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My mom has dementia and has declined to the point where I feel I can no longer keep her safe and that a memory care facility would be best. She's having delusions and talking to people who aren't here, very unstable on her feet, incontinent more often than not, getting argumentative and combative, trying to get out of the house, etc. She currently lives with me and my husband. She has no home or other property, no car, no savings, no pension, no assets of any kind. Her only income is roughly $1,200 a month from SS. I'm doing some research and getting ready to apply for Medicaid, but I'm worried about a few things. First of all, she's legally married, but she has lived with me for about 15 years. I have no contact information for him at all. No clue where he is or if he's even alive. That's my first issue. Second, they did own a home together, but he lived there alone. He wasn't paying the mortgage and the house was eventually foreclosed upon and sold at auction about 3 years ago. They both had to sign the check, since the house was in both of their names, but he kept it, then later wrote her a personal check for a portion of the remaining funds after the mortgage was paid. That money was deposited into a newly opened account with her name AND my name on it, then immediately transferred into MY account, and the joint account was closed less than 30 days later. The purpose of that was to avoid mixing that money with her SS money, which is in a separate account, also with my name on it, but she is the primary account holder. That brings me to my third concern. As I mentioned, she lives with me and my husband and has for roughly 15 years, since long before she even had dementia. I don't work because she can't be left alone at this point. We have a verbal agreement that she'll give us her SS check as payment/compensation for us taking care of her, part of utilities, food, etc. So, when it comes to applying for Medicaid, I'm concerned about her still being married (technically) but he's completely out of the equation and has been for a very long time. I can't answer any questions about him or his finances. I'm also worried about the lookback period and that auction/sale of a home that her name was on, as well as the check her husband wrote her afterwards, which was spent a long time ago. And is the monthly transfer of her SS check a problem? I don't know if I can afford an elder law attorney. I feel like I'm drowning though and need some help with her, quickly.

I understand your worry, this is going to be long……Medicaid does not expect your mom to live on air, so mom can use her $ to pay for her share of her living costs in your home. What I’ve found is that Medicaid is looking for a pattern of spending over time that makes sense for her to be “at need” financially now…. Which means under 2k in assets and her income under whatever your state has as its max. The max on income tends to be abt $2100, so your mom with only $1200 SS as income is ok.

Personally with a bit of work on your part, you can show that her paying you $1200 a mo to live with you is sensible & cost effective. Like you measure out her living space (her bedroom & make a bathroom totally “hers”) then 1/3 of all other living spaces…. That’s her Sq footage she’s paying for. Look up rentals in your area for that size and presto you have a comparable for rental costs. (I’ll bet this alone is over $1200 a mo.) Tally up utilities and 1/3 of those. Ditto 1/3 for groceries. Add it all up and that what her costs obstensibly are to live with you.

plus she has items paid for from that acct she has her SS going into that totally her own…. Like her RXs, clothing, toiletries, beauty shoppe, etc. If u go thru 2021 receipts, tally them up and then add in “1/3 sharing of house costs”, that what her $ was used for. There’s no gifting, she’s compensating you & hubs for her living w you. Now as it’s your home, you cannot include 1/3 of property taxes, or property insurance or repairs…. those costs r all yours & hubs.

You or hubs can do an excel spreadsheet for 2021. If he’s a #’s guy, have him do ‘20, ‘19, & ‘18 as ‘18 takes it to house sale $ yr. Having something like this to show Medicaid caseworker will have it be ok on how her $1200 SS has been spent in a pattern over time.

I’d be more concerned on the MIA husband & the less than 5 yrs on the foreclosure & that $. That Mr MIA managed to find her 3 yrs ago as he needed her signature to ever deposit house sale $ check, to me means he’s still in the area. He knew where she was then & he can be found now. If mom is getting her SS$ based on his income, she might be able to get his contact info from SSA. He’s getting his SS $ deposited & having correspondence from SSA getting mailed to him; SSA knows where he is. Stuff like this is actually kinda common & is Pitt Bullie divorce atty work as a good one will find a way to have them legally separate or divorce with his taking responsibility for all debts. Your mom probably doesn’t have the $ for one but she can find a probono legal clinic in the area to at least start on what to do to find Mr MIA. If there is law school in your region they have probono clinics and there’s also going to be some sort of low income legal aid center in the region that mom can contact. Bar association might have info on state website. I’ll bet there’s a divorce atty who does some probono upon referral from one of the clinics.

As long as they are married, Medicaid has to look as to his financial situation as to if there are assets that could be considered joint that would need to be spent down first & before mom could be eligible for LTC Medicaid. He may have been out of the picture for years but he was there to get that ck signed off on 3 yrs ago. That’s what she needs an atty to deal with imo. It’s not a DIY.

Regarding the house, find the foreclosure paperwork. And on the check. That’s going to be an income / asset issue for Medicaid. As long as it got deposited and obstensibly spent on her living costs, it should be ok.
Again doing an Excell spreadsheet will come in handy to show her $ was spent on her overtime. If there was a bigger transfer to you from her house sale $…… like mom gave you 23K outright which you used to put on a new roof ….. that’s gifting. Medicaid will place a transfer penalty against the date of her eligibility to have Medicaid pay her room&board at the NH.

more in Part 2.
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ShannonEgen Jan 14, 2022
Thank you so much for your insight and suggestions. I have so much to figure out but I'm feeling a little more hopeful, at least at the moment.
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If she's still married and knows his SS#, I'd bet you could find him through Social Security.

Heck, my grandfather abandoned my grandmother in 1934, and she managed to track him down to claim the widow's benefit after he died in 1983. That was before the internet. (She was a pistol.)
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igloo572 Jan 14, 2022
Absolutely! Her SSA $ is more than likely based in his income or his on hers if she was the main breadwinner. SSA knows his banking and contact address. Trying to get this from SSA will be the issue. The SSA offices where I’m at are currently closed due to Covid for in person walk in. VegasLady is super knowledgeable on SSA, SSDI, SSI stuff, maybe she can shed some light as to how you can do this.
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If you can’t afford an elder law attorney, get a Medicaid caseworker assigned to help you thru the application.
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ShannonEgen Jan 15, 2022
Thank you for the suggestion. I think we're going to have to figure out a way to get a lawyer though, because this is so complicated due to her being married.
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Part 2. The actual date of the LTC Medicaid application is very important and financials based on that date. Like 5 yr lookback starts that date. And also as of that date, your mom will have to do a copay of her income to the facility as a required by Medicaid less a smallish PNA aka personal needs allowance. PNA varies by state, most have it at $50 - $ 60 a mo. So if PNA $50, mom has to pay the NH $1,150 ea mo.

I mention this cause if y’all have gotten used to her SSA $ to cover your household expenditures, that $ won’t be there anymore. Often family continue to have an elder stay living in their house as they aren’t working or not working FT as caregiving so their (the kids) household income is way way less than they realistically need & they are interdependent on elders $ to make ends meet.

On Medicaid applications, For an widow or widower on the financials it’s very straightforward…. They provide banks statements (could be 5 full years or 1 year and 4 prior for the month of application), info on life insurance, their will, their annual awards letter from SSA & any other retirements, etc; if they own a home or car, then paperwork on those. If you’ve been active in your elders life, have a tight DPOA & signatory on their banking, it’s imo totally a DIY.

But for couples, there’s a whole raft of other things needed to determine the eligibility of the NH spouse. The community spouse aka a CS - which would be her estranged husband - will have to provide info on his assets & his income. They r married, the $ is viewed as joint whether or not it’s accounts in only her or his name. As a CS, he is allowed to have some assets segregated from her. Tends to be $128k but varies by state. So if Mr MIA has bank acct or other investments of $150K, 22k will have to be spent down b4 mom could b financially eligible. I’m guessing he has no $, but until that’s a known with documentation, LTC Medicaid cannot determine if mom is actually impoverished enough. On flip side of this, if Mr MIA is himself impoverished, he could file to get some of your moms copay to be “waived” over to him rather than be paid to the NH….. yep it’s called CSRA or MMNA. Any you as moms POA will have to deal with this getting paid to him…. nothing but fun it will be if this happens. It’s basically a needs / resource allowance to him from her money, and for even more fun in all this there’s annual paperwork required to be done & submitted to Medicaid by him; if not received, Medicaid can suspend moms eligibility.

If Mr MIA has his own home, & mom -his wife goes onto LTC Medicaid- his home is subject to MERP (estate recovery) regulations. So in theory, it could have a lien or a claim placed on it. This lil factoid could be used in leverage by your moms atty to get him to do whatever needed to resolved their legal separation or divorce.

The check from the sale of the foreclosed home was just 3 years ago. I think it’s gonna be hard to get Medicaid to overlook that they are still legally married. You nor mom cannot say he’s been out of her life for ages…. the deposit was made… it’s gonna be an issue. This to me is what you have got to find an attorney to deal with and resolve in moms favor. This imo needs to be the priority.

Again it’s not a diy. Maybe try to probono clinics first to try to work thru the married / legally separated aspects. They refer mom to an atty that works at low or no cost w/clinic. A good pit bullie divorce guy to me is the key as they know how to find people and their assets and love love love doing the slow roasting of the ex & they will know elder law attys that can best deal with Medicaid once marriage stuff resolved.

Downside is that you will have to continue to have mom live with y’all till resolved. LSS Mom cannot file LTC Medicaid application yet. Mom should use her $ to pay for CG if need be. I’d get CG from an agency as you cannot be dealing w FICA, wage reporting, etc atop everything else. good luck!
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ShannonEgen Jan 15, 2022
Thank you again for all of this information. It sounds like getting a lawyer is the only option because this is just way too much to try to navigate on my own.
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Shannon, www.nelf.org is the best place to find a certified elder law attorney. I found that an actual CELA was more knowledgeable and had better prices then attorneys that just did elder law. No special certification means clients are usually paying for the attorney to get educated about the specifics to their situation.
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ShannonEgen Jan 15, 2022
Thank you for that, I'll take a look!
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The only thing you can do is apply and see what happens.

Do a breakdown of her SS check, x amount for rent, x amount for utilities, groceries, vehicle expense, insurance, etc. It is okay that she pays her share of all the living expenses and pays for caregiving. They are looking for transfer of wealth.

Depending on what her equity of the home was spent on, you might have a penalty period but, the clock starts only after you apply.

They will be able to find her husband, if needed. Hopefully, she has been receiving mail at her actual address to prove they are separated and it will be a non issue.

Be completely transparent about everything. If you aren't and they think you are trying to pull something it will cause problems.

Take a deep breath and start, it turns the light on at the end of the tunnel.
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ShannonEgen Jan 15, 2022
Yes, she gets mail here. She's lived here with me for over 15 years. We plan to explain everything exactly as it happened, like the fact that her giving me/us that money was just to cover some household stuff and pay off some of my credit cards. She didn't have dementia symptoms at that time. We weren't thinking about medicaid or anything like that then, so it was in no way an attempt to hide money/assets. It was just us going about life in a normal way.
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She is married, so that has to be on the application. It's very possible he is deceased, so when they run his info, there would be no income from him to consider. As a warning, if you leave that off the application and it comes up later - the penalty could mean problems with Medicaid not paying (in full) for the NH.

You did mess up with the house money by moving it into an account in your name. The look back is 5 years, so during that period she received XX dollars from the sale of a home. By moving it into your name, it will be treated as her gifting you money and there will be penalty months applied where Medicaid will not cover the cost of bed for certain number of months. - It would be best for you to list that money on the application to complete the trail of her money: from sale of house, to her, to you. That money will be spent each month to pay for her NH bed until it runs out and then the Medicaid kicks in.

Break the 1200 down as to what it covers for her care: If you have mtg, divide by number of people in the home. Let's say 3, = $400 for rent for her. Do the same with utilities. Let's say that comes to $200 each person. Then do same with groceries - another $200 per person. That would leave her about $400 a month for misc personal items, over the counter meds/supplies - very easily spent on an older person and not questionable. -- Usually, when you turn in the bank statements for past 5 years to account for her money, they are going to ask you to explain certain expenses over a certain amt - in Texas I recently helped someone and they asked for any ck over $200 to be explained.

If she gets $1200 per month and you move the whole amount to your own acct, you will definitely have to explain that. So make the list of HH expenses so you can account for the $1200 each month. As for the lump sum she got from the house, make a list of what it was spent on - did you do modifications to your home for her, buy her furniture, medical equipment, etc. If you were the only one who benefited from the money, it will likely be considered a gift and create a penalty period for her. Start gathering documents soon.

Pretty much, what has happened can't be changed at this point. Income considered, she's probably going to get the Medicaid for NH. It's the penalty period that might create some problems. One thing to think about is if she ends up at ER for any reason, that is going to be the time to talk to hosp social worker and her doctor to release her to rehab, apply for the medicaid while Medicare is paying for the rehab bed. Then transition her on to permanent NH care.

As for location of hubby - when you apply and list his name as legal husband, enter or write a note of the separation day/year. They will be able to look him up. If he is deceased on SS records, they will find it.
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Katefalc Jan 18, 2022
Awesome info right on point. I said the look back is 7 yes but forgot it changed to 5
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I doubt whether or not Social Security has the legal authority to give out any info on the missing spouse. Not their problem. I would either have a divorce attorney handle that as part of a divorce proceeding or just find him yourself. I would do that by searching for him online and signing up for a one month subscription for a public records search (could just cost 99 cents) or hiring a local skip tracing agency to find him. People are surprisingly easy to find these days. However once you find him how would you get any financial info out of him? Here's where an attorney might be able to apply some pressure.
Before doing any of that you might try anonymously calling the Medicaid office and see if there is a workaround solution like a sworn affidavit that she has tried unsuccessfully tried to find him
or any financial info on him. Or consult an attorney versed in Medicaid for advice.
You can get divorced without knowing where the missing spouse is...that's what legal ads in the right newspaper are all about.
Explaining away the financial use of her money over the years doesn't seem too hard to me. Just say it how it was.
Gold Luck.
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ShannonEgen Jan 15, 2022
Thank you, I'm going to try to locate him myself and/or see if I can get a free consultation with an elder law attorney. Even if I do find him, he's not going to be cooperative at all. My mom doesn't even remember being married or understand that she still is.
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It is worth going to an eldercare attorney. In the long run it will save you money. She definitely will qualify for Medicaid but the red tape is too much for a layperson to handle.
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ShannonEgen Jan 15, 2022
We're going to try to at least get a free consultation with one to get some initial questions answered. You really think she'll qualify even with the sale of that house and her giving me the money? It was roughly $35k if I remember correctly. I'd have to call the bank and ask them to find the deposit because it's farther back than what's available to me online.
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Bottom line - speak to an elder care attorney.
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