My Dad is definitely going in to a assisted living facility within this month. He's in a rehab place now and is not improving.
We want to buy him clothes, shoes, jackets and other things that will make him a little more comfortable.
Being he's not able to get out I'll be buying this stuff with his debit card (I'm on the bank account also). Seeing how this is real close to the move to a Medicaid facility and the start of the approval process I want to make sure this is going to be fine with them.
How do they check the look back period? I don't think they'll expect you to keep every receipt for the past 5 years. Do they just see that the purchases were made at the type of store you told them they were for? How can we remember every purchase?
For example I going to a clothes store to buy my Dad clothes this week, do they just see the purchase was made at a clothes store and that's all they care about? Do I need to itemized every purchase?

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Understand that the “look back” period only pertains to transfers that are made without fair market value compensation (gifts). A potential Medicaid applicant is permitted to spend what they will on anything related to their own health, maintenance, and welfare.
As long you retain receipts there should be no issue whatsoever. Using the debit card is fine.
Expanding further on understanding the “look back” period:
The law allows Medicaid agencies to examine asset transfers made by Medicaid applicants that took place in the five years prior to application.
Those transfers made without fair market value compensation are considered “ineligible transfers” and the value of the asset so transferred may then be included in the applicant’s asset base in determining Medicaid eligibility.
Example: Mrs. Jones gifts $5,000 to her daughter Emily for home repairs in Emily’s home. Two years later Mrs. Jones applies for Medicaid.
Because Mrs. Jones did not receive any goods or services from Emily valued at $5,000 or more, the $5,000 gift may be considered a countable asset in determining Mrs. Jones asset level for Medicaid eligibility purposes.
How agencies discover asset transfers varies by state. In Florida, for example, the application still only asks about transfers made in the past three years and only three months of financial records are required to be produced at application. In New York, however, the applicant must produce five years of financial records at application. Go figure.
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Hello Dadskid,

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I wish you the best,
The Team
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I've been through this for NH in TX and LA and each NH has it's own list of required documents but are based on what the state requires. I think the states are looking for patterns of spending and there probably is a forensic program that get's run on applications that look suspect. When they apply for Medicaid, they sign off on an all access pass to their entire financial life and things will show up. Real property transfer or sale is recorded by the state, so houses, cars, boats show up eventually.

The NH will give you a list, for my mom, it was 1 page and for my MIL it was 2 pages but both for different NH in TX. Go figure. For my mom, I submitted the prior 6 months of all bank statements with the initial application but also they required a notarized letter that was a 3 year review of all bank accounts (or investment accounts, like CD's) that were closed and where the $ went from each bank. My mom banking was OK because as all accounts closed or expired, the $ went into her main drawing account. She was in IL before NH and she still owned her home, so the pattern of where her money went and how it decreased was pretty well set. Her review was based on 3 years 6 months. And she had a transfer penalty on her car which was like 3 months within the 5 year window. I got the value reduced and the transfer penalty lifted, but my point is, the states have ways of finding out stuff.

I'd suggest you find the last 3 years of dad's bank statements. Go through then and look to see where there are significant payments that seem out of place. Can you justify them? For example, you find a check for $ 8,923.45 written to John Jones but also find a receipt paid for a new central heat system for that amount. So it was not a gift to an individual. You just want to be able to provide this should the state request it.

About the spend-down, you want to make sure when you buy stuff that the checks are written to a business and not to you or other family members as that can be viewed as gifting. If you've been buying stuff and then reinbursing yourself, you need to be able to provide a 100% match-up for the receipt. They may never ask but if they do, you will be prepared as you have a very short time frame to provide the documents or their Medicaid application gets denied. Good luck.
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