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Old 03-06-2009, 05:46 AM   #1
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Caregiving: Fair Market Value!

Does anyone know what the Fair Market Value per hour is for taking care of a family member in your own home!

 
Old 03-06-2009, 07:39 AM   #2
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Re: Caregiving: Fair Market Value!

Anyone?

I had a rep from respercare (sp?) (a friend of a friend), who had also been a director of a nursing home in the past, tell us that it was $8.50 per hour and that it could be for up to 16 hours a day.

We just signed a caregivers agreement the other day and the lawyer told us and put in writing that it is $17 an hour. Of course that seems ludicrous to us, but it is in writing.

I guess I should have started from the beginning.


We've been taking care of my mother (who has alzheimer's) in our home for over 2 years for approx $3.00 an hour. This is being paid to us from her account from my brother who is power of attorney.

Mom had very little money (and only had this money after selling her small home). Family wanted her to be immediately placed in a nursing home after daddy passed, but we said no way, and she came to live with us.

We get NO assistance from family and after talking to our friend was told that services (adult day care specifically) through medicaid (paying for 3 /8 hour adult day care visits) was available for her but only if she had under $2000.00. She also told us that we could pay down her money since we should have received more in the way of compensation for taking care of her.

With this in mind we started asking questions and it ended with us going to a lawyer. The lawyer says it is illegal to back pay and that we should have had a caregivers agreement all along. That medicaid can deny her services even when she gets to the $2000 income level because we didn't have the agreement to begin with. That seems odd to us because we had a verbal with my brother, took good care of mom, and got very little ... but you can't buck the system I guess.

Anyway we decided to go ahead and do the caregivers agreement as of yesterday. But now what she told us seems odd to us.

I mean, she is saying that medicaid will not allow my brother to back pay us to pay down her money to get services, but will allow us now to charge $17 per hour for her care, (but not to use 24 hours she said).

One last thing.

The thing that has us concerned now, is that the lawyer says that because we did not have a caregivers agreement from the beginning, that medicaid (when she is able to apply for it) has the right to look back over the last 5 years and could deny her benefits (a penalty which would delay her from getting benefits for 7 months) because we didn't have that agreement.

Again, I find that odd since we only were receiving about $3 per hour and the lawyer is now telling us we can charge up to $17.

Thanks in advance,
D :-)

 
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Old 03-06-2009, 08:30 AM   #3
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Re: Caregiving: Fair Market Value!

My mom who has alz, has been living with my brothers alternating months and in the beginning (maybe for about one year), I just made a check to them for $1000 a month (which is a joke, considering the fair market value for 24 hour care can go near $8,000 a month). Then I found out about the caregiver agreement and had that drawn up last year with agreement of $1500 a month for her care (which is still a joke and the lawyer broke down the fair market value in the agreement and we are saving the system thousands a month). Now like you, I am wondering about the money I gave them before the agreement. That would be so unfair of medicaid to penalize the family for mom's care. Maybe we can write up an informal monthly agreement for those months and just stick them in our check books as a bill for mom? Don't know - but when the time comes for medicaid, I am a nervous wreck about what and how it is done - and scared mom will not be able to get on if there is a snag somewhere through no fault of mine (I am POA and do all her bills). I am keep every single bank statement with all the papers attached each month. The stack if so high - and I am making copies monthly for medicaid.

The lawyer also wanted me to make a breakdown of the $1500 on how it is being spent for mom and I made a chart for each month with rent, food, bathing, etc. to equal $1500.

It makes me despise the entire system - they just don't care how families suffer and want to help their parents and keep them out of nursing homes as long as possible (doing them a favor).

Sorry for the long post.

Good luck, and I agree, we should have done the agreement in the beginning.

maryann

 
Old 03-06-2009, 08:45 AM   #4
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Re: Caregiving: Fair Market Value!

Thanks Mary,

So are you saying that your lawyer said that you could only pay your brothers $1,500 a month, or was that just the amount that you and they agreed on?

Again, our lawyer said that you can charge $17 and hour but not to use 24 hours. Considering that mom sleeps 8 hours a night (hopefully) then we could in essence charge 14 or 16 hours a day. Just using the 14 hour day scenario that is $7,140.00.

Another crazy comment was that we could "pay down" the money as long as it was for things for mom. For example she said mom could buy a wide screen TV or a Car. I said that is crazy ... mom has Alzheimer's and couldn't ask for those things. She said it didn't matter. Go Figure! The system is messed up big time!

D

 
Old 03-06-2009, 08:48 AM   #5
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Re: Caregiving: Fair Market Value!

Quote:
Originally Posted by Survivor101 View Post
Thanks Mary,

So are you saying that your lawyer said that you could only pay your brothers $1,500 a month, or was that just the amount that you and they agreed on?

Again, our lawyer said that you can charge $17 and hour but not to use 24 hours. Considering that mom sleeps 8 hours a night (hopefully) then we could in essence charge 14 or 16 hours a day. Just using the 14 hour day scenario that is $7,140.00.

Another crazy comment was that we could "pay down" the money as long as it was for things for mom. For example she said mom could buy a wide screen TV or a Car. I said that is crazy ... mom has Alzheimer's and couldn't ask for those things. She said it didn't matter. Go Figure! The system is messed up big time!

D

 
Old 03-06-2009, 09:01 AM   #6
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Re: Caregiving: Fair Market Value!

Hi D,
The lawyer said I should increase it to $2,000 but I didn't want to do that so it remains $1500 as my brothers were thrilled with that. I had called different places for in home care and they use a night nurse and charge even in the middle of the night meaning 24 hours a day - that's how I got around $8,000 a month which is ridiculous. I don't want mom's money to run out so fast as she is also maintaining her home which is in life estate and that costs a lot a month, and I still didn't pay for her funeral which we can do with her money too.

I believe you can pay down the money for her - does your mom look at TV even though she cannot ask for one? I would never get a car - no explanation for that.

Eventually nursing home care will be needed and then the nightmare will begin. Paying down her money if there is any left (nursing home in NY is about $10,000 a month) and then getting the medicaid process going. I am going to hire a medicaid specialist to do all this for me. they charge less than a lawyer (about 3,000 in total from start to finish). Lawyer can go up to $10,000.

I am just keeping everything in order now with her bills. Her CDs will be used for her care even though they are in trust for her children, that money is hers. The lookback is now five years (used to be three years).

Just think about how screwed up the system is: scenario: A parent who is young and healthy gives their children monetary gifts over the years for different occasions. then all of a sudden parent needs permanent nursing home care and the five year lookbook shows all that money given innocently to the children, there will be a hefty penalty period for that innocence. Isn't that awful.

maryann

 
Old 03-06-2009, 11:03 AM   #7
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Re: Caregiving: Fair Market Value!

ah hem (clearing my throat)

To all

We've been the route and was just beginning the dealings with Medicaid.

let me tell you -- you must have a funeral purchased and medicaid will direct through the funeral palor that the money goes to a third-party (here in NJ its a organization called "choices"). They hold the funeral money until the individual dies and then releases the funds to the palor.

just know two things we learned:
1) I'm sure they put it into an interest bearing account; only you nor the funeral palor gets the interest, its turned over to medicaid, I think or Choices may keep it, I'm not sure.

2) If the funeral costs are cheaper then the pre-paid amount, you do not get a refund, the extra money is sent to medicaid.

We were lucky (unlucky) depending on how you want to view it. My sister was just starting that nightmare and had just given the palor the check for the funeral plans the day (hours) before my mother passed. We were able to rip the check up, give the funeral director a check directly -- he was able to come in $646.00 cheaper than previously planned and gave us back the difference the day after the funeral!

---------------------------------------
regarding the 5-year lookback -- yep its true. We were lucky (again unlucky???) to have had mother's things put in an irrevocable trust dated 2002. so 5 year deadline was 2007 and my sister was keeping her home so 2007 came and went. In 2009, mom fell in January, was in hospital and was to be transferred to nursing home, it was the end -- she wasn't eating or drinking was severely dehydrated and kept falling.

Everyone, from hospice to medicaid, was sooooo ****** that they couldn't get any funds out of Mom and was screaming at us that we were hiding the money from them. My sister didn't get caregiver pay, she lived with my mother and both lived on the trust account from a house sale and my mother's social security. When the facility was going to take Mom's social security, it would've left sister with no money to live on and at this age and the fact that she hasn't worked in 8 years and the economony being as bad as it is for job searches, give me a break.

They are ruthless. They will want bank statements and will ask if any money has been given to anyone and will want an accounting of exactly how much and for what purpose.

Average Bayaya nursing care did cost us $20.00/hr. Weekend rates and night rates are different. Just if you wanted to know.

That's all the info I can help you guys with. Now that my mother died and we were able to stop the medicaid claim, etc. I said a prayer of thanks to God that we didn't have to deal with all the crap.

Take Care and good lucky to all. Remember they will demand the funeral to be pre-planned and pre-paid out of the account.

CaringSister54

 
Old 03-06-2009, 11:25 AM   #8
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Re: Caregiving: Fair Market Value!

Dear CaringSister54

I was planning to pay for mom's funeral way before she goes into nursing home. I was going to duplicate the funeral I had for my dad in 2007. Can I do that directly with the funeral home? The funeral cost is about $9000 and that is with only 1/2 day viewing. I wanted to do that soon from mom's funds.
thanks,
maryann

I too hope I never have to deal with those monsters but I know she is in God's hands and what he wants is what will happen and not what I want.

 
Old 03-06-2009, 06:40 PM   #9
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Re: Caregiving: Fair Market Value!

Thanks for your response caringsister54.

Marypar, I believe my brother went through the nursing home! That part is all done. He has paid for her burial, plot, stone and all that. I remember the lawyer asked him something like (but not sure this was the word) is it "irrevocable" and he said yes, and the lawyer said good. So that part is taken care of.

Mom had/has no other bills. She had as I mentioned a small home which was sold after dad died and she moved in with us. My brother (again power of attorney) took care of everything that had to be taken care of and the money is in an account. No gifts of any kind has been given to anyone.

The only thing that has been issued from these monies was a check that he wrote to us monthly for her care. The first year it was only $1000.00 a month. We didn't get a check for the first month. Dad died on Dec 23, 2006 and Mom came to live with us immediately. We received our first check in Feb.

The second year we received $2000.00 per month.

My brother wrote on each check what the money was for.

We are with mom around the clock. Take her to her doctors, out to eat, to relatives parties, 4th of July, ... everything.

Lawyer is trying to scare us....and told us that medicaid (when she is ready to apply for it) may balk at the fact that there was no caregivers agreement from the beginning and penalize us by not covering anything for 7 months.

We do however have the checks/bank statements for that period.

We do have a caregivers agreement now .... (we just did this in the last couple of days).

Now if mom would have immediately went into a nursing home when dad died, the money would have been gone in 10 months or less. Then the government (medicaid) would have been responsible.

As it is, we have taken care of her for 26 months and the money will last at least til the end of this year.

Although I know they have the right to look back 5 years, I don't understand how they or why they would fight us, because in essence we saved the government money. They would have been paying for 2 years or more prior had we gone the route of putting her directly in a nursing home...but who knows what they will do.

And I believe some of the fear mongering might have to do with the fact that the lawyer says that they will help us get through the medicaid junk....but of course they want a tidy sum of $2,500.

The lawyer is also telling us that we can be paid more than the $2000 we had been receiving, and with the threat of having to wait for 7 months (if they deny us) it sounds like the thing to do.

Because if we do get paid more we can put it back for her. Then as the money in "her" acct is paid down and we apply for medicaid and they deny us and we have to wait 7 months, we can take care of her during that time with the money we've put back.

Any other insights from anyone would be appreciated.

Thanks,
D :-)

Last edited by Survivor101; 03-06-2009 at 06:58 PM.

 
Old 03-06-2009, 08:37 PM   #10
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Re: Caregiving: Fair Market Value!

you don't have anything to worry about if 5 years has passed from the date the irrevocable trust was created. Was it? Our irrevocable trust was done in 2002 and the 5 year deadline was June, 2007 -- therefore when Mom fell and went into hospital and from there to nursing home, she technically owned nothing. That's what ****** off hospice, the hospital social worker, and other people.

My mother was covered for 100 days under medicare and 180 days under a secondary insurance provider that she was covered by. However, both hospice and the nursing homes told us they don't and won't deal with filing anything with any secondary.

The end result was they were yelling at us all the time, our elder-care lawyer said that we don't have to give them anything and most importantly we don't have to show them anything. However, medicaid told sister that they wouldn't process our claim if we didn't provide them with a copy of the bank statement when the trust was created, the statement from June, 2007 when the trust converted at the 5 year deadline when Mom became totally inconpatitated and they wanted bank statements from the last 4 months. They saw the latest one and literally went through line by line wanting sister to describe what each withdrawal was for. Sister said, that's the water bill, electric bill, phone, tv, etc. They weren't too happy that they couldn't find anything but they still wouldn't submit the claim until we did the funeral.

It's all bull. Its a game with them to hassle real bad anyone in dire straits.

You're in good shape if you have an irrevocable trust and its been done years ago.

Take care and most of all Best of Luck. By the time you get done with everything, you'll wonder what the heck is wrong with people.

And -- I feel bad for those who have no family No one told us about Medicaid or explained the process. They just all said "I can't believe you haven't done anything with Medicaid!!!!". They weren't much help in directing what is done and by whom.

I heard that some nursing homes will do the process with medicaid for the families and there's others that make it the family's responsibility.

In any event, I'm glad Mom died and we were able to tell them that we didn't need the claim after all. They kept asking for more info and we got into a power struggle between them and the elder-care lawyer we had.

CaringSister54

 
Old 03-06-2009, 08:44 PM   #11
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Re: Caregiving: Fair Market Value!

Quote:
Originally Posted by marypar View Post
Dear CaringSister54

I was planning to pay for mom's funeral way before she goes into nursing home. I was going to duplicate the funeral I had for my dad in 2007. Can I do that directly with the funeral home? The funeral cost is about $9000 and that is with only 1/2 day viewing. I wanted to do that soon from mom's funds.
thanks,
maryann

I too hope I never have to deal with those monsters but I know she is in God's hands and what he wants is what will happen and not what I want.
Marypar, yes you can deal with the funeral palor directly before you deal with medicaid -- You will probably come in around the same price but it may be higher so expect that. BUT if you start the medicaid process first, you'll be able to deal directly with the funeral palor but the funds have to be sent to the group that is identified for the medicaid purpose. That is why I mentioned it.

Good luck

 
Old 03-07-2009, 04:08 AM   #12
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Re: Caregiving: Fair Market Value!

That is a loaded question...
I would call a local home care agency and ask what they charge the family for one hour of care for what you need...also will the person be damaging your home in any way???
I took a Leave from work, this was before FMLA AND MY MOM paid me what I would have brought home @ that time (1989) it was I think $1300.00 a mo. I was a LPN @ the time, I think I made about $9.45 hr. and she also paid to keep my medical ins current at that time it was $600. a mo. So almost $2,000/mo.
Highway robbery you may think???
I would NEVER do it again. I would put my loved one in a nsg. home and make sure they were taken care of. It was the hardest thing have ever done!!! I watched her deteriorate almost daily. I took care of her most private needs. I felt trapped in the house as she was bed bound until she died...Cancer, and some one always had to be in the house. Some one will be left holding the bag and it will be you no matter how many people say they will be there.... We tried home care agencies and they were unreliable. One woman dropped my mom on her foot and sued us because she broke a bone in her foot. It is not like a child... you can take them to the mall when the a/c breaks in the hot spell of summer...
What ever you get paid or are charged it is not enough..... This is for 24/7 care I am talking. If it is recup, I may consider it, as the person will get better and can do progressively more and more for them self. If it is part time care, and the person just needs a little... If it is end of life, I say hospice was a choice I would consider now.
I would/have other family out and did not charge them, other than their food I ate, but that was short term and I could come and go freely...
Anyway that is my experience. I was 23 at the time and newly married and didn't have a clue what I was signing up for...
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Old 03-07-2009, 12:54 PM   #13
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Re: Caregiving: Fair Market Value!

want a good out.

sorry it was tough on you and I'm not being frivolous. I saw my sister who acted like it wasn't that big of a deal, suffer the most horrendous lifestyle because of her choice.

She was downsized by a company. And she was never one to immediately go out looking because she lived at home with parents anyway. Well, Mom got use to having her always there. so when the time came and she decided to look for work, Mom started having real bad panic attacks.

as time when on and sister was complaining that she couldn't find anything she liked and that Mom was being impossible, she said, I think I'll stay home and take care of Mom. i said, why don't you get a nurse in and her reply was she didn't want strangers in her home. There you go.

I said that the only thing then was to either change her mindset or just stay home and take care of Mom. In the meantime, my husband's health started being bad and my attention was focused on him and his needs. he ended up dying in front of me in April of '05

I couldn't believe what my sister was undertaking and as my mother deteriorated she made excuse after excuse more times blaming herself for my mother's failure. she always thinks, if I do this, Mother will be fine, etc.

the last year was the worse while i saw my sister's desperate attempts to get my mother to take her medicine. it became a 2 hour battle each morning. thank God, doctors told sister that the medicines weren't doing anything anymore and why fight the battle. If she takes it fine, if not, don't fight it. but my sister wanted my mother to live as long as she can and was frustrated that nothing she did or would do, could change what was happening.

As her sister is was painful, extremly painful to watch. BUT all along, I told her I didn't have what it took to take care of my mother. i was able to sit with her for a hour or two, etc. but to do it everyday, all day like my sister, nah, I truly don't have the ability. Not sure if the chronic fatigue I suffer from or the chronic anemia i carry has anything to do with it, but I could not do it for my mother. Don't think I could've for my dad either. thank God it didn't come to that, he died in 1995.

Take Care and God Bless.
caringsister54

 
Old 03-08-2009, 08:42 AM   #14
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Re: Caregiving: Fair Market Value!

We paid $19 an hour for a home health aide in New York City in 2004-5.

Martha

 
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