We are looking to place my 90-year old grandmother in a care facility and are figuring out how Medicaid eligibility works for her. Upon further research, we are now aware of the five-year lookback window and the issues associated with it. However, this raises a lot of questions for us.

Here is the situation:

My grandmother has a fair amount of assets left. We are aware that she has to use it all up until she hits $2,000 after which she is eligible to apply for Medicaid.

Over the past two years, she gifted me a cumulative total of around $25,000 (from a joint account) to help pay for college costs and other miscellaneous items like birthday gifts, new year presents, etc. This was back when we had no clue that we needed to send her to a facility. I assume this is still considered a gift and is not counted as an asset transfer. Am I correct?

Assuming we do get penalized, I believe the formula is: total amount of asset transfer / what Medicaid believes is the average monthly cost of nursing home in your state.

So a few questions:
Are gift amounts counted in the asset transfer penalty?
Where do I go to find what the average monthly cost of nursing home is in Hawaii?
When does the penalty begin? Does it begin the date when the money was transferred? Or does it begin when she enters the nursing home? Or does it begin when she uses up all her funds and needs to apply for Medicaid?

Thank you for your help.

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Gift amounts are considered in transfer penalty. Lookback is 5 years from date of application. You will need a lawyer if you had a joint account with deposits from anyone other than grandmother to make sure you can track all activity in that 5 year lookback. If you were paid for caregiving or monies from sale of home given to anyone that can count too if you did not declare the income. It's a valid use of grandmothers money to consult a lawyer well versed in Medicaid in Hawaii. They can answer with current $$ amount of penalty divisor and best ways to spend down.
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Joint account with whom?

Is there a spouse? In any event, the best use of some of grandma's assets is a visit with an eldercare attorney who is familiar with Medicaid regs in your state.

Medicaid does not with to impoverish the "community spouse" (the one who is not in the Nursing Home).  Even if there is no spouse and there is another owner on the accounts, it is important to get accurate legal advice.
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