My mother-in-law gifted us 20K. She was living with us, now she is in AL. Do we have to give the gift back if she goes on medicaid?
We cared for my mother in law at first we would go down to the bronx and stay a week, eventually in late october 2010 she came to live with us in Poughkeepsie NY. She gifted my husband about 20K, we in turn purchased a new hot water heater, paid to reroute our heating system she needed to be 'warm' warm was 75 degrees, us suffocating and our heating bills through the roof. our house being old we had siding put in along with a new roof and of course insulation. we live in a bi level house, my husband and did not care much for heat or how the house looked, but since insulating and putting back the old cedar shakes would have costed more we did the sliding. We installed new windows because she felt 'drafts'.we took care of all her doctor visits and vet visits for her dog who sadly died in March of 2011, she became depressed so we enrolled her in a day program, she loved this very much In May of 2011 rushing to get to her day program she took a fall, she was in the hospital and the doctor reccommeneded ASL. I began looking and found nice clean ones in my area for about 2k a month. My sister in laws guilt kicked in and she wanted Ma (as i call her) out in long island, she applied and being the surviving wife of a vet got in for about 3k a month. Last week she became ill with Pneumonia. she was transferred to a rehab place because she is very weak and the ASL won't let her come back until shes better. Today a "hag" called and told my husband that medicare may ask for the money back, we informed her that our intention was for ma to be with us for the duration of her life, we also told them that she gave us that money as a gift and to use to improve her quality of life. the woman told my husband to prove it. He told her that if she just got to the rehab place medicare covers the cost and then we can revisit the issue. Ma had made my husband give her a copy of the agreement when she gave him the money, it was important that she was not a burden and everyday she'd read what my husband and her signed. My sister in law initially threatened us saying we had no right to take the money actually calling my husband a thief, we informed her that she did NOT want Ma, made thousands of excuses, Me being disabled I felt we can take Ma and just work it out, which of course we did. Our hope was that she would come back to live with us until my sister in law decided she wanted to be a daughter. Being that we can prove the money was a gift it is memorialized in writing and signed by Ma and my husband, being that we wanted her quality of life improved the money was used to update the heating system, she detested going to the doctor in my low slung honda which was paid for in full and I traded the it for a 4 door car so she can be comfortable. Every last cent and alot of our own money was used to care for her. Again we never anticipated her going to a NH or a ASL. the woman at the rehab center said medicaid will force us to pay the money back whether it was a gift or not. I researched alot and it appears that we do not have to give it back, and yes we can prove where the money went. I just wanted to see if I am reading it right, you see in July 2012 I had a brain tumor removed and have a hard time understanding what I read, we filed bankruptcy in 2009, and now we have over 25k in co payments for my surgery. I just want to know if this is going to be a problem for us, and to apologize because sometimes I ask things the wrong way. Yes we can prove the money went to the house and the switching of the car, yes my husband and ma signed on the gifted money, and she wanted to give us more and we said no, can medicaid, medicare make us give money back when it was spent to improve her quality of life? please please I need an answer that I can show my husband, we are already in debt over the MY brain tumor bills and this comes at a time when the stress can bring on seizures all over again. I will greatly appreciate an answer.I'm lost here and my husband is sick over this, Ma was happy here, she wanted to stay with us, my sister in law said "I want my mother in lily white long island" that left me speechless because my family is mixed with hispanic, afro american, dominican, irish and itlaian im lost please help me?
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If that happens you need to do an appeal of the penalty (within the timeframe which most states are sticklers for and it seems to be a short window to file in) and provide documentation as to the use of the funds and their purpose as it related to the applicant.
How the transfer penalty works is that your states daily NH Medicaid reinbursement rate is what is used to determine the # of days in which the applicant (who is qualified for Medicaid) is ineligible for NH Medicaid payment.
My mom is in TX and the day rate is about $ 143.00 a day, so 20K would be 140 days in which her stay at the NH needs to be private paid as that would be her penalty period. What makes this scary is that often the transfer penalty letter goes out from the state (which may be managed not by state employees but via private contract with a firm, like HMS) to whomever is the contact person for the Medicaid individual AFTER they are residing in the NH. Now also the state sends a copy to the NH, which is essence tells them that they (the state) is NOT covering payment or is doing a clawback of payments until the penalty days are done. The NH will pretty much expect you to either private pay the penalty amount or sign off on a contract to do such or other agreement. If you don't, then you will get the dreaded "30 Day Notice" - which means you have 30 days to find another place for mom.
Until the penalty is lifted, mom is toast on getting into another NH that accepts Medicaid too. You can buy time by filing an appeal and going through that whole monkey cage as the NH that takes Medicaid cannot discharge a resident who is under a filed Medicaid appeal. My appeal hearing date with my mom was like 4 months out, and that is a whole lot of time to get your documentation in order. I was able to get the paperwork (this was over her car which she gifted and it's Kelly Blue Book value) all done and to the caseworker within a couple of weeks. So the caseworker was able to check that issue off his list of concerns. I also had an issue with my mom's insurance policy (a cash value ?) and that documentation had to be provided within 72 hours or my mom's application would go into the "information not provided" line and then into the declined application pile. Couple of other issues too. What I've found is that the caseworker (who doesn't get paid much) has about 15 minutes to evaluate the application, - it's not that they don't want your mom to get into Medicaid system - and they need paperwork to fatten up the file so show why it's OK to approve. You really want to provide them as much as possible that is clearly legible and matched up the dates/time/year of the $$ so they can check off "documentation provided".
Remember when they apply for Medicaid, they or you as their POA, sign off on allowing an all-access pass to their banking, insurance, burial polices, property ownership info, etc. Property ownership is recorded by the county and then dovetails into the state's system and info is just key strokes away.
I wouldn't assume Medicare is paying more than the 1st month in the NH. Most of the time with the elderly, they stop qualifying for "rehabilitation" (which Medicare pays) after 3 or maybe 4 weeks. It's exactly like what OnceHated described.
We found examples online of families that had divided up their parents money within the 5 year window (which could always again be opened wider some day) and in all those cases the money distribution did incur a Medicaid penalty period. In the example of money being distributed to children and one child housing the parent for a comparable length of years, the money given to the child that did that housing of their parent was (OFTEN) not counted in the penalty period.
But you have to wonder if the other siblings will back the money by paying for the parents nursing home care during the penalty period. I suspect in many cases the other children probably claim the money is "gone" and just look the other way, while some responsible sibling tries to handle the mess.
For people looking forward and considering such use of their elderly parents money. You would have to proceed with caution and back up plans, as there are not any guarantees at all that your actions wouldn't trigger a penalty period. While you are not being ordered to give a gift back, you are being denied Medicaid until someone pays.
BIL and his family declined the offer. I suspect it was the part where we made it clear to them that they would have to commit to the rest of us that the ILs would have to remain in their home, until death. They live in a state that the income limits for Medicaid were lowered and the IL's as a couple or alone did not qualify in their state for Medicaid.
Good luck,
-SS
Generally, if an elder just gives the money away, it can be reclaimed by Medicaid during the five year look back period. The paperwork here is the difference. Your state laws may play into this, as well, so an attorney is likely the best way to go unless you show the papers to the Medicaid qualification people and they say it's okay. Good luck. This is a problem for many people.
Carol