Medicaid was declined. Now what?

My father is 92, has mid stage vascular dementia and has lived with my husband and I for over seven years. Recently he has been having frequent mini strokes and with each one we see a significant decline. He was recently declined by Medicaid due to owning two homes. Both homes are owned jointly with estranged wife, she lives in one and refuses to sell either one. Both homes have a combined valued at $110,000. Upon his death she will receive the homes. We have talked to an attorney about a divorce and and he said dad he is not competent to sign papers. My husband was diagnosed with cancer eight years ago and underwent surgery and chemo, we just found out it has metastasized and he will begin radiation in two weeks. The stress is killing me and I am wondering how I will be able to take care of both of them on my own. I am an only child and our children live out of state. Without Medicaid there is no way we can afford long term care for dad. Any suggestions would be greatly appreciated.

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Expert Answer
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The solution to your problem is somewhat dependent on the Medicaid eligibility rules in your state (what state do you live in?).

Every state, however, will have overarching Medicaid eligibility provisions which:

1. Only consider "countable" and "available" assets for eligibility purposes. The definition may vary but you will find it in your state's policy manual.

2. Have hardship exemptions with respect to excluding assets that would otherwise cause ineligibility when the life/health of the applicant is at issue.

I am sure you can imagine that you are not the only one to face this circumstance or one similar to it. I believe this is a relatively easy case to get approved with the proper argument and evidence.

Expert Answer
415 helpful answers
Ralph Robbins makes some good points. Also, it may be possible to go to court with a "petition to partition" the jointly owned homes, separating them. Then, the one determined to be owned by your dad will be exempt under the home residence rule, and he should then qualify for Medicaid.
Have you talked to an eldercare attorney who specializes in Medicaid?
In the "desperate measures" column, have you thought of dropping dad off with the estranged wife? She's still his wife, right? Isn't he her responsibility? Her obdurateness is what's causing you grief.
Have attorney fight that the asset is not really his due to the community spouse not being impoverished rules.
Dads - honey you are truly caught in a Catch22. Could be worse…. like dad left properties to you as per his will BUT also provided in the will that lil' Queenie had use of it via a "usufruct"; so after he dies you technically own properties and all their cost$ but she gets use of it till she dies or decides she's over them (as everybody in the blended family is all kumbaya) or you pay her off the "value" of the usufruct. It happens often in my state (I live in New Orleans) for second or third wife situations and usually the property is a weekend place on the MS, AL, FL coast (so the extra fun of dealing with other states laws & atty's). So when you think what a clusterF you have with lil Queenie, well…. it could be wor$e.

But I do have a suggestion for you - dad becomes a ward of the state.
If you are paying for anything for him, no matter how small you stop. If dad is paying any of the costs on the property, it does NOT happen anymore. Let all costs - taxes, insurance, utilities, whatever fall to Queenie. Whatever monthly income dad gets (like his SS or pension) needs to go to a bank account ONLY in his name with no $ ever on the properties or available to Queenie. To me your doing guardianship is kinda a waste cause you'd be a guardian with no real ability to do anything as she controls the jointly owned assets & you are too overwhelmed to approach the whatever's. But if dad is a ward of the state, then a judge (usually probate court judge) will appoint a guardian from a list of them that is vetted by the state. The court appointed guardian - who more than likely is an atty - has a lot of ability to do things you cannot. Like he can sue her on behalf of the state to recoup costs paid by the state for the guardianship; can place dad into a NH and have those properties used as collateral for the cost. He might try to have the Quit Claim invalidated. It will be ugly (so keep us updated as this should be interesting) and she will have to eventually capitulate. It takes a real pit-bully of a legal personality to do this and it's not you. You really need to make hubs & his&your health as the priority. You've gone way beyond to caregive 7 years.

Now how to get him to be placed as a ward is going to be sticky. I'd suggest that you contact your Area on Aging to see what atty's they know about and then also if there are any pro-bono legal clinics. Remember all this is on dad's $, you should NOT be paying for any of this & if dad has no $ then he will qualify for services for low cost or free. And then make an appt for dad with them and you go and take all the paperwork on the properties and work up in advance a "face sheet" on dad. If you don't have property paperwork then try to get the entire chain on the PPIN from the courthouse. Most CH have maybe last decade or so on-line for a low cost download. The face-sheet is basically a documentation of dad's life, all marriages and divorces and children with specific dates (even if dead or divorced), job, property & income listing. A a separate asset / debt listing for EOY 2016. You really really need to do this and provide to guardian so they can get onto Queenie faster.

Or you do a Plan B - which would be to have dad admitted to the hospital and then when he is ready to be discharged, you refuse to bring him back home. You have to hold firm in this & if you can't then get one of your kids to come in to back you up or get a "take no prisoner" type of friend to handle this. Your hubs illness should be an automatic out on this and will be likely viewed that way by the hospital social worker or discharge planner. They will likely contact APS and the court to have dad made an emergency ward of the state with court appointed guardian to get dad place into a facility. Now you want to be friendly with the guardian and work with them on all things dad - but dealing with lil'Queenie is all on the guardian. Best of luck in this and in hubs radiation.

Also If you are up for it, & after you've done the face sheet, I'd try to do an excell on whatever you & hubs have paid for dad over the 7 years. The guardian may be able to have it included as a debt against dad that he tacks onto everything else onto lil' Queenie.
I had to laugh at the suggestion of dropping dad off at her home. Of course I would never do that because I am sure she would abuse him. It would be fun to
see her face though. Thanks for taking the time to answer.
Are one of you his durable POA? If so, I would think that person could sign the needed papers. Just a thought.
It sounds like they must still be married. Also, if she owns two homes, are you sure his name is not on the deeds as a joint owner? If not, then she's the sole owner.

Another thing to consider, if these homes happen to be located in a community state, were these homes obtained during the marriage? If so, I would check your state laws regarding community property, but I would just about bet if his name was never on the deeds, I'm really not sure if there's going to be much you can do. I mean, look at the situation, she owns those houses if they happen to be under her name alone. They're hers fair and square no matter how she got them as long as she got them on her own and they didn't become marital property. If you get something before you're married and you get it on your own, as long as you own it, no one can really take it from you as long as you keep the bills and the taxes up on it and marital money is not involved. Once both parties start investing in the same property, that's where there would have to be a split. I think if I owned property before I ever got married, I would definitely take the proper legal steps to protect it in case of a split, and this would start with a prenup. If I were drawing up a prenup, it would exclude any possibility of sharing any portion of my house with my spouse should we split the sheets. Once it's signed, it's a binding contract. I don't know how the estranged wife has things set up, but I would find out why she won't sell the houses. If they happen to be rental properties, then you have your answer right there. If I was renting out at least one property and the tenant was a very good tenant who never caused any trouble and always paid the rent in full on time each month, I would never consider evicting them. Good tenants are hard to come by and you want to keep them when they do come along. Renting to good tenants is actually an investment with a promising income as long as the tenant lives in that unit.

I understand one home is supposed to be exempt as long as the person on federal benefits is actually living in it. If he's living in one of these homes then it should be exempt. If she is estranged, it would be interesting to know who is paying the bills on this particular home. Does he pay her rent to live there? If so, then that would be proof right there that he actually lives there if he can show record of it. It would also prove that he doesn't own that particular house if he's paying rent to live there. As long as you can cough up all the rent receipts, that would be proof that he actually doesn't own that house, he rents.

As for his condition, someone here mentioned getting an eldercare lawyer involved. This may actually be necessary because they know all the laws most people don't. I seriously doubt they can just take her houses unless she's done something seriously wrong and the judge grants a lien on them. I wonder if maybe calling your local Medicaid office or even visiting your local human services would be beneficial right about now because this is a situation where you need answers. I would make an appointment with a case worker and if you're patient is not on the deeds, see if you could get copies of those deeds from the county recorder where these homes are located. The problem though may very well be that he's still married to her. It sounds like she has no interest in him whatsoever and she's probably started a new life with someone else, this is a possibility. What I would do is definitely go for guardianship so that you or whoever gets guardianship can actually sign any appropriate documents necessary to get him Medicaid. I wouldn't try to go for the houses if she alone owns them unless you want a serious fight on your hands. Just do the peaceful thing and help him get legally divorced from her if she no longer has an interest in him. This would be the most peaceful thing to do because going after her assets that she rightfully owns will only make matters worse. As bad as I hate to have to even mention divorce, I guess there are some situations where it's absolutely necessary. If you think about it, these days there are various problems people face through marriage where assets are involved. Of course there are a multitude of other problems, i'm sure many people have their own reasons why they won't marry, protecting money and assets in some cases is among those problems. If you don't marry then you don't have to worry as much about someone coming after what you have since there's no spouse involved. The Bible even says that in the end times people will forbid marriage, this is only one sign of ending times. I'm sure there are plenty of legit reasons to refuse marriage, in fact I'm sure there are just as many legit reasons as there are wrong reasons
Have you considered Hospice? (End of life care). Medicare is under Hospice.

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