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My boyfriend's mom is on the waiver program. Currently she gets 28 hours of home care health and 14 hours of self determination weekly. She cannot be left by herself due to falls, dementia and incontinence issues. His father is also very I'll and has a bath aid once a week. We live with them and provide care 24 hours a day. We asked for an extra 2 hours a day and was told by the waiver program that we were not providing enough informal care. Does anyone know what informal care is and is there any way to appeal the decision?

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Cut all financial dealings with BF and his family. You are not going to recooperatr the money you put into their house. Sorry.
Reconsider if you want to spend your future with a man that will not listen to your opinion and makes these sorts of bad financial decisions. DO NOT drag your parents into this by taking their help.
Marriages end over money all the time. In laws lose respect for the husband that cannot take care of their little girl.
Walk away from BF family, have a frank conversation w BF and start to rebuild your life, your savings.
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Yes they gave him a W2 form. They did not pay in federal withholding, social security etc from 1996 to 2010 on any employees. They filed bankruptcy in 2012 but taxes are not discharged. During that process they improperly transferred assets to my boyfriend. The cpa and I both said the lawyer did not do things right but no one listened. His brother gave information to irs to put him on the hook for the debt. It's all ridiculous and no they don't go to casino anymore. And yes she hits all the time. My mom will help me and my boyfriend but not his parents. She's furious about the situation.
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she hit you? oh tacy - oh my - where is your boyfriend in all this but somewhat hate to say this (but otoh) may be time to bail on him too if he won't; will your mom help just you out but you saying his mom didn't pay in his taxes? did they give him a W-2? so they didn't pay or file their taxes and they've gotten caught up with? and so they still have a business? but obviously not working but they can go to the casino? hope Medicaid doesn't find out - wow
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The answer to all the questions is my boyfriend did not incur the tax debt. He was an employee of the parents business who had payroll taxes taken out of his checks. Those money's were not paid but given to casino instead. The rest of the idiots in the family created more problems. My mom and her partner said they would loan us money no interest to purchase property and fix everything under the condition we do not provide any financial support and bail from the situation. I have been called every name in the book today by his family and got hit by his mom. I'm completely done with all of this.
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my point, guestshop - they know how to look at all this stuff as just trying to get out of things - hate it, in a way - but why don't understand this whole situation anyway
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Tacy, please be careful about the "business loan" to the parents. If the IRS is already looking at the parents' finances and (maybe) your boyfriend - loans to clearly insolvent RELATED person/s that do not have a prayer of repayment from a closely related person's business are not necessarily treated as loans that you can simply write-off to the estate. Especially if the boyfriend's business is not usually in the habit of lending money! The IRS really looks at related-party transfers (especially if one of the parties was in trouble with taxes and other debt) with a gimlet eye to make sure that gifts are not being treated as loans and written off to estates that claim insolvency. Just a word of caution so that you don't have extra problems on the other side of the situation....
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can I ask how you thought you were going to get paid back if they weren't making the payments themselves in the first place but also I can somewhat see how you could think you would inherit the house with you taking care of them but even so with him having a brother unless you had that nailed down that was iffy too so....somewhat situation I have with my dad's house - and my own feelings - he did have his grandson move in with him to stay and help/take care of him - however, he was getting paid, something I'm sure not getting the idea you are, on top of everything else, while not only was he getting paid but he wasn't having to pay anything either, at least not any household expenses or bills besides the fact that dad's house didn't have a mortgage anyway, so all he had were his own expenses that he was getting paid for and yet he still thought he should inherit the house - and I'm having people tell me he should because you can never get paid enough - and he tried to get dad to sign it over to him then but he wouldn't ever do it - said he intended for me to have it - (he'd given him enough money - he wasn't getting paid then from dad's funds - he hardly had any left; he'd already given most of it to him - he was getting a VA pension, how he was getting paid - so why he wanted me to at least have the house) - but after he passed he won't get out even though he'd said he didn't want to stay there - and there's been even more money come in from somewhere else since that would have easily bought him a nicer/better house; I didn't know about the care for over 2 years thing part of the hardship clause in the MERP program - interesting, though not needed in the case of my friend with her mom, but good to know since her sister and her husband did basically what you and yours have done but since she was disabled it didn't matter anyway, just not sure if they continued to make the payments on the place after mom was placed, just know they were being made as long as mom was there, so not sure though if they'd availed themselves of that clause re the MERP or not, might be something to check into. But how did the IRS get involved already? you weren't already 1099ing them for bad debt since I'm getting the idea they weren't repaying you, right? was this EA doing their taxes or ya'll's/his/his business? so they were still paying or at least filing taxes? see, my dad wasn't - his only income(s) were nontaxable while hub's aunt and uncle were filing just not having to pay, just getting back what was being taken out of his taxable private pension. But what was the problem with brother giving the info to the IRS - is that what created a tax situation for them with the bad debt, in that sense, to you all already then? so now they already have a IRS lien? so now they can't pay you because they have to pay them? but could they pay you anyway since they hadn't been? guess that's the part not understanding or was really your thought to just get paid out of the house and now looks like IRS may put a lien on it? and you won't get your money back after all? did brother know any of this was going on - well, guess he knew about the - loan? - or wouldn't have had anything to tell - so, hm...did he just not care or did he, that he didn't want you getting the house - to go back to somewhat like my situation - we also, even though there was no mortgage - put out quite a bit of expense on dad's house, same thing, knowing I was supposed to get the house, were willing to do with the idea of getting it back out of it, but that doesn't matter to some, does it?
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We had thought we were going to get paid back or inherit the house since we have provided care for over 2 years which is one of the hardship clauses in the MERP program. When the IRS started wanting information about 2 and a half years ago I told the family do not give any information to IRS hire the EA who did the taxes to handle all dealings with IRS. We went out of town for my sisters wedding and his idiot brother who has a god complex gathered the information while we were gone and gave it to the IRS. After that, I went into damage control mode because I'm dealing with a bunch of morons. Sorry I'm venting, I'm just mad because if they would have listened to me this never would have happened but his family is old school and think that women can't comprehend things and that is not how I was raised.
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so was that your idea? because you didn't really expect to be paid back, did you?
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Also all the loans were from his business so when they die technically I can 1099 misc the estate for bad debt which would be taxable income for estate and another irs lein but it can be wrote off for him not me though
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That is correct in our situation. Since my degree is in finance and accounting, I had drawn up loan papers which they had signed but we would be last in line in the chain of creditors. So the lawyer said to quit paying everything for them. They are crying about it and the boyfriend wants to pay for them still so they quit crying. I told him he's stupid. I'm not on speaking terms with any of them right now and im glad my parents are not that selfish.
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tacy - so correct me if I'm wrong, but what you have found out is that due to the Medicaid claim or lien on the property (as your BF parents get Medicaid paid for services), that basically all the money you have either paid on the mortgage on your boyfriends parents home and all of the other costs you have paid for their debts, you will never ever get reimbursed for. All the $ you spent on settling their debts, paying their mortgage, etc. basically has been a gift to them.

That's it, right?
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hm, maybe so; maybe that is why I think the property is still there even though I don't believe the mortgage is still being paid on it since mom's still alive and in nursing home; at first disabled daughter was still living there, which nixed everything; think that's one of those things that disallows the MERP, at least during their lifetime, but since she moved out, took that away, so back in place or would be - hm...wonder if they even know, but anyway yea, seems like somebody must know something since seems like bank hasn't done anything but I had thought they'd talked like they would or maybe just the family was concerned they would with her living there and thought was part of why she moved out - hm....but then not sure I'd heard that value exemption and quite likely her place isn't worth more than that - I know, how could anything be worth that little but you'd just have to know this place - so that being the case wonder if something to look into but then does it really matter if nobody cares if they get it anyway - probably only people care would be the bank - hm...wonder if ought to just from that standpoint - just so they get their money, if nothing else then, though never really understood why these banks are doing what they are anyway - kinda like, Tacy, I don't really understand why these people still have mortgages anyway...but also that helps clarify another possible hardship situation been dealing with that pretty sure their place is definitely worth lot more than $15,000 and they've spent their money too; wow...
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Actually an irs lein is first, state second, child support third, bank then other creditors. The lawyer says after irs they will all fight each other
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and it didn't really used to be but as things are getting tighter everywhere states are beginning to use it more and more but I'm more wondering about the mortgage in the first place because don't think Medicaid can touch the house until the mortgage holder does
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Also in our situation, we write one mortgage check directly to bank as a business expense for rening a barn that they get 1099 for at end of year. The social worker would not put that on dhs application cause it went directly to bank.which would have disqualified her for program to begin with. When I asked about recovery program they said don't worry about it it's never used.
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We went to 2 lawyers last week because people did not want to accept answers. What we found out is when his mom signed up for the waiver program and starred receiving service, the state put a lein on the property so when she dies the state gives the estate a bill. If the bill cannot be paid by the estate the house and all its belongings is taken by the state and sold to recoup the care costs. In addition to care costs an administrative fee of just under $500 a month is added to the bill. The hardship exemption is only good if the house is worth under $15000. Even though the husband is not on the program and signed nothing and was not aware her signature was good enough. Also the social workers are completely incompetent at aaa. My advice is talk to a lawyer first
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you can always ask for a review.
What is the review process, who reviews your request? (The local AAA?)
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Please explain "You should also realize that every dollar you are paid will become a lien against the estate when they die. Medicaid waiver is really a lot like a reverse mortgage "
We are waiting for results for a Frail Elder Waiver in Massachusetts. Trying to get information from our local AAA is like talking to a cat. I find the clients case manager to be either brain dead or incompetent. Even his manager who has given me some information hasn't been forthcoming. Who at the state level can I turn to for reliable accurate information?
Will I be able supplement support by using direct pay agencies? Will Mass Health/Medicaid specify the agencies and services they pay for?
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I did ask for a review that's when they said that her husband who has less than a year to live her son and I were legally required to do hours to make up 24 hour care. If the house needs more help put her husband on hospice and hospice workers can do work for both of them.
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The amount of hours received is related to the assessment that was completed. If there has been a change in status, a decline in functioning, they you can ask that there be a re-evaluation. This may increase the hours. Waiver has changed and I see those on the program receiving less hours per week. Any waiver, usually saves states money by keeping people in their home rather than in a nursing facility. Continue to advocate for the care needed, you can always ask for a review.
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Tacy, I'm glad that you got clarity on this and can get back to work.
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Well anyway we just got back from the lawyer found out we are out absolutely everything. The state owns everything. The best part of the day is I found out I'm not under any legal obligation to have provide any care so I can go back to work. If he continues to pay for everything he can but my money will be for the future and they are not getting another penny of it. Sorry I sound rude but I'm very angry right now
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Wow, Tacy; it sounds like things are getting shaken up, and in a good way!
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Igloo I read your post to my boyfriend and he completely freaked out. He decided to take a day off work to deal with his parents and he managed about 6 hours before he told his mom she needed to straighten up cause she brought most of the problems on herself. He also had me make an appointment with an elder lawyer for next week. He also called his brother and told him and his wife to quit undermining me with his parents diet and to stay out of decisions unless they were going to step up to the plate. Thank you for your help.
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Thanks for the advice. The doctors have said repeatedly they need nursing home care. The problem is his brother and his wife say doctors are just trying to generate business for friends. I keep trying to get him to go to lawyer and he doesn't want to upset his mother. I'm gonna at least make an appointment for myself.
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Tacy - you are probably on the application as a member of the household, so that is why you are expected to provide caregiving.

So you have been paying your boyfriends parents mortgages, correct? Do you understand that if MI is like most states, that every $ the Medicaid has spent on his parents will be a claim or a lien on their estate & their assets. This is MERP - Medicaid Estate Recovery Program. MERP is not just limited to NH payments made by Medicaid but any Medicaid funded program for those over 55.

What that means that when they die - if they stay in the house - the state places a claim or a lien on the property so the state has to be paid first & foremost from the proceeds of the sale unless you have exemptions or exclusions to offset MERP. IF the house is sold while they are alive, the proceeds from the sale have to be used for their care in a facility OR reimbursed to the state to pay for already provided for and paid for services. Just which approach depends on your state.

There is a caregiver exemption but you have to be able to show that you provided needed & continuous 24/7 care for a # of years prior. Boyfriend since he works can't do this. You, if you go back to work or cannot show the full time required as providing care, can't do this. Just what documentation is needed for caregiver exemption depends on the state - like for TX it is a letter with a details on their history with the patient and a listing of services provided done by their MD or a social worker on their letterhead with state registration number and their signature. If you can't provide what is needed, essentially all that $ you all have paid on their mortgage, their house, etc will not be repaid to you. All goes to the state. You would have to have all sorts of legal in place from this point on to establish that it's a debt owed.

I would run not walk to get an appointment with a elder law attorney this week to possibly discuss what options are out there at this point in time. Since you both live in his parents home, you are getting a benefit of the use of the home, so your payments made (utilities, taxes, maintenance) could be disallowed.

As you live in the home, that is why you are expected to provide for care.

Really & not to sound harsh, it sounds like you all are just prolonging the inevitable…..that they both need a higher level of care in a NH…and you are continuing to jeopardize your own financial situation by paying for all for them. And you are possibly jeopardizing your own health by trying to be a caregiver for them with your back situation. You have none of the safeguards that being married provides either on all this. Do you have a domestic partnership legal agreement? or some other safeguards in your being repaid for any of your funds spent on his parents many debts? Really you need experienced legal advise & asap.
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Thanks Pam. You kind of verified what I thought when I read everything but everyone else said I was over analyzing. So the only question left is can they force me to do 20 hours of care without pay since I am not family?
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Tacy, the cold hard fact is that Medicaid has a track history of not approving more than 35 hours per person per month. Once that limit is exceeded, they want to put the patient in a facility.
You should also realize that every dollar you are paid will become a lien against the estate when they die. Medicaid waiver is really a lot like a reverse mortgage
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We pay both of their mortgages, utilities, cable and food. In addition we found out they hadn't paid property taxes in years so we paid 16000 in back taxes. In addition they transferred assets improperly during a bankruptcy and he is liable for their debt when they die. So no one is getting anything for free here. Their money is ate up by levies and medical bills. I do not do personal care because I had back surgery and they weigh too much for me to safely do it. I'm not trying to be rude or ungrateful for the help given but I have no idea why they say I have an obligation to do the other 20 hours a day in care but the other actual children don't have an obligation to help. The doctors have all said they should be in a nursing home based on needs. Waiver program states they need 24 hour care but they will only provide 4 per day. Therefore there should be a way to appeal a decision they made for me.
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