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My Mom is POA for my grandmother. My mom is one of 5 children. My grandmother lived with my mother for 3 years prior to going into a nursing home. After a long fight with Medicaid, the nursing home wants $27,000. My mother is a nervous wreck as all of my grandmother's assets are gone. Can they take my parents to court or take their house?

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Igloo, thanks for answering the call! You are needed! I read your posts to learn from your answers.
Falling asleep during the humidity, lack of circulating air, zip, then I am asleep!
Will come back with a clearer mind tomorrow.
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Found this info through googling free legal clinics in utica NY
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From my reading, TP is $ from when she moved out of apt & was living with Brpwns parents. TP not about house, but abiut where proceeds to the penny of what house sold for went to ( bath reno & to uncles).

MrsB - how much was $ to uncles? 1 @$8k or 2 @ $8k ea?
Will they return the $ and pay it to the NH?
If not, mom has to either pay their TP to keep grannie in NH or go total bad b*itch nuclear on uncles. Going nuclear, well not everybody has the personality to do this, let's keep peace in the family at all costs position. BUT As DPOA she can get legal to send a debt owed letter to uncles to pay, which I gonna guess they will probably ignore. But could be another option, mom as DPOA does an new or amended IRS filing of grannies taxes and issue them a 1099 for the $. You know they didn't report it.....can we say audit?

This nugget from the legal (now deceased unfortunately) I worked with on an "aunts" estate as executor. I was named and totally unexpected. The nephew who had been heavily getting $$$ from her was totally left out. He made all sorts of commotion on filing to be executor, all the work he had done, yada yada. Attorney said we can stop this cold by telling him as I'm named I can and will do a final IRS with all the $ reported to IRS and amended filing for past years as well. From what I'm told he is still peeved.....
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Sorry I missed the last part of your last post.

I'm not sure a NH or Medicaid would accept your explanation of no responsibility, even if your mother was acting on your grandmother's advice. Nor do I think that shifting responsibility to the uncles for receipt of the funds would be an acceptable defense. They aren't responsible for the initiation of any transfer of funds to them.

I think if anything, it might be suggested by the NH that your mother should attempt to recover the funds from the uncles, since she made the transfer at your grandmother's behest.

I do think asvwell that your mother's own affirmation of no responsibility isn't going to be a determining factor for the NH or Medicaid. They will make their determinations. One thing to be careful of is providing more information than is necessary.

All of this aside, the issues are becoming more complicated. There are some very knowledgeable and helpful posters here, but at some point the need for paid professional expertise at a higher level really becomes mandatory. I think your situation has reached that point.

Your suggested remedies and defenses are getting into areas that are way beyond my level of expertise and I don't want to give incorrect answers. I can help trace back the timelines, but as to remedies, I really do think that this is a topic for an attorney with substantial experience in the Medicaid funding area.

Not all attorneys require retainers; and most firms that I worked with will also work with someone of limited financial means to devise a monthly payment plan.

It's an unfortunate situation, but your mother is clearly stressed by it so it might be time to figure out where financial sacrifices can be made before your mother becomes ill from the stress.

I do understand how upsetting something like this can be; I would hate to see your mother become ill from all of the uncertainty and stress. Please take my advice and contact law firms to see what can be worked out financially.
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Not all law firms require retainers. That's why you check with different firms to determine what they require.

If you don't get legal counsel, I think you're pretty much at the mercy of the NY and Medicaid.
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You are correct regarding the time frames. I have checked with a few law firms, but we cannot afford the upfront retainer of $2000.
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After selling the house in 2008, your grandmother lived in an apartment for 2- 3 years (to perhaps 2010 - 2011?), then lived with your mother until about 2014? When did she pay for the upgrade for specific medical accommodations and when did she give money to the uncles?

Those expenditures might be the ones triggering the transfer penalty, but I'm only guessing, trying to pinpoint when the house was sold so you have more background information to try and sort this out as well as get legal counsel.

Iggy, can you throw Mrs. Brown a cyber life preserver here? If the house was sold in 2008, that's 7 years back, generally, so something after that must be what triggered the TP? Am I on the right track? Again, just trying to narrow down the periods for Mrs. Brown.

Mrs. B, I do agree though that this is a complex issue and your mother needs legal counsel.

This is always my recommendation for finding counsel, based on work experience in law firms as well as personal experience for my parents and sister in their estate planning.

Contact the attorney bar association for the county in which Utica (or where your mother lives) is located and/or contact the NY State Bar Association, or check their websites for practice areas. These are specialty areas of law. Look for Elder Law practice areas which include Medicaid planning as well.

Having worked for single practitioners, small, mid and large size law firms, I stay away from the single and smaller firms. They don't have the resources of the larger firms, nor do they have cross specialities which can often be helpful as issues develop during representation. I prefer mid to larger size firms.

As an example, one firm for which I worked had several attorneys in their Estate Planning practice areas. Although all of them prepared estate documents, one had an additional specialty in gift transfer and gift taxing. Others similarly had other complimentary specialties. If an issue arose which was outside of a given attorney's specific knowledge, he or she could just consult with others in the firm.

That provides a much wider range of knowledge and experience from which to draw for clients with more than just straight estate planning needs.

Review the websites of the elder law firms, see what their practice areas are, review their newsletters and any public information seminars they might hold. Good firms often extend their presence through these types of volunteer efforts.

Make a checklist for interviewing, including names of attorneys, experience, hourly rate, retainer rate and whether you feel you have a rapport with them.

Attorneys can balk at providing the compensation rate, so you might have to attend a first meeting just to scope out the situation. Some of the elder law attorneys who solicit heavily often provide a limited first free consultation. I'm not sure if the medium or larger law firms do, but they have a much different focus in drawing clients.

If so, meet with a few so you have a choice; this is going to be someone on whom your mother will rely heavily so you want to establish rapport up front.


I too am unfamiliar with Elder Net. I did a little checking and learned that it appears to be a common name for organizations that aggregate and make available information on elder services. It doesn't appear to be a law firm, unless there might be some contributors amongst the various Elder Net groups. It might just be a clearing house

I did find a disclaimer on one Elder Net site that clearly states it aggregates information from various sources not controlled by them (here comes the waffling), and that it cannot provide assurance the information is true.

So, I'd say, scratch ElderNet.
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2008 with a profit of 86K. Question, could my mother send a letter to both NHs and to my uncles stating she released monies to the uncles under request by grandma and she is not personally, financially responsible for repayment of said monies. Would this "absolve" her of at least that portion of the penalty amount owed, therefore transferring the dept to the uncles? I guess I would need to have these letters signed and notarized by all parties and sent to the NHs. Would this work? I am having my mom request the admission paperwork from both NHs to review how they were signed, as she cannot recall.
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Mrs. Brown, you wrote "about 5 years"... do you know the exact date?

Igloo, I'm wondering if the sale occurred more than 5 years ago, would the transfer penalty still apply? When does the backward 5 years begin to run - the date of Medicaid application?
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Toast as in over & done. I moved my mom from nh #1 (a litany of issues....) to a much better nh#2 at about mo #10 of entering a NH. Mom got approved for Medicaid at mo #6 but the incompetency of billing at NH #1 along with rebilling /reclaw issues with mom bring suspended by BCBS (once approved for Medicaid her BCBS suspends paying as Medicaid superscedes BCBS - and it's can be a clusterF to get resolved and a whole other post...) meant billing not correctly done and at zero till about mo #9 at old NH. When I went to get mom into NH #2, admissions went on-line (I'm sitting there) to state medicaid to see what moms eligibility was and if any notes or other unresolved problems. It showed NH #1 was current and paid by state. Now I paid moms SOC from moms checking account (neither NH ever were direct deposit of moms income & really i feel strongly that you should never allow the nh to be the payee) and took copies of the old cancelled checks with me just in case there was any questions (also I'm OCD and was totally wary as old NH was so incompetent). If there had been any issue with payments to old NH, the new Nh would have required me personally to sign off on a financially responsible contract. Otherwise mom would have been toast on getting into this N.h or any other.

Grannie having an unresolved TP will be an issue for any other NH.

You like this NH, correct? Mom & dad cannot caregive, correct? Other family cannot either, correct? Then you are going to have to come to terms with the nh. Really 27k in N.h costs is nothing as average annual stay is 100k. I'd ask nh if the 27k is based on their private pay rate or the state reinbursement rate. If its private pay, see if they will accept the lower state rate and waive the difference, doesn't hurt to ask.

I'm not familiar with "elder net", what is it and how is it funded? Let us know as we all learn from each other.
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Also grannie with broken hips probably is bedfast & should qualify for hospice - whether in facility or at home. For many NH having a resident on hospice (a Medicare benefit) and Medicaid (which pays the room & board) is a preferred resident as Medicare pays for extra hands 2-4 times a week. My mom was on both for her last 18 mos at the NH (shattered a hip from pulling her wheelchair on her way to dining room at NH) and had much better care due to both.

You know since grannie sold her home, the extract amount it sold for is a known so that $ plus her monthly income & old savings balance all were known when the Medicaid application was done. Your mom probably did not have a personal services contract done so whatever $ grannie gave her was viewed as gifting because if no contract done, caregiving is viewed as done for "free" and subject to penalty. The $ grannie gave to pay for the new bathroom was viewed as gifting and subject to penalty as well. Ditto on $ grannie gave to uncles. Medicaid seems to allow for some if their $ to go towards the household they live in, but renovating a bathroom or building on a grannie wing won't be allowed.

Really calmly & clearly try to figure out what payment could be worked out. If the debt is upheld, your folks could see it morph in interest & fees. Good luck.
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Unfortunately, mom was never advised of a fair hearing by "eldernet" which is supposed to be a resource for people in our area. I really feel they were working on the side of medicaid and not my mom. I will find out about the paperwork, to see how things were signed. Please advise what you mean by "UNTIL THIS IS RESOLVED, GRANNIE IS TOAST ON GETTING INTO ANOTHER NH EASILY AS WHEN THE NH DOES A CHECK ON MEDICAID THE OLD TP WILL BE THERE." We do NOT want her moved from her current facility. Thanks.
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NH doesnt want a house...they want to be paid for a debt for services provided.

What it sounds like is happening is that grannie has a transfer penalty placed against her for gifting or transferring assets which means she is ineligible for Medicaid to pay till the penalty period is over. So she probably moved in as Medicaid Pending, paid her required co-pay (the SOC/share of cost) of her monthly income less a $50 personal needs allowance, as long as she did she was ok to be a " pending" resident. But then eventually was determined to be ineligible for Medicaid due to a penalty. State sent your mom & the NH a letter stating ineligibility. NH bills your mom for balance due. 27K

Now TP varies by state as the amount is based on whatever your state pays a facility for daily room & board reinbursement. Like for TX it's low at $155 day while east coast states often pay $300 a day. TP is by # of days. So however the math is for your state it comes to 27k.

Whomever grannie gave $ to hopefully will return the $ and pay it to the NH and it covers the full 27K....(.....yeah sure and I wanna weigh what I did back in 1988!). Now if the TP is from a house transfer, that is sticky to deal with and usually involves a lot of $$ & I'd run not walk to a NAELA attorney to deal with this.But 27k is pretty smallish penalty in the world of NH costs ( maybe 3 mos), the bigger issue for me would be if the penalty is resolved will the NH be ok on having her stay and is everything ok for Medicaid once TP resolved -- you need to clearly ask about this.

If your mom signed grannie into the NH what her liability is depends on just how she signed all the admissions documents. If she signed to be financially responsible, then the NH can turn it over to debt collectors and they are ruthless. She & your dad are going to have to deal with the debt and someone will have to either pay for grannie to stay in NH or take grannie into their home & caregive. But if she signed all as "Jane smith jones in her capacity as DPOA for Mary smith" (or something like this) then she is not responsible to pay but will need to move grannie out of the NH. Now DPOA is responsible to make sure grannies copay was done but thats it.Review the admissions paper work to see how this was done. One thing I will say that comes up over & over on this site is that family just flat does NOT get the paperwork!! NH mean $ 100k annual debt, you have to sign correctly to protect yourself and get a copy and the NH doesn't get a penny till they give it to you! If mom doesn't have paperwork, you should send a certified letter with a return registered receipt asking for them & the facility could charge you a fee for doing this.

I'd suggest you find out who got the $$ and family leans on then to cough it up and pay the NH. Until this is resolved, grannie is toast on getting into another N.h easily as when the NH does a check on Medicaid the old TP will be there.

You know all Medicaid conflicts have an appeal process. Did mom do an appeal? If not review paperwork to see what the time limitations are for doing an appeal. Hardship waivers of a TP are done but have to be applied for with documentation and in a set period of time. If your mom was too overwhelmed to do this, it's a no win situation. But let's you know that you need to get all your parents legal done so that you are prepared for when they themselves need care & get an elder law attorney to do this correctly.

About the $50 a mo, the personal needs allowance, it's held as a trust account at the NH. In theory NH should send a statement of balance to whomever is grannies point person. Often the PNA zeros out each month as between scheduled beauty shoppe visits and their phone or cable fees use up PNA.
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So to clarify, grandma's home was sold about 5 yrs prior to her entering the NH. She did have some of this money left when she entered the NH, but that money is since gone, as well as any other savings.
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My grandmother sold her home and moved into a senior living apartment, where she lived 2-3 yrs before not being able to live by herself. She then moved into my parent's home. When my mother could not provide the needed care for grandma, as grandma could not walk on her own, and mom is not able to lift her due to her own back issues, she went to the NH. We later found out that grandma had fractured her hip, but that's a whole other issue as the local hospital refused to treat grandma stating that elderly people naturally have pain. Grandma has since fractured her hip a second time while at the NH.
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Could you clarify one issue for me - I'm a bit confused about it.

You wrote:

"My grandmother lived with my mother for 3 years prior to going into a nursing home."

In whose home? Did your grandmother have a home at that time, or had she sold it? Was she living with your mother, in your mother's house? Or was your mother living with your grandmother in grandmother's house?
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Grandma paid for a bathroom upgrade, as she could not stand in the shower or lift her leg over the tub. She also needed a higher toilet and hand rails for safety. But the contract for the work was not kept and we were unable to get return call from the contracter either. My grandmother did give some money to my uncles also. The amounts were all small under 5 thousand. Some of which was paid back. And remember, the house belongs to my parents, having lived there more thzn 10 yrs prior to grandma moving in for care.
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We need some of our Medicaid- and legal savvy folks to chime in here!
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Ahhhh! Did Grandma gift money or a house to someone?
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We believe the bill is for the "look back period" or penalty period.
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I'm trying to keep this question at the top until one of the folks who actually knows about this chimes in. Poor mom! What is the NH billing this amount for? Do you have clarity about that? I think the real question is, does this facility accept Medicaid patients, and did they accept Grandma as Medicaid Pending?

Have you tried Legal Aid and/or your local university law school clinic?
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They are sending the bills to my mother. Yes my mother is the main contact with the NH. There are 5 children, my mom is the oldest and grandma's caregiver. The whole medicaid process has brought her nothing but terrible anxiety, anger, depression. She initially sought help from a lawyer who pushed her to Eldernet. These people were no help at all. I finally spoke with a lawyer, since my mother was no longer emotionally able to handle the stress. This is when I found out about Fair Hearing. But it's outside of the regulation for requesting this, and an experienced lawyer wants $2000 for retainer just to review the information. My mom just wants to know if she is protected from loosing her home and making sure grandma cannot be moved to a cheaper facility. My parents are both in their 70s and barely get by themselves.
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When you say "the nursing home wants $27000", do you mean they've sent Grandma a bill for that amount?
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Something else for Mom to ask the business office about. If the NH is getting Grandma's check via direct deposit, then likely she has an "account" at the nursing home that gets used to pay for beauty parlor, etc. Does mom talk to the business office at the facility regularly, or does she have difficulty doing tasks like that? Can you accompany her?
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As of April the NH has been getting direct deposit of the pension and SS from grandma. And as of July, all of grandma's money from her personal account, which was less than $500 upon entering the NH, is not gone, and the account is closed. According to Medicaid, my grandma gets $50 stipend, but my mother says my grandma has not been receiving it.
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Sorry for the typos. Phone-typing.
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Well, if your mom is POA, she would theoretically be the one who knows, unless Grandma signed the papers herself. How is mom proposing to resolve this? Best bet would be to take the bill from the NH to the NH business office and have a business-like discussion with them. She should NOT sign anything.

Usually, if a patient has assets, they start out as private pay as long as the money lasts and then apply gor Medicaid. Or, if there are no assets to start, the pstient is accepyed by the nh as "medicaid pending" meaning that Medicsid pays the bill bavk to the dste of application. Of vourse, the nh expects grandma to be paying her "share of cost" which is whatever monthly income she gets from SS, pension, etc, minus a small smount for perdonal needs. Has Grandma's SS check been going to the NH since she's been there? Is your mom her tepresentative payee for SS?
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Yes, grandma is 94. She started off in one home because her preferred facility did not have a room for her. She was transferred after 6 months, and this was during the application period. I would like to add, Medicaid took 11 months to complete her review. And I don't know about the agreement. Would this be with the NHs?
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Is Grandma still alive?

Was Grandma admitted to the NH "Medicaid Pending", or did mom sign an agreement to be responsible for Grandma's NH bills?
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