<p>We are in Florida. Mom is too. My mother is currently in assisted living, but her needs are becoming greater and we may need to move her to a nursing facility very soon. She has some money set aside that can be used for this, but it will only last about a year. The facilities we would look at would accept Medicaid, so she could possibly transition to that when the money runs out. </p>
<p>She owns her very modest home outright, and my aunt is living in the house ( and paying rent to cover taxes and ins. ) My sister and I each currently contribute a monthly amount toward mom’s income to help her avoid dipping into her nursing home $. I know mom would want to do whatever she can to help each of us, and we just don’t want to jump into any financial decisions without considering options and ideas. </p>
<p>I also have the concerns about my own kid applying to college in the next couple yrs (current HS sophomore). So, if something were to happen, and I am trying to be realistic, knowing that once in a nursing home, mom’s life expectancy may not be ‘years’…but then again May be… If she were to leave us money next year, the junior year in HS…the yr that colleges look at for fin. Aid, it seems that could negatively affect our chances at getting need based aid, even if it isn’t a huge amount, and is a one time income increase. </p>
<p>Have you had experience with these issues? Any advice on smart money moves in these circumstances?</p>
<p>Not an atty, but I think they exhaust all the patient’s money before Medicaid kicks in, at least fully kicks in.
The theory is that if she has money or property, she should pay for her own healthcare, and my experience is that “the government” doesn’t like it if people transfer money or property just before applying for “goverment” paid healthcare. There is what some call a look back period, and I think it is now 5 yrs.
My experience is that the house must be sold at market value, and proceeds applied to healthcare.
Ideally, if a person wants “the government” to pay for healthcare, they sell the house, or transfer it to offspring years before a person needs medicare. That way the family gets it rather than “the government” forcing a public sale. But obviously, such a course of action requires advance planning.
I can tell you my personal experience, and others here may do the same; but I strongly urge you to get advice from an atty that focuses on Florida estate law to get the best advice.</p>
<p>I don’t know how this works in Florida but typically concerns associated with going into a nursing home should be addressed years before it might happen. My father put 75% of his assets into an irrevocable trust and I was the executor and only beneficiary. Here in Connecticut, there is a look back period that was 3 years but I think it has been extended since he had set up the trust. He set up the trust when he was 86 which is late. He died last year at 94 and never needed assisted living or a nursing home. In CT, they will not kick a spouse out of the house even if the nursing home bills exceed how much the individual has but when the person and spouse die, the state will come into play impacting heirs’ inheritance. You should probably contact an elder law attorney to find out the details specific to your state.</p>
<p>The lookback policy probably makes any planning you could do at this point moot. But I agree with others, that contacting a professional probably makes sense.</p>
<p>I agree-they will run through your mom’s money before Medicaid pays for anything. You will need to sell her house and any profit from this will go for her care as well. This is planning that needs to be done WELL before the need arises. There are generation skipping ideas and some trusts that will shield any money that might be left over but again, Medicaid will find that information and will take that money. You still should see an estate planning attorney in case there is something they can do, but it’s highly unlikely. She should have someone appointed power of attorney and have a medical directive established if she does not have that already. Someone should be on her bank accounts and the accounts listed as transfer on death, do NOT change the house into one of your names however or you will pay hefty taxes on the proceeds of the sale.</p>
<p>We dealt with this with one aging parent. The money COULD be spent on the parent for things they needed or wanted. Our attorney suggested we get clothes, a TV, prepay for the funeral and gravestone…all things you CAN do. Prepaying the funeral/gravestone is something you really should consider doing.</p>
<p>“Stop spending your money. The nursing home will take it all eventually. Delaying it does no good.”</p>
<p>Agree with this. I’m not sure why you would be adding to your mother’s income, unless it you believe it is a moral issue. My grandmother just went to a medicaid paid assisted living facility. I think she could only have about 2K in assets, and they only let her keep about $65 per month of her income. Just approximate numbers. Seems that your mother would want to not add to her income at all now, and would want to spend down her assets (in a way that would not be looked upon badly, like transferring large amounts of property or money).</p>
<p>She shouldn’t be accepting rent or any money. She should pay for everything she can out of her assets, everything is on mom. But one thing you could consider doing is taking whatever rent she would have gotten or additional money she is spending, and put it into an account (not in her name). Then when she goes to the nursing home, that can be used to buy her additional things that she might want that won’t be provided.</p>
<p>I don’t think that is medicaid fraud, with small amounts, it is just good planning. There are very specific ways to help save some of her money so it can be used for her later on.</p>
<p>Agree with toledo. Don’t spend your own money on her now. After the spend down, when she has a limited amount of funds ($45 per month in my state last year) use your money to help her with her needs. In the meantime, use her funds to buy things she needs for life in the nursing home, including funeral/burial preparation. </p>
<p>I did this for a friend, a spend down. One of the interesting pieces of advice I got from an attorney is to put money in a trust sooner rather than later, which meant spending down faster than anticipated. My friend, disabled, had a special needs trust. By transferring a chunk to the trust, the money was available for certain needs after the spend down. When she passed away, the state was reimbursed from the trust at the medicaid rate, not the private pay rate. Not sure what sorts of trusts are available for the elderly. </p>
<p>You do need to figure out the house, so your aunt keeps her residence. Elder law attorney?</p>
<p>Just a warning re spending down Mom’s assets:</p>
<p>Some nursing homes, even if they do accept Medicaid (as not all do) prefer, in admiissions, those applicants who can sustain themselves “private pay” for a period of time. In those cases, it is good for Mom to have some significant assets in her name. Their applications will ask for a statement of assets in her name. Most homes lose money on Medicaid patients so really like to have people enter private pay, eventually perhaps switching over to Medicaid. Check with the nursing home(s) you are considering re this issue. Many will be very frank about giving preference to private pay admits. Some even told my family how long they wanted an applicant to be able to be private pay, and if their assets would cover that long they would be moved to the top of the waiting list.</p>
<p>Some do have a true “need blind” policy (kind of like colleges). LOL!</p>
<p>Some nursing homes and assisted living facilities may only have a certain number of beds set aside for Medicaid patients. When a resident is paying out of their own funds and their money runs out, they may be forced to move out if there is not a Medicaid bed available.</p>
<p>You need to talk to an attorney well versed in all of this, who can give you suggestions as to what you can be doing . Once you know the alternatives and procedures available with the ramification of each, you can discuss this with those members of the family that should be involved and with your mother and set up some sort of consultation with them all involved.</p>
<p>In a nutshell, yes, your mother’s assets and income are taken into consideration and used when moving into a nursing home. Medicaid does have a 5 (I beleve it is still 5 year look back rule on this) .</p>
<p>To JEM’s point above…when my husband’s grandmother moved into a nursing home and turned over the proceeds of the sale of her house, she started in a private room, but once the proceeds had been spent down, she was moved to a double room. The facility was lovely, but still $8K/month in a low cost area of the country.</p>
<p>Sadly, the idea that a person “may be going to a nursing home very soon”, and “how can we make financial plans?” don’t go well together. The planning should have already been done and already put into action. Nevertheless, seeing a pro to get advice now is sure better than going next yr(for example) or not going at all.</p>
<p>My mom is in the same predicament. But she never wanted to get on to the Medicade and the nursing home we have looked at will not be her liking. So we are hiring special caregivers. Fortunately, dad’s estate and her assets can cover her for a long time.</p>
<p>Thank you all so much!<br>
I now have a to do list to start tomorrow (Monday):
-Find and make an appt with an attorney
-gather mom’s financial info
-look into home health care to possibly supplement what she gets at assisted living so she -can stay there longer
-research nursing homes, get her on a couple waiting lists if needed</p>
<p>On the long term care ins. idea…mom tried to get that years ago, but has had health issues (mostly diabetes) for many years so that option wasn’t really available to her. We will look into it, probably in the next couple years…maybe after paying for college. ;-)</p>
<p>“My mom is in the same predicament. But she never wanted to get on to the Medicade and the nursing home we have looked at will not be her liking. So we are hiring special caregivers. Fortunately, dad’s estate and her assets can cover her for a long time.”</p>
<p>It seems that it is far cheaper to hire caregivers to take care of people at home, then for them to go to a nursing home. And often much more to people’s liking.</p>