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Hi. My dad is 83 and still lives at home alone. His home is in a living trust so it is protected. He only has one vehicle. He makes about $2,000 a month in Social Security. He makes enough to pay his monthly bills, food, gas, and Dr. co-pays. He has had back surgery, has diabetes, and walks with a walker. He seems to always have a wound under the care of a home healthcare worker who comes by once or twice a week to check on it and change bandages. He also has to wear a compression stockings which he cannot put on and takeoff by himself. In the future, within six months, have to move in with my brother and SIL. He has about $100,000 in a mutual fund that he makes about $300 a month off of the interest. we can protect this money from nursing homes he had to go to one within the next year? The house is protected and a living trust specifically made to protect the home. Also, can he gift $13,000 each year to his daughter, son, and their spouses without any ramifications from Medicaid if the time comes? And if he does go to live with my brother and SIL is there anyway for them to get paid for anything for being caregivers? We all take so much time away from work, and our businesses taking care of things for dad that our businesses are suffering financially. I know a lot of questions. I hope you guys have some answers. Thank you.

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I'm not certain about the mutual fund but most states' Medicaid look-back period is 5 years. If he gifts money he will certainly disqualify himself from Medicaid (or delay it for a long time).

He saved that money to pay for his care and comfort in his old age. Now he should spend it on himself for good care.

Yes, he can privately pay anyone to care for him but he needs to have a written contract for sure (even for family members). If he is tempted to pay for caregiving in cash, please know that Medicaid asks for copies of bank statements and may require an explanation (or receipts) for where that cash went.

If he pays someone privately to care for him, this makes him an employer. This means he has to do wage withholding and quarterly reporting, and submit a W2 for this employee at the end of every year.

I personally would not move him into a private home but everyone needs to make their own decision on this. There are some very great facilities that have activities, events and great staff, and my MIL is in one, in LTC on Medicaid (she even has a private room). It's close to our house and the staff is amazing. They get her out of her room every day and she jokes around with them.

Your Dad will get so much more social exposure in a good facility. Plus, he may qualify for LTC, which in most states is what Medicaid covers (it doesn't cover AL or MC in the vast majority of states). If he takes this path, he should pick a good facility and go in on private pay. Make sure they have Medicaid beds and a continuum of care (like MC and LTC, hospice). Once he needs and qualifies for Medicaid, he will get first dibs since he is already a resident there. Outsiders can often be on waiting lists for Medicaid beds.

Is anyone the PoA for your Dad? If not, this is a dealbreaker for providing his care. He needs to assign someone who is at least 1 generation younger than himself, who is willing and able and local to him. The FPoA needs to read the document to see when the authority is active and needs to meet with an elder law attorney to learn what kind of record-keeping and boundaries there are in managing your Dad's finances. Then also meet with a Medicaid Planner for his home state so that he and the PoA don't accidentally mismanage his funds in the eyes of Medicaid.
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If he gifts money within 5 years of applying for Medicaid, yes, there will be ramifications. Either the money will have to be returned, our the total amount gifted will be divided by the cost of each day of care under Medicaid, and Medicaid will not pay for that number of days of care. So, for instance, if $50,000 is gifted and NH care costs $500/day Medicare will not pay for the first 100 days of care. That is a huge risk for the family.

In my state you can have an attorney draw up a PCA agreement where family members get paid, OUT OF THE PATIENT'S MONEY to care for the patient. Under the agreement my family has, it is the family member's responsibility to claim the income on their taxes. When the patient runs out of money, some states will allow family members to be paid for care out of state money.

If your hire someone outside of the PCA agreement, then you will have to do what Geaton said, withhold taxes, social security, etc. You need an attorney and you need to know what the laws are in your state.
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You need an attorney.
His home is protected in that he can have a home and car and still receive Medicaid, but this income in not protected and his home will face "clawback" by the government after his death. A living trust is a "revocable trust" still within the control of the trustor (your Dad) who created it. That means the funds in the trust that are liquid (not a home) will be spent for his care.

You are attempting to do something illegal if you are attempting to preserve your fathers funds for YOU while he receives minimal care from Medicaid. Your father's assets should stand to provide decent care for his last years.

If your father is moving in with family then they need to see an attorney to work out a shared living costs contract with Dad so that Dad can pay his share of mortgage or rental, food costs, utitlites with them.
In short, you need an ATTORNEY, not the collected, often differing opinions of a Forum of caregivers.

Seek advice of a good elder law attorney regarding ALL these questions. He will tell you what funds can be protected, and how to create a fair contract with his son and dil.
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Lovesgirl Feb 9, 2024
It is my understanding that you get the same care in an AL or nursing home whether you are medicare, medicaid or self paid. My MIL is self paid in a memory care unit in AL and her unit/apt looks exactly like the lady across the hall on medicaid.
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The idea should be for dad to use his OWN money to pay for better care in private pay facilities than in sub-par Medicaid facilities where he'll have a roommate. Not to "gift" his money to children or hide his assets in an effort TO have the government pay for his sub-standard care so all his hard earned money can go towards inheritance rather than his OWN care in old age. If dad winds up going on Medicaid, and I hope not for his sake, then the children he lives with can apply for a tiny wage to care for him at home.

I managed my parents nest egg with a fine tooth comb to prevent the need for Medicaid to manage their care. Dad didn't work as hard as he did to wind up sharing a room and a toilet with someone blasting a television set 24/7.
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Lovesgirl Feb 9, 2024
Actually you are incorrect, my mom and dad said they saved this money to leave for us. and frankly we are trying to provide what he WANTS which is to not have to go to a nursing home. We want him to move in with brother and SIL, but he doesn't to and wants to stay at home. . . . and frankly I think the government should be paying for ALL elder care in nursing homes after a certain age. The govt has double, triple and quadruple taxed every penny we make from the time we are born. At the end they want to take it all. The cost for assisted living and nursing homes for someone who just needs a little help and oversight (not major medical assistance) is disgusting. I have had a lot of experience with both AL and Nursing homes and have friends who work in them, there is no way it costs $8,000-$10,000 to house and feed 1 person. . . and we are not looking for "big money" to take care of him at home which frankly is insulting. For me to go to my dad's to fix his tv remote or some other thing is a 3 hour trip at a minimum. So my home, my family, my job, my sanity, my income or lack thereof suffers for it. I spend my money and several hours EVERY day handling his calls, concerns, text messages, voice mails, his bills, his finances, his doctor appts, his social media accounts, checking his email, blocking his spam in email, and finding and blocking the scammers in Nigeria that are trying to take advantage of a lonely old man on facebook. He wants to spend more time with us but he will get way more than he bargained for when we are ALL homeless because we lost our jobs or business because we spent so much time with him. I came here for help, advice, and a shoulder. Show me a job where you can take 15 calls/text/messages a day AND take 1-2 days off every week to take someone to doctors appts, pharmacies, etc. I'm about to lose my mind and check myself into a mental hospital and you just want to throw rocks at me. No thank you.
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Yes we have trust for the house, and I and my brother share POA. I keep receipts of everything that I spend and get reimbursed for, even receipts for what I spend and don't even ask to be reimbursed for.
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His mutual fund should most likely be used for his care. If having his house in a trust saves that money for his heirs, even if he is on medicaid for his care, well, good for you I guess. Sure, we all want to leave $$ to our kids but if his needs require money to be spent, then that's what it really is for. Sorry to say.

You are spending way too much time during the work day attending to your dad. 15 calls/texts a day? Time to silence your phone. If he has an emergency, he needs to call 911. His other non-emergency needs will have to wait.

While waiting to move in to your brother's, I would have him hire and pay for some aides so you and your siblings can be freed up. Yes, your jobs, businesses, spouses and children need to come first. You can help your dad but not at the expense of everything else.

If you and your siblings are going to take gifted money to try to shelter it from Medicaid, I would suggest putting it into a separate account until the medicaid look back period has expired. Otherwise, it could be very difficult to come up with that amount of money when medicaid demands it.

Do your brother and SIL really know what they're getting themselves into? Do they have room for dad? Are they willing to hire caregivers? When my mom lived with us, I started with a cleaning lady when mom could no longer keep her room and bathroom clean. There was a 3 hour minimum and they did her stuff first and then worked on the common areas. Then I started adding caregivers, telling mom it was for ME. So I could go out and not worry about what was going on at home. An elder with mild dementia at home alone for hours on end is not a great idea and I was not comfortable with it.

Do you or any other family members plan on giving your brother respite care relief? Having dad live with them could be difficult even if his needs are not too large at this point. My sister would take my mom for a weekend about once a month until her condition got worse. It was very helpful but was also only a spit in the bucket cuz you're right back into the same crap different day when she returned.

Best of luck.
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It’s too late to gift this money. You will not meet the look back requirement. Your father will need it to pay for his care with his money. Caregivers are expensive. He will blow through this money quickly. Once it is gone, he can apply for Medicaid.

The only gifting he can do is set up irrevocable funeral trusts for his children and children’s spouses. Not much of a gift but that can be done.
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At this point since Dad is having health problems, none of his money should be gifted. He may have meant the money for you but Medicaid looks at it as his asset and it needs to be used on his care before he can get Medicaid help. Medicaid is for low income people. If he gets $300 @ month in interest from that fund that is considered income and so is any pension he gets. There will be penalties if his money is not spent on him.

Even though IRS allows 17k a year to gift money, Medicaid does not allow it. I think that having a talk with a Medicaid caseworker would be a good thing. Each State is a little different.
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