If my mom has to live in a nursing home will they just take all her money?

Let me first say that nursing homes are EXPENSIVE. Medicare/supplemental insurance doesn't pay for nursing homes. So your looking at least $2000.00/mth just for her to live in a nursing home. Thats for room and board. Usually, things like medication, medical equipment,etc.. are not included and is an additional cost added on. Since your mom just sold her home, she is unable to qualify for medicaid(welfare) which would pay for Nursing home. But, there is a five year look back review of income & assests. I don't know too much how that process works.

I will tell you that a neighbor told me her sister whom needed 24/7 care paid out over $100,000 dollars in 2 years for home care. So you need to plan for costly care before you split money or set aside. The worse thing would be running out of money that was your moms and you will have to pay for living expenses. Just something to think about.

One is able to gift money I think up to $10,000(check irs website) However, if your mom is in a questionable mental status, I would not proceed unless I 'd talk to an elder attorney. If your POA, check your papers. There are limitation clauses. What your able or not able to do. I have Durable POA of mom. However, One thing that is stated that I am not allow to give "gifts". So be careful.

To handle this situation properly, please speak to an attorney.

The rules for rehab (after a minimum hospital stay of 3 days) are that medicare pays full for days 1-20, as long as rehab can show need/improvement. Then days 21-100, medicare pays 80%. If you have secondary insurance, they may pay part of the remaining 20%. You will have to check with them. Same deal, rehab has to show need/improvement.

As posted above, medicare doesn't pay for nursing or assisted living after rehab. You should begin to check out options in your area now while your Mom is being well cared for in rehab. This process took me 3 months of constant looking!

In my area, skilled nursing is over $10,000 ... a MONTH! After a certain number of months some of the nursing homes will take the resident on as medicaid. I found them to be few and far between and frankly, not the nicest ones!

Assisted living runs $7-8,000/month in my area. NONE of the ones I visited take medicaid residents. They all ask for your financial status during the initial meeting!

Current gifting rules are $13,000/per person/per donee a year. But as the previous responder said, before Medicaid pays, they look at 5 years worth of spending. Before you select a nursing home, determine if an assisted living facility would work for your Mom.

The rehab section of the skilled nursing facility told us we would need skilled nursing for my Mom. ($11,900/month at theirs). We checked out a few other choices and one in-take person asked why we were looking at SNFs. She thought my Mom only needed an assisted living (AL). We took her advice and for the past 6 weeks my Mom has been doing fine at the AL ($7100/month) . This helps the resources last longer and in this case it is working fine.

The journey is interesting. My feeling (and my sibs too) is that she and my dad accumulated the money and it should be used for her. The places that take medicaid near me are not places I would want for me or a loved one. Good luck.

I don't know about the state you live in, but in Arkansas, they went back 36 months on my mom's property and assets. In order for her nursing home care to be paid for - (nothing fancy at all about her nursing home) her bill is 5,000./month- she only received a little over 700./month soc. sec. Fortunately, my mom didn't want to stay by herself in her home after my dad died- so she sold the house to live with my uncle about 5 years before she was diagnosed with dementia and 6 months later was in a facility. I am talking about medicaid making up the difference. Her home does take medicaid- not a bad place, older building- but clean, and taken care of.

KerryM...

The problem is that personal resources are exhaustible and it is unknown for how long mom will require care.

There are some accuracies and inaccuracies shared above.

First, as described above, Medicare will only pay for the first 100 days IF she requires skilled care and is improving.

Second, Medicaid is the only other payor source other than personal resources.

Third, to qualify for Medicaid the applicant must have less than $2,000 in assets. There is also an income limit which varies by state. All of her income (Social Security, pension, etc.) will go to the nursing home if she qualifies for Medicaid.

Fourth, the asset transfer rules prohibit uncompensated gifts within 5 years of application for Medicaid. The annual gifting exemptions mentioned above apply to the Federal Estate and Gift Tax and have NOTHING to do with Medicaid qualification. It is irrelevant.

Fifth, if mom does go on Medicaid she will still need funds to meet her other needs. She will need clothing, glasses, hearing aides, dental, other personal needs, etc.

Sixth. There are several techniques available to move money legally so she can qualify for Medicaid. This is NOT about kids getting the money. It is about assuring that mom will be well provided for. For instance, look in to having her gift the money to a Supplemental Needs Trust. Gifting to this irrevocable trust will allow her to immediately qualify for Medicaid and the funds so transferred can be used for her health, maintenance, and welfare while receiving Medicaid benefits. You do not need an attorney to do this. Do a search for such a trust in your state. They are run by non-profit organizations. Compare several as costs vary (not surprisingly, some are run by attorneys and are very expensive).

You can also use part of the money to establish a Personal Service Contract between you and mom whereby you would be paid to perform services for her above those that are provided out of love and affection. This will allow a lump sum to be legally transferred from her to you and she will also thereby immediately qualify for Medicaid.

Again, this is to provide for her needs...not to enrich family members. Prudent planning of this sort makes sense.

Good luck!

kerry - Whatever route you take for your mom it will be expensive and she will run out of $ eventually. IMHO what you need to decide is how her care is going to be paid for.......do you & the other family plan on spending all the house sale $ on a facility and when that's gone have her apply for Medicaid OR do you all plan to continue to pay for her privately. If Medicaid is in the plans, then try to get her into a facility that takes Medicaid so you don't have to go thru moving her again. The social worker at the SNF can tell you how they handle this or recommend other places. I've found social workers are better on this than dealing with admissions.

Whatever $ she got from the sale of her home needs to be used for her care & her needs. Because the sale was so recent, it would come up in Medicaid asset review & look-back which can be 3 - 5 years depending on how her state manages Medicaid applications.

Remember for Medicaid for NH, they must show that
1) are 65+,
2) medical condition requires that level of Nursing health care,
3) monthly income is less than her states ceiling +/= 2K,
4) countable assets are less than $2000 and
5) not gifted away anything of value during the spend-down & look-back period.


However, you do have the advantage of where the $ is “spent down” – which means getting her assets (excluding homestead & car) under the state’s Medicaid asset ceiling. You can buy her funeral and burial policy, small term life insurance Whatever they need to be irrevocable NCV. Glasses, dental care (spotty on Medicaid), hearing aids, walkers, clothing suitable for being in a NH. She can own a car. No $ gifted to others but if she went to live in a family members home she could possibly do a personal services contract for managing her care ( I don't think she can do this if she is in a SNF but that's an attorney question). Basically everything must be for their care or property.

All this being said, alot of this depends on what the house sold for. If we're talking
a very modest amount, I would just spend the $ on her care at the SNF &/or NH and apply for Medicaid. If the $$$ is significant then go and see an elder care attorney who practices in the county that she resides in to see what the options are as her state law allows. All these issues are sticky, you'll need to hire an experienced lawyer to help so you don't run into a Medicaid penalty period later on. To begin your search for the best lawyer for the job, contact the local bar association and ask whether it has a lawyer referral service that includes those who specialize in elder law or conservatorships. You can also contact the National Academy of Elder Law Attorneys for a referral to its members in your area.

Also IMHO you should have the following done if you haven't already:
- Durable Power of Attorney (not just POA & not a "springing" DPOA)
- Medical Power of Attorney

- Living Will &/or Advance Directives (DNR)
- Declaration of Guardian in Event of Incapacity

- HIPAA Waiver
(general release one)
- Will or a Living Trust

I'm a firm believer in having an elder care attorney take care of all this. It will not be expensive as most is done by the paralegals. But is invaluable if there should be a problem later on. You do want to go in prepared with what the information is for the documents (e.g. Ann Smith, wife of John Smith, with the info on all the births, deaths & prior marriages) as well as valid ID for the elder. If the decisions have been already made, this should all simple, straightforward paperwork. Should take 1 - 2 hrs for intake & then 1 hr a couple of days later for the signatures to be done.

If mom has assets, then all this should be paid from her assets. This also is important if you ever get challenged. If you pay for all, and you benefit, then other family could go to court to find it a coerced document. Good luck.

I think she should ASAP purchase another home as a rental or you should go to an elder law attorney ,its worth it.In Calif. reinvesting is the key.

I do not know where you people live, but my Mom is in a Nursing Home here in New York that costs $450. a day....not different from other Nursing Facilities here. And...NY charges over $700. a month in Room and Board tax. The money goes down very fast. We have a few months before we apply for medicaid....and it will cost us to do that as well. Whatever my Mom needs after she is approved for medicaid, (they allow her $50. per month personal money), I will provide for her. You want your Mom to have the best care...that is the most important factor. We went to an eldercare attorney 9 years ago and had her house put in a life estate. He also did the poa's and the health proxy forms. But she would not allow us to do anything else. Do see an attorney, and get the advice you need in your state.

My mother would like to move in with us. We are contemplating building a house with 1/2 the proceeds from her house and all proceeds from our house. She would have approximately 70,000 left to give my brother. Is this legal and would medicare be able to come back on us should she need a nursing home?

Daisy, Is it legal for your mother to spend the proceeds of selling her house on some arrangement to meet her housing needs and also to give some away? I certainly hope so!

Would this use of her money cause her trouble if she needs to apply for Medicaid in the next 5 years? I'm afraid it would -- especially giving cash to her son. Also, you'd want to be sure that the home ownership is set up in such a way that if she does have to go on Medicaid in the future the state's claim on the house after she dies is dealt with.

Do NOT go forward with these plans without consulting an attorney who specializes in elder law, or a certified financial planner very familiar with Medicaid, or both. Make sure that whatever is done is done in a way that will be most advantageous to all of you, and, of course, unquestionably legal.

Good for you for thinking ahead. I hope your mother never needs a level of care that would require Medicaid help, but it is better to be prepared than to be woefully sorry!

The Look Back law changed as of July 1, 2012 - the look back is immediate and goes back 5 years. See an elder law attorney. It may be to late to do anything with her money except pay for her care in the nursing home. See a GOOD Elder Law Attorney - they are the only ones who know what can and cannot be done at this late date. The laws have recently changed and it changes EVERYTHING.

Daisy - as others have said good legal is needed.
Do you understand the difference between MediCARE & MediAID? This site has
a couple of good articles on what they are and more importantly are not. Mcare is a federal entitlement program basically for hospitalization and medical costs and everybody who paid into SS also paid into Mcare and has it available to them once they hit 66. Maid is a joint federal & state entitlement program for the very poor and will pay for long term care for those that qualify for it both financially and medically.Maid has an asset & income review within 5 years back from date of application. So that would mean your mom in order to avoid any lookback could not apply for Maid before Sept 2017. If she applies between now and Sept 2017, there could be a transfer penalty imposed on any and all $ not spent on her care or her homesteaded property (exempt asset). Sales or transfers of real assets - like a car or house - is recorded by the state so all that information is easily available for Medicaid review. All her financial records - like bank & insurance- can also be reviewed for 5 years back. You sign off an all access is OK when you apply.

You really have to be especially careful when you are co-mingling assets which is what you would be doing by using mom's $ and your $ to build a new house. Co-mingling puts everybody at the same risk or exposure to the others debt if there should be a problem later on even decades from now. Not just for Medicaid but also if something else happens like a lawsuit against you.

Ideally you want to work with an Elder care attorney who is certified for that speciality in your state. They might suggest doing a personal services contract for you or your brother to divest some of the $; they could suggest doing a trust; or a medicaid compliant annuity. Alot of this is dependent on what your mom's financial & health situation is & where she sits on probability of need &/or death.

In general, IMHO you should have the following done:
- Durable Power of Attorney (not just POA)
- Medical Power of Attorney
- Living Will &/or Advance Directives (DNR)
- Declaration of Guardian in Event of Incapacity
- HIPAA Waiver (umbrella/general one)
- Will or a Trust

The Declaration of Guardian is one that most don't have - this is really important to be done as it sets whom mom wants in her current & cognitive state to be her guardian(s). Once they get a dementia that can change on a whim due to their changing mental abilities.

I'm a firm believer in having an elder care attorney take care of all this. You do want to go in prepared with the information for the documents (e.g. the residence located at 123 ABC street, aka parcel #5678; Ann Smith, wife of John Smith, with the info on all the births, deaths & prior marriages) as well as valid ID for the elder. If the decisions have been already made, this should all simple, straightforward paperwork. Should take 1 - 2 hrs for intake & then 1 hr a couple of days later for the signatures to be done.If mom has assets, then all this should be paid from her assets, so bring her checkbook This also is important if you or other family ever get challenged on who is DPOA or end of life issues. If you pay for all & benefit, then others could go to court to find it a coerced document. Good luck.

My mother went into a nursing home august 24 2012... she had to pay 635.00. medicaid took car of the rest. we decicded we wanted her to live with us. we talked to the social worker, the nurse and the dr came in and checked her and said she could go. The next day the the nursing home called and said in order for medicaid to pay she would have to go back and stay 4 or 5 days. Is this Legal?

My mother went into a nursing home august 28 2012. She paid 635.00. On the 21 of august I brought her home to live with me. we talked to the social worker, the nurse and the dr came in and checked her out and said she was free to go. the next day, the nursing home called and informed us that she had to come back for 4 or 5 days in order for medicad to pay the bill. Is that Legal? we live in N.C.

My mom is in AL and has a large sum of $$$ in an account ( cd's etc). If she gave the kids all but say $100,000....that would leave her enough to pay 5 yrs in a nursing home! She gets 3400 from her X husband...if she applied for Medicaid after 5 years...they couldn't come after us for the money...right?

Safer to wait until AFTER she is gone to divide up her money. The 'look back' is immediate - it is not done after they pass and that is not how the five year look back works. IF your mother has the funds to pay her way until the end of her days - that's what they expect her to do - they don't want just 5 years, they want it ALL for as long as she lives.

Somehow, nursing homes have a way of upping the anty - extra charges, etc. so it costs more than you ever dreamed. See an GOOD Elder Law Attorney ASAP. 1st hour is free for most. If you divide and spend her money - Medicaid WILL want it back

Both of my in-laws went into a nursing facility this past month....after a hospital stay. Their home is paid for but needs a lot of work. Their savings amount to maybe $15000.00. They have already applied for Medicaid, as I was told it takes a long while to get it, and I know the money will be spent down. Eventually, their medicare takes their social security also. My question: The home will have to be sold to pay the nursing facility....must I renovate the house before selling? Their money will be gone, and we would have to pay it ourselves. There is only 1 son left in the family.

I don't think so - the nursing home or Medicaid just puts a lien on it. But I am not positive about this. As I mentioned before, the first hour with an Elder Law Attorney is usually free - it was for us - and an hour was all we needed - found out we could not proceed just yet. After the first hour - the price per hour varies depending on your location. In our medium sized city it runs around $200 and hour - but it is money well spent. Otherwise you are flying in the dark and this is stuff a person really NEEDS to know in order to make informed decisions.

I am not sure where I posted it and I would re- post it except that all my emails recently went 'POOF' :0( But look at some other of my posts and I put in a link that I was given where you can put in your zip code and come up with a list of Elder Law Attorneys in your area. It worked for us!!

jane & codger - what you will be dealing with is MERP. Keeping the home imho really depends alot on what your real estate market is like, what the house could be on the current real estate market, how much you can balance and how big of a sense of humor you have....My mom is in a NH and on Medicaid and still has her exempt asset homesteaded property. The house sits empty and I and another family member pay for all on it, and will deal with MERP after she dies.Under her states MERP program, all expenses related to the empty homesteaded property (taxes, insurance, repairs, maintenance, etc) can be a exemption against the MERP tally but you need to file for this and with documentation.

All the states have to have MERP - Medicaid Estate Recovery (or Recoup) Program (or Policy) in order to participate in Medicaid (which is a joint federal and state program BUT administered by each state). So there is quite the variety of what happens in MERP depending on your state law.

In my mom's state (TX), Medicaid via MERP can put a claim on the property after death.When you apply for Medicaid you acknowledge the MERP is in effect in your state. The "can" part is important because MERP has all sorts of exemptions and also has to evaluate whether to do the legal needed for the claim or lien which can
vary by state. Now TX is a level of claim probate state and MERP is a Class 7 claim so there are 6 levels of claims ahead of MERP and with higher standing to be paid. Because of that MERP is somewhat lower in TX than in other states. Other states have MERP as an equal level lien on the estate and the estates assets (like the house). Other states have it such that whatever is the state's homestead exemption amount is discounted from the MERP tally. MS does this and it's set as the first 75K (maybe 65K), so if a house is worth 72K it is totally exempt from MERP in MS. What your states probate / death laws are make a big difference on what happens and how to deal with MERP to your best advantage.

For us, my mom's house would be a very difficult sale and would cost a good bit to get market ready and then more $ to maintain it "staged" for the possibly many many months it could be on the market. In discussing all this with my mom's attorney, it was figured out that $ was better spent on IL and other health needs (like expensive dental care) rather than the house. Now my mom is in her 90's so the probability is such that we won't have to maintain the house for years and years (yes, this is not very kum-ba-ya but it's the reality) but if my mom had been early 80's with the liklihood of a decade plus in a NH then we probably would have taken another approach. Whatever the case, you need experienced legal to explain the options you have in your state. Good luck.

We saw an Elder Law Attorney last month. MERP now as of July 1, 2012 comes FIRST - not after death. It changes everything. See an Attorney ASAP if you have financial questions. It is too important to guess or hope. IF YOU SPEND MONEY OR TRANSFER ASSETS WITHINT 5 YEARS - you have to give it all back. They now do the '5 year look back FIRST.'

They will allow the person to be admitted - and it does take a couple months or so for Medicaid to come through and maybe even longer for the look back. BUT, if there was any assets given away, spent inappropriately, transferred, etc. Medicaid WILL NOT PAY and the bill goes to either the person admitted or to their POA to pay - to the tune of $3,000 -$5000 per month on average for however long they were there so far. It can get pretty messy. See an attorney - 1st hour is free.

The new look back date became effective for all states on July 1, 2012 from what we were told. Obamacare.

my mother has altzhimers and may need a nursing home. She had 50000.00 in cds and they were in my name and her name. They have been like that for 9 years. I took her name off approsimatley 3 years ago and they are just in my name. the house was put in my name when my father died in 1999. the car is in my name and her name. what will happen if she has to go to nursing home now and we apply for medicaide?

Vicki - you will need an elder care attorney to sort this out so that it can pass Medicaid review. Co-mingling of assets is sticky to deal with and needs good legal. The good news is that you can use mom's 50K to pay for this and will be the best $ she has spend in a long time. She will (and should) be expected to spend down her assets to get to Medicaid compliance level of about 2K for assets. The CD's will likely involve a transfer penalty for the last 2 years if she needs to go in a NH like mañana. Otherwise you can work within buying her things that she needs ($ must be for her and her needs or her property) for the spend-down till she goes into a NH. Get a certified elder care attorney and go by thier advice. Good luck.

oldcodger2, I am very interested in MERP right now. I can't find any information on the Internet regarding changes made to that program this year.

The five-year look-back has ALWAYS come first, before/at the time of application. That is certainly how it was 9 years ago when we applied.

MERP has nothing to do with the look back. It has always applied to the assets remaining at the time the recipient dies, but since all other assets were reviewed and needed to be spent at the time of application, that only applies to the house (and maybe a car ??).

What you describe does not sound like a change to me.

And it is always a good idea to have legal counsel for this application, especially if there have been transfers of assets in the last five years.

Jeannegibbs - Since this was our first time looking into it - you could very well be correct. Maybe nothing has changed -except the look back for IL. The Elder Law Attorney told us that the look back for IL was 3 years until July 1, 2012 - then it became 5 years.

We appreciated the hour of his time - it was VERY enlightening. A person should see an Elder Law Attorney as soon as they become a care giver. It can save a lot of heartache and possibly costly mistakes as far as handling the financial affairs. What seems 'fair' to us isn't to Uncle Sam.

Wow...okay so I was almost thinking the same thing here. Mom saved what little bit she could so she could leave something for us kids..7 of us. She has a measly 12000 in the bank and 4000 in her checking. I have taken her in my home now for 3 months and have POA. But had no idea what I was getting into. She is 91 and has progressive dementia. I am going out of my mind with frustration. She isn't abusive yet..but is starting to show signs of it. I have started to rethink everything and I know she would just be so sad knowing what she is doing. She was the best little mom in the world. But this is not her at all. I might have to let everyone down and set her up somewhere..but that money will be gone. What can I do to save it?

msdaizy, it is a sad reality that few middle class/working class elders are able to leave a financial legacy to their children these days, especially if they develop chronic conditions/ imparitments. $16,000 won't go very far toward a care center if Mom needs it. And it really doesn't go very far split 7 ways, does it?

If she doesn't already have a prepaid burial/cremation plan, that would be a good thing to do at this point. The will reduce her savings considerably but it is something that has to be paid now or later, and it gives many elders a sense of comfort to know their children won't have that financial burden.

Another thing to consider is having a personal care agreement in place, so that your mother can pay you, at least room and board and perhaps for care services. This eliminates the stressful conflict of one child doing all the caring and yet all the other sharing equally in the estate (if there is one).

All of these issues can be ironed out in detail with an elder law attorney.

Good luck.

Well luckily mom was thinking..she did already purchase a niche in a mausoleum next to my father and older sister. She had money put aside for creamation but when the dementia set in ..she found the money in her drawer and spent it. I know all her wishes because we sat down 10 years ago and told me right after she had me assigned as durable power of attorney. We have a DNR filled out and the money in the bank was to be divided only 6 ways because one of my siblings had exhausted her share years ago. What was left in her checking was suppose to go to me. She appreciated everything I did for her up until the dementia got ahold of her. Up until last year July..she was the old mom I knew and loved. She is not so anymore. I don't know who she is...but it's not her. My sister inlaw is a para legal and I have her support when it comes to legal matters. As for the rest of my siblings they are the best support family I will ever have. They are totally behind me whatever my decision is. My mom raised us all well..so sad that she can't see it that way anymore. It's stressful for sure..but I will do it as long as I am able. Thanks so much for your advice.

My mom and dad got legally separated 15 years ago the court gave her the house but she never took his name off the house she has her paperwork from court stating the house is hers but now my father had a stroke and need to be in a nursing home will her house be in any danger of being taken

Cream - your mom needs to see an elder care attorney to deal with this as each state law and interpretations will make a big difference. While she is there she can also get the paperwork done for you or whomever to be her DPOA. MPOA and update her will and whatever else is suggested, like "Guardianship in Case of Incapacity" done if that works in your state. The house - if it is a legal residence and homestead - is an exempt asset under Medicaid no matter what.

The nursing home doesn't want the house, they want to be paid for their services either through private pay, long term care insurance or Medicaid (if they participate in that program). The state doesn't want the house, but they do want to you to pay for your care from your assets until you reach the minimum in non- exempt assets allowed (this is usually called the "spend-down") and then after death whatever proceeds come from those assets via the MERP program IF there are no exemptions. Your parents aren't divorced so I would imagine that your mom would be viewed for Medicaid purposes as "the community spouse" and as such is allowed to keep a significant amount of $ (about 109K but varies by state) to enable her to remain in the community and in the house. She does not herself need to become impoverished for your dad to go into the NH. But how this gets sticky is that Medicaid looks at the overall couple finances to determine qualification and the first day of admission into the NH is the day at which that is set. This is often called the "snapshot" day and takes into account both of their assets unless they are really divorced or how your state views legal separation and property ownership. If your mom has $ in a retirement program or $ in savings and it takes her over the limit for community spouse $ max, she could be required to spend it towards his care as they are still married. You need legal to sort all this out & get the property transfer done & whatever else has been hanging about.