Elder Care Costs and Family/Financial Issues - Long

[Cypress]

Support and Feedback on Elder Care Costs and Obligations


My mother has been living at a long term care facility since February 2012. Her health concerns are so complex and costly that her estate executor is saying she has spent $200,000 out of available funds. She is now down to $2000 in the bank and applying for Medicaid and MassHealth to cover cost of daily care.


Two years ago she gave me $10,000 in support of restoration of my home. I needed a new roof and chimney and asked for and accepted this support.


The State of Massachusetts/Medicaid requests a five year look back at financial records. The $10,000 check to me came up as a potential problem. The estate executor stated…”If the money is not returned to Mom’s savings account, MassHealth will issue a penalty. The penalty consists of withholding payment to the nursing home and effectively putting Mom in a position where Facility can withhold payment to the nursing home and effectively putting Mom in a position where Facility can ask her to leave because of non-payment.”


FYI – The estate executor is my eldest brother. As in many situations like this, a marginal relationship to him has deteriorated to that of communication in writing only. He is a highly controlling individual who is used to people agreeing with everything he says. I always had questioned his actions and wanted to hear the whole story. He controls the communication and is the only person talking to the social services, doctors, etc…..I have no idea what he has or hasn’t done. At this point, I stay out of it. I have no energy to approach the family on this situation as I have taken pains to separate myself. We are not close, never have been and I am on the outside of the situation. The family has always been fairly dysfunctional and family in name only.


I consulted a lawyer with regard to having to pay back the $10,000 and no, I do not have to do that as it was given in good faith but there may be penalties as expressed. I am not responsible for what is happening now. The way the communication was made to me, it paints me as the bad guy here.


Has anyone ever dealt with the complexities of care for a relative who is out of money and applying to state aid for support? The state is making it look like a simple, common act of support between family is now a means to make it more difficult for my mother to obtain what may be within her rights. She still gets payments from Social Security and the VA. It’s the high cost of her daily care that is the concern.


Morally, I feel bad and beyond awkward, I have no idea what to do or what to say at this point.

[ToomuchStuff]

Last I checked, this is 2013. You said she GAVE you, $10k, you didn't say lent (IRS allows parents to gift to their kids x amount (not sure what, but I thought it was $10k) per year. If she did that, and she was healthy and mentally fit at the time (2011), I don't see a problem, personally. You might contact Massachusetts, directly if that is the case, and see if they can discuss this with you. since it was all above board.

[Gardenarian]

Last I checked, this is 2013. You said she GAVE you, $10k, you didn't say lent ...
My thoughts exactly. If she gave $10,000 to the Audubon society, would they go after them for funds? This is completely illogical.

You have no reason to feel guilt about this. None.

[Float On]

Actually I think it's now $14,000 per year before the Gift Tax form has to be filled out. Sounds like brother is just being a bully. I'd print off the tax code and mail it to him and let him deal with it. At the time she gave it, she was not already in the care facility.

[Mad_Hen]

Wow, you have my sympathy. My mother is getting older, and because my sister is married, and I am not, she is deferring to my sister's husband for all her financial issues. (Happily, I was able to get her to give me access to her medical records, but power of attorney is still up in the air.) There is a long and sordid history of my sister's family's actions after my father died, and the ultimate result was that they ended up $40,000 richer and with a new house, and my mother ended up $40,000 poorer, living in an apartment (when she started in a house that was paid off), and having to scrape for several years before she was eligible for social security. I suspect I will be in a similar situation as yours down the road, minus my mother giving me any money.

I would say that the STATE is not making that transaction look suspect, but your BROTHER is. You might check with the care facility or any senior citizen care center, as they often have advisors who help family members figure that kind of stuff out and may be able to direct you as to how you can clarify that the money given to you was a gift, rather than a loan.

[gmpg54]

Contact the facility social worker,they should know how the law is written.

[Cypress]

Grazie, mille grazie......I so much appreciate a realistic, practical approach to my question. Honestly, I thought things were skewed. Also, he sent a letter almost the very next day going on about her medical condition and that she is fading fast, I better go see her now. He has my telephone number and could call at any time. Apparently, my other siblings do not share e-mail addresses either as he prefers to communicate that way and asked everybody to respond to him at his e-mail address. The thing about the letter that irked me most of all, that instead of offering options and what's the best that could happen, he offered the worst and made me feel to be an outsider once again. And, the letter was cc'd to all my siblings.

I am very tempted to stamp return to sender on all mail.

Thank you so much.

[iris lilies]

Actually I think it's now $14,000 per year before the Gift Tax form has to be filled out. Sounds like brother is just being a bully. I'd print off the tax code and mail it to him and let him deal with it. At the time she gave it, she was not already in the care facility.

IRS rules have nothing to do with Medicaid look back periods, two separate Gubmnet agencies, two separate sets of regulations.

I don't know the answer, but I know that my brother and I were incredibly careful about this kind of thing with our mother in a nursing home and her approaching a point of public aid. Where she was the "look back" period was 5 years, too. Fortunatly, she died before her money ran out.

I think that the suggestion about getting another POV is good, but what your brother told you is basically true. Whether or not the state acts on their own rules is part of the problem of lack of clarity.

[try2bfrugal]

I agree with Iris lilies. There are Medicaid laws in place to prevent parents from giving money away to their kids to deplete their assets and then going on Medicaid. The look back period is five years.

You should probably talk to an elder care attorney, but I think what your brother is telling you is most likely correct.

This link has more information -
http://insurance.lawyers.com/medicare-medicaid/Rules-to-Transfer-Assets-for-Medicaid-Look-Back-Periods.html

"... if your parent gave away $30,000 in assets, and if the average cost of a nursing home in your state is $5,000, your father would be ineligible for Medicaid for six months, or $30,000 divided by $5,000. The penalty period usually begins on the day your parent applies for Medicaid, assuming he meets all other qualifications."

If it were me and I had the money I would pay it back to your mother's estate, unless an elder law attorney sees another way out of it other than you mom being denied the care she needs.

[Mad_Hen]

I have used this website before with very good results. I think I paid $35 at the end (no payment necessary, but they ask that you pay what you think the advice was worth). You might try posting your question here to see what answer you get. I have a litigious neighbor who was very interested in a dead tree that I cut down near his fence-line, and after multiple emails back and forth with the lawyer, I felt very comfortable that I could fight him, if necessary.

http://www.justanswer.com

[Float On]

IRS rules have nothing to do with Medicaid look back periods, two separate Gubmnet agencies, two separate sets of regulations.



Thanks for that clarification.....had no idea. I'll have to point that out to my DH because his mother gifts us money every year (and I don't want to listen to him complain about it if something like this happens).

[jennipurrr]

I would be very careful about this and mentally/monetarily prepare to pay back the money if need be. The Medicaid look back got a lot stricter a few years ago. Basically, there was a loophole where folks were gifting their extra assets in advance and then using government nursing home care for indigent people.

I have a friend whose mother was aging and she is an only child. They both sold their houses and bought a home together with a mother in law suite. She and her mother planned for her to live there for years, but her mother's health deteriorated quickly over the next few years. She ended up going into a nursing home paid for by Medicaid. They said the money from the home sale had to be used for nursing home payment...it was a huge mess. There are all sorts of rules about you can have a primary residence, but not sell and have cash, etc. My friend was not trying to do anything shady intentionally at all, she had not even considered the issue around this. As the amount was six figures, she had to set up a plan for wage garnishment for a number of years unless she wanted to sell the current home...it was very sad.

[iris lilies]

...My friend was not trying to do anything shady intentionally at all, she had not even considered the issue around this. As the amount was six figures, she had to set up a plan for wage garnishment for a number of years unless she wanted to sell the current home...it was very sad.

I just heard a story from a friend in my state who sold her father's house after putting money into it to fix it up for the sale. She was surprised upon closing that the state took a large portion of that profit as payback for her father's nursing home bill. I thought that, when she was sinking money into it for resale, the money for fixing it up was a bad idea, but it became a terrible idea when she didn't recover that money.

Beware, there are minefields in this.

[Cypress]

Just a follow up. My mother died this weekend from natural causes. She had been very ill for quite some time.

What happens next? My brothers are executor and power of attorney respectively. How does this go forward? I have no idea what to expect.

[SteveinMN]

I'm sorry about your mother's death, Cypress. :( Prayers to you and your family.

Having not been through this process myself, I'll let others weigh in on what happens next.

[Cypress]

My mother was ill for many years and the quality of her life was poor. She had medical issues that made her an invalid.

As a surviving sibling, I have legal questions and concerns. The family relationship is poor. My eldest brother is the Executor and the second eldest the POA. I found out she died when the eldest left a voice message on my phone. I have not heard about funeral arrangements as of yet from any family member.

However, I checked the website of the funeral home as this was pre-paid for and her name and information are available. Relations are strained due to what I perceive as passive-aggressive behavior. Someone of four siblings needs to share the information and it's not forthcoming, I had to go find it.

My intention is to attend the funeral and pay my respects on Wednesday.

The legal question is survivor rights. My mother may or may not have left funds to be distributed among all surviving children. How is this process managed? Also, I have a question about funds use during her life time over the last year and 1/2. Apparently, $200,000 was spent on healthcare. I wonder about the sum and the integrity of the POA.

It's a sad state of affairs and I've kept my distance physically because of behaviors less than family. Do I need to consult an attorney on my behalf? Or, contact my mother's attorney for clarification as the brothers are not generally forthcoming on details.

[iris lilies]

...The legal question is survivor rights. My mother may or may not have left funds to be distributed among all surviving children. How is this process managed? Also, I have a question about funds use during her life time over the last year and 1/2. Apparently, $200,000 was spent on healthcare. I wonder about the sum and the integrity of the POA.

It's a sad state of affairs and I've kept my distance physically because of behaviors less than family. Do I need to consult an attorney on my behalf? Or, contact my mother's attorney for clarification as the brothers are not generally forthcoming on details.

This is not legal advice but is common sense advice: Be very clear headed about how much your mother actually had before you go wading into attorney fees to represent your interests. Do not let the acrimony in your family dictate how your spend your own money. You had to borrow money from her--that tells me that you likely don't have much of your own. Don't squander what you've got in a family feud.

You said that she had only $2,000 in her bank account at the end of her life. Was there other assets such as a house? Cars that were paid for? Outside of real estate and financial accounts her "stuff" will likely be worth very little. As a point of reference, it is common to spend $70,000 - $80,000 here annually on nursing home fees so in your state, an expensive east coast state, I would think $100,000 would be gone in a year without question.

If you think (note I said "think" not believe or hope) that she had assets, if you think that she divided her assets equally among her 4 children in a will, then sure, pursue it by contacting her attorney. The fact that you know she HAD an attorney is a good sign. He can tell you the state of her will. Keep your emotions out of it, I've seen people waste so much money chasing their "inheritance" that simply is not there.