near family. Dad could be in independent living our mom does need fulltime skilled care. When mom passes the intent would be for dad to possibly go back to his home in Florida if he is healthy enough. They have a very small amount of savings. My family is not in a financial position to pay the electricity, taxes, etc on the house to keep it going while Dad is with Mom. If we decided to sell the home right away, we would still need to have those expenses paid from Dad's account while he is in a facility. Can we hold funds back from his account to cover these costs? We have been told that they need to use all liquid assets for care prior to medicare. The home was deeded 20 years ago into my brother and my name. If we use up all their money we have nothing left to try and cover the expenses while we sell their home or if my Dad gets better to eventually return. Any advice is appreciated.

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First of all, it's only Medicaid where you need to spend down assets. Medicare is likely their health care now, but they won't pay for a facility. I would strongly advise that you see an elder law attorney or an estate attorney to help you do this legally. Then, look for a place that has transitional housing opportunities, such as retirement, assisted living and eventually a nursing home, so your dad can be accommodated, but be near your mom who needs more care. However, your dad may love assisted living for as long as your mom can get enough care in that setting. Please do see an attorney, and then look at assisted living options where you want them, but investigate transitional aspects for your dad. He probably doesn't need another house.

Good luck. It's all complicated, as they say.
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Just to amplify and clarify some of what Carol and Doreen said above...

1. Make sure you understand the distinction between Medicare and Medicaid.

2. Both Florida and Wisconsin have Medicaid Home and Community Based Waiver Programs. These programs are designed to help elders in need who might otherwise have no option but Medcaid nursing home benefits to receive care at home or in an assisted living facility. The Florida program is currently closed but typically re-opens in the fall/winter. You can find out information about the WI programs here: . You should call and see if the program is available to new beneficiaries.

3. The VA pension benefit Doreen mentioned above should not be confused with service related disablity compensation. If a vet is receiving compensation they may receive a higher award from pension (both cannot be received at the same time). If dad is a vet, you can find more information here: or for a readable summary go here:

3. Both Medicaid and VA pension can be received simultaneously. The maximum VA Aid and Attendance pension for a couple is $1,950 per month. In Florida, the Medicaid waiver program will pay a sitpend of up to $1,300 per month per beneficiary towards the cost of care in an assisted living facility. Combined, the two benefit sets offer powerful financial help. The VA benefit will be the same nationwide. Medicaid Waiver benefits vary from state to state.

4. DO NOT SPEND DOWN ASSETS TO QUALIFY FOR MEDICAID. This is the typical advice and it is financially devastating. Whether your parents stay in FL or move to WI there are techniques that can be implemented to legally preserve your parent's assets for their own use while receving public benefits. Using these techniques can mitigate the problem of ongoing home maintenance expenses as well as cover the cost of services and supplies not covered or covered inadequately by Medicaid.

5. Community Spouse protections. Again, as Doreen mentioned, Medicaid treats the applicant and the spouse separately. The spouse applying for Medicaid cannot have more than $2,000 in assets. The spouse not receiving benefits may retain up to $109,560 (in Florida may vary in other states) in cash assets not including home, auto, personal effects or IRA's (in Florida may vary in other states). Simple planning technique: Transfer all assets above $2,000 from the applicant spouse to the community spouse and then apply for Medicaid.

6. If you decide to work with an advisor, make sure that person is expert in both Medicaid and Veteran benefit eligiblity. They are two separate and distinct programs with different eligiblity and qualification requirements. You do not want to disqualify yourself from one while attempting to qualify for another. In my experience there are many elder law attorneys who are not knowledgeable about VA benefits.

It is a shame that your decision may have to based on finances rather than what would truly be in your parents best interest...hopefully that will not be the case.
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Yes, Medicaid requires certain spend-downs, but now the home is in someone else's name. By the way, many people believe mistakenly, that if you have a home, you can't get Medicaid and that's not true. Especially where one spouse is still "in the community" meaning don't need that care, they are NOT required to bankrupt Themselves to care for the other spouse. There is a letter about being unable and not intending to provide for that, due to the need to care for oneself.
Particularly at our folks' age, the assets and income are often largely in the Husband's name - that's a huge problem for the Typical couple that the Husband is older, weaker, sicker and the wife cares for him. Sometimes the shoe is on the other foot, though and that works to those people's advantage.
I know a very good elder law specialist in FL. Are they in the Miami-Fort Laud area? We are in Broward County, near Fort Laud and the lawyer is farther south in Miami Shores but covers the whole tri-county area.
That said, the Law of FL and Medicaid, along with the VA paperwork, is the Same Anywhere in FL. So she could help.
This woman works with our Residents (we have a small Assisted Living home, with only 6 Residents at a time, and we also offer Day care for seniors) Medicaid typically pays about Half the cost of care at a smaller ALF where they will get Quality One on One care and Attention, which is so much more family and senior-friendly than a nursing home, with far less Cost. The problem is MediCare pays for nursing homes and that solves the MedicAid qualifying problems in the short run.
Is your dad a veteran? If he served in the military (even one day of active duty) During a Time of war (need not have even been Interested in that war, much less taken a bullet) then he can get benefits and if she survives him (don't think "healthy" caregiving spouses don't pass first from the stress of it) then she can get Survivors' Benefits.
Please let me know if you'd like to call and talk to us. I'm not sure how this system does with information but we're online at Angel House Seniors (take out spaces) dot com or dot org is the other part of the site address.
I founded this non-profit to help seniors and their caregivers after my own dad passed away and I thought there had to be a better way and set out to build that way.
As a Housing expert for over 30 years here in FL, there's nobody better qualified to help seniors with reverse mortgage, decisions to rent or sell (depends on the stage of market recovery, age & location of their home) keep the home in the family, and much more. There's Always a way to get them good care, if the family cares about it. That's half the battle and I know you do.
Take care, and please let dad know he needs to take a break sometimes too. I know it's hard for dedicated guys like him to do that but it's important to safeguard his health.

God bless you and hang in there. I'm not sure moving them to a cold place, away from any friends and Life as They Know it, is a great idea... Seniors don't tend to love change so much and your dad may even feel 'inadequate' needing help from his kids to care for his wife. I feel for them both. Please let me know if we can help you in any way.
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I take care of my Dad at home-had to quit work but still need an income to survive. HE is a disabled vet WWII and I applied for him for assisted living pension. they had to upgrade his disability compensation to a pension to get it he did quailfy but it takes at least 6 to 7 months to get it. They will pay back pay up to the date you requested. Just about everything you ask for from VA (except for a hospital bed and lift and motorized chair you can get immediatly) takes at least 6 to 7 months. I went to a local VA branch and the man there assisted me with everything I needed. He todl me what I would need and helped fill out the forms correctly, and they must be correct or they will send them back and deny the request. The VA doctor will help get some things quicker. He also does recieve his SS retirement payments. These have nothing to do with VA.
But keep up hope. It takes some foot work to get eveything going but sounds like you are used to that. Good Luck and God bless You.
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