Finally she has gotten approved for Medicaid but with a penalty period in the amount of 150,000. The lawyer is disputing this. They looked back to when my dad was alive and found transactions that neither my mom nor myself can explain. She has dementia as well. If the fair hearing does not go in our favor with Medicaid, how can we pay this money? Her funds are depleted and I am her POA. Am I liable? If so will the nursing home work out a payment plan or expect this whopping sum of money up front. Will she be discharged if I can’t pay it all back? We are in NY. Thanks for any advice, I have been in touch with the elder care attorney but seeking advice from any others that may have been through this type of situation. Thank you
In NJ you need to spend down to 2000. 00 before Medicaid kicks in but you should certainly apply for it before you hit that amount but each state is different. You should speak with the NH directly to see if they are willing to work on a payment schedule with you; each NH has different policies and tolerances.
We did have something like this at one of the NH I worked with. Really bad quidance of a fairly new family by a high priced attorney in regard to changing the ownership of a condo, gave the resident a Medicaid penalty and my facility was within their rights to demand the family find her another placement. Because we were a county facility, we did a lot of work (like several calls everyday) with Medicaid. I phoned and explained what had happened but Medicaid held hard to their original decision of penalty in place. I actually had to go down to the Medicaid office (I was the admissions director so I could easily leave my facility) and plead the case with the management board. Luckily, we were within about a month's time of the ownership change, the family was more than willing to spend their own funds to have the ownership change reversed and I had documentation to prove that the attorney had recommended the ownership name change in the first place. Medicaid reversed their ruling and had the state initiate a suit against the attorney (state won that one!) however that was a highly unusual case. I wish you good luck.
When you sold Moms condo the proceedes should have been placed in a bank account in her name. What this lawyer told you is fraud, its hiding assets. That 100,000 could have offset the penalty period by paying for Moms care privately.
So, you have been only sending the 2700 a month? In my area its about 10k a month for nursing home care. So you would have needed to pay about 7300 extra a month. Medicaid would never have paid the difference until the penalty was satisfied. (Medicaid doesn't pay the private pay amount either)
This is what should have taken place so you understand the process. I will base this on Mom had no other assets than her Condo.
You applied for Medicaid but were told that there were some large amounts of money withdrawn that you could not account for so it caused a penalty period. When this happens, the decision has to be made to care for the person in their or your home or you pay privately in a NH until the penalty period is met. Seems you chose to keep Mom in care. If you were only paying 2700 a month you were not paying the full monthy balance. When you sold Moms condo, any back payments should have been made and the balance of the 100k would have continued to be paid to offset the monthly balance. I think if this had been done, you may have met the penalty period. But there is a formula for that. Then just before Moms money ran out you could have had Moms application looked at again and she may have been excepted by Medicaid before now.
What is the monthly cost at Moms facility? You will owe that amount minus the 2700 you send and the 50k you previously gave them. Then minus the 40k you have left. What is left is Moms debt. The only thing I can see a lawyer doing is maybe getting the balance owed lowered and setting up some kind if payment plan with no interest. Interest will make it harder to pay off in a timely manner. I would wonder when the penalty period was met and if Medicaid could have been applied for earlier than it was.
Once this gets settled and you know Mom is staying where she is, I would allow the NH to become Moms payee. Her SS and pension checks going directly to them. Then all you need to do is visit. She will have a PNA (personal needs account) where a small amt of money from her SS will be deposited monthly. My State its $50. This is to cover any personal things she needs like a haircut, clothing, snacks out of the vending machines. The NH should provide stuff like toothpaste and her Depends, toiletries, ect. You need to set yourself up for reimbursement for anything u may buy her. You will need to produce a receipt.
Seems like you have received the wrong information and I am so sorry for that. Please come back and tell us how it works out. This is how we learn and can pass it on.
Just MHO, which counts for nothing--but as long as mom is alive, all her money and tangible assets are hers--only upon her death can funds be 'paid out' and then only after all the bills have been paid.
You can't really 'inherit' things, esp money, until the creditors have been satisfied and all bills due are paid.
If there isn't money left, then there isn't money left. BUT, if they can prove you took a chunk of $$ while mom was alive and in a NH, they can and will come after you for it.
I see where you posted in 2019 but you never responded to our replies. You talk about selling Moms Condo. Were the proceeds used to pay for her care and offset some of the penalty period? I will assume that you have not been paying monthly for Moms care hoping that Medicaid would be approved? Not sure how far back Medicaid will go when finally approved.
I hope your lawyer is very well versed in Medicaid law. I did question, on ur 2019 post, the lawyer going thru statements and writing down anything over 2k. To me this was a waste of time since Medicaid requires 5 yrs of bank statements that they go thru and pick out any large expenditures and question them.
My question would be, and hopefully another member can explain this. I am just brainstorming here because there is a formula when it comes to penalties. But lets say Moms penalty period was 15 months. This means she would have needed to pay privately for that time or the proceeds from her condo offset the the costs during the penalty period. Whatever, the penalty period ended at 15 months. So why did it take another 15 months for Medicaid to approve her. Why couldn't Medicaid have taken over once the penalty period was met. Because the way I look at it, all Mom may have owed is 50k, the difference between the 150k penalty, minus the 100k for sale of the Condo = 50k. In my opinion your lawyer did not do his job.
I’m new to all of this.
Thanks.
Where did the money from the sale of mom's condo go? Was it sold at fair market value?
You are not personally liable.