Ralph Robbins
Certified Financial Planner
Ralph S. Robbins, CFP©, is a licensed Certified Financial Planning Practitioner and an Accredited VA Claims Agent specializing in Eldercare Financial Planning. He works everyday helping families in crisis find creative ways to fund long-term care expenses and deal with family financial issues.
Show:
Articles Question
Question
Are aid and attendance benefits exempt from income tax?
CORRECTION! I left out the word "not" above. So to be clear.. All VA non-service connected pensions (Basic, Homebound, and Aid... CORRECTION!
I left out the word "not" above.
So to be clear..
All VA non-service connected pensions (Basic, Homebound, and Aid and Attendance) are NOT deemed as income for federal and state income tax purposes. see more
I left out the word "not" above.
So to be clear..
All VA non-service connected pensions (Basic, Homebound, and Aid and Attendance) are NOT deemed as income for federal and state income tax purposes. see more
Question
Can the ex-wife of a Veteran receive help with long term care?
If they were divorced, no (unless it can be proved that the divorce was a result of some form of abuse). If the she was married to the... If they were divorced, no (unless it can be proved that the divorce was a result of some form of abuse). If the she was married to the veteran and he passed away while still married, then yes. see more
Question
Are aid and attendance benefits exempt from income tax?
All VA non-service connected pensions (Basic, Homebound, and Aid and Attendance) are deemed as income for federal and state income tax... All VA non-service connected pensions (Basic, Homebound, and Aid and Attendance) are deemed as income for federal and state income tax purposes. see more
Question
I need to spend down money for my mother. Should I spend all her money on a house?
If I'm reading your question correctly you are not asking if mom can buy not "A" house with her $35k but, rather, can she buy... If I'm reading your question correctly you are not asking if mom can buy not "A" house with her $35k but, rather, can she buy "YOUR" house. Correct?
If this is indeed the question the answer is that sure she can, but you don't want to do that.
If she is going to be living with you for at least two years you could have her purchase a "life estate" in your property and that would be fine from a Medicaid eligibility point of few.
If the plan is to have her move to assisted living or a NH then spending down some funds as suggested above is fine.
However you may wish to maintain some flexibility with some funds as mom is going to need funds while receiving Medicaid.
Consider establishing a Personal Services Contract between the two of you whereby you are paid to perform services for her. The rules allow you to transfer a lump sum amount from her to you in advance satisfaction of the contract. (Caveat: this is a taxable event).
Another alternative that allows more flexibility is transferring funds to a Supplemental Needs Trust. Such a a transfer allow immediate Medicaid eligibility while permitting funds to be used for the health, maintenance and welfare of your loved one while receiving benefits.
Good luck! see more
If this is indeed the question the answer is that sure she can, but you don't want to do that.
If she is going to be living with you for at least two years you could have her purchase a "life estate" in your property and that would be fine from a Medicaid eligibility point of few.
If the plan is to have her move to assisted living or a NH then spending down some funds as suggested above is fine.
However you may wish to maintain some flexibility with some funds as mom is going to need funds while receiving Medicaid.
Consider establishing a Personal Services Contract between the two of you whereby you are paid to perform services for her. The rules allow you to transfer a lump sum amount from her to you in advance satisfaction of the contract. (Caveat: this is a taxable event).
Another alternative that allows more flexibility is transferring funds to a Supplemental Needs Trust. Such a a transfer allow immediate Medicaid eligibility while permitting funds to be used for the health, maintenance and welfare of your loved one while receiving benefits.
Good luck! see more
Question
Do a husband and wife both receiving Medicare pay separate premiums?
Carol is correct. Medicare is an individual benefit. Each will pay $99 per month for Part B in 2012.
Question
I am confused about being penalized after Medicaid pick ups. I has no choice but to put my mom in a home, will...
Hi.. You are doing an amazing job taking care of your mom! I have nothing but admiration for those attempting to manage these intense... Hi..
You are doing an amazing job taking care of your mom! I have nothing but admiration for those attempting to manage these intense situations at home.
To answer your question:
1. Document everything! The re-payments you have made to yourselves and the purchase of the SUV should not be a problem nor should money being spent on living expenses as long as they are for her benefit. You may be challenged on living expenses if the transfers are going from an account in her name to an account in yours and the transfers seem to high.
2. Given the numbers you disclosed above she will still be "over-resourced" for Medicaid eligibility (no more than $2,000 in assets). From what you are describing it sounds as though continued home care is going to be untenable. I would suggest that you begin the process protecting her funds for her benefit now.
Two methods I would suggest that will allow her to qualify for Medicaid immediately or when required are:
a. Create a Personal Services Contract between you and your mother where you are paid to care for her. This will allow you to transfer a lump sum amount equal to the value of the contract without penalty. Here is an example of how it works: A rate of pay is established, say $20 per hour. This is multiplied times the number of service hours per week (make it reasonable even though this is a full time job, I know, so let's say 15 hours per week). Multiply this times 52 weeks. This sum is now multiplied times the number of years of her life expectancy according to the appropriate tables. For example, if mom is 85 the HCFA table states her life expectancy is 6.62 years. This would allow for up to $103,272 to be transferred from her to you without Medicaid penalty. Caveat: this is a taxable event. If you do this after admittance to a NH the authority will not appreciate 15 hours per week; it should be no more than 5.
b. The other alternative which can be used in conjunction with (a) above is the transfer of funds to a Supplemental Needs Trust. This irrevocable trust is established by a 501c3 non-profit organization. The funds transferred to the trust are available for her health, maintenance, and welfare (she will need money even when receiving benefits to pay for things Medicaid does not pay for). She will immediately be eligible for Medicaid. Caveat here is that funds remaining in the trust at her demise go first to the state to "pay Medicaid back" before residual goes to heirs.
Before readers start screaming at me that this is not fair please keep in mind that this planning is NOT so that the family can benefit and the state foots the bill. The purpose of this planning is to make sure that money is available for mom while on Medicaid as there will be plenty of expenses that will need to be satisfied. Anyone who has had a loved in a nursing home knows how this adds up and adds up quick, particularly if the loved one's medical situation is complex as it is in this case.
Good luck, my prayers are with you.... see more
You are doing an amazing job taking care of your mom! I have nothing but admiration for those attempting to manage these intense situations at home.
To answer your question:
1. Document everything! The re-payments you have made to yourselves and the purchase of the SUV should not be a problem nor should money being spent on living expenses as long as they are for her benefit. You may be challenged on living expenses if the transfers are going from an account in her name to an account in yours and the transfers seem to high.
2. Given the numbers you disclosed above she will still be "over-resourced" for Medicaid eligibility (no more than $2,000 in assets). From what you are describing it sounds as though continued home care is going to be untenable. I would suggest that you begin the process protecting her funds for her benefit now.
Two methods I would suggest that will allow her to qualify for Medicaid immediately or when required are:
a. Create a Personal Services Contract between you and your mother where you are paid to care for her. This will allow you to transfer a lump sum amount equal to the value of the contract without penalty. Here is an example of how it works: A rate of pay is established, say $20 per hour. This is multiplied times the number of service hours per week (make it reasonable even though this is a full time job, I know, so let's say 15 hours per week). Multiply this times 52 weeks. This sum is now multiplied times the number of years of her life expectancy according to the appropriate tables. For example, if mom is 85 the HCFA table states her life expectancy is 6.62 years. This would allow for up to $103,272 to be transferred from her to you without Medicaid penalty. Caveat: this is a taxable event. If you do this after admittance to a NH the authority will not appreciate 15 hours per week; it should be no more than 5.
b. The other alternative which can be used in conjunction with (a) above is the transfer of funds to a Supplemental Needs Trust. This irrevocable trust is established by a 501c3 non-profit organization. The funds transferred to the trust are available for her health, maintenance, and welfare (she will need money even when receiving benefits to pay for things Medicaid does not pay for). She will immediately be eligible for Medicaid. Caveat here is that funds remaining in the trust at her demise go first to the state to "pay Medicaid back" before residual goes to heirs.
Before readers start screaming at me that this is not fair please keep in mind that this planning is NOT so that the family can benefit and the state foots the bill. The purpose of this planning is to make sure that money is available for mom while on Medicaid as there will be plenty of expenses that will need to be satisfied. Anyone who has had a loved in a nursing home knows how this adds up and adds up quick, particularly if the loved one's medical situation is complex as it is in this case.
Good luck, my prayers are with you.... see more
Question
If my mom has to live in a nursing home will they just take all her money?
KerryM... The problem is that personal resources are exhaustible and it is unknown for how long mom will require care. There are some... KerryM...
The problem is that personal resources are exhaustible and it is unknown for how long mom will require care.
There are some accuracies and inaccuracies shared above.
First, as described above, Medicare will only pay for the first 100 days IF she requires skilled care and is improving.
Second, Medicaid is the only other payor source other than personal resources.
Third, to qualify for Medicaid the applicant must have less than $2,000 in assets. There is also an income limit which varies by state. All of her income (Social Security, pension, etc.) will go to the nursing home if she qualifies for Medicaid.
Fourth, the asset transfer rules prohibit uncompensated gifts within 5 years of application for Medicaid. The annual gifting exemptions mentioned above apply to the Federal Estate and Gift Tax and have NOTHING to do with Medicaid qualification. It is irrelevant.
Fifth, if mom does go on Medicaid she will still need funds to meet her other needs. She will need clothing, glasses, hearing aides, dental, other personal needs, etc.
Sixth. There are several techniques available to move money legally so she can qualify for Medicaid. This is NOT about kids getting the money. It is about assuring that mom will be well provided for. For instance, look in to having her gift the money to a Supplemental Needs Trust. Gifting to this irrevocable trust will allow her to immediately qualify for Medicaid and the funds so transferred can be used for her health, maintenance, and welfare while receiving Medicaid benefits. You do not need an attorney to do this. Do a search for such a trust in your state. They are run by non-profit organizations. Compare several as costs vary (not surprisingly, some are run by attorneys and are very expensive).
You can also use part of the money to establish a Personal Service Contract between you and mom whereby you would be paid to perform services for her above those that are provided out of love and affection. This will allow a lump sum to be legally transferred from her to you and she will also thereby immediately qualify for Medicaid.
Again, this is to provide for her needs...not to enrich family members. Prudent planning of this sort makes sense.
Good luck! see more
The problem is that personal resources are exhaustible and it is unknown for how long mom will require care.
There are some accuracies and inaccuracies shared above.
First, as described above, Medicare will only pay for the first 100 days IF she requires skilled care and is improving.
Second, Medicaid is the only other payor source other than personal resources.
Third, to qualify for Medicaid the applicant must have less than $2,000 in assets. There is also an income limit which varies by state. All of her income (Social Security, pension, etc.) will go to the nursing home if she qualifies for Medicaid.
Fourth, the asset transfer rules prohibit uncompensated gifts within 5 years of application for Medicaid. The annual gifting exemptions mentioned above apply to the Federal Estate and Gift Tax and have NOTHING to do with Medicaid qualification. It is irrelevant.
Fifth, if mom does go on Medicaid she will still need funds to meet her other needs. She will need clothing, glasses, hearing aides, dental, other personal needs, etc.
Sixth. There are several techniques available to move money legally so she can qualify for Medicaid. This is NOT about kids getting the money. It is about assuring that mom will be well provided for. For instance, look in to having her gift the money to a Supplemental Needs Trust. Gifting to this irrevocable trust will allow her to immediately qualify for Medicaid and the funds so transferred can be used for her health, maintenance, and welfare while receiving Medicaid benefits. You do not need an attorney to do this. Do a search for such a trust in your state. They are run by non-profit organizations. Compare several as costs vary (not surprisingly, some are run by attorneys and are very expensive).
You can also use part of the money to establish a Personal Service Contract between you and mom whereby you would be paid to perform services for her above those that are provided out of love and affection. This will allow a lump sum to be legally transferred from her to you and she will also thereby immediately qualify for Medicaid.
Again, this is to provide for her needs...not to enrich family members. Prudent planning of this sort makes sense.
Good luck! see more
Question
My parents currently have Power of Attorney over one another. Is there a way to arrange in advance for a third...
As Carol mentioned above, most Power of Attorney documents (POA) provide for a successor agent in the event the primary agent is... As Carol mentioned above, most Power of Attorney documents (POA) provide for a successor agent in the event the primary agent is unavailable or unwilling to serve. Read the document to see if this is indeed the case.
A POA may be changed by the Principal at anytime as long as they are mentally competent to do so. If there is no successor agent named, it would be wise to have the documents redrawn.
Additionally, if mom and/or dad are in a state of decline it may be wise to go ahead and have the documents redrawn anyway so that another agent other than "each other" is named on a current basis.
Otherwise, some institutions (banks, brokerages, insurance companies, etc.) will require either a "Revocation of POA" or some other demonstrable evidence that the primary agent is not able or unwilling to serve. Just complicates things at the very time when "uncomplicated" would be beneficial. see more
A POA may be changed by the Principal at anytime as long as they are mentally competent to do so. If there is no successor agent named, it would be wise to have the documents redrawn.
Additionally, if mom and/or dad are in a state of decline it may be wise to go ahead and have the documents redrawn anyway so that another agent other than "each other" is named on a current basis.
Otherwise, some institutions (banks, brokerages, insurance companies, etc.) will require either a "Revocation of POA" or some other demonstrable evidence that the primary agent is not able or unwilling to serve. Just complicates things at the very time when "uncomplicated" would be beneficial. see more
Question
Can a creditor make a claim against parent's house if it has been signed over to adult child?
Only if they file for a judgment and they will then have to prove that a "fraudulent conveyance" took place. It will never... Only if they file for a judgment and they will then have to prove that a "fraudulent conveyance" took place. It will never happen. see more
Question
My brother-in-law has Alzheimer's. Does my sister's Power of Attorney let her change it if her was her POA?
Your sister can change her own POA at anytime as long as she has cognitive capacity. And, as Carol suggested above, she absolutely should... Your sister can change her own POA at anytime as long as she has cognitive capacity. And, as Carol suggested above, she absolutely should do so if her husband has Alzheimer's, especially if there is no successor named.
However, understand this:
A Power of Attorney only operates with respect to financial and contractual matters.
If health matters are your concern (as they should be in addition to financial and contractual matters) what needs to be arranged for is a Health Care Surrogate (aka: Health Care Proxy, Health Care Power of Attorney). Sometimes this is incorporated in the Power of Attorney, sometimes it is not. So read the existing document carefully.
Particularly with the new HIPPA laws, it is extremely important that a Health Care Surrogate document be updated.
Love and Peace.... see more
However, understand this:
A Power of Attorney only operates with respect to financial and contractual matters.
If health matters are your concern (as they should be in addition to financial and contractual matters) what needs to be arranged for is a Health Care Surrogate (aka: Health Care Proxy, Health Care Power of Attorney). Sometimes this is incorporated in the Power of Attorney, sometimes it is not. So read the existing document carefully.
Particularly with the new HIPPA laws, it is extremely important that a Health Care Surrogate document be updated.
Love and Peace.... see more
Question
My mother's husband is using her social security check for his advantage. What can I do?
Is this your perspective or does your mother share the same view? Does your mother have cognitive capacity (can she make decisions for... Is this your perspective or does your mother share the same view? Does your mother have cognitive capacity (can she make decisions for herself?). Does she therefore have or not have the ability to change or create a new power of attorney?
There are many options here. I'm guessing her husband is not your father, correct?
The absolute bottom line here is that if mom is not being well cared for you can file a petition for guardianship. Most family courts make it relatively easy to operate pro se (represent yourself) in these matters without an attorney.
Also, most counties have an elder abuse hotline and most Adult Protection Services in those counties are very good at what they do.
If the situation is precarious, contact them first (the equivalent of Adult Protection Services in your area). If you are then not satisfied you can always hire a private attorney.
And by the way, although I appreciate the recommendations to contact an elder law attorney, it is a very expensive way to get help. Most seeking help are not in a position to pay hundreds, if not thousands, for advice that can be obtained from social service agencies.
An attorney will have to gather and present the same evidence as Adult Protection Services will have to in order to present a case in family court.
Love and Peace to you and your family... see more
There are many options here. I'm guessing her husband is not your father, correct?
The absolute bottom line here is that if mom is not being well cared for you can file a petition for guardianship. Most family courts make it relatively easy to operate pro se (represent yourself) in these matters without an attorney.
Also, most counties have an elder abuse hotline and most Adult Protection Services in those counties are very good at what they do.
If the situation is precarious, contact them first (the equivalent of Adult Protection Services in your area). If you are then not satisfied you can always hire a private attorney.
And by the way, although I appreciate the recommendations to contact an elder law attorney, it is a very expensive way to get help. Most seeking help are not in a position to pay hundreds, if not thousands, for advice that can be obtained from social service agencies.
An attorney will have to gather and present the same evidence as Adult Protection Services will have to in order to present a case in family court.
Love and Peace to you and your family... see more
Question
My mother gave my family & I a gift of $24,000. My sister's are saying I have to return it. Am I required by l...
Regarding ItalianBabs comment on Gifting: "Gifting" for Medicaid eligibility purposes is ANY transfer of assets made for less... Regarding ItalianBabs comment on Gifting:
"Gifting" for Medicaid eligibility purposes is ANY transfer of assets made for less than fair market value compensation whether in the form of goods or services.
Therefore, a gift made to help a loved one out a financial jam IS considered a non-compensated gift and if made within five years of application for Medicaid can be accumulated with other gifts made during the same period of time to impose a Medicaid penalty.
Medicaid will not require return of gifts. It does not work that way. Medicaid will impose a "penalty period" based on the value of the transfer. During the penalty period the applicant will have to pay privately from whatever source.
Federal Law does provide, however, for "hardship" wherein the applicant is not able to pay privately under these circumstances.
The way to cure a gift made is to return the asset to the applicant and then use a proper strategy to move the funds (e.g., a Personal Services Contract aka Personal Care Contract whereby the the adult child is compensated - key word - for assisting the applicant).
If the adult child is also power of attorney (POA) it is legitimate for the POA to be compensated for services rendered to the principal. see more
"Gifting" for Medicaid eligibility purposes is ANY transfer of assets made for less than fair market value compensation whether in the form of goods or services.
Therefore, a gift made to help a loved one out a financial jam IS considered a non-compensated gift and if made within five years of application for Medicaid can be accumulated with other gifts made during the same period of time to impose a Medicaid penalty.
Medicaid will not require return of gifts. It does not work that way. Medicaid will impose a "penalty period" based on the value of the transfer. During the penalty period the applicant will have to pay privately from whatever source.
Federal Law does provide, however, for "hardship" wherein the applicant is not able to pay privately under these circumstances.
The way to cure a gift made is to return the asset to the applicant and then use a proper strategy to move the funds (e.g., a Personal Services Contract aka Personal Care Contract whereby the the adult child is compensated - key word - for assisting the applicant).
If the adult child is also power of attorney (POA) it is legitimate for the POA to be compensated for services rendered to the principal. see more
Question
What will happen financially when my mom goes on Medicaid after we cashed in one of her CD's she gave us?
You have two separate issues here: The house and cash assets. In both cases, it looks to me as though you have made or are about to make... You have two separate issues here: The house and cash assets. In both cases, it looks to me as though you have made or are about to make a big mistake.
As stated above, gifts made without fair market compensation within five years of a Medicaid application may be brought back into the applicant's "estate" for Medicaid eligibility purposes. With respect to the CD, this may cause an "ineligibility penalty" based on the value of the transfer.
This can be cured by returning the money to mom and then using a legal method to safely transfer the asset back to you. The purpose of doing so will not be to benefit you but, rather, so mom will have additional funds to support herself while receiving public benefits.
Federal law provides Medicaid asset protection for the primary or "homestead" residence if there is "intent to return" by the applicant. Some states presume this and the home is automatically protected. Others do not presume this and will require evidence that intent to return is viable.
Either way, transferring the home to you husband is a big mistake because of the transfer rules mentioned above.
Alternative ways to protect the home include (again, state variations apply):
Listing it for sale (it becomes an "unavailable asset")
Renting it (net income must go to cost of care)
Also, if you lived in the home for two years or more as mom's primary caregiver, the home can be transferred to you with no penalty.
Lastly, if Medicaid in your state allows her to keep the home, be mindful of Medicaid estate recover at her demise. All states are required to seek recovery of Medicaid costs at a recipient's demise. However some will only attempt to recover from probate assets. If this is the case in your state, there are methods to title the property and avoid probate.
Good luck! see more
As stated above, gifts made without fair market compensation within five years of a Medicaid application may be brought back into the applicant's "estate" for Medicaid eligibility purposes. With respect to the CD, this may cause an "ineligibility penalty" based on the value of the transfer.
This can be cured by returning the money to mom and then using a legal method to safely transfer the asset back to you. The purpose of doing so will not be to benefit you but, rather, so mom will have additional funds to support herself while receiving public benefits.
Federal law provides Medicaid asset protection for the primary or "homestead" residence if there is "intent to return" by the applicant. Some states presume this and the home is automatically protected. Others do not presume this and will require evidence that intent to return is viable.
Either way, transferring the home to you husband is a big mistake because of the transfer rules mentioned above.
Alternative ways to protect the home include (again, state variations apply):
Listing it for sale (it becomes an "unavailable asset")
Renting it (net income must go to cost of care)
Also, if you lived in the home for two years or more as mom's primary caregiver, the home can be transferred to you with no penalty.
Lastly, if Medicaid in your state allows her to keep the home, be mindful of Medicaid estate recover at her demise. All states are required to seek recovery of Medicaid costs at a recipient's demise. However some will only attempt to recover from probate assets. If this is the case in your state, there are methods to title the property and avoid probate.
Good luck! see more
Question
My mother gave my family & I a gift of $24,000. My sister's are saying I have to return it. Am I required by l...
Hi Jill... You do not need a lawyer until someone takes some action against you. There is absolutely no reason to panic! My experience... Hi Jill...
You do not need a lawyer until someone takes some action against you. There is absolutely no reason to panic! My experience has been that most of these issues between family members are not pressed and although bad feelings may remain, legal threats/remedies die in process. To successfully "prosecute" you via a civil action (trust me, this will never be considered a criminal matter) your sister would have to prove that mom was incompetent at the time and/or that you somehow coerced or "stole" the money from her. From what you have stated, she will not succeed.
I will add this for what it is worth: I believe in repairing familial relationships. It is a huge part of happiness, fulfillment and success in your life and the lives of your progeny.
I would also like to correct some of the information provided above regarding Federal Gift Taxes.
First, a gift is not taxable to you as "income" under any circumstances. Second, the Federal Estate and Gift Tax is actually called the "Unified Federal Estate and Gift Tax" and each individual has, therefore (under current law), a lifetime exemption of $5 million for all gifts and estate assets. As a result of this lifetime exemption there will never be any tax on the gift (unless mom has over $5 million). Also, it is your mom's responsibility to file the Form 709, not yours. And, if there were tax due, it would be her obligation to pay it, not yours.
Lastly, in my neck of the woods elder law attorneys are VERY expensive and usually work on a flat fee basis. There is no reason to even approach an elder law attorney unless you have a complicated asset situation when applying for Medicaid benefits. Even then, I would seek alternatives before paying crazy fees for work that can be done by your family or a non-lawyer planners who specialize in these matters. For low income/asset applicants there are plenty of social service agencies that will assist at no charge.
Good luck! see more
You do not need a lawyer until someone takes some action against you. There is absolutely no reason to panic! My experience has been that most of these issues between family members are not pressed and although bad feelings may remain, legal threats/remedies die in process. To successfully "prosecute" you via a civil action (trust me, this will never be considered a criminal matter) your sister would have to prove that mom was incompetent at the time and/or that you somehow coerced or "stole" the money from her. From what you have stated, she will not succeed.
I will add this for what it is worth: I believe in repairing familial relationships. It is a huge part of happiness, fulfillment and success in your life and the lives of your progeny.
I would also like to correct some of the information provided above regarding Federal Gift Taxes.
First, a gift is not taxable to you as "income" under any circumstances. Second, the Federal Estate and Gift Tax is actually called the "Unified Federal Estate and Gift Tax" and each individual has, therefore (under current law), a lifetime exemption of $5 million for all gifts and estate assets. As a result of this lifetime exemption there will never be any tax on the gift (unless mom has over $5 million). Also, it is your mom's responsibility to file the Form 709, not yours. And, if there were tax due, it would be her obligation to pay it, not yours.
Lastly, in my neck of the woods elder law attorneys are VERY expensive and usually work on a flat fee basis. There is no reason to even approach an elder law attorney unless you have a complicated asset situation when applying for Medicaid benefits. Even then, I would seek alternatives before paying crazy fees for work that can be done by your family or a non-lawyer planners who specialize in these matters. For low income/asset applicants there are plenty of social service agencies that will assist at no charge.
Good luck! see more
Question
Does Medicare or Medicaid pay for a nursing home?
This is a very tough situation and one for which there is not a succinct answer. It is not as easy to gain the required 3 day hospital... This is a very tough situation and one for which there is not a succinct answer.
It is not as easy to gain the required 3 day hospital admittance to qualify for Medicare skilled nursing facility benefits as it used to be so cooperation from your loved one's physician would be required. Even so, it may not be doable if there is an absence of medical need.
The most extreme option would be to have the elder declared incompetent, have a guardian appointed, and then have the guardian spend the funds necessary for a private pay nursing home stay.
Less extreme: Does someone have a health care proxy and durable power of attorney for the elder? If so, that person may have some luck in obtaining funds and therefore the services the elder requires as follows:
Simple "refusal" by the elder to gain weight for surgery may not be enough to establish that he/she is not able to make decisions for him/herself but having the proxy will allow the holder thereof to at least speak to the physician(s) involved and see what they believe as to the elder's capacity and find out what the medical recommendations are. If a physician is willing to state that the elder does not have capacity then the agent (the person designated as the holder of the power of attorney) could take a written determination to a financial institution and gain the funds necessary to implement the physician's recommendations. This does not, of course, address the elder's "refusal".
To that end, you may also want to consider the enlistment of a geriatric care manager or social worker who may be able to gain the confidence of the elder and then guide him/her in the right direction.
Good luck! see more
It is not as easy to gain the required 3 day hospital admittance to qualify for Medicare skilled nursing facility benefits as it used to be so cooperation from your loved one's physician would be required. Even so, it may not be doable if there is an absence of medical need.
The most extreme option would be to have the elder declared incompetent, have a guardian appointed, and then have the guardian spend the funds necessary for a private pay nursing home stay.
Less extreme: Does someone have a health care proxy and durable power of attorney for the elder? If so, that person may have some luck in obtaining funds and therefore the services the elder requires as follows:
Simple "refusal" by the elder to gain weight for surgery may not be enough to establish that he/she is not able to make decisions for him/herself but having the proxy will allow the holder thereof to at least speak to the physician(s) involved and see what they believe as to the elder's capacity and find out what the medical recommendations are. If a physician is willing to state that the elder does not have capacity then the agent (the person designated as the holder of the power of attorney) could take a written determination to a financial institution and gain the funds necessary to implement the physician's recommendations. This does not, of course, address the elder's "refusal".
To that end, you may also want to consider the enlistment of a geriatric care manager or social worker who may be able to gain the confidence of the elder and then guide him/her in the right direction.
Good luck! see more
Question
How can Medicaid take into consideration what has been done with money the last few years if you did not know...
The answer above is great...but it is more with respect to the "why" Medicaid has a financial "look back" as opposed to... The answer above is great...but it is more with respect to the "why" Medicaid has a financial "look back" as opposed to "how" Medicaid deals with this issue.
The answer as to how Medicaid actually deals with the 5 year look back is depends on the state in which you live. In New York, for example, the applicant is required to actually produce 5 years of financial records whereas in Florida the applicant is asked whether there have been asset transfers but is only required to provide 3 months of financial records (of course Florida reserves the right to request more if they so desire).
The "look back" is designed to protect the public interest as described above however federal law provides a "hardship" provision where it may not be possible for an applicant to "cure" any transactions that took place in the past. see more
The answer as to how Medicaid actually deals with the 5 year look back is depends on the state in which you live. In New York, for example, the applicant is required to actually produce 5 years of financial records whereas in Florida the applicant is asked whether there have been asset transfers but is only required to provide 3 months of financial records (of course Florida reserves the right to request more if they so desire).
The "look back" is designed to protect the public interest as described above however federal law provides a "hardship" provision where it may not be possible for an applicant to "cure" any transactions that took place in the past. see more
Question
I'm afraid my sister is trying to steal all of my mom’s money by being on joint accounts with her. What can I...
PegDBeeLady... Do raise bees? If so, that is so cool! I'm intrigued by bees... To answer your question the simple rule is this: A... PegDBeeLady...
Do raise bees? If so, that is so cool! I'm intrigued by bees...
To answer your question the simple rule is this:
A trust will have a trustee. If accounts are titled in the name of the trust the account will read: XYZ Trust dated 00/00/0000 XYZ, Trustee.
Assets in the trust are governed by the terms of the trust at the grantor's demise. Not by the will (unless the trust directs proceeds back to the estate of the deceased), or by other ownership, or by beneficiary (testamentary) provisions. see more
Do raise bees? If so, that is so cool! I'm intrigued by bees...
To answer your question the simple rule is this:
A trust will have a trustee. If accounts are titled in the name of the trust the account will read: XYZ Trust dated 00/00/0000 XYZ, Trustee.
Assets in the trust are governed by the terms of the trust at the grantor's demise. Not by the will (unless the trust directs proceeds back to the estate of the deceased), or by other ownership, or by beneficiary (testamentary) provisions. see more
Question
As my mother’s Power of Attorney, is there anything I can do to avoid family disagreements if my mom should re...
Much will depend on the jurisdiction in which mom would apply for Medicaid. Some require the applicant to actually produce five years worth... Much will depend on the jurisdiction in which mom would apply for Medicaid. Some require the applicant to actually produce five years worth of records and if those records show payments to you, your copious notes will certainly be of benefit to making your case. And of course if there was just one lump-sum payment more than five years ago then there are no issues.
The fact that you are POA can also be a saving grace in that most jurisdictions allow the POA to be compensated for services (especially if the POA stipulates this). So, if the "salary" was not too great, you can claim the payments as reimbursement for your out of pockets as POA and for payment of POA services.
If mom still has assets you are concerned about you may still be able to execute a Personal Care Agreement going forward since you are her POA and have the power, therefore, to enter into contracts on her behalf. Some jurisdictions deem this self-dealing are not pleased with this...however others are ok with it. Here in Florida some districts require that the applicant, even if incompetent, at the very least make there mark on the document. Sometimes rules can be so silly.
Some jurisdictions will also allow for lump sum payment immediately in advance satisfaction of the contract based on the applicants life expectancy.
Also, given that mom is now living with you, it is reasonable for her to pay you fair market room and board.
Lots of possibilities to preserve assets to assist with mom's continued care needs whether home or in a NH.
Good luck! see more
The fact that you are POA can also be a saving grace in that most jurisdictions allow the POA to be compensated for services (especially if the POA stipulates this). So, if the "salary" was not too great, you can claim the payments as reimbursement for your out of pockets as POA and for payment of POA services.
If mom still has assets you are concerned about you may still be able to execute a Personal Care Agreement going forward since you are her POA and have the power, therefore, to enter into contracts on her behalf. Some jurisdictions deem this self-dealing are not pleased with this...however others are ok with it. Here in Florida some districts require that the applicant, even if incompetent, at the very least make there mark on the document. Sometimes rules can be so silly.
Some jurisdictions will also allow for lump sum payment immediately in advance satisfaction of the contract based on the applicants life expectancy.
Also, given that mom is now living with you, it is reasonable for her to pay you fair market room and board.
Lots of possibilities to preserve assets to assist with mom's continued care needs whether home or in a NH.
Good luck! see more
Question
If elderly parent has joint account only with one child, will other children be disinherited from those accoun...
Wow. This is certainly a hot topic. And one that I encounter in my work with families all the time. The question I always come up with... Wow. This is certainly a hot topic. And one that I encounter in my work with families all the time.
The question I always come up with for myself is: Where is the love?
Of course family dynamics are always exacerbated by stress.
This is more a psychological issue than a financial one that I am very much interested in exploring further.... see more
The question I always come up with for myself is: Where is the love?
Of course family dynamics are always exacerbated by stress.
This is more a psychological issue than a financial one that I am very much interested in exploring further.... see more
Are aid and attendance benefits exempt from income tax?
Expenses were paid for services received by your father. If you are seeking to deduct these expenses for income tax purposes they should be deducted on his return as a medical expense. see more