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Hello! I have read about an exemption for adult children moving in with their elderly parent to keep them from going to a nursing home. The parent can give child their home without violating Medicaid 5 year look back period. It states this is a Medicaid sanctioned method that enables the adult child to be compensated for their caregiving for otherwise the home would have to be sold to pay for nursing home. Is there any compensation for child caregivers who move a parent into their home because the parent doesn't own their own home? Possibly a credit of sorts for each month they are able to keep their parent out of a nursing home. For example if cost of nursing home in area is approximately $5000 a month and the parent lived with them for 24 months... Medicaid would give an exemption for $120,000 in their 5 year look back period in case there is no home but there any other assets left. Does anyone know if there is any help for caregivers that keep parents out of nursing homes by moving them into their home? Any information would be greatly appreciated! Thank you!

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Caregiver exemption system will vary on your states rules. It is like
Estate Recovery aka MERP, what happens is very much interdependent on your states laws for property rights, probate and administrative code. What will be especially important within all this is IF your state does TEFRA (predeceased) lien or only is allowed placement of post death liens (or claim against the Estate if probate is opened).

Caregiver exemption is - in theory - a way to compensate the individual who lives in the elders home and provided full time care that kept the elder from being otherwise in a NH for a period of time. Usually it’s 2 years. You have to be a full time caregiver and not have another job. The care must be for an individual needing skilled care.

Now just how you establish this and have it qualify for an exemption, will not be simple. Medical records have to show there’s need. Just their being old and needing help living in their home isn’t enough. Some states require a letter from their MD or a SW that details the health problems with ICD-10 codes or other supporting documentation, like they have been on hospice for 2 years, or were discharged from a hospitalization 2 years prior and there is a detailed care plan cause their like bedfast.

The lien placement point of entry matters cause it will make a difference as to IF you can file the caregiver exemption & transfer title in tandem with their filing their LTC Medicaid application OR the caregiver exemption is filed after death. Filing in tandem is better as you then own the property. I have no idea which states do it this way, it’s an elder law atty question to ask & have them deal with. Not a DIY imo.

Whichever option, you will have to have the $ to pay all property costs from Day 1 of Medicaid as mom must basically pay all her monthly income to the NH less as smallish personal needs allowance.

If your state follows the post death lien / claim format, & your mom lives in the NH another 5 years, it’s totally on you to pay all property costs & keep detailed records of all this till beyond death as MERP can take a while. Plus you’ll need to get the documentation regarding your caregiving like from 7 years ago from her long ago doctors or SW.

caregiver exemption to me is kinda a unicorn..... sounds awesome but not as simple or straightforward as you imagined it would be.

there are other exemptions and exclusions to MERP. Low income heir is one, as is sibling living in the home or home is used within a family business (like home is on a farm or ranch, or 2 story where biz is below and living above). If there’s lots of heirs as per the will, it get quite complicated as some will not qualify for exemptions or exclusions. There also is a cost benefit requirement for recovery. There are also things that take the property outside of recovery, like for states that do Lady Bird Deeds or non-allowance Testamentary Trusts. Really none of this is a DIY. It needs legal for how your state runs.

To me the biggest hurdle is if you can totally on your own pay property costs for an indeterminate period of time. If there is a traditional Mortgage or a Heloc, monthly nut could be $$$. There have been a couple on AC who have gotten the caregiver exemption but have no $ to afford house. Your finances are critical in all this. That’s why it’s important to find out if you can file in tandem with mom or have to do the pay for all till beyond death system.

Dealing with a property that you do not own that is. costing 25k a yr probably manageable but one costing 50k+ maybe not.
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There is no such thing as being paid for keeping a parent out of a home.

What can happen is that you have moved in with a parent to care for them and because of this, Medicaid may allow you to stay in parents home once Medicaid is paying for there care in a nursing home. But you have to prove it.

If Mom is competent, then a agreement can be made that she pays so much a month for her care and room and board. I would have this drawn up by a lawyer. Otherwise, Mom just giving you money can be looked at as a gift and you will have to return it for Mom to qualify for any Medicaid.
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nance0418 Apr 1, 2019
Thanks JoAnn - I was just asking for information or any help for caregivers of parents that live with them. Thank you for your info and advice. I don't want to be paid to care for my mom and I hope she will never have to be in a nursing home. This is what I read and it didn't seem fair to me so I wanted to try and find answers in case I am ever have to go through the Medicaid look back. Thanks again :)
"The Caregiver Child Exemption allows adult children to care for their parents at home as opposed to moving them into a Medicaid-funded assisted living residence or nursing home. It is a Medicaid-sanctioned method that enables the adult child to be compensated for their caregiving in the form of a transfer of the parent's home. The home would have otherwise have to be sold and the proceeds used to pay for nursing home / assisted living care."
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Nance - you comment that you hope someday it would be taken into consideration situations like yours so people don't try to hide assets so "they don't take every dime". Your mom is responsible for paying for her care - just like she is responsible for paying for housing, food, etc. It is only when she RUNS OUT OF ASSETS that she qualifies for the taxpayer to fund her housing and care. Why should the tax payer pay if she has assets? That is the issue. I have no issue with her paying you with a caregiver contract - that is using her assets to pay for her care and you are doing a tough job that you should be compensated for. The tax payer only comes in when your mom becomes indigent.
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nance0418 Apr 1, 2019
My issue is with people who transfer and hide their assets so they don't pay a dime to the nursing home. What I was asking about is the Medicaid exemption that allows a parent's home to be given to a child if the child moves into the parent's home to take care of them. I totally agree that taxpayers should not have to pay for someone that has assets! I do not agree with Medicaid's "Caregiver Child Exemption" that does not require the parent to run out of assets. It allows the parent to give their asset (a house) to their child and have the taxpayers pay for their nursing home expenses. Rules should be the same for everyone in my opinion but they obviously are not. I was just trying to find out if there was any similar exemptions for my situation. My apologies if it came across that I think the taxpayers should pay for her care....just figured since they have the house exemption maybe there were others :)
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nance0418, then it seems that you have time to set up a caregiver contract, so your mother can pay you for caregiving and a portion of the food/utilities/mortgage/rent, etc. So when/if it's time for a nursing home, you will have gotten at least some compensation for what you've done.

I've been thinking about this since I posted my previous comment. Caregivers often feel uncomfortable requesting payment from their parents, and would feel more comfortable if the government would pay them somehow. But, unfortunately, in so many cases, the only way to get compensated is directly from the parents.

Are you going to pursue getting money from your mother now in the form of a caregiver contract? And prorating your monthly expenses so she pays her fair share?
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nance0418 Apr 1, 2019
I don't think so...I never thought about it until I heard about the caregiver child exemption. Thought it would be nice if Medicaid gave a break to caregivers in my situation too but oh well lol! I never thought it was fair when people hide their assets....but Medicaid helping compensate a caregiver of a parent that is not trying to cheat the system got me hopeful :) One day I hope they consider including more situations like mine so people won't feel the need to hide their assets for fear of the state taking every dime they saved!? Who knows! Thank you!
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Sorry - right now....yes lol! There is no nursing home plans at this time but heard about the exemption and figured I would start researching now. She is not rich...thinking she could maybe pay 2 years in nursing home right now. Friend's grandpa never paid a dime to nursing home because they transferred his assets long before he went in because he was rich. Just doesn't seem fair that nursing home will get everything just because she doesn't own a home and had to move in with me?
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Shell38314 Apr 1, 2019
It's not fair that the rich can hire the best lawyers to hid their assets and the poor have no assests to hid, but if your parent(s) or you have just a house and a little bit of money then you lose everything to Medicaid. I am not saying people shouldn't pay their own way, but just remember these people who worked their whole lives and own a house paid taxes too., therefore, they did pay into Medicaid.

I too know a rich man who owns 7 businesses and more houses and apartments then I can count, but guess what...the state will never see a dime of it. He made sure he could pass everything down to his kids and grandkids, so at the end he will be able to collect Medicaid! Ugh!!
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I've not heard of such a program. That's why it is usually recommended that you get paid by your parents in a caregiver contract while you are doing the caregiving, not afterwards. You can also charge them a proportional amount of the rent/utilities/etc. All of this should be approved by an elder attorney.

Too many family caregivers get shafted when they wait for their compensation for caregiving (no proper recordkeeping, Medicaid qualification, etc.) until Medicaid enters the picture. The caregivers who move into their parents' home to take care of them do seem to be favored in the Medicaid exemption process.

I like your idea of giving credit for the time the caregiver kept the elder out of NH. But that seems to run counter to society's expectation that the elder's family take care of the elder for free.
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nance0418 Apr 1, 2019
Thank you!
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I don’t think so unless your parents have a contract to pay you from their own resources set up &/or certain criteria need to be met to qualify for state paid CNA’s if the person has Medicaid and if this program is offered in that particular state.

Hopefully others more knowledgeable in this will come along.
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nance0418 Apr 1, 2019
Thank you!
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I am a little confused by your wording. Are there any assets left?
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nance0418 Apr 1, 2019
Sorry I am new to posting. I see where I could reply to you directly!
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