I have been a senior's power of attorney for both financial and medical for 3 years, I have never taken any compensation for my services. Is there a legal limit that I am allowed to take before a medicaid claim is made? I am trying to understand my legal rights and limits before we are at that point. Thank you for your time, I look forward to your response.

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I would like an answer to this question, also. I am all of the above, plus housekeeper, errand runner, bill payer, diaper changer, bather, cook, taxi service to doctor and hospital, nurse, laundry person, dishwasher, etc., etc., etc.. In other words, I do everything but feed her and put her straw to her mouth. She can walk, just won't. All she does is eat, drink, smoke, and watch TV. I don't get paid a dime. I have no money of my own. I quit my job and moved in to care for her. I would love to know if I can can be compensated out of her income for the care I'm giving. If I ever have to move (if she were to die or move to nursing home or long hospital stay) I have put myself in a position where I have nothing. I'd be homeless and penniless.
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The answer to this question depends on a lot. Are you living with them, or them with you? Are you changing diapers and assisting with 3 or more areas of their life they cannot do alone? Can the person be left alone? I went to a lawyer after a year of caregiving and he drew up a caregivers contract for me. My Mother moved in with me having dementia and couldnt walk. The first year I had her with no contract I got no retroactive pay once I got the contract. You cannot take any money until that contract is signed, and yes it can be signed by you acting as the persons DPOA. IF you want to draw this up and then take back pay for 3 years it could be a big court battle if siblings, children, or relatives are wanting a piece of the pie. Once drawn up you get approx $15 an hour for 8 hours a day. You do not get paid overnight because its considered your "daughterly duties." (or whomever you are taking care of in the same house). You must pay taxes on it and it amounts to 30% of the amount paid to you so you would owe a lot should you chance just taking money retroactively . You have to show back those three years of every penny spent on a spread sheet . The Caregivers Contract will cost you probably $2,000. As far as Medicaid goes, they want to know what you did and how long it took you to do it, etc, they are very exact on your caregiving. For example, bathing and dressing might be logged as 1 hour. Feeding 1 hour, etc...
I didnt do it for Medicaid. I did it for my Mothers care and supplies only, and she has now been with me for years and her money is long gone. Hope this helps answer a few things, get yourself to an Elder Attorney asap.
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Medicare has specific and strict guidelines, for caregivers, home health aides, i.e. services for seniors.
go to their website read it.
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vc345vc355, you are correct that when the government is paying the bill their rules apply. But I don't know where you are getting the "rules." For example, my husband has been on the Elderly Waiver program under Medicaid. When he became too sick to attend the adult day program he was enrolled in he was evaluated for home care help and was authorized for 32 hours a week for a PCA plus 3 hours for homemaking services. My mother is also getting home care services. She has a PCA, homemaking (cleaning) help, and a nurse visit. I'm not sure of the total number of hours, but it is based on her needs, not some "2 hour a day" limit.

It is much less expensive to maintain a senior in his or her own home than to pay for placement in a nursing home, and the waiver programs are geared for both the senior's welfare and also saving money.

In any case, someone intending to charge for services to a senior on Medicaid should consult a local attorney specializing in Elder Law. Rules do apply and it is best to know what they are and set things up to comply right from the start.
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Pizzazzy, go talk to an elder care attorney. You should be able to get a Lady Bird Deed on her home. It gives you an interest in her home so that Medicaid could not take a lien on it. Does she have a will leaving everything to you? You should be able to be paid a salary, but it must be reasonable and I believe you will have to file a 1099.
You really need to talk to a lawyer to protect your interest and to do it legally so there is no question. You cannot be paid for future care, but present care can be charged for.
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I am a bit confused; you stated “I have been a senior's power of attorney for both financial and medical for 3 years”

1. What type of POA do you have? There are several different types of POA, with limited and specific powers.
2. Who drafted the document? [A] Lawyer? [B] You and the senior?
3. What is your relationship to this senior? Where is the family?
4. You stated; “I have never taken any compensation for my services.” What exactly are your “services” you perform?
5. Handling one’s “financial and medical” does not require more than 12 hours MAX a month.
To pay monthly bills, open mail, review bank statements, deposits, keep medical records in order.
6. Has this senior been declared incompetent by a court?
7. Why is the senior on Medicaid?
8. What happened to the Medicare?
9. You did not mention if you where PCA or CNA, cert, caregiver?
10. You did not state if you are working or have been for past 3yrs, 24/7 caregiver?
11. There are so many variables to your purposed question.
12. You need to look up the laws where you live, and carefully read them. [Specifically POA & Elderly Laws &]
13. If this senior has a Lawyer she has used in past years, I would consult with him, and a Lawyer
in Elder Law issues ASAP.
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JeanneGibbs and Reverse roles have pretty well nailed it as to what's what.
You need an experienced elder care attorney to do this, as one who has a practice in the county in which she resides as that cuts down on courthouse runs & cost.

Reindeer - LadyBird deeds are not valid in all states. It's valid in FL, TX, MI, OH. I think it's validity has been challenged in CA and KS. It seems that in TX how the LadyBird is written can be kinda critical so that it is not viewed by MERP as a regular life estate deed.
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ahtoo 12 I would like to express my thoughts on this matter. First of all, it is always refreshing to hear that a person took care of business and care of an elder in need before they thought about "how will I benefit". The whole priority factor in the Power of P.O.A. is a trustworthy, selfless, putting someones needs before your own act. If you thought about yourself first you wouldn't have to ask this question.
I completely understand that your duties should be compensated, if you have acted "in the benefit" of the Principal. This is what medicaid wants to prove.
For example if you have been taking the elder to the Dr's, making sure they are taking meds as prescribed or care needs have been in order, bathing, dressing, activities, food, clothing, etc.. If you can clearly provide proof of these things and have been spending the funds they have to provide the elder with a decent quality of life, paying the bills for them keeping the home life decent and safe, promoting safety and health care needs, etc. It should be apparent in your records. This is what I believe medicaid looks for in the application process. Put it this way if you have to be payed for a job well done and you need to be paid to help someone that gave you the duty to do an act for them, that is your duty by law. Read your papers, call the local medicaid office for info on the application process ask them what is allowed for "look back period" laws etc..
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I think I will throw my two cents in, for what it is worth. I live in Washington state. My father had a major stroke in July 2011. The only help from Medicare was to cover his home health visits after he was released from the rehab unit and moved into our home. Home health is a short term program and lasts from 6 to 8 weeks. It's goal is to help the family get in sync with the patients needs. They help with bathing, they offer a physical therapist, a nurse, etc., but this is short term. When they are done they are done and Medicare help in providing in home care stops there.

I found through our local Area on Aging that additional in home help could be provided. The assistance was based on the fact that I was over 60, retired and had no income of my own. It was not based on my dad's income and my husband's retirement income was also not considered. I received 30 hours per month, to be used as needed, until I no longer needed the help; meaning my father no longer needed the help.

There were programs via Medicade, that would have provided 5 hours per day of in home help. At that time, we chose not to go that route. Eventually, my dad did go on Medicaid.

I think there is some confusion between Medicare and Medicaid. My experience was that Medicare only covered the home health, short term services, that kick in when a elderly person leaves the hospital or rehab unit and comes home.

Ahtoo12: I think you are up the creek on any contract that gives you past compensation. Should you attempt this, it is quite likely that the senior in your care will have difficulty qualifying for Medicaid.

In short, if you want to get paid, get a legal contract. Payment starts then. Retroactive payments are a no no.
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Jeann -thank you for your information which proves there are answers out there that are not pasted on correctly. When my husband needed home care I was told to apply for medicaide and he would get 5 hrs a day five days a week-I did not believe them which was good because they did not have the staff. I was told he could get paratransit for 3 dollars a trip not true -we lived 1/4 of a miles away from the buss stop-even though the buss would pass my house often. I never was told about sposual refuseal so if he went on medicaide I would still get some of his pension or SS. So get things in writting and see a good elder lawyer for advice-there is help if you can learn about. I could have kept my husband at home if I had had what Jeanne had as stated above.
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