Replies

I heard that once she was in the hospice, her funds were placed in a "trust" and she was getting Medicaid to pay for her stay. After her death, the "trust" funds are turned over to Michael.

Which is legal in the State of Florida apparently.

Hm....

In the state of Texas, which is where we live, Medicaid will only kick in once a beneficiary's assets are "spun down". That is, the beneficiary can only have so much cash, property, etc. At that point, Medicaid may be used to pay for custodial care(such as nursing home placement), but to my knowledge, Medicaid does not have a separate benefit for hospice. Hospice is a Medicare entitlement, although some commercial insurance plans do provide some type of hospice benefit, but it is usually not as rich as what Medicare provides. I am not sure about Florida law, but I don't think she would have qualified for Medicaid in Texas given the size of her trust fund. However, I am not an attorney, so I supposed there could be a loophole somewhere.

My understanding was that she was in a hospice and had been in a hospice for 5 years. I am not sure how she qualified to be placed in hospice in the first place since the feeding tube was already in place which was the source of her nourishment. I personally do not think the hospice should have accepted her since with a feeding tube in place and given her age and physical condition, it was reasonable to assume that she would live longer than 6 months.

In hospice, a beneficiary may receive some physical therapy, but it is not going to be enough to maintain a beneficiary at their current functional level.

Here are my thoughts, if indeed Michael Shiavo did apply for her to receive disability benefits under Social Security thereby qualifying her for Medicare, and if indeed she was receiving hospice benefits under Medicare, then I suspect that she continued to qualify for hospice benefits because she was not receiving enough physical therapy to maintain her functional status, therefore she showed a steady decline. If this basic supposition is true, then I think it would also be logical to conclude that at some point in time, she bottomed out, that is did not continue to show decline and her hospice benefits were either denied are were under scrutiny. At this point, her trust funds would have been fully at risk for her continued care. The level of custodial care that she was receiving would probably cost anywhere from $5000 on up per month. Her trust funds would not have lasted long at that rate. I think Michael Shiavo figured this out and then began petitioning to have her feeding tube removed. Once her feeding tube was removed, she actually did qualify for hospice at that time.

It is horrible to think that this scenario is really what happened, but it is plausible. I am an RN with 25 years of experience and the last 12 being in managed care(working with health insurance). I understand how hospice under Medicare works because it is truly a wonderful benefit for those individuals who truly need it. It is sad to think that this wonderful benefit is now being abused by greedy individuals willing to sign that an individual has 6 months or less to live when that is not the case, as in Terri Shiavo. It is murder, but a very slow murder that takes place by depriving a patient of what they need to maintain their health, and it is being done for money.

Mrs. PlanekT

Well, that should be just plain illegal. That just gives the guardian a good reason not to take proper care of the patient.