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So far my husband and I have spent $20,000. Now my mom seems to be doing better with anxiety level and wants to try at home care again. If she goes home and we don’t sell house, how am I to be reimbursed before Medicaid starts claiming their share? Should I have my mother take an equity loan? I am her DPOA.

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The moving around will only make her confused. It's an unnecessary hardship on every one. she's doing well, don't 'fix' it. Appreciate the progress.

Like a game show, for instance, if you win some money, you stop and keep the money, so you don't lose it.
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MCs do not except someone unless they have a Dementia of some type. I have to agree with everyone else that Moms improved because she is in MC and you will see a decline if she returns home. Dementia does not get better. It worsens over time and 24/7 care is needed. There is really no "we want to keep Mom in her home as long as possible". The cost for 24/7 care in home can cost more than the MC. Then its making sure everyone is on time and even coming to work. And someone needs to oversee that or doing the caring themselves.

My question is was the 20k spent on paying for the MC. If so, IMO your entitled to that refunded because it was used on her care. Using the rest of her proceeds from the sale of her house to continue to pay for her care. But that is a question is for Medicaid. If the 20k was put out to pay bills, spruce up the house, and taxes you may not get that back. I was told by a Medicaid caseworker that I would have to keep very meticulous records to get back any OP money I put out. So, I did no work on the house, sold as is. I stopped paying taxes. The township put a lean on the house so would be able to get back their money when the house sold. I kept the electric on for the house to be shown. My OP was about 2k. Mom passed before the house sold, so all leans, Medicaid too, were satisfied. I recouped my OP and we got a small amount to split between us children.
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She is doing better because of the care and regularity of meals, meds, etc.

Do not let her go home.

I know that we can not force someone to do things, however, we can refuse to do what they want and if she can pull off moving home and arranging to pay you back, without you or anyone else propping her up and stepping and fetching for her, before, during and after the move, maybe she can be at home.

I would make it very clear that you will not be able to step up and prop her up at home. She is either able to live fully independently or she stays put. Period, end of discussion.

If she has been diagnosed with dementia, she will only get worse at home. Do and say anything that you can to keep her put. This could turn into a rollercoaster ride from hades if she is allowed to go home this time. Because she will fail at home without someone propping her up and you will have to place her again and she will remember that she got to go home before and she will start in again once she is stabilized. A demented mind doesn't have a say, sorry.

Edit: I would get a promissory note now. It should include future money if you have not applied for Medicaid and it should be very clear, use an attorney to get this done so it stands up to close scrutiny.
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igloo572 Jun 2021
You are so right that you need good legal on this. The issue with Promissory Note ime is that traditionally it is a fixed amount of $ actually loaned or asset with set value “sold” with some sort of interest attached (or waived) and repayment schedule. That’s not gonna be the situation for POA or family dealing with maws house….. it’s more plumber $900, tree surgeon 3k, plus utilities & yard varies each month. The house cost will be a moving target. You’ll need to craft something that can pass scrutiny for your states laws for debt PLUS whatever Medicaid wants.
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Is 20 large totally for property costs? Im guessing this is right?

if so, here’s what I see as the problem…. Medicaid tends to look at whatever we do or spend for our folks or their home as done out of a sense of familial responsibility & done for free or without compensation. That property is moms & any & all $ paid to her at the Act of Sale is her $. Should she give you $, it looks like gifting from her to you by Medicaid. Gifting = transfer penalty placed on her Medicaid application.
To get past this, You would have to show some sort of memo of understanding or Promissory Note to establish that she owes you for any costs incurred & paid by you BEFORE expenses incurred. OR that something was/is at risk if not done…. Like you paid her property taxes, you paid to repair a gas leak.

But otherwise it can pose problems. So if you spent 7K to repair moms roof, you chose to do that. You did not have to repair the roof or fix the foundation or garage or whatever…. Mom’s house could have been sold needing a new roof and the sale price would reflect that as there would be inspection done by the buyer and inspection report shows “F” grade roof so reduced market value. Often Realtors will want a property to get all spruced up….. new carpeting, yard beautified, kitchen upgrades, have it staged, yada yada. $$$$. Realtor will say it’s needed to make it competitive for what the comps are in her ‘hood. Realtor is right but doing this type of outlay $$$ only works if the property owner pays for it and Medicaid is not going to be involved.

if mom pays you from house sale $, expect that Medicaid will do a gifting / asset transfer review on her LTC application. It could add on 2-4 months onto the processing of her application. Personally I’d have an elder law atty work with your mom & you as POA prior to mom ever filing for Medicaid. You might be able to place a workmans lien on the property b 4 it goes to Act of Sale. Good luck.

Also I’m with the others that if mom is doing eons better, leave her there. Doing a yo-yo will only make her confused.
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Mom s doing better because of the care she is receiving. Do not bring her home. Sell her house, reimburse yourself, then use her remaining funds for her care. Keep meticulous records. An elder law attorney can help to make sure this is done correctly.
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It is complicated, but yes to the equity loan.

Ignorance of the laws is not an excuse but some states take it into consideration. In Michigan, a DPOA can request a probate case hearing and the judge can order the reimbursement of funds to a DPOA which gives you coverage in the event of financial exploitation accusations and Medicaid cannot count that reimbursement against you.

Check your state laws.
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igloo572 Jun 2021
The mom might not qualify for a HELOC if she’s too old & beyond actuarial tables for 10 or 20 yr loan.
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Most care "given" without contract cannot be reimbursed without accusations of elder fraud by the POA who is a Fiduciary sworn to meticulous records and to act in the interests of the elder. Some care can if all receipts and agreements were kept. This is a question for an elder law attorney. If you are getting paid for care it should be done AT THE TIME and should be done with a care plan contract and with agreement done with elder law attorney. A POA cannot have even the slightest HINT of enriching him or herself or there may be legal consequences. See an attorney with this question. THAT the elder's finances can pay for.
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Linda, if your Mom is doing better living in Memory Care, then the facility must be doing something right. Plus your Mom is around people closer to her age, so that is positive. She has a village that is looking out and helping her. If it were me, I would not move her back home.

As for the house, this is complicated. It would be best to speak with an Elder Law Attorney about the ins and outs of Medicaid, and how it would affect the house. And what can you do to get reimbursed for the $20k you spent of your own money.
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Bumping u up.
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