difference in assisted living facility and private home facility

[hurricanefan]

My parents are currently receiving A&A benefits.  My father is in assisted living and my mother was until 2 months ago she is now in a nursing home because of lack of participation in rehab and Medicare would no longer pay.
I have found a private home that provides care someone on staff 24/7 to move them to say they can stay together.
Is this type of facility covered under the A&A benefits??   
Also would I receive more money if I told the VA she is not going back to Assisted living facility and now resides in a nursing home? 
Any help appreciated as I need to make a decision by end of December

[vetadmin]

Depending on the amount of the award your dad received filing as a veteran with spouse, if he is at the $1949.00 rate, then no, as that is the highest award regardless of where your mom is.

Do you know if the home you want to move them to is licensed?

[hurricanefan]

Yes they are licensed in the state of texas as a residental care home. 

[vetadmin]

Then no problem moving them.

[MomsAdvocate]

My Mom (who receives A&A) has been in an assisted living for over 2 years; but now is in rehab recovering from pneumonia and not doing well --at all --she's not eating, no longer getting up, she is tired and wants to sleep alot.  She could very well be slipping away.  I don't think she will get the care needed at her Assisted Living and if possible, I am sure it would be at a higher care cost. And we don't want her to be in a nursing home.   In her present health and IF--she is nearing the end of life, I want to bring her home to my house and care for her.  If I decide to do this, will I still receive her A&A benefits?

And do the A&A benefits continue if she goes into the hospice status?

Thank you,
Jody

[vetadmin]

Jody,

Sorry to hear this.  You can bring her home, and provide her care, and still have her continue to receive A&A. but she would have to actually pay you the same way she does now to the facility, so that she continues to have the same expenses to claim.  If she does not pay you and generally Hospice is free, she would not qualify financially, so keep that in mind if you make this decision.  You have to maintain the allowable expenses for her care and services.

I hope that it all turns out well.

[MomsAdvocate]

You mean, I can just say, "she's paying me" or "I'm charging her $$" and that will be sufficient?  Do I have to keep up with hours and hourly rates, my expenses etc.?  That sorta sounds too easy?  Do I have to notify VA when I bring her to my house?
Thank you so very much for you expertise and help!
Jody

[MomsAdvocate]

I forgot to add that her countable income, including max widow benefit of $1056 totals about 2,700.00 per month. Then minus her meds, needs, food and Dr. bills etc.  How do I justify charging her $2000 per month to be with me?  Of course I keep her with me no matter what they would determine, but more money helps the situation.
Thanks again,
Jody

[vetadmin]

No, not quite that simple.  You should draw up a contract stating the services and the monthly amount to be paid.  If she is with you, then it is pretty much 24-hr care.

Generally it is recommended that you contact agencies in your area, and get a quote for the same services and what it would cost for outside care to come in and do the same thing for the same amount of time.

You would need to have a check written from her account to you for the services.  You would treat this the same way you would if you were paying for outside care.  You would have to claim the money as income.

If your mom has $2,000 left over at the end of each month prior to paying anyone for care, then is not going to qualify for this pension.

She would not qualify until her monthly "countable" income is below the $1056 award for A&A.

Yes you need to let the VA know her new address and residence when she moves.  You also need to let them know the change in her monthly expenses so they can determine her continued eligibility.

Not an easy decison to make for you.

[MomsAdvocate]

I'm not sure what "She would not qualify until her monthly "countable" income is below the $1056 award for A&A." really means.  -If you have time, could you read the below and asset and maybe restate the above comment based on her situation.  I don't want to do anything that will gum things up.  It took 12 months to get the first A&A check.

Without A&A she brings in medicare and retirement equally about $1700. 
Her total income is about $2700 a month (including A&A)

Her monthly script run about $150, a life insurance policy, Dr. Co pays and medical bills ($1000.oo year deductible) and then there will be her incontenence supplies and personal tolietries. 

When I go to Vet office (Canton GA office is a GREAT), they check off the paper in like a few minutes, fills out the form and faxes it in for me.  She says because the assisted living is $2840 a month which is more than what Mom brings in, the automatically qualifies.  My husband and I have been supplementing her income to make the rent difference and ALL other expenses. 

Thank you so much!
Jody

[vetadmin]

Jody,

If she leaves the ALF at $2840, and no longer has this expense, and she does not have to pay for care living with you, what would she have left over out of the $1700 a month minus the A&A supplement after paying out allowable medical expenses?

Look at the formula below, and don't factor in the current A&A amount and base it off of her coming to live with you.  If she is not paying you, not paying for outside care to come in, what would she have left out of the $1700?

Do NOT count their residence or vehicle when estimating net worth.

Do NOT count a life insurance policy (because the policy holder must be deceased in order to benefit from it).

DO count CDs, annuities, stocks, bonds, savings, checking, IRAs, Keogh, etc.

DO count any assets owned by the spouse as well.

As a rule of thumb, assets should not exceed $80,000. That amount drops depending on the age of claimant.

List below the estimated ANNUAL income of the veteran or surviving spouse:

 Estimate total income (If married include spousal income): ______

All income must be included. This includes social security, pension, interest income, dividends, income from rental property, etc.

If the veteran is married, then any spousal income must also be included.

List all unreimbursed, recurring health care expenses:

 This includes:

 Assisted Living costs (per month): _________________

 Nursing Home costs (per month):________________

 Home Care service (per month):_______________

 Health Insurance premium (per month):_______________

 Medicare premium (per month):_________________

 Regular (unreimbursed) prescriptions
 (per month & verifiable through a pharmacy print-out): _____________

 TOTAL Expenses per month: __________
 (multiply x 12 to get total annual expenses)

Subtract your total annual health care expenses from your total annual income and write the amount here: _____________. This is your "countable" income.

[MomsAdvocate]

Okay, let me look this over and do some figuring.
Thank you,
Jody