She went into hom aug 2013 and is now out of money, Trying to get Medcaid, They want to know where the money is cause never went into my moms bank account, What shall I say or what can we do for her to get accepted
I don't see that there is any option of what to say but the truth. Mom had money and she gave it away. There will be a penalty with a certain number of days not covered by Medicaid, based on how much the gift was. During that non-covered time the care center will have to be paid from private funds. Can you and your sister cover that, out of the money you received, perhaps?
It is too bad Mom didn't have the advice of a lawyer at the time of the sale. Perhaps seeing a lawyer now would ensure that the penalty is as small as it can be.
Unfortunately, Medicaid will not pay until you pay the money back. There is a good chance the NH will sue you as well. A man in PA had to cough up $99,000 to a nursing home, the judge said "he had the means". You can't hide assets and the government already knows where the money went, they just want you to fess up and pay out.
Coondog - what you are dealing with is Medicaid's "Transfer Penalty".
When mom applied for Medicaid, there were specific ? regarding her assets and if any assets had be gifted or transferred within 5 years prior to her application. Did you put the information on the home on the application? If you didn't that possibly will be a whole other issue to deal with in addition to the transfer penalty. Now your mom's house is considered "real" property and as such her name and ID and perhaps even her SS is tied into her ownership on the property. Now the local tax assessor has all this info and it gets dovetailed into the state database which Medicaid can access. So eventually the sale of the home, what is sold for and when, will surface. They know that mom had a home and what it was sold for too. So you really can't try to be creative now after-the-fact on the $ amount.
Basically how a transfer penalty works is: say mom sold the house for 100K.Now mom's state daily room & board reimbursement rate for Medicaid is $ 145.00 a day. So basically mom is ineligible for Medicaid to pay for her NH for 690 days. Mom technically is qualified for Medicaid as she is impoverished but she has to work out the transfer penalty before she will be eligible for Medicaid to pay. Now actually how the transfer penalty is done has other factors & there is a whole formula on this…..like if it was sold below fair value to family that is an issue.
Transfer penalties are super sticky to deal with, I would get an elder law attorney to deal with this and negotiate it for you. Now the NH is going to be an issue and soon. If mom is found ineligible, the NH will get a letter from Medicaid on this (just as you will). Have you received a letter from Medicaid? and what is the amount of time you have to provide this information?. Most of the time, you have just a couple of days to provide the documentation to Medicaid, if not, they will send you a letter that mom's application is denied due to documentation and that there is a transfer penalty inquiry in play. Don't just ignore this…you can buy some time but only if you in writing ask for an extension to get financial documents. Realize that the NH will expect you or whomever signed mom into the NH, to either pay for her stay or sign off on a contract to pay asap if mom is declined Medicaid. If you don't, then NH can do a "30 Day Notice" which you get as well as the state gets and the local Agency on Aging (usually) gets too. Most folks end up either coming up with the money or taking mom back home till the penalty days are done. If you all are low-income or have extenuating situation, then it can be waived but if you have a job, income, etc, you are expected to pay or sign an agreement to private pay the penalty amount. Really I would get an attorney to work it through as you don't want this is morph into other issues.
The NH expects to get paid. Now depending on the contract, they can bill you at the Medicaid rate or at their much higher private pay rate. You need to carefully look at the contract. You do have a copy of the contract, right?
Now the NH won't kick ma to the curb but you have to keep the lines of communications open with the NH. At my mom's first NH, a resident was transferred to another NH and made a ward of the state, as her son refused to deal with her outstanding balance and the transfer penalty.
Just out of curiosity, were you given advice to do this with mom's house $ and by whom?
Does she really need a nursing home? You will either have to pay for her care through the penalty period or pay her fair market value for her home. Too bad you did not get an attorney before the transfer. Was mom competent when the transfer was made? If not, you definitely need an attorney to protect yourselves. I can see this blowing up and possible charges of financial exploitation.
It is too bad Mom didn't have the advice of a lawyer at the time of the sale. Perhaps seeing a lawyer now would ensure that the penalty is as small as it can be.
When mom applied for Medicaid, there were specific ? regarding her assets and if any assets had be gifted or transferred within 5 years prior to her application. Did you put the information on the home on the application? If you didn't that possibly will be a whole other issue to deal with in addition to the transfer penalty. Now your mom's house is considered "real" property and as such her name and ID and perhaps even her SS is tied into her ownership on the property. Now the local tax assessor has all this info and it gets dovetailed into the state database which Medicaid can access. So eventually the sale of the home, what is sold for and when, will surface. They know that mom had a home and what it was sold for too. So you really can't try to be creative now after-the-fact on the $ amount.
Basically how a transfer penalty works is: say mom sold the house for 100K.Now mom's state daily room & board reimbursement rate for Medicaid is $ 145.00 a day. So basically mom is ineligible for Medicaid to pay for her NH for 690 days. Mom technically is qualified for Medicaid as she is impoverished but she has to work out the transfer penalty before she will be eligible for Medicaid to pay. Now actually how the transfer penalty is done has other factors & there is a whole formula on this…..like if it was sold below fair value to family that is an issue.
Transfer penalties are super sticky to deal with, I would get an elder law attorney to deal with this and negotiate it for you. Now the NH is going to be an issue and soon. If mom is found ineligible, the NH will get a letter from Medicaid on this (just as you will). Have you received a letter from Medicaid? and what is the amount of time you have to provide this information?. Most of the time, you have just a couple of days to provide the documentation to Medicaid, if not, they will send you a letter that mom's application is denied due to documentation and that there is a transfer penalty inquiry in play. Don't just ignore this…you can buy some time but only if you in writing ask for an extension to get financial documents. Realize that the NH will expect you or whomever signed mom into the NH, to either pay for her stay or sign off on a contract to pay asap if mom is declined Medicaid. If you don't, then NH can do a "30 Day Notice" which you get as well as the state gets and the local Agency on Aging (usually) gets too. Most folks end up either coming up with the money or taking mom back home till the penalty days are done. If you all are low-income or have extenuating situation, then it can be waived but if you have a job, income, etc, you are expected to pay or sign an agreement to private pay the penalty amount. Really I would get an attorney to work it through as you don't want this is morph into other issues.
The NH expects to get paid. Now depending on the contract, they can bill you at the Medicaid rate or at their much higher private pay rate. You need to carefully look at the contract. You do have a copy of the contract, right?
Now the NH won't kick ma to the curb but you have to keep the lines of communications open with the NH. At my mom's first NH, a resident was transferred to another NH and made a ward of the state, as her son refused to deal with her outstanding balance and the transfer penalty.
Just out of curiosity, were you given advice to do this with mom's house $ and by whom?