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Looking specifically for info on the “sibling exemption." My mother does not have an equity interest. My question is, how far in advance must an equity interest be established before applying for Medicaid.
Does your Aunt have Dementia? If so, she no longer has the ability to sign anything over to your Mom and either does the POA. If your mother lived with Aunt and cared for her for at least two years, then she may qualify for Caregivers Allowance which she then has to prove she can pay the taxes, mortgage, utilities and upkeep on the house. Even if left to her in a Will, there will be Medicaid recovery when Aunt passes.
I would do nothing until you consult with an Elder Lawyer well versed in Medicaid. The wrong move could effect your Aunts medicaid.
This will entirely be interdependent on how your State administers its LTC Medicaid program and your states laws on property & probate. It’s very much a question for an attorney experienced with the nuances for how Medicaid Estate Recovery runs for your State (so an attorney in a firm that does both elder law and probate).
NAL but I’ve seen how a couple of States deal with exemptions & exclusion's to MERP. The big takeaway imo is that….. 1. this will likely be an after death process. There will be a notation in Aunts case file that there is an aged sibling in the home and living there prior so that there would be no rent requirement. Nevertheless after Aunt dies, MERP will still do its required attempt to recoup costs paid and their after death questionnaire will have details on the type of documentation needed to be submitted to get ann exemption. Like for the caregiver exemption, it’s documentation as to the type of care they provided and that is was the equivalent of a FT job. For aged or disabled or low income heir, it’s other documents. If it’s exclusion due to some type of Trust, it’s that paperwork that’s submitted. Some States are easier than others. BUT! but keep in mind…. 2. due to how the LTC Medicaid program requires the applicant (your now in a NH Aunt) to do an every month Share of Cost* / Resident Liability*, your mom who remains in the home has to - HAS TO - have her own financial ability to pay 100% everything for house still in her now-in-a-NH sisters name till beyond their siblings death….. and 3. Due to the SOC, often the aged sibling still in the home cannot afford the property costs themselves for possibly years and years, so the house ends up being sold (& 100% of the $ from the sale is Aunties so makes her ineligible for LTC Medicaid so she ends up doing a spend down) and mom either herself goes into a facilty or moves in with family. Often the same situation happens for the long time caregiver as they haven’t worked for years (as they were caregiving) so once the parent enters a NH and has to pay almost all their income as their SOC, there is no $ to cover the house costs, so it gets sold. Only a community spouse or a legal dependent (to yiur Aunt) can file for a waiver to retain a portion of the SOC is my understanding.
As a suggestion, go thru your Aunts financials to see exactly what her house costs are. Especially property taxes and insurance as those imo have to be paid. If there still is a mortgage (horrors!) the costs to keep that house could be significant. Does your moms own SSA income and any other retirements cover all cost plus provide for her own personal expenses? If not, can you for sure cover all these costs for sure and for an undetermined period time? If it, then retaining the house just may not be feasible plan.
* how the SOC works could be like this: NH elder on LTC Medicaid in TX has mo income of $1890 in SS retirement income and $500 from a pension. So $ 2,390 a mo income & under the $2901 income max. Now TX has a $75 a mo Personal Needs Allowance. So elder has a SOC of $2,315 that must be paid to the NH each month. & that $75 PNA is restricted spending so should not be used for anything related to housing as LTC Medicaid is paying for their room and board cost, LTC Medicaid is a extremely narrow program for any type of flexibility. So LSS you &/or your mom have to have the a ilty to pay all cost for an indeterminate amount of time.
fwiw even if your mom had an equity interest, due to SOC required by your Aunt, your mom would still have to pay for everything. The equity interest would matter after Aunts death in that if it was 50/50 co-owned, so would be that the State would only be concerned on Aunties 50% for their required MERP attempt after Auntie died.
Really it would be worthwhile to have Aunt and your mom meet with an attorney now so go over all this and so that there is plan on how to dealt with the property after Aunts death and an atty to do it!
Also like to add, the aged sibling exemption within MERP is a completely different issue than doing an equity interest. If Aunt is already in a facilty and on LTC Medicaid or abt to soon be on it - in my NAL opinion - the only path forward for your mom to retain the house would be the after death sibling exemption. There flat isn’t the lookback period to distance being able to do asset transfers (usually a 5 yr lookback).
If Aunt were to sign off on any type of title transfer of her ownership of her home to her Sister that is a transfer of assets. Asset transfer is a big compliance issue for the LTC Medicaid program. Doing one triggers Medicaid to open a compliance report. Once the match up is done btwn Medicaid and State/County databases, a mere matter of keystrokes, presto! the transfer of an asset by a title change surfaces. Aunt becomes ineligible and this snowballs into other very sticky issues.
also if you are POA, there will be a renewal done and within it you have to sign off attesting that all the info is accurate and with legal issues if you fib.
Imo if Aunt is already in a NH, that ship has sailed for doing and creative asset moves.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
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I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
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APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
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APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
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If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
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This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
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You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
I would do nothing until you consult with an Elder Lawyer well versed in Medicaid. The wrong move could effect your Aunts medicaid.
NAL but I’ve seen how a couple of States deal with exemptions & exclusion's to MERP. The big takeaway imo is that…..
1. this will likely be an after death process. There will be a notation in Aunts case file that there is an aged sibling in the home and living there prior so that there would be no rent requirement. Nevertheless after Aunt dies, MERP will still do its required attempt to recoup costs paid and their after death questionnaire will have details on the type of documentation needed to be submitted to get ann exemption. Like for the caregiver exemption, it’s documentation as to the type of care they provided and that is was the equivalent of a FT job. For aged or disabled or low income heir, it’s other documents. If it’s exclusion due to some type of Trust, it’s that paperwork that’s submitted. Some States are easier than others.
BUT! but keep in mind….
2. due to how the LTC Medicaid program requires the applicant (your now in a NH Aunt) to do an every month Share of Cost* / Resident Liability*, your mom who remains in the home has to - HAS TO - have her own financial ability to pay 100% everything for house still in her now-in-a-NH sisters name till beyond their siblings death…..
and
3. Due to the SOC, often the aged sibling still in the home cannot afford the property costs themselves for possibly years and years, so the house ends up being sold (& 100% of the $ from the sale is Aunties so makes her ineligible for LTC Medicaid so she ends up doing a spend down) and mom either herself goes into a facilty or moves in with family. Often the same situation happens for the long time caregiver as they haven’t worked for years (as they were caregiving) so once the parent enters a NH and has to pay almost all their income as their SOC, there is no $ to cover the house costs, so it gets sold. Only a community spouse or a legal dependent (to yiur Aunt) can file for a waiver to retain a portion of the SOC is my understanding.
As a suggestion, go thru your Aunts financials to see exactly what her house costs are. Especially property taxes and insurance as those imo have to be paid. If there still is a mortgage (horrors!) the costs to keep that house could be significant. Does your moms own SSA income and any other retirements cover all cost plus provide for her own personal expenses? If not, can you for sure cover all these costs for sure and for an undetermined period time? If it, then retaining the house just may not be feasible plan.
* how the SOC works could be like this: NH elder on LTC Medicaid in TX has mo income of $1890 in SS retirement income and $500 from a pension. So $ 2,390 a mo income & under the $2901 income max. Now TX has a $75 a mo Personal Needs Allowance. So elder has a SOC of $2,315 that must be paid to the NH each month. & that $75 PNA is restricted spending so should not be used for anything related to housing as LTC Medicaid is paying for their room and board cost, LTC Medicaid is a extremely narrow program for any type of flexibility. So LSS you &/or your mom have to have the a ilty to pay all cost for an indeterminate amount of time.
fwiw even if your mom had an equity interest, due to SOC required by your Aunt, your mom would still have to pay for everything. The equity interest would matter after Aunts death in that if it was 50/50 co-owned, so would be that the State would only be concerned on Aunties 50% for their required MERP attempt after Auntie died.
Really it would be worthwhile to have Aunt and your mom meet with an attorney now so go over all this and so that there is plan on how to dealt with the property after Aunts death and an atty to do it!
If Aunt were to sign off on any type of title transfer of her ownership of her home to her Sister that is a transfer of assets. Asset transfer is a big compliance issue for the LTC Medicaid program. Doing one triggers Medicaid to open a compliance report. Once the match up is done btwn Medicaid and State/County databases, a mere matter of keystrokes, presto! the transfer of an asset by a title change surfaces. Aunt becomes ineligible and this snowballs into other very sticky issues.
also if you are POA, there will be a renewal done and within it you have to sign off attesting that all the info is accurate and with legal issues if you fib.
Imo if Aunt is already in a NH, that ship has sailed for doing and creative asset moves.