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MarkInCT Asked June 2014

How tightly is the 5 year lookback scutinized?

Mother in nursing home, father is spending down assets. Problem is father was old school and never had a credit card or a checking account. Would go to back and withdraw something like $1000 or $2000 each month cash month and paid all bills and utilities also by cash. Will be doing Medicaid application in a few months. I am told by many people that if he cannot produce receipts for that 1000/month or 2000/month, then Medicaid will automatically assume it is a gift to someone. Can anyone tell me how close Medicaid scrutinizes an application? Do they want a full 5 year accounting to the penny? Thanx all.

igloo572 Jul 2014
Durable Power of Attorney, this usually means they can do anything financial for the person. For my mom, I needed to change some items on her utilities and it had to be a DPOA notarized with state seal & license of notary for me to even have anyone speak with me for both water district and electric co. A plain POA would be viewed as a "springing" POA and would need lots more documentation to be in force. Some banks won't recognize a plain POA too.

Probably you will just have to do the work to establish Dad's income, assets and spending history in order for mom to get to the point to qualify. Only you know if you can find the time and get all this done. I will say that it is going to be pretty critical to get the details right as Dad will be considered the "community spouse" for Medicaid. And as such, you really don't want him to spend a penny more in the spend down that he needs to to qualify your mom for NH care. One big problem for elderly spouses in doing this, is that they don't understand that they do NOT have to impoverish themselves in order for the spouse to qualify. The state does NOT expect that to happen. Most states have the community spouse (and that means living in the community rather than community-property) so that they can keep up to 113K in liquid assets. You don't want dad to spend down any more than he absolutely needs to. He may have already spent-down to that point and just didnt understand that he didn't have to make himself impoverished too. He will need all the funds he can to maintain his situation. Also there is a whole CSRA available to him - Community Spouse Resource Allowance. Like for TX the CSRA is almost 3K a month that does not have to go to the NH as the NH residents co-pay but can be diverted to pay the community spouse if need be. Most Medicaid for NH are widows or widowers and their $ is truly impoverishment level to qualify (roughly 2K in income & 2 K in assets). One big problem is a lot of what you read & hear on Medicaid for NH is all geared for widows & widowers. Personally if I was dealing with CSRA for my parents, I would go to an elder lawyer who is NAELA and make it clear that this is a community spouse situation to get a plan that works best. Dad is probably too overwhelmed to deal with this.

Whatever the case though, Dad will have to show what both his & mom's income and assets are and for up to the past 5 years. My mom's was 3 years & 6 mo lookback. The income will be whatever they gets each mo, like their SS and retirements. You will have to submit the annual statements that show this for the Medicaid application. For SS it gets mailed out in Dec for the new year. Ditto for retirements. These are the 2 central things needed because it will establish mom qualifying for Medicaid and what dad's possible CSRA is and then what the NH can expect as mom's co-pay or share of cost for her stay @ the NH.

Do you think you can find these things at your parents house? Can you find bank statements and insurance policies, etc too? It will take time and will dad work with you in going through the house to find stuff? Perhaps someone else in the family is better at working with dad at his home and becoming Nancy Drew or Hercule Poirot to find stuff. Then I'd suggest that once you find the basic info, schedule a attorney visit to come see where your parents stand in all this. Good luck too.

MarkInCT Jul 2014
What is DPOA? POA=power of attorney? but What is DPOA? I am in Connecticut. It seems like I can consult with a lot of elder law attorneys and I can get a whole boatload of maybes. I wish I could just consult with an actual Medicaid caseworker to find out just what they look for? Hearsay from other people tell me some caseworkers are somewhat lenient and some almost want a CPA covering every cent.

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igloo572 Jun 2014
OK what I think Medicaid is looking for is a "pattern of spending" that makes sense as to where the income went. Dads like to do everything cash and he ain't gonna change…..I think you can make all this work BUT you are going to have to basically create a ledger for his cash withdrawals. Dad sure won't do it, now will he??? so you might as well get Quicken, QUickbooks or some other software to start this now for dad.

I hope you have DPOA for them as this is going to be easier to do if so. I'd try to get registered on-line for every account that dad pays for. Some things will want you to produce a DPOA to do this (especially utility companies). So that each month you can just go on-line to see what the phone, gas, etc bills are and what dad paid. He still gets the paper bills but you can see them all on-line. You can also go back to see what he paid in the past too. Or you can go to the house and try to ferret out statements from the past too. On-line much easier!

The Medicaid caseworker has probably dealt with this before. You just need to provide a ledger that makes sense for the income they get and where it went and it will be OK. Time consuming as all get out but OK. Good luck too.

MarkInCT Jun 2014
bank not back.

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