The monthly cost for a Memory Care home is $4200. We would like to charge dad $3000 a month for care in our home. Is that acceptable?

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Dad is 88, in a wheelchair & needs 24/7 care. He recently had a stroke & suffers from dementia. He is a happy & sweet man. We have to dress him, change diapers, bathe him. We take him to all medical appts & coordinate all healthcare care including medication. He receives 3+ delicious home cooked meals a day. We do his laundry & change his bed linens. It takes both of us to get dad in & out of the car. We are also in charge of selling his assets. I have POA. We don't want to overcharge but want to be fairly compensated. Dad can afford the $3000 a month

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The staff here at AgingCare.com asked me to comment as they felt that your question has not been properly addressed.

To think that staff is actually going through responses to make sure that your needs as readers are met is, I think, quite remarkable! What a great act of service!

So let me see if I may be of help to you and others in similar circumstances. There are two primary issues to be considered here: 1. income and other tax liabilities possibly accruing to the parent and adult children and, 2. qualifying for public benefits.

Let’s take the last one first because if you are interested in making sure that all of Dad’s expenditures or transfers are in line with meeting the financial requirements to qualify for Medicaid or Veteran benefits (non-service connected pension) – either now or in the future – there are certain do’s and don’ts. For instance, you will want to carefully document all transactions and you will not want any uncompensated gifts coming from
Dad to the adult children within five years of application for Medicaid.

If, however, you are not interested in, or can never foresee Dad receiving public benefits of any sort including Medicaid, then the ideas below are of no value to you and Dad can just gift all of his assets to you with no tax consequences at all (except for potential Unified Estate and Gift Tax consequences if total lifetime gifts exceed $1 million in 2013 – presuming the “Bush tax cuts” expire).

In the case where public benefits would be helpful now, or may be needed in the future, you have several options that will work with varying efficacy from a practical and taxation standpoint. (By the way, all of the strategies below can be used either by themselves or in conjunction with one another).

1. Charging Room and Board – It is perfectly legitimate to expect any adult to contribute to household expenses and to pay for their own health, maintenance, and welfare. Expenses paid by Dad, whoever they are paid to for these purposes, will not have a negative impact with respect to public benefit eligibility from a “gifting” standpoint as all transfers from him, to you, will, hopefully, be for the fair market value of goods and services being provided. There are income taxation implications which you can read about here; IRS “Renting to Relatives” regulations.

2. Charging for Care Giving Services – Here too, there is nothing “wrong” with being compensated for the personal care giving and other services (advocacy, management of financial and other personal affairs, etc.) you are rendering. For public benefit eligibility purposes it is important that the details of the arrangement be established by contract. This “Personal Services Contract” will establish a term, the rate of pay, the services to be rendered, and other provisions that will, in fact, allow a lump sum amount to be transferred from Dad to you in full advance satisfaction of the contract – a legitimate and legal transfer from a Medicaid eligibility standpoint. Again, though, there is a tax issue in that because this is an employment contract, income taxes and other employment based taxes will apply causing appreciable diminution of funds with little in the form of “deductions” available to offset the liability.

3. Purchasing a Life Estate – When an parent moves into an adult child’s home and has assets that would disqualify them from public benefit eligibility, or if the adult child would like to avoid the income tax consequences resulting from numbers 1 and 2 above, it may make sense for the parent to purchase a “Life Estate” in the home of the child.

The purchase of a Life Estate is as its name implies - the purchaser is buying the right to live in the property for the rest of their life with all the rights thereto. At the purchaser’s demise, all rights revert back to the “remainderman” (the adult child who sold the Life Estate to the purchaser).

The maximum amount that will be considered fair compensation as a purchase price will be the fair market value of the home minus the “remainder interest” as determined by using tables provided in your State’s Medicaid manual. Here is an example using Florida’s tables: If the home has a fair market value of $300,000 and the purchaser age is 88, $92,577 can be transferred to the adult children to purchase a Life Estate. (If the parent were younger, say age 77, a transfer of up to $141,147 would be permitted).

The purchase of a Life Estate by the parent would effectively reduce his/her assets without creating a Medicaid eligibility penalty and without creating (in most cases) a taxable event. If the purchase of the Life Estate were not enough to bring the parent’s assets to a low enough level for eligibility, either or both 1 and 2 above could be used.
Caveat: The parent must live in the children's home for at least one year for the transfer to not be deemed a gift.

4. The Supplemental Needs Trust (SNT) – Another option available in many states is participation in an SNT. This is an irrevocable trust, in fact the only irrevocable trust other than an Irrevocable Funeral Trust, that the parent can transfer assets to and become immediately eligible for Medicaid provided all other requirements are met. Unlike other trusts, a new trust document is not drawn and a lawyer is not required as the parent is simply joining an existing trust previously established by a 501(c)3 organization specifically to benefit Medicaid beneficiaries. Assets transferred to the trust may be used for virtually anything required for the health, maintenance and welfare of the grantor (parent) including paying for room and board and/or the support services of an adult child. The caveat here is: a) the cost of trust administration and, b) any funds remaining in the trust at the demise of the parent must first be used to pay back the State Medicaid program for the cost of Medicaid services rendered. Any residual thereafter may be distributed to heirs.

A lot to consider, I know, but I hope this helps. Good luck and God Bless
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Since you do have siblings, be sure all of the financial arrangements are spelled out in writing. Just because you have POA doesn't mean they wouldn't try to fight your decisions.

This surprises me because it is not how things are in my family, but it appears that there are many adults who think it is perfectly OK for one family member to sacrifice privacy, sanity, earning opportunities, building a pension, having a normal social life, etc. etc. to take care of a parent, while they do as close to nothing as they can. And they expect this care to be done very frugally, begrudging money spend on respite care and in home help. They seem to think one sibling should make huge sacrifices so that they all can have equal inheritances.

In spite of how common this attitude apparently is, it is Wrong, Wrong, Wrong.

If Dad has money to afford to pay his way, that is what the money should be used for. He could pay $4200 a month, or he could pay $3000 and get more personalized care. Gee, that is a no-brainer in my book. And some of that "savings" should go to respite care. No one can be an effective caregiver 24/7/365.

Since you have siblings, spend a little of the money on a lawyer who can help you set this up in a way that will make it easiest to defend your actions, should that ever be necessary.

May your dad remain happy and sweet, and may you have the strength to deal with it if that changes.
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Luv - you can get a "Personal Services Contract" done by an eldercare attorney. This is specaility practice and you really need to go this route and not get someone who just practices law you know from high school. This will spell out what dad is paying for, etc and protects both of you for the future - both from challenges from other family and from Medicaid application issues later on. IMHO if they live long enough they will run out of $ and you will run out of ability and then will have to do a NH placement and Medicaid application - you want to do whatever to be prepared for that so that you do NOT face a Medicaid penalty for the $ transfer.

Now by having a PSC there are tax implications as you are being paid and will need to get a 1099. @ 3K a mo. 36K in income a year. So when you go to see the attorney you need your & your DH tax items as well as mom financial & old legal.

Your attorney may suggest that the amount be lower and more in line with what a home health care worker would get based on community standards.

One thing you can do is contact 3 home health agencies and have them come to your house to do an evaluation on dad and what they would charge. This you keep for both the attorney to use & more importantly provides "a value" that you can use for charging for his care if you are challenged in court by your sister or by Medicaid later on if you end up needing to place him in a facility and spent all $$$.

Whatever the case, you need to keep track of your time and expenses& mileage but you should be doing that already.

Having a personal services contract is an invaluable tool but really needs to be done to whatever meets the standards for your & dad's state law. If you can't find an certified elder care attorney in your city then contact a good probate attorney.

If you have a specialized skill set or education then you can base the contract to reflect that. Like if you are an RN or have a social work degree you can charge more and it is OK. If you just have a h.s. diploma then you can't - that's why getting what a home health care agency would charge is good. Good Luck.
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It sounds reasonable to me. Are there any siblings? Will this be acceptable to them? Since we never know what the future holds, I strongly urge you to draw up a contract to spell this out. Is he still legally competent to make decisions?

To me, the notion that Dad's assets should be preserved until he dies and then passed on as an inheritence is absurd. His money is for his care, as long as he needs it. He can afford to pay for it, so why shouldn't he? Better to keep it in the family, assuming he is truly getting his money's worth of great care.

Sounds like Dad is very lucky to have you, and to be getting such personalized care.
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Campbellgirl44, by your unkind answer, I can only assume you must be a full time 24/7/365 caregiver who does not receive any compensation for your care. I hope that you allow happiness & compassion into your heart otherwise not only you but most importantly the person you care for will suffer. Being a martyr solves nothing.
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luvmydad- im in the same boat ure in . dad beg me to tak ehim to my home cuz he doesnt want to stay in the NH , told him i cant afford to quit my job cuz i have bills that needs to be paid . he agreed to pay my bills so he could stay in my home and i could care for him . it works out good . if he was to stay in the nursing home he would have to pay 3 times as much and not getting the loving care ,
i took dad home with me after pickin him up over thousands of miles away .
it was hell but well worth it . he s been here almost 4 yrs now . is now on hospices , when he is gone i wont have anyone to pay my bills . i ll have to go find a job afterwards ,
people think we caregivers are after our parents money , phhhhhttttttt , that money doesnt mean anything . it only means to pay the bills and be worry free about owin bills , i have ruined my body , mentaly , muscles , and heart aches watching dad goes down hill and im doing it out of love . i didnt make any money to save it up for nest egg . no 401 k no health ins etc . just enuff to pay th ebills and keep him warm and cool and run electrity high cuz he needs oxgene so forth ,
people thinks shame on you for takin dad s money chargin dad for staying here . well let me tell you , he s here cuz we love him and we dont worry about him begin in nusring home and be mistreated . he s here 24 - 7 , i love my dad , he s the sweetest guy on earth . always thankin me for whatever i do for him . when he was in the nusring home . his blood pressure was sky high and he was lonley and always hollaring for me , very biter man he was . and that place cost him tooooo much money !
he s here to pay my bills like he would have if he lived at his own home . way cheaper to save him money .
hell with siblings and hell with people that doesnt see eye to eye . if they want no money then they must be well off .
i need money to pay my bills so dont make me look like a bad selfish daughter chargin pa . cuz im not ! if it was a stranger believe me i would have charge him a hellva more and so i could rebuild my egg savings .
luvmydad ure good to ur pa and he is happy with you and u do need income to feed him buy him food , diapers to shampoo . its not free and its not cheap !! xoxo
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Just another thought: Caregiving isn't always about money.

I do think it is a terrible thing that the government will take everything an older person has and then will pay a facility to look after them - but will do nothing to help families care for their loved ones.

Many of us retire early or quit our jobs to become full time caregivers. No money, no benefits, no breaks.

I would be grateful for a week or two of paid respite a year - instead - we BEG other family members to help and they have every excuse whey they cannot. Uncle Sam says 'sorry' we have no programs to help in-home caregivers. Thank you, though, for saving Uncle Sam $50,000 a year that we would have had to pay for their care.

It isn't always about money. Most of us do this because we care and then find out that no one really cares about us - our health, our emotions, etc. It is sad. I do appreciate this forum.
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Well eydie57, you were very lucky. My parents never spent a penny on me, no education, no frills, no wedding, nothing. They told me from the time I was about 16, every time I needed something, that they had to save for a nursing home or their old age (this was just code for I am too damn cheap to live).

However, when I was working and living at home they made sure I paid 1/3 of the bills. And I did this for about 10 years. Claimed they were saving it for when I married. I am 60 and have never seen a penny of this money. So, I guess that went for the nursing home fund too.

My point is not everyone came from a loving, giving family. Did I mention my Dad verbally abused me? That both my parents were narcissistic, as is my brother. That Mom and Dad never babysat for me and my husband to go to dinner, even on my birthday. I could go on and on. But you get the picture.

I will have no problem putting Mom is that nursing home. All her money will be used for her care and if I had to keep her, you bet I would not feel bad about charging her. But I could never keep her, no way in hell.
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When my father became ill two years ago, my husband and I had 21,000 dollars in savings to help with our retirement pensions. We have a child in college that we wanted to use the money for, also. We used all of our savings during my father's illness. No matter how much we want to ignore the issue of money, it is a concern that must be dealt with when someone becomes a caregiver.

Most of the answers were helpful and kind to the member who posted the question. However, some of you came across as judgmental and just thoughtless. This is the one place many of us come to for comfort. Honesty is different from unkindness. Please be kind even when you disagree with someone. Rebecca
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I too decided $3000 was too much. So the amount my sister & I agreed upon was $2000. I drew up an agreement for other expenses that we already both signed. I was surprised at some the of the answers. My dad is not eligible for Medicaid and has income from 3 sources. My husband & I are both retired and 61 yrs old. We provide a loving, safe, healthy &supportive environment for my dad. He has his own bedroom & bathroom. And 2 cats!
My dad is happier & healthier since he has been living with us for the past month, than he was the past year. In my area, assisted living is over $4000 a month and long term care is $10,000 a month. Thank you all for your help!
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