Father is in hospital and Dr says he cannot live alone and needs skilled care-he has no money. He is technically married but is estranged from my stepmother. She has her own income and he has his. I am his natural daughter with advanced medical power, what do I do?
PS he is a Florida resident but it happened up here in Virginia
I would consult an attorney to see how to handle the estrangement from your stepmother just to make sure there are no strings attached when you place him.
When i placed my mother in skilled nursing, the facility took all her financial information and applied for Medicaid for her. Other than providing the information, I had to do nothing. She was approved within three months.
First - I’d try to do whatever you can to have him stay in the hospital as long as possible. His costs - I assume- are being paid by MediCARE & whatever MediCARE gap or advantage policy or another secondary insurance policy that he has. Everybody happy as long as he’s hospitalized as everybody getting paid.
Second - try to clearly speak with the MD (often called the hospitalist MD) or Social Worker discharge planner at the hospital IF he is to be discharged with orders written for rehabilitation. If so, rehab is a covered post hospitalization Medicare benefit at abt 100% for the first 20/21 days as long as he’s “progressing” in rehab and then at 80% up to 100 days. Be aware that most elderly do not get much past the initial 20-21. He cannot get all not gonna do attitude with rehab, he has to actively do exercises/ activities while in rehab. You may need to put on your best cheerleader outfit and get him motivated. If he’s going to rehab, personally I’d have him in VA by me so I can get my pompoms over to see him daily and work up a relationship with the therapist to be more aware of what he needs to be actively trying for in rehab to have him stay on the MediCARE paid post hospitalization rehab benefits as long as possible.
Whatever the case, this - in addition to getting him better - is all about buying time to figure out what & where to go next & which state & what the situation is with the wife. He needs to be on MediCARE Benefit as long as possible. Comprende?
Medicare is totally federal, so it’s good whether the hospitalization happened in VA or he fell while surfing in Hawaii, as long as hospital and doctors who bill for care all participate in Medicare, Medicare pays for services at whatever rate is prenegotiated. There likely will be some copays, & hopefully his Medicare gap or advantage policy or other secondary policy pays those. By other secondary policy, I’m referring to like BlueCross that may have carried over from his old employer, like if he was civil service retiree they can stay on BCBS forever & have essentially little to no copay. His state of residence is not a factor for Medicare. Unless he’s on a state specific Medicare advantage plan (so he switched from original Medicare to a more narrow Medicare advantage plan).
If they are still legally married, without some sort of paperwork to establish a legal separation, should he apply for Medicaid, Medicaid will probably want to look at all their joint assets and income. Yeah, joint assets no matter whether he becomes a resident of VA and applies for VA Medicaid or returns to FL where he is current viewed as a resident of. This could be quite complicated.
So What is their relationship... like friendly but apart OR bitter and beyond communication??? Would she be forthcoming in providing any of her financials, tax filings, property ownership details, etc. if you asked her?? Does she live in VA or FL?
Normally I truly think that a child if they have dpoa & mpoa and have been involved in thier widow or widower parent life, they as DPOA can totally DIY a parent’s LTC NH Medicaid application. But if there is a spouse still out there and living in the community, it’s not ever a DIY but needs a NAELA or CELA level of elder law attorney, as there’s stuff like resource allowance for the CS (community spouse) and how the CS income & assets gets factored in that isn’t simple to determine. You have all that plus an estranged marital situation. Your dad needs an elder law attorney. This site has a drop down list by state at the bottom of the page. Perhaps start there for phone calls.
Also whatever you do, never ever sign anything as just your name. Always, always sign as “Jane Smith Jones as DPOA (or MPOA) for John Smith”. For my mom’s NH admissions paperwork at least a dz plus signatures, on every one I did the long signature as above. Admissions not happy, but not your concern. Limits your liability.
FYI Medicaid has a 5-yr "look back" reach.
When my MIL went into a facility, I had to do the application myself.
Rules may vary from state by state, but our elder care attorney (initial visit, free), told us to separate their finances, and file separately for Medicaid.