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.
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?
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 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?
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 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.
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?
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).
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...........
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.
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.
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.
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.
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.
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.
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.
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?
And what happens if the family cannot take him in or come up with the funds?
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.
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?
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.
Thanks!
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.
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?
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.
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.
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.
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?
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.
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!
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.
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.
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?