Medicaid suspended; can the nursing home release my mother in her current condition?

It sounds like you need a certified elder attorney well versed in Medicaid in your mothers state as rules are a bit diff in diff states.

In addition to finding an eldercare attorney, I think I'd call Adult Protective Services and ask how they can help protect your mother.

I think that reporting the theft of your mom's funds may need to happen so that Medicaid views this as a "crime" and not a "gift".

Does your brother have addiction problems.?

$200,000 is a sum to make your head swim and make you keel over. But hang on a minute.

$200,000 minus:

Any pre-existing debts
Upkeep and taxes on the unoccupied home for two years
Nursing Home fees up until the current outstanding $30K, which might have been quite a lot.
Sums legitimately spent on mother's own expenses including health care.

Mother was admitted to the NH two years before the house was sold. How long in total has she been resident there?

Your brother has made a right pig's breakfast of his POA responsibilities but he hasn't necessarily just pocketed the money and fraudulently spent it. First of all, I'd get the numbers thrashed out and the reporting gaps filled in as far as possible. Then you can see where you are.

But in any case, he as POA is the one who is responsible for the money and the only one of you siblings who can be liable for its repayment.

I don't know this to be true, but I would be beyond astonished if the Nursing Home could legally evict your mother without first finding a place of safety for her to be discharged to (I agree that APS will be the best resource for advice on regulations like this, among other things). And if her state of health is such that any move would endanger her, then get her an attorney or an advocate to get a court order to prevent it.

Mom will likely become a ward of state who will place her in a nursing home (she and you will not be able to choose). The state is likely to sue your brother as POA for recovery of the funds. They are likely to place liens against his property and garnish wages if he no longer has the $200K. It is not a small amount and it will not be a forgiven debt.

This scenario happened to a co-worker only when they put mom in nursing home they sold the house and divided the proceeds among the kids later who spent it all before they found out they had just gotten mom disqualified from Medicaid - bad move.

They will attempt to release Mom into your care. If you are unable to care for her, DO NOT SIGN THE PAPERWORK. However, you should cooperate with them in attempting to have her become a ward of the state.

Thank you all so much. Your responses have been very helpful. The proceeds were actually close to $300,000 but we were told brother put about 90,000 for expense: $12,000 towards taxes and maintenance and approximately $25,000 for 2 months of nursing home private pay charges before Medicaid payments began. I can only assume the balance ($63,000 was used for closing costs and incidentals --- leaving the remaining $200,000 with "nothing to show" as he claims.

None of his remaining math adds up, and said he has no documentation/receipts. What we were given were the notices from Social Security, Medicaid and correspondence from the eldercare lawyer (who also wasn't aware of the missing funds).

He has recently completed an application for a Qualified Income Trust (Q.I.T.), which I understand is a requirement under the new Medicaid regulations? My mother's income (SS and pension) would fund this trust, which would then pay the nursing home monthly. Her income is only about 1/3 of the Medicaid rate, so I'm not sure how that will work. At this point the Q.I.T. may be too little compensation too late.

One of my other brothers mentioned that our mother could become a ward of the state. We're unsure of much information. Unfortunately, our mother wouldn't share her end of life plans with anyone but the brother who has Power of Attorney.

Have you called APS?
63K in closing costs?
A QIT (also termed a Miller Trust in some states is a way of qualifying for Medicaid when your INCOME (not assets) are above the Medicaid limit. So, say mom gets 3K per month in pension and SS and the Medicaid limit is 2K. 1K per month goes into the QIT; Medicaid pays for mom's care and the funds in the QIT revert to the State at mom's death.

Does mom have dementia?

Nothing to show?

There may not be documentation that he wishes to share, or (see below) is able to organise. But documentation there most certainly will be. He didn't just leave $200K in used notes sitting in a box on the kerb, did he. And failing that, there must be a paper trail to be followed.

Is he having any sort of mental health crisis? Just wondering if it genuinely is more that he can't deal with this than that he won't.

Forensic accountant to figure out the $.
And there’s actually quite a lot of these but finding them will be sticky. Most cpa firms I’ve found don’t do this. But who would use them would be the more pit bull divorce attys. Ask your elder law atty as to who they know. 

NH may try to release mom to family’s care. But if everybody’s out of state, but the worthless DPOA, NH may take the ward of the state approach. 

I’d like to echo Kimber’s post.... at my mom’s first NH a lady across the hall from mom became a ward of the state. What happened was that she went onto Medicaid but kept her home (allowed as an exempt asset); dpoa son (a real ahole imo & clueless on dealing with staff... always demanding stuff) sold house and pocketed the $; the transfer surfaced to the penny as it’s tax assessor info that dovetails into state database; Sonny ignored Medicaid letters and multiple NH 30 Day Notices from NH. One day when I was visiting mom, huge commotion with Sonny as he arrived to visit only to find mom GONE! As now she was a ward of the state and the guardian had moved her to another NH. Sonny not notified nor was the NH going to tell him where she went.... cops called. Not pretty. 

I cannot imagine how beyond traumatic for the little lady, she was sweet.

The 30 day notices I’ve seen usually have it cc’d to APS, & a pro bono legal clinic. By including APS, it sets it up for them to swing in quickly to request ward of the state to be done or other actions. Judge (PC court) will sign ward orders and once that’s done stand back. You do not want to get caught up in the undertow of being involved in the financial & social irresponsibility of Brother. Guardian can ask APS to do an inquiry on Bro “taking advantage of a vulnerable adult”. It’s then criminal matter.....

All leans, such as property taxes, have to be paid at time of closing. Taxes are prorated as is the water / sewer bill if Township runs these. All other bills are responsibility of owner and does not get deducted at time of sale. Yes brother should have paid debts out of that money but seems he didn't. Medicaid would not have put a lean on the house till her death. Charges need to be brought against your brother.

"NH may try to release mom to family’s care. "

Be careful here. You say there is one sibling in state. Do NOT let that sibling have to take care of your mother. And don't any of the rest of you quit a job to come take care of your mother.

It's all on your POA brother -- HE made the mistakes.

IANAL, but my understanding is that both 1. arguing misappropriations and 2. appealing the penalty will resume coverage until a determination is made - which can take years.

Also, ASP will likely get involved no matter what you do, so don't worry about trying to spare him anything in your decision making.

All of the above is valuable advice. Study it and follow through.

Call APS, report bro, cooperate with APS, and hold bro accountable.

my brother who mishandled Mom's assets did not retain power of attorney ,she became ward of the state in FL, trying to get someone from guardianship as a ward of the state would be costly, the Guardian will run her life now, contacted Eldercare and filed a number of complaints answered by OIG in FL, but to date Mom left me out of all, and I could do nothing due to not having $ for an Attorney when they had the competency hearing and Guardianship proceedings.

I was the POA for an elderly Aunt before she passed away, one of her scumbag granddaughter’s took her to the bank and had her withdraw over $1,500 dollars and also substituted cut up paper for the money my Aunt had on her and because the lump sum withdrawal was taken out with no substantiation, they in Ohio were going to suspend my Aunts Medicaid. So I had to takes my elderly Aunt to the police station and file a complaint against her granddaughter in order to keep My Aunt from losing her benefits! The bank had a video tape of the money being withdrawn! This person wasn’t on drugs, she’s just a lowlife!!!

It sounds like a high probability that your brother has mixed the funds of your mothers assets with his. I would suggest that you have a cpa go over her account, and speak with law enforcement about possible criminal charges.

Can you transfer to another home? Or if they send her home, then return her to hospital for 3 day stay....then back to nursing home & Medicare pays & then secondary insurance? What about hospice? Medicare pays for that & she can stay put. Talk to Social Worker in person asap so it can be worked out amicably. Good luck. Let us know how you do. Hugs 🤗

Your brother, who spent all of the money from the sale of your mother's house & is the only person responsible for this mess, wants you & your other siblings to "fix" it? I think that the collective response from you & your other siblings should be to tell him to f*** himself if he thinks you are going to "fix" what he destroyed.

It sounds like he is the one that your mother "trusts" & who she made POA---that is her error & her problem. Entrusting a son that is untrustworthy with her assets & end of life wishes was her problem.

You don't have to, nor should you, do anything about this. If the nursing home contacts you, hang up the phone or don't answer or call them back. They cannot do anything to you & are only trying to get money from whoever they can. They will probably even try to threaten you (which sounds like they've already done by telling you that unless $30K is received they're going to kick her out----legally, they cannot do that if she can't take care of herself, has nowhere to go or anybody to take care of her) in order to get you to pay or at least assume responsibility for the debt.

I'd leave this to the nursing home, Medicare & Medicaid to hash out. The government will likely sue your brother for the proceeds & what is owed to the NH/Medicaid. He is currently filing for bankruptcy, but that won't last forever. Even if his current debts are discharged in the bankruptcy, he is still allowed to keep certain assets, which the government will place a lien on, so he won't be able to sell his house or car or keep more than a couple thousand dollars in cash. He must have some type of income---the government will also go after whatever income he has until the debt is paid off. And that could take years. Don't get involved in it---let him figure it out. He thinks he is so smart by filing for bankruptcy so he doesn't have to pay the NH debt, but he's not. One thing that is for sure---the government will get its money.

Elder Attorney - as in YESTERDAY!

Legally? Probably. But where will your mother go? Her home was sold.

ELDER ATTORNEY time.

LIEN

Unfortunately, Nursing homes are a business. And just like any other business, the bottom line is all that really matters to them. I spent four years in one, and that is my opinion. The people there were caring enough, but if there were any money issues; they had to be resolved in order to stay there. What your brother did was terrible. But karma is hell. And it will surely come back upon him. If my brother did something like that, I'm not sure what I might do.

When you become a ward of the state, they will place her in a nursing home of their choice, usually these are not the best, HOWEVER, if you speak with the person in charge from the state and appeal to their sensitivity, I have found them to be reasonable and will place her in the "best" place that will accept her. I would suggest finding out exactly the services she needs to sustain from the social worker and do a little "pre investigation" by contacting various homes yourself based on her needs and being a ward of the state, without giving your name, etc., then suggest to the guardian at Litem the home of your choice. This usually works. Good success to your family.

Three priorities:
#1 Hire an elder law attorney NOW.
#2 Call APS NOW.
#3 Something is MAJORLY amiss with the brother. Something's fishy to say the least!!  "Sibs are supposed to fix it?" I think  NOT.

BarbBrooklyn: That's a good call...perhaps the brother does have addiction problems.

happened to my dil's grandmother, but upon investigation and yes, garnishment of wages of daughter who took mom's money, she was allowed to stay; another situation with friends of son's dad, who moved him out of state, causing him to lose his insurance, leading to having to have emergency surgery, then rehab, without being told about previous tbi not equipped to deal with, then the friends moving back to out of state where they'd brought him from, leaving him, with him being scheduled to be discharged without saying anything; took it upon myself to call and let them know what was going on, so, yes, they had my phone number they kept calling but I wasn't going to be responsible, they were going to go get his check, which was still coming to the house, since he wasn't long-term care yet, but they were going to make him ward of the state and, like you said, family, which he'd been under the care - though apparently not too legally, or else he was in a place that he could still leave - of his parents, wouldn't have known where he was, did come get him
now, having said all that, concern regarding mil, with property being already divided among children but with a life estate for her, but with some of them wanting to sell, but POA, which not sure has to be invoked yet even with mil having dementia dx but wanted nothing to do with anything even before, saying lawyer says can't be done; don't really think exactly true, but think is concern regarding value of life estate and proceeds for mom's care, that POA's concerned re this exact type situation, not sure if anybody's prepared to finance mom's care - point of why wanting to sell in the first place, somewhat like brother here

What your brother did may have been criminal. Best to contact Probate Court or an attorney, or even the authorities.

Thanks again all! Your responses are very much appreciated. The plans for my mother's estate were put in place by an eldercare attorney. I feel the one glitch in the planning was my mother's choice of POA and her refusal to speak directly to our other siblings.

I believe that my POA brother felt his conflicts with two of our brothers gave him cause to make all decisions without consulting anyone. Particularly during the last few years, my mother fueled much of this division. But that was certainly no license for him to act as he did. He was way in over his head and wouldn't admit it.

I asked POA brother if the eldercare lawyer who took care of both of our parents' estate is aware that he (POA brother) kept the proceeds of the sale of our mother's house. He said the lawyer wasn't aware. He said he would make an appointment with the lawyer, as he felt that was a conversation that needed to take place "in-person." The same lawyer advised setting up the Qualified Income Trust several months ago; POA brother ignored his advice. He called me a few days ago, boasting that he "saved $3,000" by visiting the Social Security office and completing the application himself.

I'm still stunned. I told him a $3,000 savings for the over $200,000 he stole from our mother's estate wasn't anything to brag about and that the nursing home invoice still remains open. He then asked me if I was expecting HIM to pay the nursing home. I couldn't believe what I was hearing. I told him I was very angry and had to end the call. He asked me to not give up on him and that he is seeking help.

He is grandiose and self-righteous one moment then becomes full of self-pity and begins crying saying (over and over) how badly he messed up. I do suspect various addiction issues with both him and his wife. He claims he didn't know he was doing something wrong. I don't believe him and feel he is in deep denial about his dishonest actions.

I am going to contact our older brother to discuss contacting the eldercare lawyer ourselves. He, along with me, are the only two siblings that still speak with POA brother. The other three brothers had a great falling out with POA brother years ago. Older brother wants to help POA brother but doesn't want to end up in the middle of a legal mess himself. POA brother asked me to "take over" for him as POA, as he no longer feels he is capable! I refused.

POA brother has children; One has serious medical problems and special needs. His wife is unemployed, has issues with alcohol and has also amassed huge credit card debt It's a mess on all fronts. I am heartbroken about what he's done, and it hurts to think about bringing up criminal charges on him.

We have never been a close-knit family, yet none of my siblings live such dramatic lifestyles as POA brother. My own adult child is seriously angry, worried about grandmother.

I sincerely appreciate having this space to vent my feelings. Thank you all for your kind and informed suggestions.

TheOnlySister, I'm sitting staring at the screen thinking "Good grief. What can I say?"

And this isn't my brother, and it's not my mother who still has need of care and accommodation.

Do you expect him to pay the NH. Do you expect him to pay the NH.

Can't get over it.

No, I expect you to start thinking now about how you are going to REPAY the very large sums you have stolen from your mother, moron.

The thing is, what DO you do with someone who is not innately wicked or larcenous but who, in abusing the position of trust in which she placed him, has landed his elderly mother neck-deep in the umska and as a matter of plain fact committed an extremely substantial financial crime?

I suppose, you have to take all the circumstances, including other offences perhaps, into account. Everything has gone wrong, hasn't it? He seems to have experienced a domino effect.

Well, he isn't your problem. He will just have to face his own music. I'm sorry for his children but you really can't be worrying about them because you're not in a position to help them, are you?

Who is leading discussions/negotiations with the NH? If it's still POA brother, I'd say that's the issue to tackle first.

Wow. I'd say POA brother has serious mental health problems. Whatever led your mother to appointing him POA? Do they have an unhealthy enmeshed relationship?

I'm so sorry for your trouble.