Look-back period. Any advice? - AgingCare.com

Look-back period. Any advice?

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I have a question about the "look-back" period for Medicaid eligibility. The lady in question had a daughter who was her caregiver and also has two sons who live out of state but visited regularly. Against the wishes of the sons, the daughter had complete control of her mother's finances and made sure that the sons could not get any information. The mother refused to let the sons check into her finances. The daughter died suddenly and when the sons got access to the financial records, they found that the daughter had gone through almost $400,000 of the mother's money and run up huge credit card bills (she had opened credit card accounts in her mother's name by just putting the applications in front of her mother to sign and the mother is legally blind so she couldn't see what she was signing). Cash was withdrawn a few times a week from the mother's account and money was transferred into an account in the daughter's name only (that money is gone). The charge cards were maxed out with purchases made by the daughter (she was an "authorized" user, of course.....) Unfortunately, the daughter had been added to the bank accounts as an "account holder", so technically there was no "fraud" and the bank has no responsibility.

So, the mother will need soon to go into some sort of assisted living and will need to go on Medicaid, as there is very little money left. Will the money that was "taken" by the late daughter count as a "gift" since it wasn't *technically* stolen? I know that "gifts" within the look-back period will result in delay of benefits.

We'll be seeing a lawyer in May about this, but I just wondered if anyone had any similar experiences or knowledge.

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You will hit the wall with Medicaid. They look back five years and all money must be accounted for. They will simply refuse to pay.
Your option for Assisted Living would be her SS check and VA aid if she was married to a wartime veteran. A good ALF will help you find aid, and Medicaid only covers NH care anyway.
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Well it's good you are seeing an attorney first & foremost. The son's really should do a tally on all the financials & fraud for the past 5 years before they see the attorney. If the appointment is in May, they can go and do Quicken for mom for the last 5 and then it can be an download to the law firm (& CPA too). I bet legal will have mom do some sort of IRS filing to show a loss for theft so that she can provide a document to Medicaid if needed so she won't have a Medicaid transfer penalty. You may find that legal will ask you all to do a guardianship / conservatorship for mom as she may be past the whole DPOA ability too. The good part about the whole G/C stuff is that is may just use up all the $ she has left (maybe 10 - 15K for G/C and then 2 - 5K for forensic CPA & tax stuff) so that she can now become a "ward of the state" and so will qualify for placement in a facility & the state will pay for her care.

yeah the attorney can do this (their para-legal's) but it will be very expensive and really they can do this own their own.

Now keep in mind, that by & large, Medicaid pays for NH for those that are "at-need" both financially & medically for skilled nursing care. Most states do not have Medicaid pay for AL per se. Some states have Medicaid diversion programs which will pay for AL but the # of slots for those are limited. AL's do not have to participate in Medicaid like most NH do. For most facilities, AL is all private pay. If this is a tiered facility (goes from IL to AL to NH and with hospice) the AL is the profit center for them as it is overwhelmingly private pay. So be sure to be very clear with whatever place you all are looking at as to whether Medicaid is even an option to pay for her care.
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As far as applying for Medicaid with all of this hanging over your mother's head I don't know but seeing a lawyer is a great start. This sounds like a very complicated situation.
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Interesting dilemma. It seems that if there was a proven criminal act, them Medicaid would be required to consider it. Hmmm...
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our attorney once told me that if i became springing poa over my mothers finances that a checking account would be opened in mother and all three kids names. the sisters wouldnt have authorization to access the funds but would recieve monthly statements from the bank.
this isnt helpful to your question but it might save someone else on here a lot of malfeasance and grief. as poa i would have welcomed that..
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