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I am really unsure of the 5 year look back period and as little as my mom has, I am paranoid about all of the questions that could be asked and I would have to answer for to help her get nursing Medicaid. How detailed do they get with credit card charges? If payments are made to pay a cc payment, is it questioned? Do they want to see detailed credit card transactions in detail? or they don't care as long as there is a payment to a credit card to her name. This is so hard.

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Cherokee, what you are dealing with ime are 2 different but intertwined things: MERP- Medicaid estate recovery program - as it pertains to the 127k supposed bill from Medicaid; AND city/co tax assessor/ collector - as it pertains to taxes.
Neither can make you deal with the property if you choose not too; but that won’t stop either from sending you notices of debt due. They both need a “heir” to claim assets of your late mother’s estate (that POS house) as transferring ownership of property is really really hard for state or county to do to their ownership. Like could take years and all sorts of fillings, hearings, bids, notices placed, etc. Meanwhile property continues to deteriorate plus have fines, taxes, etc placed on it. Plus if your in a very pro-property right state, it’s near impossible for state entities to do unless it’s big time blight or imminent domain stuff (property needed for egress like for a new bridge, road).

They need you to assume responsibility to make their work easier.
You don’t have to.
The letters, I bet, might be addressed to you but the wording within is that the debt is that owed by the Estate. If you were your moms contact person in paperwork at her old NH or you were her DPOA or got her Medicaid info or the emergency contract for utilities, that’s why you’re getting the letters.
But DPOA stopped cold once mom died.
Unless your name was on as co-owner for house, utilities, mortgage, it’s not yours, not your % responsibility. Your not on anything, right?
Your mom died w/out a will, correct? She died “intestate” so imo unless lineal heirship is done, verified, etc. there is NO DETERMINATION of who exactly are heirs. You cannot be forced to do lineal heirship. If your folks had prior marriages or frisky in relationships, there might be kids - who also are potentially heirs - you never ever knew about.
Even if she had a will & named you as Executor, you don’t have to be the Executor.

Family walk on dealing with Estates all the time. Not pretty but happens. But imho you have to make a decision either do nothing at all with the house (abandon) or get an atty to open probate.

On MERP, by your mom applying for Medicaid, Medicaid is required to attempt a recoup of all costs paid for her NH room & board each day from whatever assets she had at death. Her tally was 127k. The big issue is, I’ll bet a case of Prosecco, her house isn’t worth 127k. If it has decades of delayed maintenance, it might not even be worth what the tax assessor has its value set at. Am I guessing right?
Unless it could likely sell for 30/40k above what Medicaid supposedly wants repaid AND paying off all taxes and thier hefty delinquency fees, I’d walk on dealing with it. It would cost you $ to get it thru lineal then pay for whatever maintenance needed to get it safely sold. The extra 30/40k would compensate you for those out of pocket costs you will have to front to get it’s legal done & get it sold.

MERP came about early 2000’s back when housing prices did nothing but go up, & up & up in value. Even POS homes were lil cash registers. In theory grannies house would sell, pay off Medicaid and $$$ still left for heirs. Then came the housing crash. Now it’s an old place without the granite countertops or waterfall shower head that buyers just expect. It hard to sell unless at low below market price. Really run the #’s and unless there’s $ for sure back to you, walk on dealing with it. Good luck.
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imho, igloo572 provided a stellar answer. Nothing further. Thank you, igloo!
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Frances, On Medicaid “waiver” situation, Medicaid paying for care in a SNF is not actually a waiver. For Medicaid, $ is “dedicated” (read that to mean guaranteed) & federally it is for skilled nursing care aka a Nursing Home. The amount of $ based on your states demographics (& why census is mucho importante). But what states can do is request a “waiver” of some of that dedicated $ to instead go to other programs for the same population via “waiver” programs. The whole huge Medicaid system has a ton of waivers, some are encouraged nationwide by CMS (centers for Medicare & Medicaid), others are waivers programs developed by your state usually in conjunction / partnership with county government or quasi governmental entity (like University health science centers) or large grant funding organization (like Robert Wood Johnson Foundation)

Some states do virtually no waiver programs for AL or MC from Medicaid $ for aged. It’s a SNF bed only for LTC Medicaid.
Others do but it’s a very narrow and limited program, so kinda basically there aren’t really realistically any AL or MC waiver beds. This is what I found was the case for TX when dealing with stuff for my mom.
Others, like CA, are lots more proactive & expansive in using waivers and using state $ to bolster up the fed/state guaranteed budget.

For facilities, participating in a waiver program runs a certain amount of risk& extra documentation. If they can easily fill a bed via private pay, they won’t need to do a waiver and all the paperwork that comes with it. Waivers tend run on a time limited basis, like 3, 5 or 7 years, so for a 5 yr one if at 4 years the evaluation isn’t coming up like state was hoping for that waiver gets phased out. Adios to any year 6.

PACE centers are the current trend for getting waiver $$$ that would otherwise have gone to AL or stayed for NH. We have one a few block from us (Benson Center) and it’s partnership is Catholic Charities Health Care Division. In my state, AL waivers are being phased out to go to doing more PACE centers as lots more cost efficient cost containment. It does shift loads more care time onto family though....
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Triggers would be large payments that stand out, declines in banking accounts, whose name the house is in now versus past 5 years. Credit card statements are not really of concern unless, perhaps, the credit card is normally one amount and then there's a payment of 3-4 times that amount. You might be asked what it was.

The lookback period is to determine if mom was making gifts to others (giving money away), had some property that she gifted or sold below market value to someone, transferred her assets in order to get it out of her name and make it appear she had less than she has. That's what they are looking for.

If she/her family has not been moving things around to hide them, you should have nothing to worry about.
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For my mom and MIL, & their applications in 2 different states, neither asked for credit card statements. My mom had a couple of cards, MIL had close to a dz. My experience is like JoAnn’s in that Medicaid doesn’t care about debt; it’s all about assets and where they were spent & if appropriate.

That being said, I’m pretty confident if checks were written out for thousands each mo to pay a VISA, might red flags the application and then the caseworker asks for CC statements. Medicaid looks for patterns of spending, so if each mo in bank statements, payments made for a regular $100-400 per month to Visa, I doubt that will cause an issue.

Are you aware of the required copay by Medicaid?
Often facilities gloss over this requirement.
If so, for LTC Medicaid applications, the applicant is required from Day 1 of applying for Medicaid to pay basically almost all thier monthly income to the facility as a copay. They are allowed to keep a smallish Personal Needs Allowance. PNA varies by state but most have it at $50 - $60. So from here on out, PNA is the only $ they will have to spend on extras. If you put mom / dad on a set schedule for beauty / barber shoppe at the NH, it will likely use up the PNA. For example, say mom gets $1200 from SSA and $ 678.90 from another pension so her mo income is $1878.90 and her states PNA is $50. Her copay due to the NH would be $1828.90 each month. They should prorate the first month to the date of admission.

so due to copay, mom will have zero-nada-no $ to pay on old debts. So if there’s a home and elder wants to continue to keep it, family will have to cover all property costs (taxes,insurance, mortgage, maintenance) from day 1 to beyond death. Ditto for credit card, life insurance premiums, funeral premiums, etc. If not, then they default on the debt. Just how problematic this snowballs into, depends on the type of debt.

also please please realize that for LTC Medicaid they have to be “at need” BOTH financially and medically. If it’s a NH admit that your looking to get, she needs to show that she needs “skilled nursing care”. Just being old or having dementia may not be quite enough. Most NH admits come from a hospitalization..... usual scenario is mom falls, breaks hip, gets hospitalized (MediCARE) then discharge to rehab (mediCARE pays) done in a combo Rehab/skilled nursing care facility, then after rehab ends (tends to be within 21 days) they cannot return home so they segueway from rehab patient to NH resident and file for Medicaid to pay for NH. Only Medicaid pays fir room & board at at facility. They have a nice fat health care chart that shows “at need”. But if you’re trying to do this for a mom living on her own, IL or with you, that fat chart may not exist. She’s not going to easily show “at need”. You might want to get a needs assessment done and it may be that she needs a few weeks this to establish a chart that clearly shows “need”.
Folks fret on financials but the medical “at need” part is just as important.
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my2cents Nov 4, 2020
You explained it quite well, igloo572
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I think (and I don't know. Call 1 800 medicare who answers medicaid questions also to get it from the "horse's mouth") that large expenditure could be questioned. FloridaDD gave a good example of what might be questioned. If a check is written for a large amount to Southwestern College, then it may be more likely to be questioned that say to Windover Medical Supply. I am just thinking that amounts over several thousand could be questioned. Normal payments of rental, to clothing outlets, Costco, car repair, vacation rental, you name it are not likely to be questioned. You have a right to buy a CAR for yourself; you just can't buy one for your grandson. Keep careful records in memos of what expenditures are for, keep all your records. I pay toward my Grandson's education. I do that because I know I am safe in not needing that money "no matter what" for the look back years. I keep careful records. And yes, this money would not pass muster with Medicaid. There are Medicare for Dummies books out there that have a wealth of information. Get as informed as you are able there, and on some of the excellent GOVERNMENT sites. Be sure you aren't looking at ads but at .gov sites.
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No, they don't look at debts. They look at bank statements for any unusual withdraws that maybe a lot of money. Just be ready with the answers. My Moms bank supplies copies of the checks with the statement. So for Mom, if they questioned something, there was a check copy.

Be aware that if she gets Medicaid for care in a NH, that her SS and any pension will be used to offset her care. There will be no money to pay her debts. If she owns a home, no money for upkeep and utilities. You will spend her down to maybe 2k in her bank account. That 2k can only be touched for something personal for her.

All Medicaid worries about is assets. A house and a car do not count. Insurance policies will need to be cashed in if they have cash value. I used Moms policy to prepay her funeral. And remember YOU ARE NOT RESPONSIBLE FOR ANY OF HER DEBTS. Your income does not come into play.
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FloridaDD Nov 1, 2020
I disagree.  If mom spends 2K a month on her credit card, they will want to know I it for her (maybe doctors, home health care, which is fine or her grandkids college -- not fine).  If mom is spending 50 a month, they may not look at it. 
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Don’t know, but others will. Stick around for answers.

Best wishes to you.
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