My elderly mom just approved for Medicaid but was penalized?

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Elderly mom just approved for Medicaid. Only been in nursing home since last August penalized her for lot she gave grand daughter 3 yrs ago as a gift before applying for medicaid for large amount of penalty

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Tony - although your mom is now "approved" & qualifies for Medicaid - as she is within medicaid income & asset limits plus shows medical "need" - she is "ineligible" for Medicaid to pay until the # of days set by transfer penalty passed. Approved but Ineligible.
It's confusing terminology.....

Btw sometimes a hardship waiver can be done.

You may find that all info on mom from August 2011 forward get reviewed in detail by the state. Think if other surprises possible...
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Transfer penalty basically is a math (fraction) problem:
- The lot grannie gifted has a value. Usually tax assessor value. Most counties have have all this on-line. Let's say $85,000.00. This is the numerator (top of fraction)
- your state medicaid program has a fixed daily reinbursement day rate for room & board that medicaid pays the NH. Some states is pretty low - like $ 170. Other states pay much higher maybe $300 a day. Whatever daily R&B is is the denominator.

So 85k & $200 day rate is 425 day transfer penalty in which grannie will be ineligible for Medicaid to pay. The facility will get a notice of ineligibility.

If they were admitted "Medicaid Pending", they have been paying all monthly income to the facility, so that figure can be subtracted from the penalty. But family is going to have to figure out how to private pay the rest. August - Feb is 7 months, at least 50k I'd bet. The facility will more than likely require someone to sign off to be financially responsible with a binding contract on repayment in order for her to stay there.

If family does nothing, facility can ask court for an emergency ward of the state order. Grannie will have a court appointed guardian who controls all & without any family input. The bill is still there & NH will do a collection on whomever seems likely to have ability to pay or have judgement placed. 

Sometimes family moves the elder back to a family members house for care. The outstanding bill is still there so they face collections and are likely toast on getting into another facility as all is within their medical & medicaid history 

Or grandaughter can sign the property back to grannie and it gets under contract & listed at fair market value to be sold by a Realtor ASAP. Grannie does a spend down and requalifies for Medicaid.
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From what I was told when checking out the nursing home option is that anything that has changed hands in the last 7 (or maybe 5, not sure) years, they will look at that as an attempt to defraud the system. I moved into my mom and dad's home 2 years ago to care for them and found that I cannot change it over into my name, sell it, or have them give it to me as a gift. I found out more by going on the Medicaid website and there is a lot of good info and laws that we need to know about it. Hope this helps. Maybe someone else here will have more detailed info for you.
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