Medicaid - is this right?

[vettechick99]

Ok this is my friend's mom's situation - so I told her I'd ask here because you guys know it all.

My friend's mom has always taken care of her mother ("grandma") since her father died. She has basically supported her financially and in every other way. When she got to the point that she could not take care of her in the home anymore, she placed her mother in a nursing home that medicaid pays for.

During that time, or maybe before, she sold her mother's house for her. It had once been in a decent neighborhood, but had since gone bad and had actually been inhabited by squaters for some time. So it was in bad shape all the way around. She sold it and was lucky to get much for it. The proceeds (less than $25k) went to paying a lot of overdue bills and the other children of grandma.

Grandma has since gotten a new case mgr and she says that my friend's mom needs to find that house money by tomorrow because it needs to go towards paying for grandma's nursing home. She doesn't care that grandma has been a financial burden to her, that it went to pay bills, and wants that money ASAP.

None of them knows the laws and coming up with that money would be a huge financial burden to them now. I told her to ask a lawyer, but there is some Medicaid gag law.

So any experience with this kind of situation?

 

[DawnCt1]

Medicaid is "in line" after the bank (mortgage). If funds went to family members, it shouldn't have. Medicaid "looks back" 7 years, and even if the house was sold and the funds distributed to grand children, the state can come and claim it, as they rightfully should. I don't know what happens when the funds go to paying actual bills. The purpose of that law is to prevent people from deliberately impoverishing themselves by giving money to family members and then throwing themselves on the care of the state so the taxpayer gets the burden.

 

[Disney Doll]

What Dawn said. Someone needs to come up with that $$ or they will be in big trouble.

 

[Michelle67]

Yep, that is right.

 

[vettechick99]

This is what they are afraid of.

What they are so confused about is that when they sold the house, the other case manager knew about it and said nothing (that's how the new CM knew about it - it was in the records). So they didn't know they money was supposed to go anywhere and it went to support grandma and pay bills. Not one penny was squandered.

It just seems so unfair that years later they are now wanting the money - why didn't they say anything before!?! Why didn't that other CM tell them the law??

 

[C.Ann]

I agree with the part about the $$ that went to the children or grandchildren, but as far as the money that went for bills - if it can be shown that the bills were in Grandma's name and were paid by Grandma's checks, can they demand that as well? What if it was for doctor bills and medications? I think that's an area where it gets a little sticky.. If I recall correctly, after my mom's house was sold part of the proceeds were used to pay bills that were in her name.. She then went into a private-pay nursing home - where the rest of the money went (minus the amount my late brothers wife took off with).. When that money ran out (recently) she was moved to a new nursing home that accepts Medicaid patients and there have been no issues over the money from the sale of her house in 2005 (with a 7 yr. look back period here)..

 

[PADISFAM]

Ok this is my friend's mom's situation - so I told her I'd ask here because you guys know it all.

My friend's mom has always taken care of her mother ("grandma") since her father died. She has basically supported her financially and in every other way. When she got to the point that she could not take care of her in the home anymore, she placed her mother in a nursing home that medicaid pays for.

During that time, or maybe before, she sold her mother's house for her. It had once been in a decent neighborhood, but had since gone bad and had actually been inhabited by squaters for some time. So it was in bad shape all the way around. She sold it and was lucky to get much for it. The proceeds (less than $25k) went to paying a lot of overdue bills and the other children of grandma.

Grandma has since gotten a new case mgr and she says that my friend's mom needs to find that house money by tomorrow because it needs to go towards paying for grandma's nursing home. She doesn't care that grandma has been a financial burden to her, that it went to pay bills, and wants that money ASAP.

None of them knows the laws and coming up with that money would be a huge financial burden to them now. I told her to ask a lawyer, but there is some Medicaid gag law.

So any experience with this kind of situation?

Medicaid is a state run program -- so lots of different sets of rules -- in PA what you described is how it works -- any monies from a sale of a house or other assets goes to the care of the person in the Nursing Home.
In PA bills/debt is paid first then the remainder goes to pay for the care of the person --- this does NOT include 'the other children of Grandma' (I'm not sure what that means ?)
The bills/debt must be in the person going to the Nursing Home's name -- not just that 'mom was living w/ me & increase in h2o, electric, heat, food caused an increase in my expenses'.

 

[PADISFAM]

This is what they are afraid of.

What they are so confused about is that when they sold the house, the other case manager knew about it and said nothing (that's how the new CM knew about it - it was in the records). So they didn't know they money was supposed to go anywhere and it went to support grandma and pay bills. Not one penny was squandered.

It just seems so unfair that years later they are now wanting the money - why didn't they say anything before!?! Why didn't that other CM tell them the law??

In PA if you have receipts (e.g. clothing, medical bills, special foods -- Ensure) that show a direct relation to supporting her; those monies aren't counted. Again (in PA) an increase of utilites r/t taking care of someone in your home doesn't count.

 

[vettechick99]

Just wanted to be clear that money was not given away like an inheritence. It went to paying bills and repaying debts to the other siblings. My friend jokes she never saw dime one of that money.

Anyway, I would think that if she can prove that she spent that money on bills for grandma, that should count for something. I mean what if grandma had a hospital bill for $10k? Are they just supposed to absorb that cost and all that house money go to medicaid?

My friend's mom has a mountain of checks that proves that money was spent on grandma and her care. The CM said it didn't matter and that they want the money. It just doesn't seem right.

 

[DizBelle]

So, if you sell your house, you have to hold on to the proceeds for 7 years and not use it to pay for anything just in case you need to go into a nursing home on medicaid's dime? Because they may "look back" 7 years, see the sale of the house, and claim that the proceeds should go to them.

Example: Mom sells her house and moves in with her child. The proceeds from the house are used to help pay for the expenses of Mom (medical, food, utilities, etc). 5 years later, Mom ends up too ill for her child to care for her so she needs to go to a nursing home. Medicaid is going to see that there was a house in Mom's name that was sold five years ago and they're going to demand 100% of the proceeds from it? Even though it was all used up to offset the increased expenses of Mom living with her child for 5 years.

I agree, this doesn't seem right.

 

[Tinkerbelle'sMOM]

What they look at is to see if the person has been quietly doling out proceeds to make their assests less. You have to keep receipts and good records of how you spend that money if your parent comes to live with you. You can also pay yourself a caretakers fee, but our lawyer helped determine that for us.

Your friend may need to get a lawyer involved since the nursing home is demandig payment. I had a lawyer when my dad had to go into a nursing home and I am so glad I did because I would have never been able to go it by myself. The social worker is the mouthpiece of the place, and I had a few run ins with the one at our home, but I just turned it over to my lawyer and he handled it. I know that my dad's skilled nursing ran about $7000 a month.

It sucks that you work your whole life for stuff and then if you have to go into a nursing home the state takes it all.

 

[HighClass]

wow-this was an eye opening thread!

 

[geffric]

Contact your township Senior center and make an appointment with a SHIP counselor.. this is a volunteer but can be your advacate with SSI and Medicaid.. you will need to check Medicare too.

 

[C.Ann]

The social worker is the mouthpiece of the place, and I had a few run ins with the one at our home, but I just turned it over to my lawyer and he handled it..

There was a period of time between when my mother's money ran out at the private-pay nursing home and when they were able to find her a bed in a nursing home that accepts Medicaid.. During that time the unpaid bill at the private-pay nursing home reached $17,000.. Because my older brother is now currently her POA, guess who they are demanding the money from?

Fortunately they don't have a legal leg to stand on.. All of Mom's money was paid to the nursing home until it ran out.. My brother never signed anything even remotely implying that he was the "responsible party" and since children are not financially responsible for their parents, there's no way on God's green earth that they can make him pay it.. Of course that doesn't stop them from harassing him on a daily basis - phone calls; letters; etc.. It's already been turned over to his attorney, but still they persist - hoping they can get him to make one payment - which then legally puts him in the position of "assuming" responsibility for the entire balance.. They're sly - so you have to be very careful when dealing with bills in your parents name - and never, ever write a check for a parents bill out of your checking account.. If you do, once again you have "assumed" responsibility for the entire bill - even upon the death of your parent..

 

[heretohelp]

Anyone with a relative who looks like they may be going into a nursing home needs to have the person transfer their assests into someone else's name a few years before otherwise, they will find themselves in the same situation posted in the OP.

 

[PADISFAM]

Just wanted to be clear that money was not given away like an inheritence. It went to paying bills and repaying debts to the other siblings. My friend jokes she never saw dime one of that money.

Anyway, I would think that if she can prove that she spent that money on bills for grandma, that should count for something. I mean what if grandma had a hospital bill for $10k? Are they just supposed to absorb that cost and all that house money go to medicaid? No

My friend's mom has a mountain of checks that proves that money was spent on grandma and her care. The CM said it didn't matter and that they want the money. It just doesn't seem right.

It sounds as though a lawyer needs to be involved -- one that specializes in Medicaid Law --
Also an Ombudsman will be helpful

 

[Disney Doll]

This is what they are afraid of.

What they are so confused about is that when they sold the house, the other case manager knew about it and said nothing (that's how the new CM knew about it - it was in the records). So they didn't know they money was supposed to go anywhere and it went to support grandma and pay bills. Not one penny was squandered.

It just seems so unfair that years later they are now wanting the money - why didn't they say anything before!?! Why didn't that other CM tell them the law??

Because she didn't do her job. Unfortunately, that won't fly with the federal government. I would agree that your friend should call an attorney who specializes in elder law.

 

[PADISFAM]

So, if you sell your house, you have to hold on to the proceeds for 7 years and not use it to pay for anything just in case you need to go into a nursing home on medicaid's dime? Because they may "look back" 7 years, see the sale of the house, and claim that the proceeds should go to them.

Example: Mom sells her house and moves in with her child. The proceeds from the house are used to help pay for the expenses of Mom (medical--yes keep great records, food--'special foods (Ensure) yes, utilities--not usually, etc). 5 years later, Mom ends up too ill for her child to care for her so she needs to go to a nursing home. Medicaid is going to see that there was a house in Mom's name that was sold five years ago and they're going to demand 100% of the proceeds from it? Even though it was all used up to offset the increased expenses --of Mom living with her child for 5 years.

I agree, this doesn't seem right.

keep very, very good records/receipts.

 

[Disney Doll]

It sucks that you work your whole life for stuff and then if you have to go into a nursing home the state takes it all.

You know, I know people always say that, and I have never understood why, other than the obvious fact of wanting to leave it to your children, which, while altruistic, may not be realistic. Why does it suck if the money someone worked for all their life was used to care for them in their declining years? What else should thei[/U]r $$ be used for? If they can't use it to enjoy themselves due to physical/medical limitations, then I would be happy that they had the financial wherewithal to be able to provide themselves with good care.

I have elderly parents. Their money is THEIR money. If every cent of their money has to be used to care for them, then so be it. THEIR money is not MY money. Yes, as parents I am sure they will hope they could leave me something, because that is what parents hope....that they can do things to make their children's lives easier. And certainly, when they pass away if there is any money left I will inherit it. But I have no expectation that their money is going to be my money, nor would I ever minimize their care or needs to save their money so I could someday inherit it.

 

[PADISFAM]

What they look at is to see if the person has been quietly doling out proceeds to make their assests less. You have to keep receipts and good records of how you spend that money if your parent comes to live with you. You can also pay yourself a caretakers fee , but our lawyer helped determine that for us.

Your friend may need to get a lawyer involved since the nursing home is demandig payment. I had a lawyer when my dad had to go into a nursing home and I am so glad I did because I would have never been able to go it by myself. The social worker is the mouthpiece of the place, and I had a few run ins with the one at our home, but I just turned it over to my lawyer and he handled it. I know that my dad's skilled nursing ran about $7000 a month. & that is the average!

It sucks that you work your whole life for stuff and then if you have to go into a nursing home the state takes it all.

the monies are going to pay for the care of the person in the Nursing Home

Contact your township Senior center and make an appointment with a SHIP counselor.. this is a volunteer but can be your advacate with SSI and Medicaid.. you will need to check Medicare too.

Medicare -- whole different ballgame -- unless there is a 'skilled need' & a 3 day qualifying stay Medicare does nothing for room & board.

Anyone with a relative who looks like they may be going into a nursing home needs to have the person transfer their assests into someone else's name a few years before otherwise, they will find themselves in the same situation posted in the OP.

& here it is -- the reason I knew I should have stayed out of this thread

The VERY reason this is how it all works is because people do this.