody on their finance or credit control team might be able to answer - they must have some kind of policy on it.

And in the circumstances, where your mother's affairs have got into a bit of disarray, you Heaven knows have enough on your plate, and your sister can't altogether fairly be expected to take over, this might not be an unreasonable thing to do.

I came on here overwhelmed and worried asking for help on what to do with her bills and house. Not about taking my mom off dialysis.

Will APS take over and do all this stuff if there is no one willing/able in the family? Just wondering....

Yes I understand they are fatal. But before she got confused she told me she didnt want to die and wanted to continue dialysis. I cant go against her wishes. Her dying right now could very well put me into labor. Hospice told me it can be longer then 6 months. The NH she is at is where I used to work. I was a cna. Lots of our patients were hospice patients and they are still going. She is confused right now because her toxins are up and she needa extra doses of her medication. Which I'm working on right now. Could it just be permanent this time? Yeah. It could. But I'm not taking that chance. Taking care of my mom and her health stuff isnt as stressful so much as it is everything else on top of it.

You're not going to like this, but I'm going to say it anyway.

You love your mother.

How long do you want her to suffer like this?

The thought that taking her off dialysis would mean her certain death very quickly so that you would suddenly become responsible for killing her is - wrong, on so many levels. I don't mean wrong as in evil or sinful, I mean wrong as in inaccurate, being far too selective with issues that are really important if you're to make the best decision for your mother. It's the cirrhosis that has signed her death warrant, and is carrying it out slowly. The dialysis is just making it take longer.

Talk it through with the hospice people again. Write things down under two headings:

1. What happens to mother if we continue dialysis.
2. What happens if mother is admitted to hospice and we stop dialysis.

It might not change your mind about what to do, but it could help you feel more confident about what you've decided.

The timing is absolutely atrocious. What about resigning your POA and asking your sister to take over, on the understanding that you will still be ready to talk things through with her if she wants? She is young to take it on, I agree, but 21 isn't a baby, plus she isn't pregnant, plus she doesn't have a 2 year old who needs her.

Now I'm rambling - but talk to hospice again. You do not have to reach every decision on your own.

I understand you love your mother and you really want her to meet the new baby. That is so sweet.

Her medical conditions are pretty doggone fatal. You say she qualifies for hospice - do you realize that means that she is expected to live no more than 6 months? She's in a confused state that she's not coming out of - that's likely permanent. Would you want to live that way, or would you want to be freed from your body and into the everlasting arms? You are not signing a death certificate- your mother abused her body and these are the consequences of her actions, not yours.

The future is the most important - that's your baby. Your baby will need your time and attention 110% as you know since you already have a 2 year old who is pulling at your skirt. It would be unfair to both children to have a distracted mom who is worrying about their Granny in the nursing home. They will not remember Granny who dies in the next 6 months - the qualifier for hospice.

It just fits to place Mom on hospice *now*. I would want her passing to be a special time when I can focus on her, and if I wait, it will be harder on the baby and toddler, and they don't need that. If I wait, I won't be able to say goodbye at the right time, and I would be distracted by the baby in the 3-4 mos after birth when she will pass without hospice.

By continuing to treat mom when she is in this bad of shape, she is continuing to suffer. Hospice has all sorts of comfort - medical, social, spiritual. The social worker at hospice can help you with mom's paperwork. The chaplains at our hospice did not mind that mthr had sworn off church. They held her hand and asked if they could pray for her. They sang songs that brought mother peace, and she even tried to vocalize with them. I don't know if mthr is a believer (she was not when I was a kid) but she certainly welcomed these ministers to be with her. They also called me and prayed for me. The drugs hospice offers make the passage to eternity pain and stress free. I expect that would be better than suffering more. (((((((Hugs)))))) This IS hard, but we are with you.

It just all happened at a very inconvinient time. Not that any time is good. But right now was awful timing. Everytime I turn around there's a new issue with her or something else. People throw me around on the phone. Paperwork. All kinds of paperwork. Never ending stuff. I have my own health problems and in lucky if I remember to do my own stuff. Meanwhile I have my 2 year old daughter that needs me. Totally just exhausted and over it. But i have to push on. I really just wanna push it all aside for awhile. My mom is dying. Id like to spend these last weeks or months with her and enjoy the rest of my pregnancy. I'm high risk anyways. Here I am rambling on again lol. I have therapy today. Not gonna bother wearing makeup today thats for sure.

My mom is only 69. She has been sick for years with cirrhosis of the liver. She hasnt drank for years and years though but the damage was already done. She was never a heavy drinker anyways. But yes, that led to alot of problems. Shes a diabetic. I had to have her liver bypassed years ago because she was bleeding to death. It saved her. But she relies on a laxative to keep her toxins down. She is a very stubborn woman. Wont follow a diet. Etc. This last few years have really gotten bad for her. Bones getting brittle. Bad back pain. Now her heart and kidneys are failing. She has dialysis 3 times a week. And this past 2 weeks she has been stuck in a confused state and isn't coming out of it and it breaks my heart. Medicaid wont approve her for a couple different reasons. Her income is too high and I'm not sure how that is being she cant even afford her NH without us kids pitching on on top of it. Its A lot to take in all at once. My mom was selfish and made a mess, but I Love her and I dont even know what I'm gonna do when she passes being this pregnant. Along with everything else. Oh and hospice will cover her, but only if I take her off dialysis. That would be signing her death certificate because she would die within 2 weeks. I cant do that.

Your mom left you a mess.

Hell with the car. Call the dealer or bank, tell them to come get it.

House. If you don’t know how, find someone who can turn off the main water valve. If it’s a well, turnoff the breaker to the pump.

Get anything of value out then sell “ as is”.

DO NOT spend your money on mom’s bills and debts.

Someone at her nursing home should be able to help you with a Medicaid application.

Would mom qualify for Hospice? This would be covered by Medicare.

Or, call APS and walk away from the whole mess. None of this is your fault.

I’m going through a similar situation currently, folks placed in car, left old car and crappy house.  If I were not retired I don’t know how I would have had the time to deal with all this stuff.

Igloo is brilliant!

It won't affect your credit. These bills remain your mother's liability and not yours. Think of yourself with POA as a computer: you process her income and her outgoings and that's it. It's not your money and it's not your debt.

If your mother is incapacitated, your POA should give you the authority to manage her money and assets for her benefits, and that would include the authority to sell her house. Re-read the document in case it's got any special instructions but you should be fine there.

When you say your mother doesn't get Medicaid, is that because you've tried and she isn't eligible or because it hasn't been applied for? There should be someone at the NH who can help you with this issue.

This is an awful lot to be stuck with when you're seven months pregnant (I think by that time I wasn't fit for much except snoozing and leaping up when I got cramp). Do you have a friend or neighbour or someone who can sit down with you and the pile of bills and make a To Do list? It's important to let the tax, utilities and similar people know what's going on and ask them for time to get it sorted out. You won't be the first person to get handed this kind of mess and you'll probably find them quite reasonable to deal with.

I'm not surprised you're feeling overwhelmed, and I hope it'll be easier once you've at least gathered everything together in one grippable heap. But what about how you're feeling about your mother? She can't be any great age if you and your sister are this young - do you mind if we ask what's happened?

I’d make paying NH as priority. To me it’s 2 part - one to cobble together moms $ to pay and then get family to pitch in for the balance. NH needs to be paid without glitches cause if there’s problems the NH will press upon family to sign off on a enforceable private pay contract. Neither you or Sissy want to get boxed in signing such a contract. Mom should sign off whenever possible. 
- second, why is mom supposedly not eligible for Medicaid or Medicare??? Is it cause she’s young and you’ve heard you have to be Over 65? Or is her monthly income over the Medicaid limit? Or mom gifted $ to others? Or another reason? Mom can qualify but you may need to be creative or need an atty to shepherd her application. To me it depends on what the stumbling blocks are.

It sounds like mom has a dz plus creditors. Going to be a stack of paper. I’d suggest you within next week or so, find and rent a mail box. It’s in your name as they need current iD to open, but it’s for all things mom. I’d put it so that you, Sissy & Mom all have names attached to the box. UPS stores rent mail boxes But what may be better is a package & shipping store. If there’s a college in your city, there will be such a store. If their independent, even better, as you & Sissy develope a relationship with the place so they call you when box is full or something interesting comes in. It keeps all mom’s stuff going 1 place and you deal with it couple of times a month. Grab a FedEx shipping envelope to cram mail in and label. Tres organized!!

Car - find loan info. Certified mail & Fax over brief 1 page note that Jane Smith Jones had emergency LTC placement and she wants to do a voluntary vehicle repo asap. You can close the letter as Mary Jones in her limited capacity as POA for Jane Smith Jones. Attach a xerox of your POA too. Make this the first letter out using the new mailing address! I’ve never dealt with auto repo, so no idea what that time frame is.....

House - sounds like it needs to be sold. I’d suggest you look at current tax assessor bill. Is it accurate for value? You can speak with Realtors to see what they think it can sell for. If they are with a MLS group, they can do a comps book within a day for you as part of their sales technique. If the figure is way way off from assessor, I’d suggest you get it independently appraised so when it sells for significantly under assessor value you have legal documentation as to why. This is really about lessening any concerns from Medicaid as to house selling for way under FMV & any sass from mom’s first family kids. To me, your Realtor is gonna be super important. I’d be very clear that house must be sold “as is”, there will be no interior. staging or yard primping done, taxes if delinquent must be taken out of proceeds of sale, any seller costs will not be fronted but must come out of proceeds from the sale. House will not be cleared & cleaned by family. You may need to put this in writing in listing agreement. 

I’d ask Realtor if pulling utilities is problematic..... sometimes it is as lenders may not underwrite mortgages on vacant property with pulled utilities. If there’s really bad issues with house, ask Realtor if house can qualify for FHA & VA loans. If not, so it’s cash or conventional, ask what DOM (days on market) looks like for those sales.

As an aside on Medicaid & homes, realize that Medicaid requires mom to pay all her monthly income to the NH, so all property costs are paid by family or not paid...... BUT once property sells, all $$ from the sale is mom’s. It will be very difficult for mom to reinburse anyone for things they paid for as it will likely be viewed as gifting by Medicaid.

Mom’s probably going to default on all her debt. There will be fallout on her doing this. But what’s needed to deal with the fallout is a problem for April, 2019. So you have over a year, debts can go on back burner.

I’d try to get Sissy to go through house and do boxes of Sentimental stuff; couple of boxes of mom’s winter & summer clothes, shoes, extra eyeglasses, books, magazines & not expired unopened toiletries. Sissy can make this her responsibility to do, and find a spot to store. Maybe a lamp & a chair if the NH room has space.