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It's now 642 ...but it was 4300 dollars two months ago. How do I explain that? My sister was having financial problems and I gave her about 1500 dollars.

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OP has not responded since she posted on 11/26. Since Mom was only on Medicaid 5 months so no reapplying but nephew gets medical thru Medicaid. He gets paperwork every year asking if money has been transferred in that year. I include need to include the latest statement. I do not have to go back 5 years. That is done at time of first application why would you have to that each year of application. There is something weird that you spend down to 2k and bank acct goes up to 4300. Something is being deposited that needs to go to Moms care. Maybe a small pension?
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Reply to JoAnn29
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My sense here is that we don't have enough information from you on this situation to give you the most helpful replies. Because Medicaid is a program structured for the most needy in society, recipients are not supposed to be in a position to have $4000 to loan to their daughter.

The annual Medicaid re-qualifying process is very involved, and we still use an elder attorney every year to help with oversight. In Texas, if this transaction occurred during one of the 4 months examined to re-qualify, it would be flagged.

Even so, if your mom had >$4,000, and $1,500 went to your sister, your mom would still would have been over the $2000 limit. How did you get it down? Keep receipts and document.

Maybe you can provide more information and we can provide more helpful answers.
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Reply to sue3321
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Chapo - I’d suggest you
1. go to billing at the NH this week to make sure that mom is absolutely 100% current on her copay or SOC (share of cost) that she must pay to the NH each mo as required by Medicaid rules.

If she’s delinquent in her copay, you pay it so she’s current.

Remember Medicaid REQUIRES that almost all her monthly income to be paid to the NH. All she gets is a small needs allowance- like my mom’s in TX was $60 a mo.
2. The excess $ has been held where.... like in a checking account in mom’s name so your writing out a ck to the NH each mo for mom copay OR is it /was it at the NH is her personal needs allowance type of account? If it’s this, then the NH is somewhat at fault in this clusterF as they know the 2k max assets limit that Medicaid has. But ultimately the financial oversight falls on the DPOA, which is you.

There was a post on AC where the mom had her needs allowance basically untouched at the NH since day 1 & had gotten up to like 6k and the NH bought her a 6k wheelchair to get her Medicaid compliant, the dpoa daughter was super peeved as she could have used it to buy a funeral pre need but really everybody dropped the ball on $ oversight and Medicaid was lax in doing recertification.

Whichever errors happened at least she’s under 2k at $630, you leave it there, make sure it get spent so not over 2k ever and as DPOA you make sure that Sissy cannot access it. You’ve been lucky that this has not surfaced on Medicaid’s radar (as well as gifting to Sissy in the past) and I bet since part of this is due to NH billing snafus they have been able to adjust her PNA balance so it looked ok for cursory quick Medicaid review. But don’t count on that luck again.

She will need clothing replacement; she can go to or have the beauty shoppe do her hair twice a mo; buy shower / toiletries stuff. Really twice a mo beauty shoppe will likely spend all her personal needs allowance.
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Reply to igloo572
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chapos Nov 26, 2018
So in our state they just have you sign a paper every year that says "have their been transfers, or payments, or movement of money in the last 5 years" I answered no but of course my mother had said she wanted to send my sister 500 here and 500 there over time. It wasn't that much money and it was her choice. I wish the gal would have clarified that means ANY and over the last 5 years. I would have had to really do some digging but what if she had no money? She had 2600 at the time of first being approved and the gal said to just spend it down to 2000. Do they really want to know about all of these smaller checks over a 5 year period? If that's the case then it will add up. My mother was in assisted living for years and always had an extra 1000 a month coming in. We bought her depends, clothes, glasses etc. And yes she did write checks to my sister etc. The Nursing Home is fine but I think they made a billing error when they switched accounts.

Bottom line is if I pay back the 1200 dollars is it a done deal or will they want to back further in time? I wish she would have said bring me 5 years of account statements then I could have approached my siblings and said we have to pay this 7000 bucks before Mom can get approved to get into a facility.
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How did Medicaid overlook the "helping sister for years"? They audit all accounts for the five years previous to entering a nursing home. No gifting of property or money in that time frame or a penalty is assessed.

And now you continue to help sister. As POA for mom you are only allowed to spend MOM's money ONLY for MOM's benefit. What about after mom is gone? Then will you continue to "help" sis? Sounds like enabling to me.
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Reply to gladimhere
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I am assuming that Mom has been under care at a NH with Medicaid paying for her care. First, the 2000 or less in her account needs to be used for Mom only. You cannot loan out the money. Its not urs to do so.

Second, if you got down to 2k to apply initially, how did she get to 4300. Her SS and any pension should have gone to the home.

You need to get copies of her monthly bank statements and see where the money is being deposited and then withdrawn and by who and what for. If like my nephew, you r going to have to include her statement with the application. They will check her bank info.
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Reply to JoAnn29
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chapos Nov 26, 2018
OK so my mother has been helping my sister for years. My mother entered a Medicaid Nursing facility about 3 years ago. The discrepancy with the money, I think, is in the accounting Dept at the facility. We live in WA state. My mother would always want her daughter to have help. I don't have a problem with paying the money back. I'm just worried about my mother's status. I don't want her to be " kicked out" She has no money so I'll just pay back the money that went to my sister. Do you think that she'll be OK then to stay? The case worker told me to spend down her money before she went in. What do you buy a 91 year old woman who doesn't want or need anything. She broke her back and she certainly didn't need anything at the time. My sister was hospitalized and lost her job. She couldn't pay her rent and...I just knew my Mom would help her as much as she could. My mistake though. Thanks for your answer and everyone else's contributions.
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Chapo - ok so help us understand just what your mom’s situation is.... so she’s on what type of Medicaid?
LTC in a NH Medicaid? or
she just applied for LTC NH and is “Medicaid Pending”? or
still living in her home or in your home but on community Medicaid?
Your reapplying as in an annual recertification? Or cause she’s become ineligible in some way?

So how did she go from being at 2k Medicaid max for nonexempt assets to $4300 in assets and now at $630 in a bank account?
& what - besides $1500 to Sissy - has her $ been paid to?
If she’s in a NH, has she paid her required each month by Medicaid copay or SOC (aka share of cost) of her monthly income?

Yeah as everyone has posted, there’s gonna be a problem in all this. But just how much of a clusterF, is dependent on what Medicaid she’s on.
So what’s mom’s backstory?
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Reply to igloo572
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Yikes. You need to get a workable system of money out and money in. Mom’s money needs to be spent on her and not to bail out needy relatives. Nothing about handling her money should surprise you. Funds should not appear and disappear without you knowing exactly where they came from and went to. Monitor her accounts constantly so you don’t have to explain anything without knowing what you’re talking about.
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Reply to Ahmijoy
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I went through the spend down with my mom, too. It sounds like your parent is still at home? LTC required most of Mom’s income quickly so, we are a bit different. Either way, document. Document. Document. I made a three prong huge binder for every aspect of Mom’s and still do each time insurance or bank statements or even old bills come in - I’m not here to judge or stress you out about the family loan/gift because each family has a unique dynamic. That being said, if you have not already, start putting everything in a binder- even hand written notes you’ve made. It will work out. Your help with the spend down to prove one of the qualifications are met is the easiest part of the aging process. Wish you the best with your tasks. Absolutely been there! Mom is now in long term care and I’m still “hoofing it” it seems to keep everything at bay. Just breathe! Document the money flow and the truthful explanation(s) are ready when you need to refer back. Good wishes! Oh - I hope you’ve looked up gifting per year with Medicaid. It’s out there. If you don’t have an immediate case worker (helped so much), just research it, print it and have your notes and questions on it when you do speak to someone...
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Reply to MomsKid
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chapos Nov 26, 2018
So yeah my Mom's been in her NH for three years. She gets 2400 a month income and that's what gets paid to the NH every month. I wish I had someone in WA state to go to and get answers but I guess I'll just have to try and explain it to the caseworker. I can pay back the money just wondering how far back do they look now? She went was admitted in 2015. Thanks for everyone's help.
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You gave your sister $1500 of your mother's money?

Or you gave your sister $1500 to help her as your mother's caregiver and..?

If you are responsible for managing your mother's bank account, then you must know where money is coming from and where it is going to. So your question "how do I explain that?" completely baffles me. How DO you explain it? Because you're going to have to.
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Reply to Countrymouse
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You are going to have problems. Loaning/gifting money is not permitted under Medicaid. It is going to have to be repaid under their formula.
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Reply to gladimhere
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