I am very much looking forward to hearing answers to this excellent question, one I have often wondered about when listening to forum members' experienced counsel and warnings.
Presumably one attempts to recover the money from the people to whom it was given away. Are there legal tools with which to do that?
They are not exactly "denied" Medicaid. Rather there is a penalty period during which they are not eligible for the program. The length of the period depends on how much they gave away. They will have to come up with a way to self-pay for the nursing home until the period is up.
If the money was given to family or close friends, they may decide to give money back for the purpose of paying for that penalty payment. However, this is no requirement that they do so.
Cooper, I see that your mother has dementia. My heart goes out to you.
In my local support group last night one member discovered that his sweetie had given away large sums of money, overdrawing her account in the process. That was his first clue to her dementia. This situation is always heartbreaking. She wasn't trying to make herself eligible for Medicaid -- she was just behaving irrationally, and of course she got on every "charity" list you can imagine, and responded to all of them. She was a well-educated professional (architect) but saying she should have known better is meaningless when someone has dementia.
I sincerely hope you can resolve this well for your mother. Consider consulting a lawyer specializing in Elder Law.
This is a common situation here. Unscrupulous children or grandchildren talk the elder out of money, and then the responsible person finds out that the gifts disqualify the elder from Medicaid eligibility.
And then it's all on the responsible person. So the elder usually ends up living with the responsible person. I'm sure it is very unlikely that the unscrupulous ones ever pay back the money.
A transfer penalty is placed that although they are approved for Medicaid as they are now poor, they are ineligible for Medicaid to pay till the penalty period of time has passed. The penalty starts on the day of the Medicaid application and not the date of the transfer(s).
It's all a math problem. The likely scenario is that when the NH Medicaid application and the supporting documentation is turned in, the caseworker assigned will enter the awards letters #'s (their income) in and then look to see their living situation for prior 5 years. So if they still have their home or are in IL or AL, then realistically they should have funds gone. There's probably a whole algorithm with variables that is used. But if they have been living with family with no legally done caregiver & or rental agreements and are down to $ 1,200 well in the words of the handsome & talented Ricky Richardo… Lucy you have some splaining to do. Say mom got $2K a mo income (from SS & retirement) and lived with her son. That's 120K in income plus a quick scan of real property records shows mom sold her home for $ 235K in 2013. So where did 355K go? There was gifting and it's gonna show up. Lets say it's 250k...
The math problem has a "Diversion Penalty Divisor". Each state manages its Medicaid program uniquely but within an overall federal guideline. So each state will have a set amount that it pays the NH for daily room & board. Like for my mom in 2015 it was around $ 158 a day, this is the DPD. So 250K gifting in a state that pays $ 58 r&B is 1,582 days of ineligibility. That over 4 years.
Now mom is already in a NH when the ineligibility notice comes down. The NH gets the notice too. Family have stark choices: private pay for all the time she has been there and going forward OR move her back home. OR if family ignores all this, the NH will ask the court to place mom as an emergency ward of the state & it will be done. Court appointed guardian now determines all, pays the NH from mom's income & assets and can move her to another facility. That NH bill is still there and they will turn it over to collections.
Waivers can be done but imo you will need to hire an atty to shepherd the appeal and negotiate with the NH and the state. If a family member stole from the elder, you'd need to have a police report done. If they had dementia and didn't know what they were doing, you'd need supporting documentation on this. If they gave money to their church, it could get a waiver. In the application, it's pretty upfront about penalties. The DPOA has a required fiduciary duty to the elder and they could be held responsible.
Really applying for Medicaid means the state has an all-access pass to their entire financial life.
ok...which is it? Does the elder need to be somewhere else during the penalty period? Or... does the elder need to be in a NH racking up debt during the penality period?
So..just say grandma helped grandson pay for education in Germany. Grandson had an unfortunate accident. Now, grandma needs to be in NH.. let us say, the amount of money was equal to one year in the NH...
Does grandma stay with grandsons parents (her son and daughter in law...or someone else) for the penality period (one year) ...or does grandma go into the NH and rack up a year of debt till medicaid takes over? OR, does grandma just live on the street for the remainder of her days? There isn't any other answer. That money is not coming back.
Meanwhile, I don't think many nursing homes are going to allow grandma to stay there a year without paying. How will she ever repay that debt she is racking up?
I sure hope she doesn't have to live on the street! Since she has health problems that qualify her for a nursing home she may not be able to live alone, even if she qualifies and finds subsidized housing she can afford.
So ... looks like family might be her only hope. Or perhaps she can find some charity to help her out.
I think this is a totally hideous system for our elders. It needs a lot of improvement. But for now, at least, it is what it is.
An Elder Law attorney may be able to help sort out the options.
Medicaid is available only to people who are financially eligible. To prevent people from scamming the system and giving their money to family members so they are suddenly eligible Medicaid came up with rules about gifting. If you had enough money to care for yourself and you gave it away, don't come to us expecting tax money.
Well, all right. But in the case you describe, KatieKate, grandma was not trying to scam the system. She was just behaving as a loving grandmother, expecting to get the money back. She did not foresee the accident that would prevent grandchild from paying her back.
And in the case of my support group person, the loved one wasn't trying to scam the system, but was irrationally giving away money to charities because of her dementia.
I understand why Medicaid has the rules, but, gosh, they sure to present a hardship to lots of people who were not trying to cheat.
When our health care system became for profit...by heavens, the investor class demanded money regardless of the harm inflicted! Capitalism is a lousy way to deliver health care. Over the last 40 years the investor class (top 10%) has devised more and more ways (thru their wholy owned subsiderary ... the government) to strip the accumulated wealth from the middle and lower classes. And...even better...convinced voters that "yeah! Hey..you don't get any help till all your life long savings has been transferred into the pockets of the top 10%... even though taxes are no longer paid fairly by everyone...so.... Geez we have to keep those poor 10% at the top from paying for any of this!" Tax burden on 1960 was fairly shoulder by everyone, now...even the middle class is calling for the family blood ... to make up for the top 10% getting wealthier and wealthier. Who do you think owns all that stock in healthcare aproviders and service? Not you and me! How did they ever convince everyone that families have to be impoverished? But..yeah..let's all keep paying them more and more because hey..they need it..right? Hey, for profit healthcare is making the top richer every year...and everyone else...........
The thing is that so much can change in 5 years. My dad went from traveling, to needing NH because of AD in 5 years. My mom went from using her walker to visit with family at a wedding reception, to being in a wheelchair fulltime at a NH in 5 years. Neither ever expected to need every cent of their assets for care, and I can see them giving money to the grandkids for education (had they had the financial resources to do so). So it has to be a terrible situation when their generosity comes back on them (and ultimately their adult children).
We had a case a year or two ago of a woman who lived alone and gave generously to charity. Lots of charities, in fact. And those charities, knowing a good donor when they saw one, passed her name and phone number around so that she was constantly bombarded, over years, with letters and mail shots and calls asking for money, which she gave and gave and gave.
The thing is, this woman was far from rich, and eventually she became so agonised about her inability to help all of these 'deserving' causes that she killed herself. There was a great scandal about it, and the government called the charities to account, and the charities took up a lot of air time and newspaper column inches with excruciating humbug about how careful they were with data confidentiality, and not to harass the donors they value so highly.
Anyway. What worries me in the US, is what happens to little old ladies who have foolishly or selflessly or anyway misguidedly given away all their money and/but have no family to take them in? Would APS eventually step in and help them through the Medicaid appeals process, or something?
What happens in a state with filial responsibility laws is that the Nursing Home sues the children who got the money and they win. in PA see HCR vs Pittas. Mr. Pittas had to pay $93K to the nursing home.
I knew a hospice patient who was shall I say was persuaded to hand over most of her money to her daughter and SIL who purchased a very ice home in a desirable district where they continued to live as pillars of society. They were very annoyed when they had to remove Mom from the NH for a year to satisfy the penalty period, but that is what happened. Mon had dementia but on some level understood what had happened and was not pleased about it. Daughter continued her life as a pillar of local society and would leave Mom home alone for long periods. Mom was instructed to only use one room in the house which was a smaller but very adequate family room and not to venture into the luxurious, expensively furnished living room. Well one day she got her revenge and went into that living room and peed on every single chair!!!!!!!! When daughter got home from her meeting with other ladies of the local top society she was extremely exasperated but still did not understand why it had happened.
What does happen though? Say a parent gives lots of $$ to delinquent kid and needs nursing home care and the delinquent is in no shape to care for them. 1) if they are already in a nursing home and got denied Medicaid, does the nursing home kick them out? where do they go? 2) if they are not already in nursing home but need it - where do they go?
Once you turn 65 you had better consider all your assets as eligible for forfeiture to Medicaid. Do not spend a penny on a birthday present or helping a family member. All your assets belong to the 10% investor class. If you fail to keep all your assets to pay for outrageous inflated healthcare prices (inflated beyond anything reasonable)....well...you could be on the street if you ever need anything back from society. That same society you worked your whole life and played by the rules..paid your taxes. Healthcare is not an entitlement..it is a basic human right. And, in the end..must surrender it all to the greed of the investors in healthcare.
Healthcare is NOT and entitlement! It is A basic human right. I think far too many people got snookered into believing that "those people"...(you know the welfare queens) were taking all the benefits and we were all paying. Turns out the vast majority of "those people" are ordinary people like us and our parents.....middle class.
I have the same question. When my father was living on his own and had very little in the way of expenses he promised to help with college costs for his two grand kids. If he had given them a set amount at their high school graduation this would not have been an issue because we would most likely past the 5 year mark, but he wanted to dole out the funds as needed. The last 'gift" went out at the end of last year. Last fall he decided he wanted to go to assisted living. So now his monthly rent is at least 4 times what it was. Needless to say he will blow through his money quickly, but he does have enough for a few years provided he does not need extreme care in the future.
What happens to him when he gets to the point of running out of money and the money he gifted has been paid to a college. There is no money to give back to him. Hoping it will only be one year of college aid by the time he runs out. Family cannot take him in as no one is financially able to just quit their jobs to watch him. Where would he go during that 'delayed' aid period? What are his options?
The options (according to the attorney I spoke with) are...
Family gets together and pays the assisted living facility until the amount of money they have paid to the assisted living facility is equal to the amount of money the he gave away....or Family takes him in until the expiration of the 5 year look back.
But...the wrinkle here is. Most facilities require self pay for the first year or two. So..once the look back period is over....he doesn't have the money to self pay to get back in.
The way around all of this...do not enter a facility until 5 years has passed since the last gift.
Family must belly up to that bar. Or...he is homeless. Maybe some charity will find a spot for him in a group home.
Most states have a law on the books making the children responsible. Some states (like Massachusetts) even make it criminal for the children to not take care of the elderly parents. Pennsylvania has actually enforced that law. The case involved a fellow who had no contact with Mom for many years. The nursing home sued him and won in a legal case. More will follow. I guess this is probably going to end with many more people forced to file bankruptcy.
I predict the states (mostly those controlled by republicans) will start getting heavy handed enforcing these laws.
Katie, are you not overlooking the point that these families have received large sums of money from their aging parents, which is why the gifting rules are applied? The rules were devised to prevent families from salting away their parents' wealth and then claiming their parents' care costs from the state - i.e. from you, the taxpayer, with a family of your own to worry about.
When there actually *is* a case where a family has been forced into bankruptcy as a result of filial responsibility laws, that will be the time to campaign against them. As things stand, the cases involve very, very rich people who either are content to throw their kin under a bus, or have actively conspired to defraud the taxpayer.
I'm sorry that so many people are getting sleepless nights at the thought of these laws, but truly they are not the target. And the people who have been targeted to date... I should save your sympathy for more deserving causes.
I feel bad for every person who is caught in this awful system while the filthy rich (I mean the top 10%) get bigger and bigger tax cuts, while the total socialital costs fall on those least able to pay. These laws came into existence because the massive tax cuts to the top meant this burden had to be forced on the lower incomes.
The real issue here is how did the lower and middle classes ever get snookered into believing that it is their moral duty to pick up the ball that the top money earners succeeded in dropping? How did that happen? This system is designed to transfer all the family wealth from the bottom to the top. And it is working. Not content to have nearly all the gross domestic product generate wealth for only the riches...they have new means to strip the family of any future financial security too. Through the government they have bought and paid for, the top 10% have created more and more ways to make sure this generation of seniors enters poverty...and strip them so the next generation will not get a leg up. (Think..reverse mortgage ... think nursing homes that are for profit.).
No, I feel pity for every low and middle class family caught in this vice created by the investor class to strip families now and in the future. The system is rigged. And too many people have been snookered into going along with it.
Why is the question "why should families help each other at tax payer expense"? Instead of the real question "why shouldn't families help each other, and the expense shared equally by all taxpayers"? It used to be.
Yeah, I feel for every family in this position. We are not "those people" ... you know the welfare queens.... we are your neighbors. Turns out..."those people"... are us.
Just to put that into perspective...not even during the 1890s (the time of the robber barons) has the income inequality been this great. Not in the history of this country.
That's at least partly because there has been a significant change in the definitions of poverty.
If you get sidetracked into believing that societal problems are the fault of fat cats pocketing everybody's money and going tee hee hee about it you ignore much more substantial issues: namely, how the expectations for individuals are going to be met by a society's resources, taken as a whole. For decades western governments have been doing it with smoke and mirrors - borrowing money so that they can pretend to their electorates that they can have all of the desiderata without being obliged to pay for them. Eventually, as one charmingly tactful economist I heard put it: "these guarantees cease to be credible."
So now, a member of our affluent societies is encouraged to expect: good primary, secondary and tertiary education fulfilling, well-paid employment stable prices home ownership or protected tenancy employment rights protecting a healthy work-life balance affordable comprehensive health care a guaranteed minimum standard of living regardless of means or ability to pay for it protected access to key utilities including clean water and heating/air conditioning general living standards rising from generation to generation indefinitely a long and enjoyable retirement the right to accumulate and bequeath wealth high quality health and social care throughout a lengthy old age.
And that's not even counting expensive stuff like national and civic security, or consumer safeguards in the finance industry, or energy and environmental policy.
These are all fine aspirations for a prosperous society with continuously improving productivity (which in our case, both sides of the Atlantic, we have not got). But expectations? Not until we can balance the books, which we can't, not even if the fat cats are hung upside in public and shaken until the money falls out of their pockets. We are in much deeper trouble than that would solve.
We have borrowed too much for too long. It is the end of the line of credit. Time to decide which really are the essentials of civilisation, and which are luxuries we would do better without.
By the way, that's not necessarily a bad thing. It won't do us any harm to have our minds concentrated on what really matters.
Well stated, Countrymouse. I've seen so much Medicare waste and possibly fraud looking back on my almost 40 yrs of nursing and now we have to pay the piper. Yep- doctor's 25 yrs ago signing patient charts when they didn't even see the patient, supply waste, inflated billing, etc. I don't see a government run healthcare system being the answer either. What agency does the government run efficiently and within budget? None. Look at all the waste the government has sustained for years! It's time the government balances its checkbook like the rest of us have to do to pay our bills instead of the smoke and mirror borrowing as you say. Deficits are up the ying yang, and who is going to pay? The younger generations- our children and grandchildren. Too much Medicaid fraud and waste as well. I see 25 year olds on Medicaid, wearing $200 sneakers. Please! Enough of my soapbox- it's a complicated system and it will take complicated solutions where you are correct we all may have to give up something for the greater good for all of us.
" I see 25 y/o on Medicaid, wearing $200 sneakers. " Really? Honestly? You've seen this with your own eyes? And you would recognize a $200 pair of sneakers? And you are sure they aren't a pair he bought when he was 22 and had his first good-paying job, before calamity struck?
It is complicated. It is way too complicated for glib accusations of fraud without knowing the circumstances.
My personal feeling is that one thing we need to take on board is that governments actually *do* very little. "Vote for us and we will do X Y & Z. Yippee!"
But X Y & Z very often are not in the power of governments to do.
Health care is not provided by governments, it is provided by medical, nursing and allied practitioners and their operational structures. Governments interfere, more or less, by providing and then restricting and distorting a public insurance model, one way or another. So they don't do the work, they do the financing - only they tend to do it very badly, with outcomes that satisfy nobody - not the people who pay, and not the people who need healthcare either.
My favourite hobby horse at the moment is a lively ding-dong about social care provision, and who is responsible for it. After several rounds there has been a loose agreement: there is going to be more money made available. Hurrah! Let's do this, then: let's put a pile of money on the floor and watch it magically turn into well-trained, conscientious, care workers with a real vocation. That's bound to work!
There are all kinds of reasons why we have nothing like enough people entering the care services profession. Insulting pay is one of them; but it's only one; and in any case the increase in wages proposed would only take average pay from insulting to pitiful. We haven't properly defined the vocation; so we haven't specified the training; we haven't created a professional framework; and we don't begin to recognise its value. No wonder you can't recruit good people to this field for love or money, but only by blind luck.
Governments, or rather candidates for government, have a fondness for promising outcomes it is not within their power to grant. Yet we continue to expect the next one to do better. We need to stop looking to them to do what they cannot do, and turn our own attention to what actually needs to be done to achieve the desired results.
Yes, Jeanne, or the sneakers could have been a birthday present, or all sorts of things. Trying to identify and exclude individual members of the "undeserving poor" from our social security provision has never really been achievable and wouldn't make enough difference in cash terms even if it was.
On the other hand, it is quite fun fuming over the latest story of shameless benefit chutzpah!
Presumably one attempts to recover the money from the people to whom it was given away. Are there legal tools with which to do that?
If the money was given to family or close friends, they may decide to give money back for the purpose of paying for that penalty payment. However, this is no requirement that they do so.
In my local support group last night one member discovered that his sweetie had given away large sums of money, overdrawing her account in the process. That was his first clue to her dementia. This situation is always heartbreaking. She wasn't trying to make herself eligible for Medicaid -- she was just behaving irrationally, and of course she got on every "charity" list you can imagine, and responded to all of them. She was a well-educated professional (architect) but saying she should have known better is meaningless when someone has dementia.
I sincerely hope you can resolve this well for your mother. Consider consulting a lawyer specializing in Elder Law.
And then it's all on the responsible person. So the elder usually ends up living with the responsible person. I'm sure it is very unlikely that the unscrupulous ones ever pay back the money.
So unfair!
It's all a math problem. The likely scenario is that when the NH Medicaid application and the supporting documentation is turned in, the caseworker assigned will enter the awards letters #'s (their income) in and then look to see their living situation for prior 5 years. So if they still have their home or are in IL or AL, then realistically they should have funds gone. There's probably a whole algorithm with variables that is used. But if they have been living with family with no legally done caregiver & or rental agreements and are down to $ 1,200 well in the words of the handsome & talented Ricky Richardo… Lucy you have some splaining to do. Say mom got $2K a mo income (from SS & retirement) and lived with her son. That's 120K in income plus a quick scan of real property records shows mom sold her home for $ 235K in 2013. So where did 355K go? There was gifting and it's gonna show up. Lets say it's 250k...
The math problem has a "Diversion Penalty Divisor". Each state manages its Medicaid program uniquely but within an overall federal guideline. So each state will have a set amount that it pays the NH for daily room & board. Like for my mom in 2015 it was around $ 158 a day, this is the DPD.
So 250K gifting in a state that pays $ 58 r&B is 1,582 days of ineligibility. That over 4 years.
Now mom is already in a NH when the ineligibility notice comes down. The NH gets the notice too. Family have stark choices: private pay for all the time she has been there and going forward OR move her back home. OR if family ignores all this, the NH will ask the court to place mom as an emergency ward of the state & it will be done. Court appointed guardian now determines all, pays the NH from mom's income & assets and can move her to another facility. That NH bill is still there and they will turn it over to collections.
Waivers can be done but imo you will need to hire an atty to shepherd the appeal and negotiate with the NH and the state. If a family member stole from the elder, you'd need to have a police report done. If they had dementia and didn't know what they were doing, you'd need supporting documentation on this. If they gave money to their church, it could get a waiver. In the application, it's pretty upfront about penalties. The DPOA has a required fiduciary duty to the elder and they could be held responsible.
Really applying for Medicaid means the state has an all-access pass to their entire financial life.
So..just say grandma helped grandson pay for education in Germany. Grandson had an unfortunate accident. Now, grandma needs to be in NH.. let us say, the amount of money was equal to one year in the NH...
Does grandma stay with grandsons parents (her son and daughter in law...or someone else) for the penality period (one year) ...or does grandma go into the NH and rack up a year of debt till medicaid takes over? OR, does grandma just live on the street for the remainder of her days? There isn't any other answer. That money is not coming back.
Is there an expert here that can enlighten us?
Meanwhile, I don't think many nursing homes are going to allow grandma to stay there a year without paying. How will she ever repay that debt she is racking up?
I sure hope she doesn't have to live on the street! Since she has health problems that qualify her for a nursing home she may not be able to live alone, even if she qualifies and finds subsidized housing she can afford.
So ... looks like family might be her only hope. Or perhaps she can find some charity to help her out.
I think this is a totally hideous system for our elders. It needs a lot of improvement. But for now, at least, it is what it is.
An Elder Law attorney may be able to help sort out the options.
Well, all right. But in the case you describe, KatieKate, grandma was not trying to scam the system. She was just behaving as a loving grandmother, expecting to get the money back. She did not foresee the accident that would prevent grandchild from paying her back.
And in the case of my support group person, the loved one wasn't trying to scam the system, but was irrationally giving away money to charities because of her dementia.
I understand why Medicaid has the rules, but, gosh, they sure to present a hardship to lots of people who were not trying to cheat.
Over the last 40 years the investor class (top 10%) has devised more and more ways (thru their wholy owned subsiderary ... the government) to strip the accumulated wealth from the middle and lower classes.
And...even better...convinced voters that "yeah! Hey..you don't get any help till all your life long savings has been transferred into the pockets of the top 10%... even though taxes are no longer paid fairly by everyone...so.... Geez we have to keep those poor 10% at the top from paying for any of this!" Tax burden on 1960 was fairly shoulder by everyone, now...even the middle class is calling for the family blood ... to make up for the top 10% getting wealthier and wealthier. Who do you think owns all that stock in healthcare aproviders and service? Not you and me! How did they ever convince everyone that families have to be impoverished? But..yeah..let's all keep paying them more and more because hey..they need it..right? Hey, for profit healthcare is making the top richer every year...and everyone else...........
Ok...got that out of my system.
We had a case a year or two ago of a woman who lived alone and gave generously to charity. Lots of charities, in fact. And those charities, knowing a good donor when they saw one, passed her name and phone number around so that she was constantly bombarded, over years, with letters and mail shots and calls asking for money, which she gave and gave and gave.
The thing is, this woman was far from rich, and eventually she became so agonised about her inability to help all of these 'deserving' causes that she killed herself. There was a great scandal about it, and the government called the charities to account, and the charities took up a lot of air time and newspaper column inches with excruciating humbug about how careful they were with data confidentiality, and not to harass the donors they value so highly.
Anyway. What worries me in the US, is what happens to little old ladies who have foolishly or selflessly or anyway misguidedly given away all their money and/but have no family to take them in? Would APS eventually step in and help them through the Medicaid appeals process, or something?
They were very annoyed when they had to remove Mom from the NH for a year to satisfy the penalty period, but that is what happened.
Mon had dementia but on some level understood what had happened and was not pleased about it.
Daughter continued her life as a pillar of local society and would leave Mom home alone for long periods. Mom was instructed to only use one room in the house which was a smaller but very adequate family room and not to venture into the luxurious, expensively furnished living room.
Well one day she got her revenge and went into that living room and peed on every single chair!!!!!!!! When daughter got home from her meeting with other ladies of the local top society she was extremely exasperated but still did not understand why it had happened.
Thanks!
Once you turn 65 you had better consider all your assets as eligible for forfeiture to Medicaid. Do not spend a penny on a birthday present or helping a family member. All your assets belong to the 10% investor class. If you fail to keep all your assets to pay for outrageous inflated healthcare prices (inflated beyond anything reasonable)....well...you could be on the street if you ever need anything back from society. That same society you worked your whole life and played by the rules..paid your taxes. Healthcare is not an entitlement..it is a basic human right. And, in the end..must surrender it all to the greed of the investors in healthcare.
Healthcare is NOT and entitlement! It is A basic human right. I think far too many people got snookered into believing that "those people"...(you know the welfare queens) were taking all the benefits and we were all paying. Turns out the vast majority of "those people" are ordinary people like us and our parents.....middle class.
What happens to him when he gets to the point of running out of money and the money he gifted has been paid to a college. There is no money to give back to him. Hoping it will only be one year of college aid by the time he runs out. Family cannot take him in as no one is financially able to just quit their jobs to watch him. Where would he go during that 'delayed' aid period? What are his options?
Family gets together and pays the assisted living facility until the amount of money they have paid to the assisted living facility is equal to the amount of money the he gave away....or
Family takes him in until the expiration of the 5 year look back.
But...the wrinkle here is. Most facilities require self pay for the first year or two. So..once the look back period is over....he doesn't have the money to self pay to get back in.
The way around all of this...do not enter a facility until 5 years has passed since the last gift.
And what happens if the family cannot take him in or come up with the funds?
Maybe some charity will find a spot for him in a group home.
Most states have a law on the books making the children responsible. Some states (like Massachusetts) even make it criminal for the children to not take care of the elderly parents. Pennsylvania has actually enforced that law. The case involved a fellow who had no contact with Mom for many years. The nursing home sued him and won in a legal case. More will follow. I guess this is probably going to end with many more people forced to file bankruptcy.
I predict the states (mostly those controlled by republicans) will start getting heavy handed enforcing these laws.
When there actually *is* a case where a family has been forced into bankruptcy as a result of filial responsibility laws, that will be the time to campaign against them. As things stand, the cases involve very, very rich people who either are content to throw their kin under a bus, or have actively conspired to defraud the taxpayer.
I'm sorry that so many people are getting sleepless nights at the thought of these laws, but truly they are not the target. And the people who have been targeted to date... I should save your sympathy for more deserving causes.
The real issue here is how did the lower and middle classes ever get snookered into believing that it is their moral duty to pick up the ball that the top money earners succeeded in dropping? How did that happen? This system is designed to transfer all the family wealth from the bottom to the top. And it is working. Not content to have nearly all the gross domestic product generate wealth for only the riches...they have new means to strip the family of any future financial security too. Through the government they have bought and paid for, the top 10% have created more and more ways to make sure this generation of seniors enters poverty...and strip them so the next generation will not get a leg up. (Think..reverse mortgage ... think nursing homes that are for profit.).
No, I feel pity for every low and middle class family caught in this vice created by the investor class to strip families now and in the future. The system is rigged. And too many people have been snookered into going along with it.
Why is the question "why should families help each other at tax payer expense"? Instead of the real question "why shouldn't families help each other, and the expense shared equally by all taxpayers"? It used to be.
Yeah, I feel for every family in this position. We are not "those people" ... you know the welfare queens.... we are your neighbors. Turns out..."those people"... are us.
Just to put that into perspective...not even during the 1890s (the time of the robber barons) has the income inequality been this great. Not in the history of this country.
If you get sidetracked into believing that societal problems are the fault of fat cats pocketing everybody's money and going tee hee hee about it you ignore much more substantial issues: namely, how the expectations for individuals are going to be met by a society's resources, taken as a whole. For decades western governments have been doing it with smoke and mirrors - borrowing money so that they can pretend to their electorates that they can have all of the desiderata without being obliged to pay for them. Eventually, as one charmingly tactful economist I heard put it: "these guarantees cease to be credible."
So now, a member of our affluent societies is encouraged to expect:
good primary, secondary and tertiary education
fulfilling, well-paid employment
stable prices
home ownership or protected tenancy
employment rights protecting a healthy work-life balance
affordable comprehensive health care
a guaranteed minimum standard of living regardless of means or ability to pay for it
protected access to key utilities including clean water and heating/air conditioning
general living standards rising from generation to generation indefinitely
a long and enjoyable retirement
the right to accumulate and bequeath wealth
high quality health and social care throughout a lengthy old age.
And that's not even counting expensive stuff like national and civic security, or consumer safeguards in the finance industry, or energy and environmental policy.
These are all fine aspirations for a prosperous society with continuously improving productivity (which in our case, both sides of the Atlantic, we have not got). But expectations? Not until we can balance the books, which we can't, not even if the fat cats are hung upside in public and shaken until the money falls out of their pockets. We are in much deeper trouble than that would solve.
We have borrowed too much for too long. It is the end of the line of credit. Time to decide which really are the essentials of civilisation, and which are luxuries we would do better without.
By the way, that's not necessarily a bad thing. It won't do us any harm to have our minds concentrated on what really matters.
Too much Medicaid fraud and waste as well. I see 25 year olds on Medicaid, wearing $200 sneakers. Please!
Enough of my soapbox- it's a complicated system and it will take complicated solutions where you are correct we all may have to give up something for the greater good for all of us.
It is complicated. It is way too complicated for glib accusations of fraud without knowing the circumstances.
My personal feeling is that one thing we need to take on board is that governments actually *do* very little. "Vote for us and we will do X Y & Z. Yippee!"
But X Y & Z very often are not in the power of governments to do.
Health care is not provided by governments, it is provided by medical, nursing and allied practitioners and their operational structures. Governments interfere, more or less, by providing and then restricting and distorting a public insurance model, one way or another. So they don't do the work, they do the financing - only they tend to do it very badly, with outcomes that satisfy nobody - not the people who pay, and not the people who need healthcare either.
My favourite hobby horse at the moment is a lively ding-dong about social care provision, and who is responsible for it. After several rounds there has been a loose agreement: there is going to be more money made available. Hurrah! Let's do this, then: let's put a pile of money on the floor and watch it magically turn into well-trained, conscientious, care workers with a real vocation. That's bound to work!
There are all kinds of reasons why we have nothing like enough people entering the care services profession. Insulting pay is one of them; but it's only one; and in any case the increase in wages proposed would only take average pay from insulting to pitiful. We haven't properly defined the vocation; so we haven't specified the training; we haven't created a professional framework; and we don't begin to recognise its value. No wonder you can't recruit good people to this field for love or money, but only by blind luck.
Governments, or rather candidates for government, have a fondness for promising outcomes it is not within their power to grant. Yet we continue to expect the next one to do better. We need to stop looking to them to do what they cannot do, and turn our own attention to what actually needs to be done to achieve the desired results.
On the other hand, it is quite fun fuming over the latest story of shameless benefit chutzpah!