I am my mom's POA, and 5 years ago, I sold her home, as she has Alzheimer's Disease, and it was no longer safe for her to live alone. I moved her to my hometown, in a quality memory care facility, using the $ she received from the sale of her house, to pay for her rent in the memory care facility. She's been private paying for the last 5 years---first, in an assisted living facility, then memory care ever since.
I humbly admit, that I was very very naive, when it comes to Medicaid---I had thought that as long as mom had enough $ to privately pay for 2 years, Medicaid would then take over her rent payments (which is the policy I was told about, upon mom moving into mc.) Anyway, between losing my job bc of covid, and then just buying things such as birthday presents for my son, paying my rent, surviving, etc., I thought that I was still being responsible with mom's money, because I believed that she needed enough $ for private pay for 2 years, before Medicaid would kick in. I was unaware of The Look Back Rule until very recently, and am just now realizing how stupid I really was. I adore my mother; but caring for her in our home (rent, do not own home,) would be the kiss of death, for the both of us.
My question is, I already know that Medicaid will initially deny her coverage, to remain living in mc. I was not feeling "greedy" or neglectful of mom at the time I was spending some of her $; I just thought that her needs would be met, especially since over the past 5 years, she's spent nearly $300,000 out of pocket for her care. If I apply for Medicaid, I'm concerned that I will be found guilty of a crime, and be fined ,all the while, they will deny her coverage. Would applying for Medicaid add insult to injury, and just be a pointless pursuit? I only want what's best for my mom, and, she's in the later stages of the disease. I know that no matter how much I try, her care will be so much less than what she's receiving at memory care, right now. I also am not prepared in any way, for her to be discharged, and to move in with me and my son. Full disclosure: I would've done everything differently, had I only known about this rule. I love my mom dearly. Any advice would be greatly appreciated.
The funds used for your personal use (instead of her care) will most likely be part of her Medicaid penalty period. Don't be alarmed by the "penalty" term. It just means the Medicaid benefit doesn't kick in until her care was paid for outside of Medicaid for a certain number of months.
So if you spent $20k on yourself from Mom's money and a nursing home costs $10k per month, the Medicaid benefits doesn't kick in until mom pays $20k in nursing home care (which is 2 months of care).
My mom gifted my family money then a year later, my dad died, I took her in, and then had to put her in a facility shortly afterwards. I remember feeling the way you did when I had to apply for Medicaid. You'll feel better after getting legal consult.
I gathered all documents. You might find useful info in her tax statements although I know that they are only needed to be kept for 3 years.
For Medicaid, If you are faulted on gifting to yourself, it means that she will not be eligable for any payments for a certain amount of time based on that financial discrepency. So when she can no longer pay for MC, there will be a gap in time for her to be covered in LTC.
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You need to see an attorney with your details, questions, and any records you kept over time.
I would start the process when the time comes. You will need to supply 5 years of bank statements. They may or may not request proof of your withdrawls for rent. I would not say anything, let them ask. They look for large amounts. Gifts for son maybe overlooked. If they question your withdrawls, they will be considered gifting and there will be penalties and a period of time Medicaid will not pay for Moms care until the penalty period is over. The facility will probably take Moms SS and any pension she gets for her care, but you may be responsible for the balance of her care costs until the penalty period is over. Maybe you can work something out with the facility. Maybe cut down on her care costs by you going in and doing things the aides would do.
If you don't apply, you will be caring for your Mom. MCs do not have to keep residents that aren't paying for their care.
If this is correct, the best thing you can do is find a certified elder law attorney, well versed in Medicaid law for your state and let them guide you on best actions to take at this point. The sooner you do this the better.
Did the MC facility tell you that they would accept Medicaid as payment after two years of private pay?
You've spent Mom's money on Mom's care, right?
I don't see what the problem is. I think I must be missing something.
Medicaid's 5 year look back is to assure that the client hasn't gifted or hidden any money. Paying for care is a legitimate use of her funds.
Another legitimate use of her funds is paying for an elder law attorney well versed in Medicaid.