Paying family members for caregiving. Any advice?

GardenArtist, we both did a good job!

GladI'mHere, that was my question and suspicion as well. Seems we posted just about the same time; your post wasn't visible when I posted mine.

AnnAtty, wouldn't that kind of gifting be a red flag in a Medicaid application, i.e., if the parent has funds to gift, why should Medicaid become involved and pay for her care?

The issue of gifting is if Mom ever needs Medicaid any gifts in the previous five years, possibly going to seven, will be viewed as a penalty/waiting period before Medicaid kicks in.

There is another option to how to treat monies paid to family member without treating that person as an employee or independent contractor. Your parent can elect to gift up to 14k a year to the family member which is tax-free to the caregiver and would not be taxable to the parent unless lifetime gifts exceed a total of 5.34 million at the time of the parent's death.

In my own case, it has helped me to recognize that we were all raised by a mom with severe deficits, which impacted each of us. I always related to the other side of the family, but a moment of clarity, towards the end, helped me to recognize that all of my siblings believe they are working hard to become more self aware. A few years ago I would have said several have no inclination in that direction and are only capable of responding on an emotional level, so this insight was very eye opening for me.

Suggest that you move forward as a family with building contractual agreements. Include all siblings in a monthly update Skype. I am sure there are emotions on all sides, as 'Venus' doesn't own emotions. We all become Venus in these situations. We all also claim mars. It is more helpful to say that, as you have to the group, the current situation had nothing I. Place and we need to work that out and then hold monthly Skype meetings. Set up a google group. Often, I observe, that siblings still can't work things out, men or women, successful siblings or non, but the sooner people start to communicate and share, the better.

Good Luck Jeff! I also met with our local Area Agency on Aging here in NE Ohio, and I was given some great advice. I hope they are helpful to you too!

Pay for the airfare - now and in the future - via weekly cash withdrawals for Mom, which she is entitled to for "incidentals". Just put an amount aside specifically for that airfare. I don't think it is fair for your sister to incur that expense, especially if she is flying in to help with Mom. Tell her that she would have to claim whatever amount she is paid, with the local going rate for home health aides (non-certified aides) being $9.00 or whatever it is in your area - for a max of 8 hours a day. And does she really want to do that? Food, etc. are NOT included in that rate. I don't believe your mother would need to go so far as to get a federal tax ID #; her SS# should suffice. Her living in an Assisted Living Facility might cover the Workman's Comp issue. Yup - definitely something to discuss with an Elder Care Lawyer. Sticky issue -- one played out all across the country.

Thanks Tulips. I am in NW OH. Looking at the AOA NW O, Area Office on Aging Northwest Ohio for some advice.

Ismiami, the recent visit was somewhat urgent as Mom was just released from 8 days in hospital. Sister did stay with Mom so no hotel or rental car. Sister says she has no money to save up for this type of thing.

I understand getting paid for daily caregiving, but expecting reimbursement for visiting mom for a measly 5 day visit is just ridiculous. Tell sister to save $20 from each paycheck, stay with relatives to avoid hotel cost and plan ahead for cheaper airfare. Everything cannot come with a tab.

Forgot to ask....Where are you in Ohio? I live in Ohio too, and we use Victoria Shafer, Elder Law Attorney in the Green/Akron area. You can look her up if you live this way. My grandmother moved in with me, which is why we needed our contract...I am no longer working in order to care for her.

You do not need a lawyer to create a contract, although, we did meet our elder law attorney to make sure we did the contract correctly. My care contract with my grandmother states my duties, hours I work per week, agreed upon hourly wage, as well as some other specifics. Then we both signed and dated it. I hope this helps.

Shame on your sister thats all i can say isnt it terrible that she couldnt give five days of her time to help out without being paid for it im sorry but i find this disgusting and very WRONG. If my sister dared to ask for money for helping to care for her own mother for a few days i would quite simply disown her. I really dont know what kind of a world we are living in but its getting scary especially when the likes of your sister are asking for money for doing a natural human caring thing gosh i wonder how much my cat OWES me for two years care and food and board ask your sister what does she think would be reasonable? selfish.......

Some always say contact a lawyer..but it may not be necessary everytime..would be interested in what Gabriel would say. It seems to me if you have proof of the airline ticket cost and dates, and document services provided each day (Not duplicated by another caregiver)..and especially if the regular caregiver was given time off...document everything. Seems like that would be sufficient. But if it was just a visit..then reconsider. .but..I am not a lawyer. I have found lawyers can be very expensive..not always helpful or necessary..lots of good info on this site.
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From the Bar Association, a one line email reply: It would be best to contact the Columbus Lawyer Referral Service 614-XXX-XXXX.

Thanks guys. I think I got it. I'll call the attorney about 50 miles to the north. He is the only one with the word Medicaid on his website out of about 20-25 so far.

Jeff, contact either your State Bar Association, ask if they list practice group (elder law) specialties on their website as you're looking for an elder law attorney.

These are generally the ones who are the most active in their field, speaking, presenting seminars, etc. I've worked for a few who aren't very reputable so you need to be sure you get a good one.

The bar association for the county in which you live, or a larger county, may also be able to provide you with this information.

Ask about rates - some will prepare documents for a flat fee; others charge by the hour.

Estate attorneys are often easier to find and most of them know the ropes of Medicaid. Also, the National Assn. of Elder Law Attorneys website may be of some help. http://www.naela.org/
Good luck,
Carol

Thanks. I am searching for an attorney in the area who indicates Elder Care on their website. Out of a dozen or so there has been one and he is 50 miles away.

Hi Jeff,
This is not an unusual situation. You could write up a contract and have everyone sign that this was a care expense (having it notarized) but it may or may not be legal in the end. Other than an by using a qualified attorney, I'm not sure how you can guarantee that it will be. However, as you suggested, a social worker may know of a form that you can use or have other suggestions.

While in the end you may not be able to go back, you could pay this and hope that Medicaid would accept this as an explanation down the road. But be prepared to pay it back if they don't.

You sound wonderful and clear headed so I know that you'll consider these expenses in the future, anyway. It's simply too bad that your sister expects to be paid since your aren't being paid for what you do.

Please let us know how you handle this. We're always interested in answers that may help another member of the community.

Take care,
Carol

Mom has a computer and internet access. She uses email. I think she tried Skype with FL sister. Not sure about results. I don't have it. Especially after illness this year there was no substitute for visits, which were very valuable to Mom. I'm sure she (and I) would consider sister's visit a worthwhile expenditure of a reasonable sum. I just need to know how to avoid jeopardizing financial assistance qualifications as I am certain we'll need that down the road.

Jeff, just a quick thought before it escapes my mind:

What about an alternative to a visit by your sister? Could you set up a Skype for your mother - either you or your sister who visits regularly could bring it at a specified time/date and connect with your FL sister (assuming FL sister would spring for the cost of her own Skype)?

I'm wondering also if the facility in which your mother resides has any of its own computer connections for the residents? If they do and have the Skype software and equipment, that would be even better.

I don't have any other suggestions on the other issues in your last post at this time other than to agree to let the issues sit for a few days while you collect your thoughts. It sounds as if this is a situation for which you really want a solid plan going forward.

Not to sound unkind about your sister, but it sounds as if she could have a personality disorder, and possibly be a narcissist.

You're smart to be looking ahead to Medicaid issues. I would really suggest that you get to an elder care attorney for advice going forward. The lawyer will advice you whether you can compensate your sister or whether this will create another hurdle later. This may not be the only time your sister flies up and expects compensation so it'd be best to address this now. Sometimes it helps bridge the communication gap between emotional and logical when a professional third party backs you up.

Hi GardenArtist,

I was hoping we could include the airfare cost on the care giving contract so I could be repaid, legitimately. Sis stayed in Mom's apartment while in OH. She is after as much money as she can get and has mentioned lost wages even though it was a holiday weekend. I am too embarrassed to mention the dollar amount she asked for (maybe demanded is a better term). I am willing to use an acceptable/customary rate and tell her she has to settle for that. She has no experience or qualifications in the field of which I am aware.

I need to wait to get all my facts and thoughts together before I forward the message to my sister.

In a way, thru me, Mom is paying for this care. And basically sister will say she doesn't have a nickel to use to get to OH to see Mom. If Mom is O.K. with paying sister's transportation cost or even a wage, I'm O.K. with it. I'm just trying to figure how to do it legitimately.

My own pocket has been tapped out with the loan for the airfare and other items with the other sister.

Similar to "no" not being an option, neither is "last time". It looks like I will have to consult an attorney. I'll wait a day or two. Maybe someone else will chime in with an idea.

Thanks.

So I asked my accountant friend if that meant Mom would have to start a business with employee(s). Answer: "Yes, your mother would have to get a federal ID number. She would be able to pay the withholding taxes when filing her 1040. However, there would be some Ohio requirements, too. For example, I think she would be required to have coverage through the Bureau of Workers’ Compensation." It just keeps getting worser and worser :-(

Jeff, this is interesting and I appreciate your sharing it. I did know that household help and caregivers should theoretically be subject to withholding, which is one reason why I decided against having free lance help for my father. I didn't want to get involve in the extra bookkeeping and tax issues, or any liability issues either.

But I'm surprised that a family member would have to be treated as an employee. However, you certainly took the right path in contacting your accountant friend.

I can see a couple options:

a. You wrote in one of your posts that you paid your sister's way this last time, as a loan. If so, then I must have been confused that she wanted reimbursement for travel costs. Or is she just asking to be paid for "services"? What about lodging? If she stayed with your family, there wouldn't even be these costs.

Does she have any professional medical qualifications that would be construed as "services"?

b. E-mail her with your accountant's message (leave his/her name off). I don't know how anyone could legitimately consider a family member an employee for the purpose of coming to visit. So it may be that you won't be able to help her out.

c. If so, you might want to make it clear that any future visits would have to be on her own nickel. After all, you and your family are providing more care on a regular basis and other than miscellaneous costs, your mother is not paying for this care.

d. Alternately, to keep peace in the family, pay her out of your own funds (I wouldn't suggest this though) and let it be the last time.

I honestly think that Medicaid wouldn't look kindly at "hiring" a daughter to come visit her mother, regardless of what she does.

O.K. A set back. I don't think a simple contract will do the trick. I got this message from an accountant friend:

"She has to become a W-2 employee. She cannot be an independent contractor and receive a 1099. She can receive a 1099 only if she is in the trade or business of being a health care provider. If a person earns more than $750 in a quarter or more than $1900 for the entire year, payroll taxes must be paid (by your mother). She would be able to do this when she files her 1040 by attaching Schedule H, which calculates Social Security and Medicare taxes for the hired person. The hired person is considered a “household employee” and rules for that type of employee must be followed."

Now it becomes much more than I signed up for :-(

"No" is a logical term. Like on or off. Like 0 or 1. It does not work with the emotions as one would expect. No is not an option here. Believe me, I've tried that before.

You sound great, but it seems inappropriate and tacky that your sister is asking for money. Perhaps you should just tell her "no" and tell her end of discussion.