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Mom has severe short-term memory problems and other mental issues (possible Alzheimer's), heart problems and is a high fall risk. She needs to have 24/7 care.


Unfortunately, she gifted the money received from sale of the old family home. Medicaid won't kick in until we pay a nursing home out of our own pockets up to the amount of the gifts OR wait 5 years to re-apply for Medicaid, so the gifts are not included in the look-back period.


We do not have the money to pay for 12 months of nursing home care to cover the amounts of those gifts. None of us are healthy enough to be her caregiver for the next 5 years. My husband is disabled and I plan to continue to be his caregiver until his health declines to the point he cannot transfer himself or my own poor health makes it impossible to be his caregiver. My brother's health has become poor in last few years as well.

Please contact your Area Council on Aging to see what day care or in home respite programs might be available outside of Medicaid. In Tennessee we have a program funded with federal/state grants that provides day care based on medical need and monthly income. A SW did an in home assessment and I provided a copy of her SS benefits letter and my mother was accepted into the program in less than one week, My mother's SS is below the income level required for payment so she will have access to the program for free. If her income was larger, she may have been required to contribute a co-pay.

Adult day care provides a few hours each week of socialization for your mother where you can know your mother is safe and you can take care of errands or your own doctor's appointments. This type of support takes a mountain of stress off long term care givers.
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Add to Igloo.
You need to see a lawyer with Medicaid and disability specialty in Montana if that is where you all are. Montana is a filial responsibility state. You need to establish your lack of understanding to support a defense against “you gotta pay.” Brother needs to document lack of assets and health. Lawyer can help with that. A lawyer can also tell you if you are getting help from all programs state offers. You have to document your own health limits. Not always a lot of sympathy with many state employees for lack of planning when family got money and bought house then Ma needs state help. Also please don’t spend Ma’s income on her own bills or bro’s support if you/she applied for Medicaid. Share of cost for all but minimal personal needs account needs to go to nursing home. People get in trouble for keeping Ma’s money to keep her bills paid and frequently family living in Ma’s property. Even if you get her on Medicaid, there will be NO money to support bro if Ma’s been his source of funds since he is obviously not working. You need legal help to prepare appeal and shepherd application what will be intense review if you already know 12 months.
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JillJoyce Jan 17, 2019
Thank you. The filial responsibility/law is frightening. Almost makes me wish I had never come back to Montana to live. I don't want to be bankrupt or homeless :( Neither does the hubs or our fur-kids.
Mom's primary home was sold to non-family member, but yes us kids did get the majority of the money. Mom isn't in regular nursing home yet. She's been in and out of hospital and rehab since October. While in rehab they suggested we apply for Medicaid. That was done and the research and questions started. We had mom's medicaid application cancelled as it became obvious we had no idea what we had gotten ourselves into and things do not look favorable.
When mom leaves rehab, she will be coming to stay with me or going to stay in her trailer with bro. I am setting up appointment with elder law attorney. Hopefully they can help.
My husband and I are both on SSDI. Bro has applied for SSI and been denied. He did qualify for Medicaid and is eligible for food stamps.
I have continued to pay her bills as she will have to go back to living in her trailer until we get legal help. I did let bro know that if she ends up in memory care facility all of her social security goes to the facility.
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Also for the 70k “falling down” house, was 70k the last tax assessor value on the property?
If not, was it appraised by the bank at 70k as part of the sale?
Was it sold “arms length”, that is sold by Realtor via a listing? So not sold to a cousin or other family or neighbor.
Did it languish on the market for weeks, and got price reduction?
Was house her primary residence with homestead exemption?
You mentioned “her trailer”, so she had the house and also a trailer.... did she have both at the same time?
Trailer is sold? Or Existing somewhere still in her name?

Anything else lurking for a Medicaid issue, like cash value insurance policy? Or annuity that’s a surprise. Actually it’s good it’s January as you need to pay attention to her mail to see if she gets any 1099 for dividend or interest or other taxable income you are unaware of. All tax stuff should be mailed / dated by end of a January.

So was mom showing issues in “executive functioning” with the house, e.g. she didn’t pay property taxes, insurance lapse, utilities shut off, etc. Like stuff that leaves a paper trail. Or did she kinda seem all competent and cognitive when she gave you all $ in 2017 & again in 2018. You imho kinda want to journal down things as you recollect and go over this with the atty.

yeah its a lot to deal with. It will be overwhelming but think of all the details you’ll know about now IF you go thru Medicaid for hubs and you can be proactively planning on how to maximize your being a community spouse if he enters a NH later on.
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JillJoyce Jan 17, 2019
She seemed perfectly competent and cognitive when she gave out the gifts in 2017 and 2018. Her decline didn't start until Fall of 2018.
She almost always paid her taxes and bills on time.
She asked me to take over paying her bills in 2016 as her eye sight was getting worse and reconciling her bank statement was giving her headaches.

Thank you, journal is good idea and I will be starting it this weekend.

The old house was assessed at about double the amount sold for. Mom owned the primary home, trailer and the land they are on. The guy who bought the house knocked on the door, introduced himself (he was living in camper on one of the neighbors land) and said he really wanted to buy and fix up the house. She and brother moved into the trailer and sold the primary homestead. New owner traded her deed for cashiers check. No appraisal or anything else was done! I begged her to at least work with a real estate attorney but she insisted on doing it her way.
The new owner had to replace roof, windows, doors, floors, wiring and plumbing. He gutted most of the inside and re-built it.

Mom has been in and out of hospitals and rehab nursing care since October with only a few weeks at a time at home (trailer) or at my house.

I sure wish I had known all this Medicaid stuff sooner, but it will be good knowledge to have for future.
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Well good part is her homestead sold for only 70k.
Bad part is your state pays low room and board reimbursement so 70k is 12 mos. and penalty is by # of days ineligible.

I’m unclear, are you DPoA, or is bro, or there isn’t one?

Any way to get back brothers recent 5k?
The $5,000 done this month in 2019. Please please try to get this done. It shows Medicaid that “omg as soon as we were aware the $$ gifts mom pressed / insisted upon us would be an issue for Medicaid, we immediately did what we could to rectify the situation.” Do whatever to get that 5k back & paid to mom’s checking account and then to NH ASAP. It’s shows a good faith gesture & acknowledgement of Medicaid rules once you became aware. Again “once we became aware” is your mantra. Plus keeps NH less hostile.

Its not fraud, mendacity or coercion. That is on your side to get this worked out hopefully with Medicaid. There’s a post from Nov on granddaughter who got dementia Grannie to gift her $300k home, that is going to be a true horror show medicaid saga. Yours will be stressful but imo manageable although imo you will need to hire a NAELA or CELA level of atty. to shepherd the process.

Ok so how exactly did you find out gifting = transfer penalty?
- like Medicaid application submitted & state has sent ineligible letter? So already in NH like 2 mos? Or 3? or more at this point in time?
or
is it that NH gave you/mom a list of documents needed to accompany mom’s LTC Medicaid application & the NH noticed the house sale document that it’s only 2 years ago and that she’s impoverished now so won’t take her as a Medicaid Pending resident? If it’s this, Has NH given you/mom a private pay bill? Or a 30 Day Notice?
or
is it you’ve realized this is an issue in reviewing the documents you are gathering together for her Medicaid application?

Prior to the NH where was mom......
Living in her home and went from her home directly to the NH?
or
living with family? Or AL? For how long?
or
was she hospitalized (MediCARE) and then discharged to rehab (MediCARE) at a NH that has a rehab unit? If it’s this route, is she still in rehab? If out of rehab, how many days did rehab pay for her? How many days since out of rehab?
- does this NH have other open beds?
- Mom gets exactly how much $ each month in monthly income?
- has Mom has consistently paid NH her monthly income less whatever tiny amount state has as the personal needs allowance?
- is tpersonal needs allowance held at the NH?
All the above part is important as you / atty are going to try to negotiate mom’s day rate.

Stay with me on this..... NH will have a private pay rate $$$; a MediCARE bed day rate $$; and daily room & board reimbursement rate Medicaid pays $. Medicaid National avg is abt $175. A 70k 12 mo penalty is abt $195 day rate. There will be an exact figure your state pays, you want to get NH to accept that rate. It will be significantly lower than private pay. The penalty is by # of days, so if you can get amount at Medicaid rate is will be hugely less. And the responsibility- if you cannot get it waived - is 50/50 you & brother.

He sounds judgement proof.... could that be his situation?
You & hubs sound like still have jobs and have income (other than SS) and own a home, is that accurate?
Did you personally sign to be financially responsible for mom?
Perchance did you & hubs spend $ to make mom’s property market ready, or pay property taxes or for caregivers? Got receipts?
perchance are you or bro disabled in any way?
Is hubs SSDI or SSI? Verified disability?

Atty probably can get some waived. It’s not mendacity, or fraud but lack of awareness. However the NH is going to want to continue getting her mo income and the $ that is the gap between that and what Medicaid would pay them. If you can get the to accept that at your 50% till atty works mom’s Medicaid appeal out, could you swing that?
Make a pot of coffee manana and go over the timeline and $.
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Kimber166 Jan 17, 2019
I have never heard of Medicaid approval to waive a transfer penalty for "lack of awareness". They simply do not cover for x days penalty. It is up to the family to figure it out.

I have heard of families turning their loved one over to the state for guardianship, then the state has gone after the people who got "gifts" because the state is responsible now for mom.
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Is there any way she can private pay for home care? I understand no one is physically able to be a full time caregiver but is it a possibility you can hire one or two private caregivers to help out for a few hours during the day? That’s assuming mom lives you. I’m so sorry. What a terrible position to be in. I honestly don’t know anyone is supposed to know about the Medicaid rules! You find out about them when you need Medicaid. This would definitely be a last resort for me, but if you get the home equity loan which I hope you don’t have to get, could you rent out a room to help cover the cost? Obviously that’s NOT ideal but it’s something I would consider in this situation. In the meantime, might as well apply for in home support services, you never know, maybe she’ll get a waiver fairly quick if she’s eligible.
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We had No idea of the impact. We got the gifts so we will have to figure out a way to take care. Probably until we die or 5 years from now whichever comes first. She is tough enough to out-live us all, especially since we are in poor health ourselves. It's scary. Thank you for your response.
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I'd suggest printing out Igloo's reply. Send copy(ies) to whomever received the money from the house.  To the POA/DPOA. In short, to everyone involved.  They need to have a clue about what can, almost certainly will, happen in this situation.  This is way beyond making "nice" with grannie and keeping it all in the family.
The nursing home WILL be paid - if they go the emergency guardian route, certain things WILL happen.
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JillJoyce Jan 16, 2019
Yes, it's frightening the way it seems to work. We had no idea of what could happen and it looks like one or both of us kids will become homeless to pay back the gifts we received from mom. Thanks for your input :)
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I’m on Snoopyz & others wavelength...... so to whom did mom gift her house sale $ to?
If it’s a 12 mo. Transfer penalty period, it’s somewhere in the $96,000 - $180,000.00 gifted as NH average 8k-15k a mo.
So who got basically $100,000.00++??

Has the DPOA contacted the giftee regarding the situation?
That is “mom / Grannie cannot get the LTC she desperately needs due to the 100k large She gave you” conversation and certified mailings. And within theses clearly ask for $ back or property title transferred back to mom if within the family “sale”.
If not, why not?

Can & will mom or the DPOA take the nuclear option to file a police report for endangerment of a vulnerable adult with coercion, theft or fraud of $100k?
Mom will have to be determined to be incompetent or incapable of executive functioning if she won’t go along with filing police report. DPOA hires a criminal atty who along with an elder law atty can get this done. It will not be pretty.... but if this cockup happened when I was POA, I’d want to get in front of this yesterday and get something criminal going against the $$$ recipient to get her Medicaid eligible. That or your willing to private pay for 12 mos of care in the NH or decide what room mom will be moving into your home .... Your options are limited.

Why...... POA has a required fiduciary duty. $100large isn’t a little bit of $ overlooked. Its not Grannie bought an expensive $500 wedding gift. It’s a totally glaring lack of fiduciary oversight. Your not expected to know Medicaid rules but are expected to do whatever to rectify issues to her eligibility.

If mom/Grannie is currently in a NH, she has a bill that is growing by each day. NH will expect bill to be paid one way or another. If the admissions contract does not have the dpoa or other family member as a responsible signatory that NH can bill and turn over to collections and pay in full ASAP, then the usual path is that the NH - after sending out a 30 Day Notice - will turn to APS to get the elder made an emergency ward of the state. The request goes before a judge (usually probate court judge) and a temporary guardian is named from an existing & vetted list of guardians. The guardian can have elder placed into a NH as Medicaid Pending. But then guardian will need to do whatever to get elder eligible. If that means police report filed, it gets done. If it means moving elder to another NH with an open bed without any notification to family it can be done.

They can also do more - since they are court appointed- they have a great deal of power. They can ask for an APS inquiry to be opened. So APS can contact your employer, neighbors regarding you. If your military or have any sort of clearance needed for work or yourself are a mandated reporter, your job could be in jeopardy. Also can go thru years of banking and if there’s no documentation as to whether $ was gifting or payment for services, they can do years of amended or back taxes, filing 1099-Cs to whomever got $ from Grannie. The annual gifting with no reporting to IRS guideline, the guardian can decide not to follow but instead 1099 everybody. They would do an initial letter asking clarification on the background on the amounts per each year along with W9 & I9. You’ll have like 60 days to submit info or amended return gets filed with IRS. It’s amazing how the anticipation of a tax filing can spur folks to return $.

So I too have to ask.... what’s the backstory? Who got 6 figures?
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JillJoyce Jan 16, 2019
Wow! Thanks for the quick response and lots of information. Here is the rest of the backstory: Mom sold the old, falling-down family house for $70,000 in 2017. She gave the IRS gift limit of $14,000 each to her two children in 2017, $15,000 to each in 2018 and gave an additional $5,000 to son this month. The remaining $7,000 went towards replacing her trailer house roof (was very leaky), funeral arrangements for mom and paying off 1 of her credit cards. The only reason she didn't just give us each $34,000 right after sale of home was her concern with the IRS gift tax. She had stroke just a few months ago and her mental and physical capabilities have declined a lot since then.
No one was trying to take advantage of her. We said Thank You Mom for the amazing gifts not knowing what trouble it would cause later. Had I known, I would have explained and then politely declined the gifts or put the money in a CD.
As a side note: In mom's very large family they have all died quickly (no one has had dementia or lingering illness). We were all idiots for believing she would pass away in similar fashion when her time came :(
I have been researching refinancing/home equity loans to replace the $29,000 in gifts I accepted. We haven't had house that long but hopefully we can get that much. It will be very difficult for myself and husband to make all our payments, but hopefully we won't end up in bankruptcy.
Our portion was used up home repairs and handicap remodel. none of the cash left.

Where can I get the additional $34,000 for brother's portion? He has no job, no usable assets and is in poor health. He bought some old construction equipment and wants to start his own business but not sure when or if that will happen...

Thanks everyone, sorry I didn't explain properly in earlier post. Hope this makes more sense.
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I am curious -- who got the gifted money from the sale of the old family home?
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JillJoyce Jan 16, 2019
majority was given to us kids, I wish I had known then what I have learned lately...Thanks Mom, but no thanks. I will never accept a large gift EVER again! Granted, this was a once in a life-time situation.
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If your mom is also in Montana, then Medicaid caregivers is most like out of the question for the time being since there are over 2000 people on the waitlist for an IHSS waiver. Also as far as eligibility is concerned, Montana looks at assets other than monthly income so that will be another hurdle you may face. She’ll probably have to private pay for in home caregivers until she is eligible for Medicaid. Can any of the gifted money be returned?
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Some posters talk about 'Board and Cares". I don't have these in my area. Maybe u can find one in yours? They might except her SS. Maybe everyone chipping in if a little more needed. Not sure if Medicaid homecare would consider the money given away. She could live with someone and have them come in doing the heavy stuff. All you pitching in to help when u can.
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JillJoyce Jan 16, 2019
Thank you. I will look into that.
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JillJoyce, this is a situation where families do not know the ins and out of Medicaid until they are faced with finding Assisted Living or a Nursing Home. I know I had no idea about anything "elder" until my own parents were going through it. And then it was an eye opener !!

Everything is so complex. Even if mailers were sent out to us regarding future Medicaid needs, how many of us would even look at it. I know I wouldn't. Same holds true for newspaper articles. If it doesn't relate to current situations, we tend to not read it.

As for finding funds to help pay for Mom's nursing home care, hopefully other writers who have been down this path can shed some light on what can be done.
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So sorry to hear this. Who was given the money from the sale of the home? Do they realize what the impact of that was? Can he or she at least help with your mom's care?
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