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My dad is currently living with my brother, but my brother's bathroom has a shower/tub combo which is extremely difficult for my dad who has very limited mobility. My brother would like to be able to install an ADA toilet and a walk-in shower for my dad. It is very probable that my dad will end up in a nursing home at some point. Right now, he makes just above the amount to be considered for Medicaid. In an effort to "spend down" could he pay for the bathroom remodel or would that somehow disqualify him from Medicaid?

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But there could be a way around that. Possibly Dad could rent from brother and the rent money would be free to pay for the improvements.
Whoever is POA needs to see a certified elder attorney to go over all Dads finances and paperwork before you start spending money.
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So an elder law attorney would be able to advise my brother (POA for my dad) as to what things my dad can spend his money on without upsetting the medicaid?
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Yes. But the specialty is critical. Consult a specialist in Elder Law, not a cousin who is in Family Law or a friend who is a corporate lawyer.
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Improvement to house not owned by father could be considered gifting in a Medicaid lookback. The states review expenses and income 5 years back from the date of Medicaid application. So it could cause problems.
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Call Medicaid directly and ask. They were extremely helpful to my neighbor and even suggested ways to "spend down" from his settlement. He was living in his FIL's mobile home at the time. One of the things they did was to install a "roll in" shower for his wheelchair.
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Our lawyer told us we could make improvements to Mom's home as a spend down to medicaid. It was Mom's homeand we had POA. Check with an ekdet care lawyer first.
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It would seem since your dad is living with your brother it would be allowed but I would check with an elder law attorney.
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Consult an elder law attorney so you don't run into problems down the road.
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We were in the exact position and went ahead with the remodel. Since friends contributed the majority of the work, it was at an extreme discount but Mom's money paid for half of the cost. Medicaid never blinked an eye and we now have an open plan, roll in bathroom with poured surface flooring and grab bars all around. It has made all the difference in the world.
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I agree with the posters who said it should be allowed, especially if he is living with his son and the son is caring for him full time. He should also be able to pay the son something for his care, either rent or for caregiver pay. It is no different than paying for homecare to come in and care for him.
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