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Mom is in a home with a two-year private pay. Mom is a very difficult woman with demensia and this home is somehow coping with her needs. There are five kids with one very greedy older sister who has POA. Greedy sister wants to rent mom's house and sell after mom passes. In doing this she says that mom will be on medicade after her two-year private pay. In order to do this we'd have to take out a loan to be able to pay the second year of private pay. My issue is that the group home's contract says they can ask a client to leave for any reason and after two-years private pay this may very well happen to mom (this goes the other way also in that the client can leave at any time). I want to sell house and use the money to take care of her without resorting to medicade. This is her money for her care and greedy sister is just cooking up a plan that will guarantee this house money lands in her pocket (actually all of our pockets an mom's will states "share and share alike). Does anyone know is this even the way that medicade works?? My heart hurts because mom deserves the best care that HER money can provide, I just don't think she's going to get the quality of care when she is state assisted. Mom is a very big pain in the butt and if the home is getting only a third of the money they usually get, I see them showing her way to the door.

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If the house is in Mom's name, then doesn't it have to be sold or title transferred over before Medicare kicks in? That is what I thought. money! amazing how it tears families apart. Sad, too.
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Medicaid care is no different that private pay care. Most likely staff at the facility will not know how payment to them is made. There are ways to protect the value of the home so that it can be preserved for beneficiaries after your mom passes, thus the popularity of Medicaid planning by many elder law firms. You should consult with an elder law lawyer.
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First of all, your mom can qualify for Medicaid even if she continues to own the house, since it would be an exempt asset--at least initially. So, you need to find out if the rule in your state would allow for the house to continue to be exempt for the rest of her life or if it may be forced to be sold if a physician determines can never return there (there's a split on states on this).
Even if the house will always be exempt, the state will file a claim for the Medicaid it paid to the nursing home during your mother's life, following her death. They cannot seek reimbursement out of the children's assets, only from your mother's assets, i.e., the house.
If your sister sells the house, the money is still your mother's, and she will have too much money to qualify for Medicaid (which has a limit of $2,000 for a single person). It will be possible to do some "Medicaid planning" to protect most of that money, which is what I discuss in my book "How to Protect Your Family's Assets from Devastating Nursing Home Costs: Medicaid Secrets."
I don't see how your sister is correct if she is saying your mother will be on Medicaid after two years, if the house is sold, for the above reasons.
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Your sister is going to get herself (and the rest of the family) into hot water if she tries to rig this up herself.
Medicaid typically has a 5 year look-back, meaning that any transfer of assets within a five year period from the date of the Medicaid application is included in Mom's available assets to pay for her own care. In other words, if your sister sells the house and distributes the money and Mom runs out of funds to pay for her own care (before 5 years are up), then Medicaid will consider the money from the sale of the house to be Mom's money and they will not start to pay for Mom's care until AFTER that amount paid by Mom. Example: if your sister got $100,000 for the house, then Mom would be liable for $100,000 worth of care before Medicaid would kick in. So, if your sister insists on scheming to get an inheritance, she better set the money aside for when her scheme backfires or she'll have to come up with the cash or care for Mom herself when Medicaid won't pay.
There's more to it than this (Medicaid is pretty complex), but that's the gist of it. Your family should see an a lawyer who specializes in elder law. This stuff isn't for amateurs and you can get yourselves into very sticky situations.
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What happens to the rental income from this house if it is rented? If mom is on Medicaid, doesn't her income have to go to the care facility except for a few dollars per month? It might be difficult to pay for taxes, insurance and upkeep if the rental income goes to the home. As Mr Heiser said, Medicaid will try to recover their money after your mom dies, and there may be nothing left anyway. Sounds like a potential mess to me.
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First, stop making judgments about people's motivations -- like you're the one who wants good care for your mother while your sister is greedy. Second, there's nothing wrong with "resorting" to Medicaid -- there's no shame in it. Both of those are emotional assessments that are complicating an already-complicated situation. In fact, there is a lot of good news here: you've found a home that WORKS for your mom AND your mom has a valuable asset. Those are both fantastic. AND both you and your sister are trying to figure out what is the right way to handle these so that your mom will continue to be ok.
Now, neither one of you has enough information to know. IsntEasy is right: get professional help for that goal that you and your sister actually have in common. Good for you both!
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Someone should write another book - this one titled "How to Protect Taxpayers from Devastating Nursing Home Costs".
The home is Mom's, the expenses are Mom's. Sell the home, and spend the money on her care. It is dishonest to distribute assets to family, and leave it to taxpayers to pick up the tab for her care.
What do I know about it? I'm spending my savings on quality care for my wife, not looking for loopholes to shelter money for our kids. Thankfully, they are with me on this, 100%.
In this age of entitlement, we need another "Every American deserves..." statement. "Every American deserves the right to pay their own way until every dollar has been spent honestly and responsibly." Let's keep helping those who truly need help.
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I agree with LonleyBoy 100 percent When mom sold her home (it took 4 years) she was allowed to pay for her own funeral out of her assets and some other medicaid approved things and any monies remaining would have to be reported to mediciad...we had to do an indepth reporting of what the home sold for, etc etc. It was simple but overwhelming such that an attorney called medicaid directly obtained the rules/requirements then we completed a comprehensive list. my mom's home sold for way below market value so there wasn't much left after we paid for the funeral and some other things...Yes, there is the 5 year look back period and rightfully so medicaid will want their share--i think the home becomes an asset if mom is not going to return to it. You need to know the laws/requirements for your state before you act or like another stated, you willl be in financial hot water. I think it is ridiculous to take out a personal loan for care for your mom because if your sister doesn't play this right you will never see your money again. You can google POA responsibilities and see that your sister might be trying to trick medicaid. Inquire with an attorney about an irrevokable living trust but when you get one of those anything in the trust can't be used or touched. Do not proceed in any of the above unless and until you absolutely know the ins and outs of medicaid or you will lose.
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Alwayslearning, I don't think you are in a position to give this advice as many siblings, family members, etc. do know each other as they've had a lifetime of learning. Also, the OP's sister isn't the brightest star in the sky either, and I'm saying this because I, too, have POA, and have an elder care attorney that I have met with extensively. So this sister is going to burn her own butt if she does this and she will get nothing in the end except, maybe, jail time.

I, too, agree with Lonelyboy, it's awful in this country that there is little to no relief for caregiving needs, as well as caregiver's needs. Do they think people can just quit their jobs and stay home, while twitching their noses for their own food, water, lodgings, healthcare, etc.?
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I respect that you want to do the right thing for your mom. You may never get your money back if you take out a loan. I agree that the assets from your moms home (and the contents) should go toward her care in the here and now. IMO medicaid should be used for those who are truly without assets. Mom deserves a happy fulfilled life. With her assets you can not only pay for her care now. Let us know how this turns out. And also IMO you can suspect someone's motivations when the handwriting is on the wall...
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@always learning. I have always felt so much guilt that I didn't quit my job and so often wondered how people supported themselves if they did so. To send home the point again sister might burn everyones financial butt so protect yourself
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I didn't mean to suggest that I knew whether the judgment about her sister was correct or incorrect -- only that it's a distraction from the business at hand, which is to get the information that they need to know how to handle the house so that its value helps rather than hurts them with Medicaid and the nursing home. We all need to stay practical and solve what's in front of us, which includes getting good help from experts when it comes to the legal stuff....
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Sorry kiddo, but the Nursing Home gets it all, even the rent. Stay away from your sister's plans, don't sign anything, let her be the one in jail, not you.
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If you and your siblings agree that eldest sis is not acting in your mom's best interest, one can be removed as POA. You'd need legal advice.
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First of all there are ways to protect assets that are perfectly legal and have been set up to be taken advantage of. I have witnessed doctors and their wives driving Mercedes, wearing the finest clothes and women wearing huge diamond rings and you ask them for their insurance and they pull out Medicare and Medicaid cards. Their families learned how to protect their assets, it is legal.

Your sister cannot possibly do this on her own no matter what she says it takes an attorney to do it correctly or she could wind up in a world of hurt and you could lose the estate anyway.

Just because she has POA (so do I) it is not ethical in my opinion to make such decisions without the input from other siblings as you all have a stake in this. I hope your Mom had a trust written up years ago and not just a will or if it is a will it is one that was written by an attorney and signed in front of a notary with witnesses. If not, I would be scared.

POA and possibly all of you need to sit down with an attorney who specializes in family law and Medicaid. You all need to hear what is said and how you can make provisions legally. Do no try this without legal assistance. If you all hear the pros and cons you can then either stand behind her or seek to have her removed from her position.

You might want to read and have POA read Attorney Heiser's book as he seems to always have correct and insightful information.
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It depends on the will. My Dad just passed and the will says it has to be sold and distributed equally between the 3 daughters. He left no provision for the evil sister that was living with him. So she has to find other living arrangements for herself.
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This has been interesting. Thankfully I have full control of Moms "stuff". When she came to live with me I took her to a lawyer and told him I needed complete control of everything. Out of 5 kids there is one sibling she pets and would give them her last dime if they hinted they needed it. The reason I am writing is---those of you who have older parents and greedy siblings, talk to your parents and explain that they need someone with POA who will see that their assets are used to to give them the best care possible in case of accident or illness. They need to also make a will that leaves all of there assets tied up for their use until death. I was on pins and needles until I was able to get Moms' paperwork taken care of.
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Lonely boy, I agree families should not manipulate funds that could be used to pay for care. However, there are many circumstances when a family member sacrifices up career, home, friends, etc to care for a loved one. Other beneficiaries think "oh my goodness, we are getting free care for mom if so and so stays, leaving more for us when mom passes". What the caregiver is providing is a gift to other beneficiaries on a monthly basis while loved one receives free care while at the same time, their own assets are decreasing. And in many circumstances the other beneficiaries very seldom if ever offer any assistance of any kind.
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Thanks to all of you, this has been very, very helpful (except for alwayslearning who hurt my feelings a bit, but I'll get over it). My mom has scrimped and saved all her life and she deserves to spend this money on her care. Also, if she has the funds to spend on her care these funds need to be depleted before going on state assistance. I am going to tell my sister that I do not agree with her plan and try and get a democratic vote with all five siblings. She's really not one to go along with a vote, so consulting an eldercare attorney may be next and if all else fails try and revoke POA. I'm thinking even if she's voted out, she won't sign the papers to sell the house. She's a tough nut to crack. One thing for sure, I'm not visiting her in jail. Thanks again to all.
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Every state and even every individual nursing home may be a little different, that's why the advice to get an eldercare attorney is very good. Choose carefully, maybe one with a free initial consultation or probably better, a reasonable fee for one; I picked the one who helped my family by his website that showed knowledgability of Medicaid issues, and paid $300.00 or so for the consultation, which turned out to be all I needed. I was told in PA, while my Dad was in care covered by Medicaid while Mom was at home and then still hoping and intending to return home, that any rental monies would count as income so Dad's patient pay would have been increased and there would be no benefit. In PA as long as a person states they intend to return to the house, it is an exempt asset, but as noted there is the "estate recovery" process. Medicaid is no longer in the business of preserving inheritances for children, for sure...I do not understand the part about private pay for two years - unless there is some kind of penalty period, once you have spent down assets to a certain limit you qualify for Medicaid. If you could get enough money by renting to cover mom's private pay and not have to take out loans, it might make perfect sense to do that, actually. Loans in your Mom's name would put a lien on her house, and loans in your name would have to be repaid by you. Sister may not be so greedy after all! No one wants the inheritance they wish for their children to go to the state for their own care instead, so there is a legitimate benefit to be had if you can reasonably avoid having to use Medicaid, but the key word is reasonable.

If Mom does end up needing Medicaid, her current placement may be fine with that, and her care might not change at all - my dad was cared for just as well before and after Medicaid. You may want to scout out other facilites in advance, maybe some non-profits, and actually go visit some so you know what you might be able to find if Mom in fact gets the boot from her current place. They typically are required to giver 20 or 30 days notice unless something is really emergent that they can't handle. We also looked at home care options for my Mom, and there may be something that could work for you, but my Mom just did not want anyone in her home or want to be there if she could not walk and do everything herself, could not get her used to the idea and she threw out three different home health company reps that tried to explain what they could do...

After Dad passed on and it was very clear that Mom could not return home, I did go ahead and use my POA to sell and put the proceeds in a trust for Mom's care, and we used them all before she passed on. In my situation, renting would not have worked out, and Mom would have ended up on Medicaid here in AR if she had lived a lot longer; thanks to the eldercare lawyer consultation we knew in advance how that would have worked. Knowing we could care for Mom on her income plus a manageable contribution from us gave us a lot of peace of mind. Also, because she really had no assets left, there was no estate recovery, and the only inheritance we had was from a no-cash-value life insurance policy of my dad's which passed to my husband and I; we had not had to tap it for her care, and those are specifically exempt from estate recovery (we'd had to cash in all of Mom's except the burial insurance to get Dad on Medicaid.)

Sorry this is so hard and complicated. It is very hard or impossible to know exactly how things will play out, and I don't think either of you is greedy for trying to have something left when Mom passes on as long as you are also providing the best care and quality of life possible. Hopefully your attorney can spell it all out on a chalkboard for you the way ours did, and hopefully the most sensible solution, with contingency plans, will emerge!
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OUR condo is jointly in both our names. I have been out of a permanent job for 16 months and just worked only one temporary job since then, now at age 57. If I'm out of work another year or longer, I may try to sell some of hers/mine valuable items in order to properly maintain our property, because my 93-year-old mother is living in a board/care home and unlikely to return home.
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