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<p>I’ve always thought the claw back should go much longer for long term care. Hiding assets is a huge business and a booming legal practice. There are very “wealthy” folks living on the dole in nursing homes. There doesn’t seem to be the same stigma for hiding assets in order to collect senior welfare as there is for people who just don’t make much money.</p>
<p>Cartera,in my state, the look-back is five years.
People routinely use family trusts for secondary properties, etc. here too - one of my clients practices in the area.
But with a five year look back, they certainly have to do their giving with a warm hand instead of a cold one 
As someone with a second property (rental) and a spouse ten years my senior, who is also my business partner, it’s an issue that I might have to consider sooner rather than later. Then again, our “retirement” plan is to walk in our back woods during deer season That may also become our long term care plan too!</p>
<p>There doesn’t seem to be the same stigma for hiding assets in order to collect senior welfare as there is for people who just don’t make much money. </p>
<p>No, It’s routine. And it’s possible to have more than nothing but a lot less than enough. My example was not a wealthy person by any definition. Actually, I’m quite confident most of you would consider her poor with a small house. Just to clarify. I doubt if most wealthy people will be wanting Medicaid.</p>
<p>Wait, this isn’t about long-term care. It’s about Medicaid expansion. Right now, low-income people with assets are being funneled into Medicaid with a couple of clicks. Maybe they’ll fix it, maybe they won’t but it’s certainly not a non-issue.</p>
<p>There are plenty of very wealthy families hiding assets to get nursing home care for their parents through medicaid. My mom was in short term rehab a couple of months ago and her roommate was a nursing home resident. Her daughter talked about how fortunate they were to have moved her mom’s assets in time for the nursing home decision. It may be routine, but it is one more example of medicaid being used for a purpose it was not intended. I don’t know why it’s not considered fraud.</p>
<p>Of course. I expect there will be wealthy people getting ACA subsidies, as well.</p>
<p>“It may be routine, but it is one more example of medicaid being used for a purpose it was not intended. I don’t know why it’s not considered fraud.”</p>
<p>I know exactly what you mean. I hear about this, and people think it’s just fine…move all the assets to the kids name (in the appropriate amount of time), so Mom can get everything covered by Medicaid. Makes no sense to me that people think it is ethical, but perhaps it’s just because it’s so common. Yes, your assets are there to pay for your care, not to give away to your kids to become broke so the taxpayers pay for you. I’m sure this is often initiated by the children and not the parents.</p>
<p>Okay, I think there is still a little confusion about this situation. Do rich people do it? Probably. But not rich people are forced to do it if they want care at all. They are advised to do it by the facility. And, if you’ve never been inside one of these places they are nothing to aspire to. </p>
<p>thishttp://<a href=““Spending Down” for Medicaid: One Caregiver’s Personal Journey - AgingCare.com”>www.agingcare.com/Articles/Spending-Down-to-Medicaid-133289.htm</a></p>
<p>Common, maybe because the law has a way of allowing for it. Just meet the look-back requirements. Or a few other provisos. Btw, we should keep the old medicare assets frame separate from what may happen with ACA, depending on your state.</p>
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<p>The majority of Medicaid spending goes to cover long-term care (usually nursing homes). Even wealthy seniors structure their assets so that if the time comes to move to a nursing home, Medicaid will pay. I’d guess you know people whose parents have moved their assets to their children in anticipation of Medicare.</p>
<p>The problem with a state run nursing home is that they will not take you unless you can pay for your care. That means lots of money or qualifying for Medicaid. There is no getting a bed if you are in between. It’s a big problem when you are old and sick. Throw in a spouse who needs a roof over their head, too and people are forced to scramble. And usually the value of the home is not enough, anyway. This stuff is very expensive. It’s not near the same thing as a wealthy person hiding assets. Also, they are not nice places at all. Take a tour.</p>
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<p>Federal law prohibits facilities from kicking patients out who are switched to medicaid so wealthier families will leave enough in the senior’s accounts to pay for a few months and then when the time comes to switch, the facility must take the payment from medicaid. It’s the families’ estate planning professionals who push it. </p>
<p>I don’t even really have a problem with payment for long term care. I was disappointed when the long term care provisions were negotiated out of the ACA. It’s the shenanigans that go one that bother me. We should just decide that we are going to provide long term care for our seniors and do it.</p>
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<p>You seem to think that there are state-owned institutions that house medicaid patients. Only about 5% of ltc facilities are government owned. The rest are private and non-profit and most take medicaid. It is big business. Nationally, medicaid pays for over 60% of the patients in ltc. The big chains take medicaid.</p>
<p>I don’t disagree with anything you wrote but we are talking about two different things. Wealthy and not anywhere near wealthy both have to do the asset dump. Finding a nice or even decent nursing home for the not wealthy is not an easy task. At least not everywhere.</p>
<p><a href=“http://www.ehow.com/list_6890553_qualifications-enter-state_run-nursing-home.html[/url]”>http://www.ehow.com/list_6890553_qualifications-enter-state_run-nursing-home.html</a></p>
<p>“State run” nursing home? Again, regulations will vary by state and it may help us to know where you are. Also, your experience was pre-ACA where they was a clear assets test.</p>
<p>*While some privately-run nursing home facilities exist, the majority of nursing homes are run by individual states. * Not in my area.</p>
<p>Yes, well none of this nursing home stuff is ACA related, anyway. The question is what happens to assets of the new Medicaid people.</p>
<p>Since there were questions related to my use of the word scramble yesterday my only point here is to make clear that scramble was not about wealthy people hiding assets. Yes, that happens. But even people with next to nothing needed to have nothing to get a bed in Wisconsin a few years ago. It was not uncommon or considered shenanigans. It was the only way to get care. That’s all.</p>
<p>My issue wasn’t “scramble.” It was, “get rid of all her assets before they were ‘recovered’”. Which implies the state was going ahead and threatening. I thought you really meant so she would meet assets tests and/or protect some assets as allowed on the front end. </p>
<p>The info I am finding is that the number of attempted recoveries is a very small percentage.</p>
<p>If she had too much money to qualify for aid but not enough to pay for projected costs she was not getting a bed. Sure, she could have given them everything she had first but that would be stupid. Who would do that? Even the not wealthy are not stupid. Well, usually lol.</p>
<p>Whoever wrote that eHow article has no idea what she’s talking about. The facilities may be state licensed but they are not state run. There are very few state run facilities. The scenario that someone has to have enough money up front to pay for a projected stay makes no sense either. That may be the case for assisted living.</p>
<p>This stuff is too important to assume and skip your own research. Here, if you deplete your assets in assisted living, Medicaid can kick in. I’d suggest folks track this for their own states. They are not required to keep you at that particular facility (some AL are pretty nifty and profit generating) if there is a waiting list for rooms/beds at full pay. They can offer a spot in another they manage. MIL was in AL and the alternate they might have moved her to if she drew down all her assets was pretty good, too. In some areas you can actually check for percentages of Medicaid residents at various facilities.</p>
<p>Cartera, agree- I think it could have meant state-regulated. Which boils down to Veterans and mental facilities and maybe some others. </p>
<p>About estate recovery: ok, so the alarm is sounded. I find lawyers commenting, perhaps in their own interests. I don’t see anything that tells me if this will be a jeopardy, for real. (Eg, I don’t find AARP weighing in; maybe I missed it.) I do see comments that they didn’t attempt this much in the past- certain assets were protected, certain situations. I see plenty that says they will (may, should) pursue fraud.</p>