If your dad has done this 4 a GF & he has dementia, there are likely to be other issues within his financial dealings. Before you even think abt filing 4 LTC Medicaid, you need to clearly look at his finances in detail
My experience is that the Medicaid caseworker will look at 3 things to see if there are red flags for eligibility: - the bank statements to see what the pattern of deposits & spending are over time and if there is anything that is large ($500+) that doesn’t fit the pattern. Like my mom had car repairs done & checks written out to mechanic’s name not his business name, Mom had receipts & cancelled checks so this was cleared up easily. Our elders will pretty much have a set of stuff paid each month.... utilities, CC payments, insurance, grocery stores, rent / mortgage, etc. And have set income deposited.... social security, other retirements, a fixed dividend, paying investments. There’s a pattern. Now if patterns seems wonky, it gets red flagged,
- how impoverishment was attained, this is more of an equation or an algorithm that the caseworker uses. When your dad applies for LTC Medicaid he or you as his POA will have to submit his annual “awards letters” like from SSA that state to the penny what SSA is paying monthly for the incoming year. Other retirements & pensions, do awards letters as well. Plus you have to submit info on dividends paid and any investments he has. Plus his life insurance info. So state has in detail what your income is and assets are. And you’ve submitted 5 or so years of his financial statements. So state know what balance was 5 yrs ago. And state knows if he rents or pay for IL /AL or owns a home and can put in a $ amount on what that costs you each month plus a mo cost of living $ amount. And state can do a search on real property records to see if something was sold and for what amount & that gets entered as well. The $# go into an equation and if it doesn’t make sense that he is now impoverished & under 2k in assets, it gets red flagged.
Say a mom moved into a NH this mo & paid 7500 rent and applies for LTC Medicaid as she has no $ for next month. Mom gets $1200 a mo SS, was in AL at 4K a mo, sold her home for 100k 3 years ago, had 50k in savings 5 years ago and now is under 2k in assets & claiming impoverishment. The math doesn’t work, she should still have between 35-50k. It gets red flagged. There could be a solid reason... like statements show 2 checks of $15k to a roofing co year house was sold. Or she paid off CC. Otherwise there will likely be explaining to do. & if not explained sufficiently, the mom gets denied LTC Medicaid eligibility. This snowballs into a problem as Medicaids application can take 3-6 mos and each month that $7500 NH bill happens with basically only moms $1200 SS paid on the $7500. If she is ineligible, the Nh will go after you to be personally responsible for the $$$ bill
- LTC Medicaid has “at need” for BOTH financial AND medical. Financial is on dad/ you to provide in detail. Medical “at need” is that he has to clearly show in his health chart to be needing skilled nursing care. Medical is more complex and if there is not obvious “at need”, then the state will send out a team to evaluate him.
If he’s galavanting out & shopping with a GF and being an old rooster, I’ll bet, he does NOT have a fat chart showing needs skilled care w 24/7 oversight. I’m guessing he wasn’t discharged from a hospitalization to NH rehab and now you find he cannot return home. He’s still living on his own, isn’t he?. If this is the situation, I’d suggest that you get a needs assessment done ASAP. If it’s that’s he ok for AL, thats private pay as most states Medicaid do not pay for AL. Please pls realize that just being old, needing help with ADLs or medications, or even having dementia, is not always enough to be “at need” eligible for 24/7 skilled care paid by Medicaid.
I don't think so. Unless these were VERY expensive like 1k ea. Medicaid looks for large amounts that maybe gifted. I hope you have POA? If it says needs a doctor to declare incompetent, then I would get that letter. I would take his Credit Cards and checkbook away.
I would assume if your going for Medicaid, Dad has no money. If so, you may want to make GF aware that there will be no more expensive gifts coming her way.
The look-back period in IL is 5 years. Anything that looks like gifting to Medicaid will be a problem. He might need to consult an elder law attorney who has Medicaid experience before applying. It is well worth the investment.
Any sudden changes in our elders should always be a medical emergency and treated as such.
My experience is that the Medicaid caseworker will look at 3 things to see if there are red flags for eligibility:
- the bank statements to see what the pattern of deposits & spending are over time and if there is anything that is large ($500+) that doesn’t fit the pattern. Like my mom had car repairs done & checks written out to mechanic’s name not his business name, Mom had receipts & cancelled checks so this was cleared up easily. Our elders will pretty much have a set of stuff paid each month.... utilities, CC payments, insurance, grocery stores, rent / mortgage, etc. And have set income deposited.... social security, other retirements, a fixed dividend, paying investments. There’s a pattern. Now if patterns seems wonky, it gets red flagged,
- how impoverishment was attained, this is more of an equation or an algorithm that the caseworker uses. When your dad applies for LTC Medicaid he or you as his POA will have to submit his annual “awards letters” like from SSA that state to the penny what SSA is paying monthly for the incoming year. Other retirements & pensions, do awards letters as well. Plus you have to submit info on dividends paid and any investments he has. Plus his life insurance info. So state has in detail what your income is and assets are. And you’ve submitted 5 or so years of his financial statements. So state know what balance was 5 yrs ago. And state knows if he rents or pay for IL /AL or owns a home and can put in a $ amount on what that costs you each month plus a mo cost of living $ amount. And state can do a search on real property records to see if something was sold and for what amount & that gets entered as well. The $# go into an equation and if it doesn’t make sense that he is now impoverished & under 2k in assets, it gets red flagged.
Say a mom moved into a NH this mo & paid 7500 rent and applies for LTC Medicaid as she has no $ for next month. Mom gets $1200 a mo SS, was in AL at 4K a mo, sold her home for 100k 3 years ago, had 50k in savings 5 years ago and now is under 2k in assets & claiming impoverishment. The math doesn’t work, she should still have between 35-50k. It gets red flagged. There could be a solid reason... like statements show 2 checks of $15k to a roofing co year house was sold. Or she paid off CC. Otherwise there will likely be explaining to do. & if not explained sufficiently, the mom gets denied LTC Medicaid eligibility. This snowballs into a problem as Medicaids application can take 3-6 mos and each month that $7500 NH bill happens with basically only moms $1200 SS paid on the $7500. If she is ineligible, the Nh will go after you to be personally responsible for the $$$ bill
- LTC Medicaid has “at need” for BOTH financial AND medical. Financial is on dad/ you to provide in detail. Medical “at need” is that he has to clearly show in his health chart to be needing skilled nursing care. Medical is more complex and if there is not obvious “at need”, then the state will send out a team to evaluate him.
If he’s galavanting out & shopping with a GF and being an old rooster, I’ll bet, he does NOT have a fat chart showing needs skilled care w 24/7 oversight. I’m guessing he wasn’t discharged from a hospitalization to NH rehab and now you find he cannot return home. He’s still living on his own, isn’t he?. If this is the situation, I’d suggest that you get a needs assessment done ASAP. If it’s that’s he ok for AL, thats private pay as most states Medicaid do not pay for AL. Please pls realize that just being old, needing help with ADLs or medications, or even having dementia, is not always enough to be “at need” eligible for 24/7 skilled care paid by Medicaid.
I would assume if your going for Medicaid, Dad has no money. If so, you may want to make GF aware that there will be no more expensive gifts coming her way.
It is truly insane what people will pay for non essential items.