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Terese, I’m going to guess that your Dad has told you that government is going to come and take the house away from him should mom go into a NH & onto Medicaid and that someone told him that if he takes moms name off the house, then government can’t do it. And you are very concerned as it sounds sketchy as hell and Dad tends to do things in a fit of pique.
If this is what’s what, here’s what you need to be aware of Medicaid-wise imo: - LTC Medicaid program will pay for the room & board costs for your mom in a NH if if she is determined to be “at need” BOTH medically AND financially. It is a two part eligibility system. - the financials are what you hear abt & have obvious fear factor, but the medical “at need” is just as important. In many ways, trying to prove medically at need without coming into a NH via a post hospitalization rehab placement can be difficult. Rehab stay plus hospital notes have a nice fat file for Medicaid to use to evaluate need easily. If mom is living at home, that degree of detail may not be there. So no “at need” medically. You need to look into this ahead of her ever applying imo.
- for “at need” financially the applicant (mom not dad) need to be impoverished & under whatever your state has as it maximum mo. income and has nonexempt assets under whatever $ amount state has set. Tends to be $2200 individual mo income, 3k in nonexempt assets. - That home owned jointly is an exempt asset for her lifetime and only after she dies that MERP (estate recovery) enters the situation. Just how MERP runs again differs by state. All kinds of exemptions, exclusions to MERP. Dad as long as it’s his homestead will not have to sell it. He could die still owing it and then it’s on his heirs (you!) to deal with the place.
- BUT if dad does something to remove her ownership now and then mom applies for LTC Medicaid b4 2027, Medicaid will assess a gifting transfer penalty. So if house value is 400k, then her 50% is 200K & if your state pays $185 day Medicaid room&board, that’s 1,081 days of ineligiblity that someone will have to private pay for her to ever stay in the NH. 1,081 DAYS! Dad changing ownership will surface & this info in states database. - Parents have to submit 5 yrs of financials in some way. Any big $ moves will surface & will be red flags waving at the caseworker. You don’t want to go there….
- Mom will be required to do a copay of almost all her monthly income (like her SS) to the NH. All she gets to keep is a smallish personal needs allowance ($60 avg). BUT Dad becomes a community spouse (going to stay living in the community) & he can ask for a resource allowance from moms mo income if he can show cause. It’s called CSRA or MMNA & again it varies by state. If dad needs $800 a mo of moms $1200 SS $ then he can get it as his CSRA. But it has to be filed for & shown cause. An attorney imo is best on all this.
- for Community Spouse / NH spouse situations, the rules on income & assets are complicated. Dad is NOT expected to impoverish himself; a CS usually gets to retain up to 128k in assets. & his mo income should not be a factor for moms eligibility.
Personally if this was my parents I would find a CELA level of elder law attorney and make an appointment for Dad & whomever is their POA to go and discuss what their finances look like & exactly how your state runs it’s LTC Medicaid program and what is likely for MERP (estate recovery) and dealing with the house; y’all come up with a plan that’s legit and workable. AND do this as far ahead as possible to mom ever needing to go into a facility. If things need to move…… like dad sets up his own savings account with his own assets….. that kinda imo needs to happen b4 ever filing for Medicaid. Just makes the process way more defined. Good luck and let us know how it goes.
I agree with getting legal advice. But it's much too late to try to hide assets and there's really no hiding a house. IIRC, he can stay in the house and at some point, when the house is sold, her half will be used to go towards her care.
Depending on her level of dementia and whether she is still competent, she may or may not be able to legally sign to give POA to anyone. If she's still competent, get it done ASAP. And dad's too.
I don't know if you're aware of this or not, but Medicaid does a 5-year 'look back' period on an applicant's finances. If her name is removed from assets like real estate and bank accounts now, the family will have to wait five years to put her into a care facility or to have get Medicaid-paid homecare help that will not have to be paid back after she dies. Because your parents are legally married, your father would be entitled to retain half of the value of their shared assets. Your mother's half would go towards her care if she's placed in a facility or if you're expecting her homecare services to be paid by the state. For example: If their house is valued at $100,000 Medicaid can only take value up to $50,000 which would be your mother's share of it. Medicaid would allow your father to remain in the house until he dies. If your mother has social security of her own, or whatever amount she collects from your father's will also get put towards her care in a facility. They will not take your father's though. The only way to get your mother on Medicaid to put her in a facility or on state-paid homecare is to take assets out of her name and wait five years. If their assets are large enough to create an Irrevocable Trust, you could try that but it's a big headache. Medicaid had to get strict like this because for too many years families were having grandma and grandpa transferring assets out of their names in the car on the drive to the nursing home.
Given that there seems to be a basic lack of information I would suggest your Dad and you go together with your Mom to do the POA (if your Mom is competent to do this). You need a well written document and someone who will serve as second (might be you). You need to learn what powers a POA gives. You need a well written POA that give you the powers you need. Does your Father and Mom already have a will or trust drawn up? If not, this needs doing as well. And if they do, there may already be a "springing DPOA" in those papers. Check them. Know going in that you NEVER get POA OVER a person. A person who is MENTALLY COMPETENT GIVES you POA, confers it upon you to act as he or she WISHES you to act. Only guardianship gives any powers OVER someone and that means that person is diagnosed usually by two MDs to be incompetent in their own care. Take these letter with to the attorney. As to medicare and the home. Again, this is attorney question. The attorney will need to know how the deed is held. The home will not be taken from your father if he is on the deed. You need to understand under exactly what circumstances in your own state the sale of the home can be recovered. There is really now way to protect the sale of home after the passing of your parents from medicaid clawback if the goal now, when your Mom is close to needing care, to protect assets. For all these reasons and most of all because these legal things cannot be done WRONG you need the help of a licensed professional, in this case an elder law attorney with knowledge also of Trust and Estate. There is document work and the attorney will have questions. You Dad should bring basic list of assets in his and your Mom's name. Sorry about the cost, but doing this wrong can be catastrophic.
A potential clawback via MERP really is -I’ve found - very interdependent on your states laws as to property rights, probate laws and what Medicaid is allowed to do via your states administrative code. If you are in a very pro-property right state that allows for enhanced benefit deed aka a Lady Bird Deed then going that route removes the property from being accessible. Ditto Testamentary Trusts. Some states exempt the homestead if the community spouse is themselves low income. Plus a slew of other exemptions, exclusions to recovery & a required cost benefit analysis. As far as the Medicaid lein situation, not all states allow for a proactive Medicaid lein to be placed onto a homestead property; so if your state administrative code does not allow for tefra type of actions (lien placement in advance), it can instead become a claim against the estate….. which then can shift all into probate court if probate opened. MERP claim then must follow state probate law as to its priority… like for TX it’s a Level of Claim by Class for probate and MERP is class 7 so any claims between 1-6 are first & foremost. Credit cards are class 8, lol. Now dealing with & documenting the whatevers on all this from day 1 of the NH till beyond the grave and is possibly years is work for family & heirs, but it is do-able.
Bigger issue imo seems to be b4 ever getting to estate recovery after death phase. That widow or widower now in a NH on Medicaid has a required copay of basically almost all their SS or other monthly income to the NH. So they have zero - no - nada of $ to ever pay a penny on their old home. No $ for property taxes, insurance, maintenance, etc. If they still have a mortgage (horrors!) that must be paid or it will be foreclosed on within 3-5 months. So family or heirs have to pay all property costs for an indeterminate period of time on a property (as NH dad isn’t a cake mix with an expiration date) that they may or may not ever own. So it runs risk. If there are several heirs, 1 of them - or better yet their spouse - will not pay their share or do their part. The others can’t force them to do squat. The others have to cover the spread so to speak. Yet all benefit equally.
There is someone who is still on this site occasionally whose mom in a NH on Medicaid put her TX house in a Lady Bird Deed equally to 2 daughters of which 1 is drug dependent. Big Sis paid for & her/her hubs did everything on the empty house for all the years mom was in a facility. Mom died and Big Sis hired a probate atty to deal w/house sale, title transfer, deal w/MERPquestionnaire, etc. As per the LBD, the proceeds divvied up 50% less court costs. Big Sis & her hubs were ok on this to able to let drug Sis benefit from their financial ability. A gracious move.
But I don’t think that many siblings / possible heirs would or could do this. Someone or their spouse gonna be unwilling or unable to deal with costs or upkeep. What seems to happen is that around the 6-8 mo point in time, or when taxes due, or when they finally realize the rules on LTC Medicaid (that there is no free rent or reimbursed for work done or paid for easily happening), that a decision is made to sell the place. This then changes the elders Medicaid eligibility and they have to go thru a spend down, perhaps repay Medicaid LTC bill to date and then have a POA reapply for them months or years later when impoverished again. If elder want to keep their home as an exempt asset and family wants to honor that, family had better be able to do this for years. Otherwise It’s best to sell the home if at all possible and before ever filing for Medicaid, just gives the elder more options.
Agree with what others have said. Check with a good eldercare lawyer. Internet and "friends" advice often are worth what you paid for them, no matter how well meaning, unfortunately, and many things change state to state.
I agree that you need to consult an attorney to do this correctly, or it might all blow up on them.
As POA, your dad shouldn't be mixing his interests with hers anyway; it isn't ethical. I assume he's a joint owner of the property, so for him to essentially sign the house over completely to himself would be a big no-no.
If he were to use his POA ability to transfer her share of anything to ownership to himself - so she never signs anything on her own; she never personally appears before an attorney or notary or bank officer on her own and appearing competent and cognitive to do the paperwork- it could be considered “self dealing” by him. It’s a huge red flag should Medicaid ever be needed & her financials are scrutinized OR should any of her siblings, children or future heirs (or their spouse’s) or even APS want to have him removed from any decision making on her behalf, this provides a reason to get him 86’d from all things mom.
Don't do that, it would be considered fraud on the Medicaid application. That will end up with someone being required to personally care for grandma.
See an elder law attorney in her state that is specifically trained in Medicaid qualification to learn what can be legally done in her state.
Was this dad's idea of yours? Remember, that dad is not a POA "over her". It is his responsibility to act in her best interest which includes preserving her assets to buy her the best care possible. Conducting her business in a way that benefits him, or anyone else, would be a breach of fiduciary duty. Google it.
You simply cannot hide or transfer in an effort to qualify for Medicaid. If he were to transfer the house to someone else, it must be sold at fair market value. If it isn't then Medicaid will charge grandma a penalty equal to the difference, meaning a period of time that grandma loses Medicaid eligibility, someone else must volunteer to care for her and then reapply once her assets are spent down.
Example: grandma's house is worth 200K, nursing home cost is 10K a month, someone else would have to volunteer to care for grandma for 20 months.
Yes, the family most certainly can take assets out of grandma's name. That is not illegal to do. Even if their intention is for the purpose of getting the state (Medicaid) to pick up the tab for her. The only catch is they will have to keep her home and care for her themselves five years to put her in a facility or to accept any state-funded homecare services. People do this all the time. I worked for a lady back when the Medicaid look-back period was only two years. She had turned over her vast land assets to her children several years before I knew her. She had a full-time staff of homecare workers five days a week. Part-time on Saturdays and Sundays. All paid for by Medicaid and Medicaid Connecticut at this time was the best in the country. She really didn't need all that much help, yet she had a staff of Medicaid-sponsored servants to wait on her hand and foot. After about a year or so she became incontinent. Her family put her in a nursing home which was of course paid for by Medicaid. This family owned half the town they lived in because the family had been farmers at one time like a thousand years ago. They of course got a tax-break on all of it because they grew a few vanity crops like flowers and pumpkins so it still qualified as farmland. No one made a living farming. At this point it was prime Connecticut real estate (undeveloped) in a most desirable and wealthy town. They dropped my client off at a nursing home and started selling off all the assets. Each of her six kids came out with 3 million apiece. Not one cent of that estate went towards the mother's care in the nursing home and she lived for seven more years. Her family used to brag about not paying for anything. With no assets in her name, my client was considered low-income. She had social security from her late husband and that went towards her care in the nursing home. The 18 million dollar land estate that her kids cashed out on by selling this land to a developer, did not go towards it. All perfectly legal too.
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I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
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If this is what’s what, here’s what you need to be aware of Medicaid-wise imo:
- LTC Medicaid program will pay for the room & board costs for your mom in a NH if if she is determined to be “at need” BOTH medically AND financially. It is a two part eligibility system.
- the financials are what you hear abt & have obvious fear factor, but the medical “at need” is just as important. In many ways, trying to prove medically at need without coming into a NH via a post hospitalization rehab placement can be difficult. Rehab stay plus hospital notes have a nice fat file for Medicaid to use to evaluate need easily. If mom is living at home, that degree of detail may not be there. So no “at need” medically. You need to look into this ahead of her ever applying imo.
- for “at need” financially the applicant (mom not dad) need to be impoverished & under whatever your state has as it maximum mo. income and has nonexempt assets under whatever $ amount state has set. Tends to be $2200 individual mo income, 3k in nonexempt assets.
- That home owned jointly is an exempt asset for her lifetime and only after she dies that MERP (estate recovery) enters the situation. Just how MERP runs again differs by state. All kinds of exemptions, exclusions to MERP. Dad as long as it’s his homestead will not have to sell it. He could die still owing it and then it’s on his heirs (you!) to deal with the place.
- BUT if dad does something to remove her ownership now and then mom applies for LTC Medicaid b4 2027, Medicaid will assess a gifting transfer penalty. So if house value is 400k, then her 50% is 200K & if your state pays $185 day Medicaid room&board, that’s 1,081 days of ineligiblity that someone will have to private pay for her to ever stay in the NH. 1,081 DAYS! Dad changing ownership will surface & this info in states database.
- Parents have to submit 5 yrs of financials in some way. Any big $ moves will surface & will be red flags waving at the caseworker. You don’t want to go there….
- Mom will be required to do a copay of almost all her monthly income (like her SS) to the NH. All she gets to keep is a smallish personal needs allowance ($60 avg).
BUT
Dad becomes a community spouse (going to stay living in the community) & he can ask for a resource allowance from moms mo income if he can show cause. It’s called CSRA or MMNA & again it varies by state. If dad needs $800 a mo of moms $1200 SS $ then he can get it as his CSRA. But it has to be filed for & shown cause. An attorney imo is best on all this.
- for Community Spouse / NH spouse situations, the rules on income & assets are complicated. Dad is NOT expected to impoverish himself; a CS usually gets to retain up to 128k in assets. & his mo income should not be a factor for moms eligibility.
Personally if this was my parents I would find a CELA level of elder law attorney and make an appointment for Dad & whomever is their POA to go and discuss what their finances look like & exactly how your state runs it’s LTC Medicaid program and what is likely for MERP (estate recovery) and dealing with the house; y’all come up with a plan that’s legit and workable. AND do this as far ahead as possible to mom ever needing to go into a facility. If things need to move…… like dad sets up his own savings account with his own assets….. that kinda imo needs to happen b4 ever filing for Medicaid. Just makes the process way more defined. Good luck and let us know how it goes.
He could cause her to be denied if he starts hiding assets.
An attorney will be able to explain what he is allowed to keep, the house and 1 vehicle and enough money to not be destitute, among other things.
Please don't change any titles or move money, they will find out and it won't be good.
Depending on her level of dementia and whether she is still competent, she may or may not be able to legally sign to give POA to anyone. If she's still competent, get it done ASAP. And dad's too.
If her name is removed from assets like real estate and bank accounts now, the family will have to wait five years to put her into a care facility or to have get Medicaid-paid homecare help that will not have to be paid back after she dies.
Because your parents are legally married, your father would be entitled to retain half of the value of their shared assets. Your mother's half would go towards her care if she's placed in a facility or if you're expecting her homecare services to be paid by the state.
For example: If their house is valued at $100,000 Medicaid can only take value up to $50,000 which would be your mother's share of it. Medicaid would allow your father to remain in the house until he dies. If your mother has social security of her own, or whatever amount she collects from your father's will also get put towards her care in a facility. They will not take your father's though.
The only way to get your mother on Medicaid to put her in a facility or on state-paid homecare is to take assets out of her name and wait five years. If their assets are large enough to create an Irrevocable Trust, you could try that but it's a big headache.
Medicaid had to get strict like this because for too many years families were having grandma and grandpa transferring assets out of their names in the car on the drive to the nursing home.
Know going in that you NEVER get POA OVER a person. A person who is MENTALLY COMPETENT GIVES you POA, confers it upon you to act as he or she WISHES you to act. Only guardianship gives any powers OVER someone and that means that person is diagnosed usually by two MDs to be incompetent in their own care. Take these letter with to the attorney.
As to medicare and the home. Again, this is attorney question. The attorney will need to know how the deed is held. The home will not be taken from your father if he is on the deed. You need to understand under exactly what circumstances in your own state the sale of the home can be recovered. There is really now way to protect the sale of home after the passing of your parents from medicaid clawback if the goal now, when your Mom is close to needing care, to protect assets.
For all these reasons and most of all because these legal things cannot be done WRONG you need the help of a licensed professional, in this case an elder law attorney with knowledge also of Trust and Estate. There is document work and the attorney will have questions. You Dad should bring basic list of assets in his and your Mom's name.
Sorry about the cost, but doing this wrong can be catastrophic.
Bigger issue imo seems to be b4 ever getting to estate recovery after death phase. That widow or widower now in a NH on Medicaid has a required copay of basically almost all their SS or other monthly income to the NH. So they have zero - no - nada of $ to ever pay a penny on their old home. No $ for property taxes, insurance, maintenance, etc. If they still have a mortgage (horrors!) that must be paid or it will be foreclosed on within 3-5 months. So family or heirs have to pay all property costs for an indeterminate period of time on a property (as NH dad isn’t a cake mix with an expiration date) that they may or may not ever own. So it runs risk. If there are several heirs, 1 of them - or better yet their spouse - will not pay their share or do their part. The others can’t force them to do squat. The others have to cover the spread so to speak. Yet all benefit equally.
There is someone who is still on this site occasionally whose mom in a NH on Medicaid put her TX house in a Lady Bird Deed equally to 2 daughters of which 1 is drug dependent. Big Sis paid for & her/her hubs did everything on the empty house for all the years mom was in a facility. Mom died and Big Sis hired a probate atty to deal w/house sale, title transfer, deal w/MERPquestionnaire, etc. As per the LBD, the proceeds divvied up 50% less court costs. Big Sis & her hubs were ok on this to able to let drug Sis benefit from their financial ability. A gracious move.
But I don’t think that many siblings / possible heirs would or could do this. Someone or their spouse gonna be unwilling or unable to deal with costs or upkeep. What seems to happen is that around the 6-8 mo point in time, or when taxes due, or when they finally realize the rules on LTC Medicaid (that there is no free rent or reimbursed for work done or paid for easily happening), that a decision is made to sell the place. This then changes the elders Medicaid eligibility and they have to go thru a spend down, perhaps repay Medicaid LTC bill to date and then have a POA reapply for them months or years later when impoverished again.
If elder want to keep their home as an exempt asset and family wants to honor that, family had better be able to do this for years. Otherwise It’s best to sell the home if at all possible and before ever filing for Medicaid, just gives the elder more options.
As POA, your dad shouldn't be mixing his interests with hers anyway; it isn't ethical. I assume he's a joint owner of the property, so for him to essentially sign the house over completely to himself would be a big no-no.
It’s a huge red flag should Medicaid ever be needed & her financials are scrutinized
OR
should any of her siblings, children or future heirs (or their spouse’s) or even APS want to have him removed from any decision making on her behalf, this provides a reason to get him 86’d from all things mom.
See an elder law attorney in her state that is specifically trained in Medicaid qualification to learn what can be legally done in her state.
Was this dad's idea of yours? Remember, that dad is not a POA "over her". It is his responsibility to act in her best interest which includes preserving her assets to buy her the best care possible. Conducting her business in a way that benefits him, or anyone else, would be a breach of fiduciary duty. Google it.
You simply cannot hide or transfer in an effort to qualify for Medicaid. If he were to transfer the house to someone else, it must be sold at fair market value. If it isn't then Medicaid will charge grandma a penalty equal to the difference, meaning a period of time that grandma loses Medicaid eligibility, someone else must volunteer to care for her and then reapply once her assets are spent down.
Example: grandma's house is worth 200K, nursing home cost is 10K a month, someone else would have to volunteer to care for grandma for 20 months.
Yes, the family most certainly can take assets out of grandma's name. That is not illegal to do. Even if their intention is for the purpose of getting the state (Medicaid) to pick up the tab for her.
The only catch is they will have to keep her home and care for her themselves five years to put her in a facility or to accept any state-funded homecare services. People do this all the time.
I worked for a lady back when the Medicaid look-back period was only two years. She had turned over her vast land assets to her children several years before I knew her. She had a full-time staff of homecare workers five days a week. Part-time on Saturdays and Sundays. All paid for by Medicaid and Medicaid Connecticut at this time was the best in the country. She really didn't need all that much help, yet she had a staff of Medicaid-sponsored servants to wait on her hand and foot.
After about a year or so she became incontinent. Her family put her in a nursing home which was of course paid for by Medicaid.
This family owned half the town they lived in because the family had been farmers at one time like a thousand years ago. They of course got a tax-break on all of it because they grew a few vanity crops like flowers and pumpkins so it still qualified as farmland. No one made a living farming. At this point it was prime Connecticut real estate (undeveloped) in a most desirable and wealthy town.
They dropped my client off at a nursing home and started selling off all the assets. Each of her six kids came out with 3 million apiece. Not one cent of that estate went towards the mother's care in the nursing home and she lived for seven more years. Her family used to brag about not paying for anything. With no assets in her name, my client was considered low-income. She had social security from her late husband and that went towards her care in the nursing home.
The 18 million dollar land estate that her kids cashed out on by selling this land to a developer, did not go towards it. All perfectly legal too.