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Mom needs to spend down about $3,000 to qualify her for Medicaid. Mom is very connected to her church. She pay ties monthly. once she goes on Medicaid she will not be able to make any ties. She would like make this a donation to her church for this amount . Will this penalize her .

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What if a sudden event forces an elderly person into a nursing home and they have given some money away in the last 5 years? After their 90 day skilled care is over do they really kick them to the curb?
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also, I don't know if this is her savings, or $3000 monthly income. That would make a difference. If is is a one time event, check and see how much she can have in cash, and buy stuff she will need with the overage. If it is monthly, talk with an elder lawyer, I don't think you can do a $3000 monthly spend down (nor should you). If it is monthly one thing to think about is medigap to pick up the copays from her Medicare. Medicaid is for folks without much funding.
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Spend the money on something significant for your mother she will not later be able to afford: Giant screen TV, power recliner, digital photo frame, new bath tub update for when she can't get in and out of the tub, tall seated toilet, new simple microwave (I like Sharp not too confusing) for when she can't have the stove plugged in, new dishwasher, washing machine, dryer, memory foam mattress topper. Some of these things she would be able to bring with her to assisted living or Nursing Home when she needs that. Most of these are things not covered by Medicaid, but incredibly helpful to your mom.
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Unfortunately, there are no exceptions to the transfer rules, so that even a gift to a charity or religious organization can result in a Medicaid penalty if the transferor applies for Medicaid within 5 years after the date of the gift.
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The word is tithe, not tie. She will be penalized for making charitable donations.
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It WILL penalize her. Don't do it. You must show every penny was spent on her care or Medicaid won't pay.
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I would think go. Contact your Medicaid office to see what's what. Most of the time any money given away is considered "gifting" and has a transfer penalty done by Medicaid. A transfer penalty means that until someone private pays for her care for either the amount of the gifting &/or a period of time that Medicaid will not pay.

So if the state considers it gifting, that 3K to the church, you will have to match to private pay to the NH before Medicaid will pay. Mom is now impoverished so she can't pay but the NH expects someone to pay and that will likely be you. Do you have an extra 3K sitting around to spare? Is her church going to pay the 3K penalty - I doubt that.

3K isn't very much $$ and really mom would be best off buying things that she will need in the future. Medicaid does NOT pay for anything dental so if she needs something dental done that easily will use up $. Or buy her new eyeglasses or hearing aids - the ones on Medicaid are minimal if even covered. If she doesn't have a funeral or burial policy, use the 3K towards that. Most traditional funeral & burial run 5 - 10K so it would not pay for all but for at least some of the costs. Otherwise you will end up paying for all this personally in the future.

Remember that once they are on Medicaid all their monthly income (their SS and any retirement they get), they are required to do a co-pay of their income to the NH. This is know as their SOC - or share of cost. The states have a personal needs allowance for them - from $ 35 - 90 a month - but the allowance really is only enough to pay for their hair cuts and some clothing replacement or other spending needs @ the NH. You will end up spending some of your own $ on mom. The NH laundry is harsh on clothes as its super high heat and with disinfectant so their clothes that could have lasted for years at home now gets worn out in a few months. Stuff walks @ the NH too, shoes & eyeglasses & sweaters most often. Even if you mark them, either they leave them somewhere or another dementia patient puts them on. The allowance alone just can't cover all the stuff they need replaced.
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