My aunt never expected to live in a nursing home but had a stroke. She always gave cash to family members for holidays graduations etc. will medicaid only look at gifts over $500 ea or add all these up? None of us can pay $6000 a month for NH if they don't pay.
1. auntie if she was discharged from the hospital (Medicare benefit) to a NH for rehab, was admitted to the NH under post-hospitalization Medicare covered Benefit. Usual scenario is 21 days covered 100% & then IF still progressing in rehab at 80% for up to 100 total rehab days. You WANT her to stay in rehab as long as possible so she stays in NH with Medicare paying. This does 2 things....pays the NH at the much much higher Medicare rate and provides you or whomever is aunties DPOA time to figure out & work through the clusterF that is her finances and “gifting” issues for her eligibility for Medicaid.
This site has articles on Medicare & Medicaid. Read up on how the M&Ms are similar yet different. You or the dpoa must understand how each work.
So right now what is auntie on? Rehab (Medicare) or skilled nursing resident (Medicaid Pending or application still in gathering documents stage)?
2. Medicaid LTC in a NH requires basically impoverishment for eligibility. Most NH allow them to stay in NH as “Medicaid Pending” while application & supporting documentation reviewed by state. Is Auntie Pending?
For impoverished, Monthly income must be under whatever limit your state has set (usually under $2100) and non exempt assets under 2k. State can do a 5 yr look back to ensure assets were not transferred & gifted. Usual situation is mom owns a home so does a quit claim and signs over her home to one of her kids. And QCD done like the year before mom goes into a NH so it’s kinda obviously done as Medicaid asset avoidance and places transfer penalty based on property assessed value on moms Medicaid application.
But your situation is unintentional gifting and NOT asset avoidance. You or dpoa is going to need to clearly established this and more than likely have a elder law atty shepherd auntie application through initial review and appeal process. How unintentional is dealt with imo depends on the amounts & to whom (like its a pattern or random) & it’s something to let atty guide you on. We had to deal with it on MILs application as she was writing $75-100 mo. to her caregiver to cash & buy her liquor; and it took almost a yr to get approved & retroactively.
3. NH bill - auntie must MUST be having her monthly income (like her SS) be paid to the NH. This is required for her to be compliant for “Pending”. Is this being done?
If not, it needs to be happening for her to stay Pending. Did you or personally sign off on responsibility for her? If you did, NH will bill you personally if she does not clear eligibility for Medicaid.
NH won’t kick her to the curb. Medicaid takes time to process. NH should be ok for 3-5 months of Pending status. But if $ is not being paid in some way, NH will usually send a “30 Day Notice”to auntie & whomever on file as responsible family member and if no action taken then NH can ask APS to request a judge for an emergency “ward of the state” status placed on Auntie. Judge will sign off & guardian selected from an existing list of vetted & approved ones. Family is out & not consulted. Guardian takes over all & can get APS to open investigation on family who were gifted $. This can get ugly. Really you don’t want to let things get to this level if you or dpoa can help it.
I was executor for 2 “Auntie’s”, with each there were lots of surprises as I was not involved in their day to day lives. So lots of piecing together & very very time consuming. I’d pass on ever doing this again for anyone unless direct family. Being executor is different than dPOA but both will require lots of time and document gathering and will cost you one way or another. If it looks like way way more than your capable of dealing with, ward of the state can be done.