My mother has either early stage Alzheimers or Dementia-Dr's haven't totally pinned this down for me yet. She is taking Alzheimer meds but they don't seem to do much (if any) good, but that isn't the problem.
Two years ago my stepfather (her husband died) and left mom without any income except her Social Security which is about $1,000 a month, however he did leave her with TRICARE for medical (he was retired military) and medicare so she doesn't really have any major medical bills. She also was left with a mobile home on about 1/3 acre. Unfortunately it isn't paid off yet, she still owes about $10K on it.
All in all mom is in pretty good physical shape but her memory is pretty bad. She generally reminds me of a petulant child and it is very hard to make her happy. This is what makes me think it is early alzheimers.
My husband and I live within a mile of mom and due to her memory lapses I immediately started taking care of her bills and things like that. Within 6 months I realized I had to stop her from driving because it was a danger to others.
My husband and I live in a tiny mobile home in a senior community. We don't even have room for a nail to hang mom on so she can't come live with us. Also we don't own the land where our mobile is, we just rent to land.
I am one of 5 children that my mother had. So far she has outlived 3 of her children. There are only 2 of us left. My older sister lives about 100 miles away and basically only talks to my mom by phone maybe once a month. I am the one that calls mom daily, takes care of her medication, buys her groceries, takes her to the Dr, takes her cat to the vet, etc. But so far she has been capable of living alone. As time goes on I can see that it won't be long before that isn't possible. I also work a full time job and can't quit because I am the one that provides our medical insurance.
I have POA for my mom and she has a will which leaves her mobile home to me. She made that decision 2 years ago because she said I am the only one that helps her. She really doesn't have anything else of value to worry about. Recently I moved mom into a tiny little apartment so that we could try to sell her place. Mainly because she needed to be in a smaller place using less utilities and closer to neighbors for more companionship. I also figured if we sold it she could use the money to live better and hopefully continue to live independently with my help. I also figured that if she had to go to a nursing home eventually the Gov would take her place anyway. My husband and I have been cleaning and painting her place in hopes of selling it but it has been a few months with no real interest.
I can't afford to move into her place and lose my place if I will be thrown out when she passes or goes to a nursing home and I can't afford to pay for my place on the side. Things are very tight money wise for my husband and I.
If her place doesn't sell, the best thing would be for my husband and I to move into it and bring mom back to live with us until we can no longer handle her, but like I said I don't want to be left homeless.
I have been told that if the house hasn't been in my name for 5 years the gov can take it from me.
What should I do? Any help is appreciated. I can see this is rambling but I hope you can figure out what I mean.
If she needs " care", then somebody just go there and do it. Don't laugh.
All states are required to do MERP - Medicaid Estate Recovery Program. When mom or dad applies for Medicaid to pay for NH care, the Medicaid application it clearly indicates this. How MERP is done depends on each state and how it deals with probate - as the MERP claim or lien usually are part of probate.
All states may file post-death liens against the real and personal property of persons who were permanently institutionalized and those who received Medicaid services throught MERP. The laws of some states (e.g., California, Pennsylvania, Rhode Island, Washington and Wisconsin) specify Medicaid as a creditor and establish its standing relative to other claims against the estate, while other states regard Medicaid as a creditor under provisions for “reasonable and necessary medical and hospital expenses for the last illness of the decedent.” Which usually means the home must be sold with the proceeds going to the state first in order to get a clear title. Some state laws (e.g., those of Florida and Texas) protect the decedent’s home by placing certain interests of survivors ahead of the claims of others, including Medicaid.
For Texas, MERP is a class 7 claim – which means there are 6 other categories that get paid first when probate is being settled. Because of this, MERP is low in Texas. That is not the case in other states, like OR/WS/NY, due to states law.
Medicaid estate recovery gets to the heart of the issue of who should pay for long-term care -- the public through the tax-supported Medicaid program, or users of long-term care through their personal resources, including those remaining AFTER DEATH. Amounts collected from Medicaid recipients' estates are not insignificant in absolute terms. They do, however, pale next to total Medicaid spending for long-term care. I think about 60 - 70% of nursing home residents are paid for by Medicaid, MERP has to be done to help pay for the program. If you don't want them to take mom's house, then do not ever use Medicaid.
Most mobile homes don't hold value well so should be well below that and there is no actual property (land). But I will say that you should be keeping track of what you spend $ on & receipts to document the $. If your mom goes into the NH and then you get a MERP letter after death, you can use the $ documentation for your own claim for expenses - AND you let MERP know that.
Remember, once they are in LTC/NH there will be no $ to be used on the home as ALL money less personal needs of $ 30-60 a month MUST be paid to the facility. So someone will need to pay for house expenses that is in parent’s name. If the home still has a mortgage, this can be a lot of $$ every mo.
It is CRITICAL
that you keep track of every $ spent as you will let MERP know you have paid for things and can file your own claim in probate.
Say you have paid tax, insurance, repairs for 4 yrs @ 8K=32K. Medicaid
paid NH, med’s, therapists, 70K over 4 yrs. The house value is 90K which could net 81K max at sale.
But you let MERP know you are planning to file your own claim for 32K. The most MERP could get is 49K (81 – 32) but only if you did a sale quickly (fat chance) before maintenance and taxes etc continue. MERP declines to do a claim as not cost effective. MERP sends you a release of claim letter. You finish out probate without ever even having to do the actual claim and get the house 100%.
With states facing increasing $$ shortfalls, we are going to see a big increase of MERP done imho. Most MERP is contracted out and pay based on recoup success rather than being done by state workers who make the same $ not necessarily based on productivity. So keep those receipts.
I think if there are significant assets besides just a single homestead then LT are best - all assets are placed in a trust. The title on the house deed and all other assets would change to reflect the trustee ownership. With the chosen child or family attorney as the successor or grantor in the trust. If you do this – must be done by an attorney and it needs to be maintained too -then you don't need to worry as LT doesn’t go to probate. Probate is how states enforce MERP lien or claim on the homestead. So in theory, Living Trust = No MERP.
IMHO you need to have real $ for LT as it must be maintained. And you have to have a clear picture of what assets are out there - not the land passed down or multiple marriage situations which many of those in their 80 & 90's have and just flat never dealt with. What I've seen (from being executrix) is that often a LT is done BUT somehow something was overlooked, like a teeny-tiny gas revenue or raw land inheirited but never worked through to have a clear title so because of this they end up having to do probate because something was left out of the LT. But LT can’t be contested, it’s all private unlike a will & probate.
An immediate annuity can also be “Medicaid compliant” if it is actuarially sound, irrevocable, non-assignable, has equal payments, and names the state Medicaid program as the primary or contingent beneficiary to the extent of Medicaid benefits provided to the institutionalized individual. Almost every insurance company offers an immediate annuity, but less than a handful of insurance companies offer a Medicaid Compliant Annuity. The problem for most insurance companies is that they cannot offer an immediate contract that is irrevocable as to the parties, and also is non-assignable and these are not profitable for the company.
May I just remind everyone that the taxpayers are the ones picking up the tab for all the families that try to find a way to keep their parents assets and let Medicaid pick up the tab. Medicaid is here to help people who have nothing. As a nation of caring people, we don't want helpless elders dying a lonely, neglected life. Medicaid will pay for an elders care until death. Is it too much to ask that their home cover part of the cost And Medicaid will not take your parent's home if they get well and come back to their former life. That's pretty kind and generous of us tax payers. And if a child lives with the parent, in their home, for 3 years taking care of them, I do believe that the home is protected and will go to that child. There are many kind things that our country tries to do. We could do more if so many would not think of themselves and take advantage.
lann -NH (aka skilled nursing facility/SNF or long term care/LTC) is paid for 3 ways: 1) private pay by either the elder or their family; 2) from LTC insurance; or 3) by qualifying for Medicaid.
MedicAID rules determined by each state & are state specific even though it is a federal & state program. Medicaid is needs-based.
For NH Medicaid eligibility, an individual must show that:
1) are 65+,
2) have medical condition(s) that requires that level of nursing care,
3) monthly income less than their states max (about 2K),
This is the “income test” – how much $ do you make.
4) countable assets are less than 2K
This is the “asset test” – how much $ do you own.
5) not gifted away anything of value during the look-back period.
If you do, there could be a “transfer penalty” when items are gifted below value. Penalty different for ea state as it’s based on state’s NH reimbursement rate.
For March, 2012, the 5 yr would probably be Feb, 2007. So you might have a transfer penalty for 4 months. If state's NH avg is 5K mo, that would mean the family or the son's who got the property will be responsible for 20K of NH costs.
Now most states do a 3 yr look back but my gut feeling is that with all states having $ issues, a 5 yr look back will be done especially if it involves something that is easily documented as an asset - like a house which is just keystrokes from finding out appraisal and history on. The car value is not an issue.
Max look-back is 5 yrs. Most states require 3 – 6 mo. of financials with initial Medicaid application. Can require more financials if something pique’s interest.
INCOME: If it is that every month they are over the states income limit BUT not enough to pay in full for the NH and qualifies for NH in every other way, then they can see an elder care attorney to do a "Miller Trust" or a "Qualifed Income Trust". Say mom gets 1K from SS & 1,500K from retirement every mo. Income=$2,500. Basically $ 500 over state's ceiling for monthly income. No matter what is always is $500 over. So this excess $ 500 is what funds the trust and therefore mom’s income is now 2K and within the states income ceiling. The beneficiary of the trust is state's Medicaid program and upon death reverts to the state. Miller really has to be done by an attorney who does elder law as it needs to be flexible/adaptable and meet the criteria of each state's law on probate (death laws) & Medicaid rules.
ASSETS: All assets are counted, unless the assets fall within the short list of "noncountable" assets:
- personal possessions,
- a vehicle,
- their principal residence, provided it is in the same state in which the individual is applying for coverage & the house may be kept with no equity limit if the "community spouse" lives there; otherwise the equity limit is 500K (750K in some)
- prepaid funeral plans (irrevocable, no cash value/NCV)
- small amount of life insurance (usually $1,500 & NCV)
All other assets (savings, stocks, whole life, rental property) are counted.Must “spend down” to get to their states asset max to qualify for Medicaid.
The financials are what most folks focus on. But remember that they also need to medically qualify for skilled care for Medicaid too. Good luck.
My suggestion would be that your dad leave things as they are. If your brother can continue to live with him and be his care giver, then there is a good chance that Medicaid would pay for your father's nursing home care and also let your brother keep the house since he has been living there and taking care of your dad. The rules are different in each state, but putting the house in your brothers name would be a mistake. Leave things the way they are.
Yes, I imagine your brother's wife could claim that they are married and she is entitled to a share in the house. Your brother would have to talk to an attorney about how best to handle that situation.
Good luck.
My suggestion would be that you pay for a formal appraisal on the property which will include comparable sales in the area and keep a copy with your records of the purchase. When your mom applies for Medicaid, you can provide the appraisal as proof of fair market value.
You can also call your local Department of Social Services and talk to a case worker who handles Medicaid applications and confirm what documentation will be needed on the purchase to establish fair market value. Always good to talk directly to those in charge.
Good luck, Cattails
I will make calls later today concerning documentation needed and scheduling a formal appraisal.
You have been an enormous help.
- the NH isn't interested in mom's house per se, what the NH is interested in is getting paid for mom's stay 1 way or another. Whether it's private pay, Medicaid or LTC insurance.
- what type of home equity situation? HELOC or a reverse mortgage? Both have very specific qualifiers and mom has to be in compliance for them in order for the loan not to be called in. Moving from the property would be out of compliance.
- most who run out of funds & need to be in a facility apply for Medicaid. Medicaid is an "at-need" entitlement which will pay for NH and in some states will pay for AL under a waiver program (not all states do this and AL's participating can be limited). "At-Need" means financially impoverished and ALSO medically "at-need" for skilled nursing services. If mom has gifted any of her funds 5 years prior to her Medicaid application, she will face a transfer penalty period before Medicaid will pay for her care. Now the state (which administers Medicaid and each state has it;s own unique twist too) can ask for all mom's financials for 5 full years prior to the application. For my mom, the look-back was 3 years & 6 months of finances (banking, insurance, real property) plus burial & funeral policies and 5 years look-back on real property. If your mom has gifted, it will surface eventually & become a penalty. I would suggest that you do a rough calculation to determine just how big of a penalty it would be & then if family who got the funds can repay.
- now your mom's home is an exempt asset for Medicaid for the rest of her lifetime in most states. Now although this sounds just fabulous, the issue will be that mom once in a NH on Medicaid, will have no - none - nada - zilch of her monthly income (like her SS or any retirement) to spend of anything on the house. When they go onto Medicaid for NH, they are required to do a co-pay of their monthly income to the NH. This is called their "SOC" - share of cost. They get a small personal needs allowance (ranges from $ 35 - 90 a month) but there will realistically be no $ to pay for anything on the house ever again. My suggestion to to look hard at what the costs are to keep the house and if you or other family can realistically & dependably pay for all on the house (taxes, insurance, utilities, upkeep etc) for the rest of mom's lifetime (whether 6 months or 6 years) AND also if there is a good reason to keep the house (could be that your are honoring mom's wishes to keep her home, or other reasons). There's no mortgage, so it may be that the costs are super minimal and not an issue. For most families, this just isn't feasible for the possibly long haul. What seems to happen most is that family who promise to do certain things (like cut the grass or pay the taxes), do it for a few months and then just don't anymore and then family who has done their part (like they pay the insurance & utilities) is stuck. Keeping the house is like having a 2nd or 3rd home without an immediate benefit.
- what is required of the home equity lender? Do they require that the borrower (your mom, who is the owner) be living in the home? Will they require an increased amount of insurance or repairs in order to qualify for the loan? - often for those who own their home for ages, they are very underinsured and when they do a loan, they find that their $ 400 homeowners just won't due and that homeowners needs to be increased and now they also need flood & perhaps other new peril insurance. So how is going to be paid? Also what would be the repayment situation?
- if you maintain the house, realize that upon mom's death it reverts from an exempt asset to an non-exempt asset. Now the state is required to recoup or be reimbursed for all spend on mom by Medicaid by placing a claim or a lien on any assets mom has in her estate. This is the MERP - Medicaid estate recovery program. Now MERP has all sorts of exemptions, exclusions, etc and if you reasonably can make those work for you & can fully document as to why, then MERP may not be an issue.
For most, keeping the house just isn't feasible. SInce your mom owns the home, the good part is that she will have 94% of the proceeds (6% commission to the Realtor) to be able to private pay for the NH. She may be able to stretch the $$ to have it so that all that gifting get outside of the 5 year lookback possibly too. Being private pay will give her lots more options as to which facility. Often some want you to do 2 years of private pay before you can be placed on the Medicaid bed list too. Good luck, none of this is simple.