A change in plans

I met today with the administrator and a social worker at Mom’s facility to start planning for the Medicaid application. Turns out I have everything compiled that I need except for one document that indicates how much Mom earns monthly from her state retirement plant. A W-2 is not enough. I also will have to apply for her to be exempt from income tax on those earnings because once she’s on Medicaid, she no longer has to pay taxes. I forgot to mention the credit card, but I can straighten that out soon enough. My first task is to surrender her annuities to get that cash into Mom’s checking account so we know exactly how much cash we’ll have to work with. And the social worker will initiate the application process, but not until June 1. She’ll tell them about me, and then someone named Susan will call me for a preliminary resources assessment over the phone. I probably won’t go in for my interview until the second or third week of June, with paperwork in hand. There’s a good chance they’ll tell me they need something else – it’s just one of those things. And then once the application is complete, Mom will be covered from that date. She might not be approved for 60 days, but she won’t have a gap during which she is not somehow financially covered for her living and medical expenses.

What threw me a little is that the staff is planning for Mom to move into the nursing home in July rather than August. It turns out you don’t necessarily wait until you run out of money to make the move. You make the move and then whenever the Medicaid kicks in, it will pay retroactively for up to three months of nursing home expenses, but not assisted living expenses. Mom definitely will qualify as a U.S. citizen and for financial need, and the administrator assures me she will meet the final requirement of medical need. He said, “She has to be cued for everything.” I guess that means she might be able to perform many activities of daily living, like eating and dressing, but she wouldn’t perform any of them without being prompted to do so. She also isn’t much of a conversationalist. She can’t take her own meds and hasn’t for more than a year. She scored a 9 on her mini-mental exam. She is semi-incontinent. She does still know when she has to go to the bathroom and uses it appropriately, but she obviously has accidents, as well. At any rate, he is certain she will be medically approved for the nursing home.

I walked through the nursing home side of the facility on the way to this meeting, entering a different way so Mom wouldn’t see me beforehand and wonder why she couldn’t come with me to the meeting. I have to say, the place oddly offers me a little bit of comfort. Sure, there are many, many people in wheelchairs, people who look lonely, people with severe physical disabilities. But there are also staff everywhere. Nurses in every hallway. And I saw some residents gathering in a little lounge area and others watching a movie in another room. The place seemed more alive than the assisted living facility often does. The staff on that side of the place is small because people are expected to fend for themselves. I just feel like Mom will actually be safer on the other side. And because she is weirdly social she will probably enjoy seeing so many people around that she can greet. I think she is sort of an irritant to some in the assisted living facility. I hope she becomes a favorite on the other side.

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