TheOtherMe
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Post by TheOtherMe on Aug 29, 2022 15:52:02 GMT -5
If a person is in a nursing that Medicaid is now paying for, all of their social security minus health insurance minus (in Iowa) $25 per month for personal items, goes to the nursing home.
If you truly have no one to help you, and there are those people out there, you have to pay for your hair, toothpaste, any goodies, etc. out of that account.
In these parts, the state stopped funding what I was doing as a volunteer so the nursing homes took over their Medicaid patients. It's very simple. They put the $25 in their personal account at the home, have insurance on auto pay and the rest belongs to them.
My sweet lady who had about $200 in total assets including what was in her checking account and what was in the nursing home account. Distant relatives and friends who had never visited her wanted the money. One told the nursing home the $75 in the nursing home account belonged to her because she had put that much in over the years.
That's not how it works when a person dies.
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Rukh O'Rorke
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Post by Rukh O'Rorke on Aug 29, 2022 16:45:32 GMT -5
that seems pretty reasonable to me! Assuming it is all inclusive, all food, utilities, onsite activities, etc. Maybe extra for field trips....just like school. But I guess downside is that it is only rentish, not mortgage, so nothing building. I think some regular retirement communites you can purchase condos rather than renting. wonder if any of those have options for assisted/skilled care as an add on? Wow - so if that were the case, image an old folks condo as part of the estate portfolio? lol, have a real estate pipeline of the house to raise the family, a condo on golf course with tennis courts and pool over 55 type complex, and then the condo for the retirement/assisted living/skilled nursing....then you have generations just filter through them for different life stages The $3500 was for a 1 bedroom independent living apartment. No meals, so basically just a senior apartment. You have to transition to assisted living to get the meals, housekeeping and services. I couldn't find any pricing for that...or the next level...skilled nursing. oh - then not so great. I guess back to the cruise idea!
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Post by Deleted on Aug 29, 2022 16:49:59 GMT -5
If a person is in a nursing that Medicaid is now paying for, all of their social security minus health insurance minus (in Iowa) $25 per month for personal items, goes to the nursing home. If you truly have no one to help you, and there are those people out there, you have to pay for your hair, toothpaste, any goodies, etc. out of that account. In these parts, the state stopped funding what I was doing as a volunteer so the nursing homes took over their Medicaid patients. It's very simple. They put the $25 in their personal account at the home, have insurance on auto pay and the rest belongs to them. My sweet lady who had about $200 in total assets including what was in her checking account and what was in the nursing home account. Distant relatives and friends who had never visited her wanted the money. One told the nursing home the $75 in the nursing home account belonged to her because she had put that much in over the years. That's not how it works when a person dies. Thank you for clarifying the SS question. Yes, in Texas it also goes to the home minus a small personal expense allowance. I've seen a poster on these boards talk about having to "spend down" her family member's allowance by buying her clothes and having her hair done. Regarding the dear lady you helped, there apparently is no limit to the venality of relatives. That's why I am very comfortable with our bank's trust department being responsible for us in our end days, versus a conniving relative with a hand out.
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Rukh O'Rorke
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Post by Rukh O'Rorke on Aug 29, 2022 16:50:23 GMT -5
royal carribean has a 274 day round the world cruise. 82k for balcony state room per person - wonder if that is assuming double rooming?
guess with the cleaning crew and all food provided could be considered assisted living?
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CCL
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Post by CCL on Aug 29, 2022 18:38:45 GMT -5
I agree that for $8900 a month, the least you can do is give the old lady a scoop of ice cream. I guess the Medicaid patients get no activities? When my sister and mother-in-law were Medicaid patients in separate nursing homes they were able to participate in activities. The activities directors arrange quite a bit for residents: bingo, movies, live music/singers, Thanksgiving dinners, Christmas parties, ice cream socials, cookouts, etc. Families were usually welcome to join, too.
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CCL
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Post by CCL on Aug 29, 2022 18:48:50 GMT -5
I went on an Alaskan cruise with the boys 5 years ago. It was awesome. Not crowded or rowdy at all and I shared an interior cabin with a 15 and 7 year old, but we were hardly ever in there. If I had a balcony one to myself? Nice. We sailed with Holland America to Alaska and absolutely loved it! I splurged for the larger room with balcony thinking it would help with seasickness. It was so nice sitting on the balcony morning and evenings! We wouldn't hesitate to do it again as soon as we get the chance.
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TheOtherMe
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Post by TheOtherMe on Aug 29, 2022 19:35:16 GMT -5
I agree that for $8900 a month, the least you can do is give the old lady a scoop of ice cream. I guess the Medicaid patients get no activities? When my sister and mother-in-law were Medicaid patients in separate nursing homes they were able to participate in activities. The activities directors arrange quite a bit for residents: bingo, movies, live music/singers, Thanksgiving dinners, Christmas parties, ice cream socials, cookouts, etc. Families were usually welcome to join, too. That is what I saw in the nursing homes I visited. I had to have my little old lady's nursing home send me their calendar because she was very unhappy if I showed up during bingo. Otherwise, she was thrilled to have a visitor. I took her birthday and Christmas cards every year and she told me nobody else would send her one. I never saw any others sitting on her table. Just her beloved husband's photo from WWII. A person on Medicaid can only have $2000 in assets and that includes the amount in the nursing home account. For the few that got to where they needed to spend some of it, my instructions were to prepay towards their funeral. My little old lady called the office one day because they were having an outing to the dog track and she wanted some money to play the dogs. She wanted $40 if she could. They called me and I got $40 out of her account. She died that winter and I'm glad she got to enjoy her day at the dog track.
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susana1954
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Post by susana1954 on Aug 29, 2022 20:26:00 GMT -5
We have a senior living facility down the road. A friend moved in about a year ago. She is in her late 70s, no children and no other family in the area, and starting to show mild cognitive decline. She wanted to get ahead of the curve, selling her home, etc. And making her own choices.
She is in a one-bedroom apartment. It is really "cute." She gets one meal (lunch), which she says is so substantial that she often takes some home with her for supper even though she has a full albeit small kitchen. Amenities include pool, exercise equipment, and transportation to doctor's appointments. That came in handy when she broke her shoulder.
The cost is $2100 a month, which also includes utilities other than internet, cell, tv. I think that is reasonable. I would love to purchase a garden home there, but I don't want to restart a mortgage when I only owe $28k on this house. For houses, you pay a $300 maintenance fee. No meals and no utilities but everything outside is done for you including your roof.
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laterbloomer
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Post by laterbloomer on Aug 29, 2022 21:01:37 GMT -5
We have a senior living facility down the road. A friend moved in about a year ago. She is in her late 70s, no children and no other family in the area, and starting to show mild cognitive decline. She wanted to get ahead of the curve, selling her home, etc. And making her own choices. She is in a one-bedroom apartment. It is really "cute." She gets one meal (lunch), which she says is so substantial that she often takes some home with her for supper even though she has a full albeit small kitchen. Amenities include pool, exercise equipment, and transportation to doctor's appointments. That came in handy when she broke her shoulder. The cost is $2100 a month, which also includes utilities other than internet, cell, tv. I think that is reasonable. I would love to purchase a garden home there, but I don't want to restart a mortgage when I only owe $28k on this house. For houses, you pay a $300 maintenance fee. No meals and no utilities but everything outside is done for you including your roof. That actually sounds great
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NomoreDramaQ1015
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Post by NomoreDramaQ1015 on Aug 30, 2022 8:30:39 GMT -5
We have some of those around here but getting approved for one is really strict. We were going to try to get my grandmother into one but because she was already showing signs of decline they refused to take her. You have to still be pretty independent and right in the head in order to qualify to move into one.
Then you need to make sure you do your homework because not all of them here have a system you can wend your way through, quite a few once you start showing decline you are booted out and you'll have to try to find another place to take you. The waiting lists here are HUGE.
They are still a great idea though because a lot of them here are rent controlled and everything regarding upkeep is done for you. I've seriously considered one when DH goes because I am not interested in maintaining a house in my old age. I can see myself being a Golden Girl in one.
It's just something you need to plan really far in advance for. If grandma had cooperated years ago one of those little senior apartments would have worked fantastic and saved her a lot of money. But she was too stubborn and now she's where she is to the tune of $8900 a month and we can't find anywhere else that will take her.
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susana1954
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Post by susana1954 on Aug 30, 2022 8:40:28 GMT -5
We have some of those around here but getting approved for one is really strict. We were going to try to get my grandmother into one but because she was already showing signs of decline they refused to take her. You have to still be pretty independent and right in the head in order to qualify to move into one.
Then you need to make sure you do your homework because not all of them here have a system you can wend your way through, quite a few once you start showing decline you are booted out and you'll have to try to find another place to take you. The waiting lists here are HUGE. They are still a great idea though because a lot of them here are rent controlled and everything regarding upkeep is done for you. I've seriously considered one when DH goes because I am not interested in maintaining a house in my old age. I can see myself being a Golden Girl in one. It's just something you need to plan really far in advance for. If grandma had cooperated years ago one of those little senior apartments would have worked fantastic and saved her a lot of money. But she was too stubborn and now she's where she is to the tune of $8900 a month and we can't find anywhere else that will take her. Yes, this! My former MIL also lived in a senior living community, more upscale than my friend. Hers had 3 meals a day, housekeeping, etc. even though she lived in an apartment. The cost had gotten to $3500 a month, I think. That still isn't bad. But it got to the point that she needed to go to assisted living, which was $6500 a month, and my ex balked. So they moved her to another facility, still independent living. Within a month, they also decided she had to go to assisted living (basically same price) so she had to move twice. I am sure moving at all to the different facility was a mistake, but no one asked me! She has the money, but that's not really how anyone wants to spend it. I think that's true of every family, but it is what it is.
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TheOtherMe
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Post by TheOtherMe on Aug 30, 2022 9:34:27 GMT -5
We were told when mom and dad moved to their independent living apartment that they could not get a mortgage, as in no one would give them a mortgage for that type of setup where you buy in and pay a monthly fee.
I don't know if that is true or not.
That place hasn't updated in years so is showing it's 20 year age. They are having problems keeping the independent living apartments occupied.
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Post by Deleted on Aug 30, 2022 9:38:06 GMT -5
We have some of those around here but getting approved for one is really strict. We were going to try to get my grandmother into one but because she was already showing signs of decline they refused to take her. You have to still be pretty independent and right in the head in order to qualify to move into one.
Then you need to make sure you do your homework because not all of them here have a system you can wend your way through, quite a few once you start showing decline you are booted out and you'll have to try to find another place to take you. The waiting lists here are HUGE.
They are still a great idea though because a lot of them here are rent controlled and everything regarding upkeep is done for you. I've seriously considered one when DH goes because I am not interested in maintaining a house in my old age. I can see myself being a Golden Girl in one. It's just something you need to plan really far in advance for. If grandma had cooperated years ago one of those little senior apartments would have worked fantastic and saved her a lot of money. But she was too stubborn and now she's where she is to the tune of $8900 a month and we can't find anywhere else that will take her. Some of these independent living units also have a residency clause requiring you to be in the unit consistently. If you get to the stage where you are in the hospital for two weeks, in a rehab center for three weeks, back home for a month before repeating the cycle, the residency clause may require you to leave.
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Post by Deleted on Aug 30, 2022 9:40:15 GMT -5
We were told when mom and dad moved to their independent living apartment that they could not get a mortgage, as in no one would give them a mortgage for that type of setup where you buy in and pay a monthly fee. I don't know if that is true or not. That place hasn't updated in years so is showing it's 20 year age. They are having problems keeping the independent living apartments occupied. That is mostly correct here in Texas as you can't get a traditional asset-backed mortgage. There are apparently some private lenders that do something that is maybe more of a personal loan thing where you pledge other assets like CD's but I've heard the rates are substantially higher than conventional mortgages
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TheOtherMe
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Post by TheOtherMe on Aug 30, 2022 9:46:03 GMT -5
I would think they would be high since you technically don't own the apartment you live in.
The contract also had statements like it is not part of your estate and you can not leave it to someone else in your will.
The payout structure for when the occupant moves has totally changed. We got 80% of the buy in returned. Now it's based on the number of years lived there. Dad occupied his apartment for 6 years. Now after 5 years, you get nothing back.
I think that is another reason they are having problems getting tenants.
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dannylion
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Post by dannylion on Aug 30, 2022 10:11:02 GMT -5
We were told when mom and dad moved to their independent living apartment that they could not get a mortgage, as in no one would give them a mortgage for that type of setup where you buy in and pay a monthly fee. I don't know if that is true or not. That place hasn't updated in years so is showing it's 20 year age. They are having problems keeping the independent living apartments occupied. Is the apartment in a CCRC? Different states might have different laws or requirements with regard to how the buy-in part is handled. Here (Maryland) and in Pennsylvania where my folks lived in independent living in a CCRC, there are options offered by some (though not all) of the CCRCs to finance the buy-in amount through the CCRC itself and different ways to configure the buy-in amount, usually affecting how much of the buy-in returns to the estate after the death of the resident. Each CCRC seems to have a different mix of options. Mom had a stroke about a year after they moved to the CCRC and spent 3 years in the CCRC's nursing center. It was considered one of the best skilled nursing facilities in the area with a waiting list, but residents of the CCRC had priority. There were no private rooms available when Mom first needed to be in the nursing center, but the shared room she started out in was quite large and had plenty of space for 2 people and their visitors. Unfortunately, her roommate was a witch, so we were very relieved when a private room became available a few months later. That was a very pleasant room with a nice view and entirely witch-free. The care was good, though they were definitely not overstaffed with caregivers. As I recall, it was about $9k a month for the private room, and she was there for 3 years. She passed away more than 10 years ago, so I'm sure it's more now. Plus, Dad was still living in their independent-living house, so that expense continued. It is expensive to be old. Some CCRCs structure their fees to remain fairly stable over the residents' entire stay, even as they move from independent living to assisted living to skilled nursing care. That tends to be quite pricey for the early part (from the places I've looked at so far, about $5000 or more per month), but it doesn't increase as the care increases. For other places, the fees are different for each stage of care, which was the case with the CCRC where my folks lived. I think I would prefer to pay for the level of care I am receiving and take a chance on not needing enough at the expensive end of the spectrum to justify spending so much early on with the other model. I've been researching local CCRCs lately in anticipation of needing one myself at some point in the not-too-distant future, so this has been on my mind a lot lately, and I'm learning all about what is available and the costs.
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Post by Deleted on Aug 30, 2022 10:22:41 GMT -5
I learned the other day that an acquaintance was asked to relocate from her independent living apartment at a local facility with multiple care levels as her "independent living" became an excessive burden on the staff. Staff got too many calls to help her after falling in her unit, too many calls from out-of-state family to check on her when she wouldn't answer the phone, too many requests to take her a plate of food when she didn't want to go to the dining room, requests to make sure she takes her walker when she leaves the building, let family know when she takes her car out of the garage etc.
Before moving to this place, her family was asked to remove her from a 55+ active senior apartment complex for also placing an undue burden on the staff. While sympathetic to the family's concerns, apartment management was not going to take responsibility for her in that way.
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TheOtherMe
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Post by TheOtherMe on Aug 30, 2022 15:12:21 GMT -5
Just looked up CCRC. I think it would be considered that. It is a subsidiary of the Catholic Hospital here but still has millions in debt from when it was built 20 years ago. The only option with the facility was cash. In 2014, they had a waiting list so my parents had 24 hours to decide if they wanted to take the apartment that was offered. It was the largest one bedroom apartment by far so it was the most expensive to buy in.
Their "rent" raised every July 1. A space in the garage was extra. The only cost the tenants had was telephone and, for some, internet. My dad thought the rent was the only cost for living there so it was a great deal.
When they got the 48 hour notice, their house had not yet closed and they also didn't have time to mail a check. Mom knew if they didn't take this one, no one knew how long it would be until the next one opened up and it would not be this unit. So my sister went in and made the down payment. My dad never knew that. Mom paid her back as soon as the house closed.
Assisted living was on another floor. If you became a pain in your needs or got injured, etc. and could not care for yourself, they could force a parson to move to assisted living. By the time dad died, they were not gung ho on getting him out because assisted living was full and the apartments were hard to find tenants. They should have been pushing to get him to assisted living
There was a charge to get food delivered from the dining room so they would not be kicked to assisted living for that reason alone. One man had 3 meals a day delivered to him after his wife died. He paid for the meal and for delivery.
Hospice discussed with the office that 911 was not to be called when mom was sick. The office said it was their responsibility to do so, which hospice had already told us. We put all kinds of signs up so dad wouldn't call 911. He always called my sister and she had to go decided if hospice should be called.
At the time we were discussing moving dad to assisted living, they had an evaluation process, which cost $1000, to determine the level of care one needed. They had 3 levels of care. The more care needed, the more it cost. There was also an extra charge for people who were incontinent.
If a person got to where they needed a nursing home, they went to the top of the priority list for the nursing home owned by the hospital. That was the only reason dad got in that particular nursing home.
They had not set it up so costs remained the same. Assisted living costs were also constant increasing.
If people had needed 24 hour care, they had to go to a nursing home or hire private nurses. We were told some did hire private nurses. Usually by that time, the end was near.
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Post by Deleted on Aug 31, 2022 13:03:09 GMT -5
We have a senior living facility down the road. A friend moved in about a year ago. She is in her late 70s, no children and no other family in the area, and starting to show mild cognitive decline. She wanted to get ahead of the curve, selling her home, etc. And making her own choices. <snip> The cost is $2100 a month, which also includes utilities other than internet, cell, tv. I think that is reasonable. I would love to purchase a garden home there, but I don't want to restart a mortgage when I only owe $28k on this house. For houses, you pay a $300 maintenance fee. No meals and no utilities but everything outside is done for you including your roof. Yes, that sounds pretty good. Is that income-dependent? And what happens if she needs a higher level of care? With only $28K left on your mortgage, wouldn't selling your house release enough equity for you to pay cash? Mine is probably worth $400K and my mortgage balance is $57K so that would allow me to buy into some places, even after realtor's fees.
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susana1954
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Post by susana1954 on Aug 31, 2022 17:44:57 GMT -5
We have a senior living facility down the road. A friend moved in about a year ago. She is in her late 70s, no children and no other family in the area, and starting to show mild cognitive decline. She wanted to get ahead of the curve, selling her home, etc. And making her own choices. <snip> The cost is $2100 a month, which also includes utilities other than internet, cell, tv. I think that is reasonable. I would love to purchase a garden home there, but I don't want to restart a mortgage when I only owe $28k on this house. For houses, you pay a $300 maintenance fee. No meals and no utilities but everything outside is done for you including your roof. Yes, that sounds pretty good. Is that income-dependent? And what happens if she needs a higher level of care? With only $28K left on your mortgage, wouldn't selling your house release enough equity for you to pay cash? Mine is probably worth $400K and my mortgage balance is $57K so that would allow me to buy into some places, even after realtor's fees. Although this facility has three level of cares (independent living including homes and apts.), assisted living, and nursing home), they are separate although I am sure they give priority to the residents of other areas of the facility. I am sure they are priced according to the going rate for these services elsewhere. No, this has nothing to do with income. As a reference, you could get an apt. similar in quality with exercise facilities/pool at a regular complex for about $1200 a month. So she is paying $900 for basic utilities, transportation to drs' appts (Thursdays only but you learn to make them on Thursday, she said), and one substantial meal a day. It's reasonable but not extraordinarily cheap. My house is worth about $225k, I would think. A property there is about $270k although six months ago they were selling for $250k. The houses are nice . . . all brick, etc. . . . but the carpeting, appliances, etc. are all in the 15-20 year range. Then you have the $300 a month HOA fee or whatever you want to call it. EVERYTHING is updated in my house. That is not an exaggeration. I just can't do it.
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