Medicaid and hate.

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In June of 2013 when my Grandmother was still lucid, she, along with my mother signed an agreement with me, in which I would be financially compensated for taking care of her (Grandma) and helping to keep her in her home for as long as possible. It was Grandma's idea to put $1,750 as the monthly amount, because she said that's about what she was getting between her SS, and her government retirement benefit.

In Sept. of 2013, she made me power of attorney, and within the next two months her mind began leaving her at a rapid rate. I was finding unpaid bills and credit cards from even before she made me POA, and it was worse at the end of 2013. She could not be trusted to take her own medicines, and so we were handling that as a family - mainly just me, and I live 80 miles away from her. In February of 2014 she was diagnosed with mid stage Alzheimer's. She could no longer be trusted to take medicine on her own, and me living so far away (and others unwillingness to step in) made it a requirement that we get someone to do her medicine twice a day as required by the Rx. The expense was $5,587.99 per month via Northland PACE... insane for the service rendered, but what can you do. They also took her to Dr. appointments and what-not, and it allowed me to be the grandson rather than the caregiver - although I was still the life and financial manager.

In order to pay for this, I began having to sell off assets. I sold some land, surrendered a life insurance policy, and an annuity. Most of the life insurance policy, which was around $20,000, and the land sale, which was around $22,000, will go to her care and to some much needed repairs on her house. The annuity came to $39,000, and it was decided I should take that. Grandma had no knowledge of this, but her daughter, my mother, thought I should have this for all I had done, and would do. I agreed that would be enough to cover anything I do forever, regardless of how long, as I felt it was more than generous.

So as time has gone on, I have paid her bills out of her account, and given on two occassions, $1,000 to grandmas cousin, who lives near her, for the purpose of a kitty fund to go and get groceries as needed and what-not.

We are to a point now though, where making the app for Medicaid may be coming down the pike. I have come to educate myself in the meantime somewhat about how that system works, and I have 3 major concerns.

1. What about the money given to me from the annuity? How does this work with the agreement we had for my compensation - which was written before the POA, but the compensation for me was not included within the POA document itself.

2. What about the money given to the cousin to tend to groceries and things?

3. I have my monies in 4 places. Grandma's generation had money in like 30 places. I have seen savings bonds for small amounts, life insurances for $2,000 or less, etc. I think I have it all accounted for, but Grandma is a pack-rat. What happens if after I file the medicaid app, I find something else in her house from a company that has changed ownership 3 times in the last 50 years for a policy or savings that I did not know about now? Is that fraud? Will I go to jail?

I feel like I would have helped Grandma regardless of money, and money was never my idea. But I took it, and used it when my wife and I bought our house. I thought this was OK. I also confess that I feel a little bit justified in this since I have multiple aunts and two sisters who live in the same city as Grandma but don't do anything to help her, ever. Nor does my dad, who is her former son in law (parents are divorced) but who also got loads of free child care from Grandma in the past when my one sister got pregnant 3 times. He's retired now, and doesn't even take those kids to see her anymore, even though he's two miles away from her.

So, apart from the questions above, the other comment I wanted to make is this; I am filled with hate and disgust at my family members who do nothing to help, nor even make an effort to visit. It is consuming me to the point I want to sever ties with them completely. Has anyone else experienced this, and what did you do?

We are in the state of ND, FYI.

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For Medicaid transfer penalty, most of the states have the penalty date starting on the date of the application and based on # of days rather than by amount per se. So if the transfer was done at year 4 or year 2, it doesn't matter - the date of the application starts the transfer time frame.

The # of days aspect of the transfer penalty makes a big wallet difference because you likely will find that you have to pay private pay rates over that period of time & NOT the lower Medicaid rates. So 40K transfer penalty for TX is about 258 days in which they are ineligible for Medicaid payment. All the states have the equation & regs for penalty within their Medicaid regulations.

Often family brings the elder back home for the # of days ineligible. As the $ been spent and they cannot afford months on end of higher private pay rates.

Also if the application gets red-flagged, you can likely expect that SSA will require you to become a representative payee as they will get a notification of inquiry into the SS recipients finances.

Delete - also once the first transfer is found, what likely will happen is that the application will go to higher level of review. Medicaid can ask for more details, which you have a specific time-frame to response to with the required documentation. You might as well start to get all that together now and meet with & pay for an elder law firm to be as prepared as possible. Legal you will need to pay for yourself and not from her funds as it may be disallowed with penalty if she already has her POA, will, codicils, etc. done.
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On the plus side, the feds may uncover other accounts that you did not know existed. If you can, do a credit check on her using her SS# and birthdate and see what turns up.
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delete, Medicaid will impose a $39K penalty against the $39K gift. That's the law. They will simply not pay for the first $39K of her care. Yes, you declare all transactions within 5 years if that is what they asked for.
You can't hide it, the feds are very thorough, they know all, see all and tax all.
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delete12321, I agree that this is not the right forum for you, at least not at this time. Too much give-and-take. Too much expectation of details. You feel (now at least) that people always turn out to suck, and if that is your belief you can find confirmation anywhere you care to look.

You don't have to cancel an account. Just don't come back.

If things settle down for you a bit and you are feeling more up to the give and take of candid discussions among caregivers, feel free to come back anytime.
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delete12321, we have all been barked at at one time or another on this site... it's all part of the give and take among the posters. Remember, we are all dealing with caregiving in one form or another, and we are all pretty much under stress.

When I first read that you were getting $1,750 a month, I first thought you were living with your Grandmother doing hands on care. I know I was surprised to read you lived almost 2 hours away from her. Then she had to pay $5,500/month to have someone manage her meds and take her to her doctor appointments. There are folks on these forums who don't get a dime who do hands-on care of a relative, quitting their jobs to move in, to manage their meds, get their groceries and actually feed the relative, and take them to the doctor appointments.

It's all trial and error. A lesson learned by others who read this particular forum to get the advice of a Elder Law Attorney as to what monies belong where.
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I digress, then he is not a fool. He is however, a jerk. If he has been on these forums as long as you say, then he is aware that his response is hostile and was a personal attack, which is in violation of the forum etiquette rules.

https://www.agingcare.com/AboutTheForum.aspx

I too came into violation of that etiquette, but it was after his response. There was no excuse for it. I opened up. I'm not trying to lie about anything. I simply stated what took place. I don't deserve to get barked at like that. When no one else will give her the time of the day, and I spend my time, my fuel, my absence from work, my answering calls at 2 am because she is sad and doesn't remember that I was there just the day before, and she - before she was this way, but knowing it was probably coming - decides she wants me to have something.... I mean, christ. I'm at a loss for words.

You read all the time about people using POA to essentially steal tens and hundreds of thousands deceptively. This money was based on an agreement with her, coherent, and has been the only thing I have received ever, or ever will, and it was not even my F*@#ing idea in the first place. Then I post about it, and the rest, just looking for some commentary on what the impact would be and the best way to go forward, or if it will result in a penalty period, or how that is normally handled, as well as the two $1,000 amounts that her cousin Helen got to hold onto to buy Grandma groceries. Right away, captain finger-pointer charges in with how he thinks I'm a complete piece of S##t. Just like the other family members, worthless to the last, but always ready to find any fault and try to hang me for it.

I handled the tax part of it of course, but I never thought about what may happen with medicaid 3 to 5 years in the future from when I accepted POA, which by the way, I didn't jump up and down or beg for. Either I would do it or they would have stuck her in a home right away to get rid of her. Something she pleaded with me to not let happen until it was absolutely necessary because she feels a nursing home is her death warrant.

I just can't believe it on this site.

Can a mod or admin just delete my account? I don't want any part of this community. I thought I did, I thought I needed to talk to people, but as always, people turn out to suck.
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delete12321, it sounds like you have made effort to take care of Grandmother's needs. Congratulations. Often it is only one person within a large family who makes the effort. You are that person. Thanks!

I am not sure what your post is really asking. If the potential penalties for the way things were handled are "no big deal," and you already have plans for going forward, what are you expecting/wanting from us?

Lots of times people come here to vent. "I worked so hard to help, and now I have to deal with a difficult Medicaid application! My family has never helped! Life is not fair!" Pretty much all the regulars here do that now and then, and sometimes that is how people start here.

If you just want to vent, I sympathize. Life is not fair. No good deed goes unpunished. Family can suck sometimes.

For your information, cmagnum has been on these forums for years, and he is no fool.

And using Grandmother's money on her care or to maintain her property is perfectly OK. That is what, as a POA, you are supposed to be doing.

If you want our comments on a specific thing, perhaps starting a new post with that specific topic would get the best results. But if you just wanted to vent, vent away!

Welcome to the forums.
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We contracted PACE out of fear, because in July of this year she was in the hospital (Psych) for "going off the deep end" so to speak with one of the people from a travel nurse company. PACE was comprehensive in their services even though she used few. Before them (meaning July 2014 and before), I was doing weekend meds, and sometimes during the week as well, as well as taking time off work to take her to Dr. Appointments, making sure all her bills were paid, etc.

Due to PACE's cost, and the fact that from Aug-Dec 2014 she didn't use anything except the medicine administration and dr. apt transport services, we disenrolled and hired a private CNA for much less just to do the medicine daily. We will handle DR. appointments ourselves.

As far as the "fool" thing. I did not come here to be barked at by strangers. I did not at all appreciate the tone of the initial replying individual. I came to navigate the situation better by exchanging info with others. As I said already, $39,000 is not that much money in today's world. If we endure a penalty period or whatever, and I have to cover that, it's a non-issue.

I'm guessing I am a thief too because I am going to have the entire exterior of her house reworked for around that same amount, out of her money. Her roof leaks and needs complete redoing, her slate siding is cracked and also leaks, her window are single pane and she is spending about $300 a month is heating. So I think that should be legit from medicaids standpoint.
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BTW, Medicaid may be able to get more information about your gma's assets than you have at present. When they do a search, anything that is under her or your grandfather's SSN should turn up on their computers.
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I too am from ND. I live in Minot. One of the gentlemen on my crew had a similar situation. It was his mother who had given him somewhere in the neighborhood of 50,000 dollars. When she applied on medicaid a couple years later, there was a 6 month penalty period, where they had to cover cost themselves before medicaid would kick in.

Medicaid uses a cost of care average (per month) to determine this period. So if the average cost of care in your county or whatever is $9,000 per month, then she would have 4 or 5 months where you would have to pay out of pocket. It's not that big of a deal. And that's only if they don't recognize your caregiver agreement.

As far as the taxes, I would ask a CPA or someone. If it's an agreement, it's not a gift, so you may want to go back and look at that again.

If you find other stuff that you didn't know about, I would think if you submit it when you find it, it should not be that big of a problem either. I think the app says "to the best of my knowledge" on the sig block.
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