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Can Someone Transfer Property Prior to Entering Nursing Home and Still Get Full Medicaid Coverage?

17 answers | Last updated: Aug 17, 2014
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Caring.com User - Joseph L.  Matthews
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Joseph L. Matthews is a Caring.com Expert, an attorney, and the author of Long-Term Care: How to Plan & Pay for It and...
93% helpful
answered...

There are three circumstances in which persons who qualify for Medicaidcoverage for nursing home care can transfer their own house to a family member without incurring any penalty from See also:
Is there a minimum amount for assets that Medicaid 5 year look back exempts?

See all 176 questions about Financial Assistance for Seniors
Medicaid, and without giving Medicaid any right to reimbursement from the house.

General rules: Ordinarily, an unmarried (single, divorced, or widowed) person entering a nursing home may keep his or her own house without the value of the property disqualifying the person from full Medicaid coverage of the nursing home costs. However, in that situation, Medicaid would be entitled to a lien against the house equal to the total amount Medicaid spends on nursing home care over the lifetime of the home owner. Medicaid can then collect on that lien when the nursing home resident dies.

If, on the other hand, the person entering the nursing home has given the house away to family members (or anyone else) within five years of applying for Medicaid nursing home coverage, Medicaid would have no right to reimbursement from the house. However, Medicaid transfer rules could mean a delay of months or years before Medicaid would begin paying for the nursing home.

Special circumstances: Three circumstances permit someone to transfer the home to a family member without either a Medicaid delayed-coverage penalty or a Medicaid lien on the property. A home may be transferred, without penalty or lien, to:

  • The person's adult child, if: (1) the child has lived in the house for at least two years prior to the parent moving into the nursing home; (2) during that time the child cared for the parent; and (3) that care allowed the parent to remain at home for that time instead of entering a nursing home.
  • The person's minor child, or blind or disabled child of any age.
  • The person's brother or sister who had an ownership interest in the property from before the five-year look-back period and has lived in the house for at least the previous year.
 

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22% helpful
The Caregiver's Voice answered...

Imagine the toll on the Medicaid program nationwide if all of us Baby Boomers tried to transfer rights to our parents' property in order to avoid paying for their medical care. With certain exceptions, for example, like those noted above, I may be in a minority on this issue; but I believe that my working-class parents lived frugally and saved, not to enrich me, but to ensure they had enough to be cared for in their years of retirement. If we all keep trying to "smart the system" we will all suffer; just as those who granted unconventional mortgage loans to those who could not afford a home were one of the straws that toppled the camel's back of our financial system. Result? We all suffer. What do you think?

 

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An anonymous caregiver answered...

I agree---we need to spend our parent's hard earned money on THEM, not us!!! When they're health failed them at about 72 years of age, I used ALL of Mom and Dad's money--including selling their home, cashing in insurance policies, savings, etc. to hire private duty sitters to help me take care of them and "spoil" them in a very nice Assisted Living facility until it ran out! The Lord took Mom to her heavenly home and she never had to go into a nursing home, but Dad did. He has been in a nursing home for over 2 years now with only his social security check left to his name. That is used to pay part of the nursing home and health insurance. He gets to keep $38.00 a month, $25.00 of which goes to pay for his telephone. My husband and I pay for anything else he wants/needs from our personal funds. It makes me sick to my stomach when I hear of kids thinking that their parents OWE them an inheritence!!!!

 

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An anonymous caregiver answered...

How about your parents working hard all their lives and would like their home to stay in the family and passed down to their children. I think the home should be exempt even after death. Now, if they also had investment and other assets as well then yes I could see reimbursing Medicaid from those assets.

 

73% helpful
grannylove2 answered...

I believe that the home should be exempt. My mom is 80 and has AD, my dad, 81, doesn't. We kept Mom at home for as long as we were able. It is costing more that my salary (before taxes) each month to keep her in a decent Memory Care unit. (Actually, it is a great unit.) My dad certainly doesn't have this kind of income and is so scared of not having enough to take care of him when the time comes. Most everything they had was jointly held. I don't have a problem with spending half on her but he needs peace of mind and deserves it, too. I am not looking at their things as MY inheritence. I already have everything I want from them that way - their teachings and values, their love, their acceptance of me, etc. My mom was very big on who was to inherit "The Farm". It was some acreage that she inherited from her grandmother and GreatGrandma got it from family. This is a wish of hers he wants to honor and it is not to me but my oldest daughter and granddaughter. The way he looks at it, they both worked very hard so they could take care of themselves and enjoy life toward the end AND have a legacy they could pass on. Not my words but his.

 

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Gary_B answered...

I believe I specifically fall within the Medicaid "child caregiver rule". I moved in with my mom when she was in her late 70's. She is a widow. My father died in 1984. She was living alone and needed someone to assist her with activities of daily life and also wanted the security and companionship of someone she could trust. She just turned 87 and recently had a mild stroke. She cannot walk anymore, not even with a walker. She is currently a resident at a nursing home. I have durable power of attorney for healthcare and finances. She was removed from medicare because she plateaued and was not improving with rehab. We are currently paying private pay. That will not last long, I will be applying for medicaid coverage for my mom soon. When I was employed (I'm retired) I took FMLA (Family medical leave) to care for my mom at her home because she has a serious medical condition with her heart. I used up all the FMLA benefits each year while I was employed since about 2007. This was taken as time off without pay. I used up vacation and sick leave each year down to a few hours. My mothers doctor filled out the FMLA certification forms and faxed them in to the appropriate processing center each time FMLA re-certification was required. I was approved each time.

Will copies of these FMLA certification forms be sufficient "Proof" that my Mother required care and I gave her the care necessary that kept her out of a care institution until her recent stroke?

Do I still need a letter from my mothers health care provider even though the provider never "Witnessed" any of the care I provided?

I have proof of continuous residency for the last 5 years, my old state drivers licenses, voters registrations, vehicle registrations, etc.
Unfortunately no one came to visit my mom much while she was living in her home so there are no viable witnesses to the care I provided.

I would very much like to remain in her home and I am in her will as the recipient when she dies.

I live in the State of Washington.

Edit: Sorry, I just realized I should of submitted this as a question...

 

55% helpful
judylee1950 answered...

I have been my mother's caretaker for over ten years and continuously in her home since 9/25/07. I worked only part time for a while and have given up working years I could have used to add to my retirement funds. I am now drawing social security and she has just gone to a nursing home for rehab. If she cannot get the the point that I can manage her at home again, I will have no choice but to make application to Medicaid for her care. I feel that since I have already saved the taxpayers over a half million dollars by caring for her, I at least deserve her small homeplace with a tax value of less than $45K.

 

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An anonymous caregiver answered...

With the likes of politicians doing everything in their power to not pay taxes by hiding money offshore etc., I wouldn't think twice about doing whatever is legal to protect a famlies assets.

 

38% helpful
Jullian answered...

The Medicare rules are all well and good for the elderly person's children but what about the grandchildren? My grandmother has Alzheimer's and to help her stay in her home as long as possible we sold our house for just enough to pay off the mortgage and moved in her. (Hers was bigger than our and allowed us more room) It was rough at first, but we have all managed to cope, until my grandmother fell and fractured her hip. She had to spend several months in a nursing home for physical therapy. Since she has been back she is a completely different person and I do not know how much longer that we will be able to keep her at home. If I was her daughter I would still have a place to live, but since I am a grandchild I have no rights at all. I stepped in and did the job that my mother couldn't do and I'm the one that will end up on the street if it gets to the point that she has to go into a care facility. Someone please tell me where that is fair?

 

86% helpful
Albert B answered...

I am GaryB,

Well after all this time! I was notified yesterday the state decided to approve the medicaid application and validate the transfer of the home per the 2 year child caregiver rule. NO PENALTY!!!

An award letter is on its way! The application was elevated to the DSHS supervisory level at our attorneys request for a "Fair hearing" after it was first denied by a DSHS case worker. It was reviewed by a DSHS supervisor and subsequently approved without proceeding to an actual fair hearing. Our attorney and his paralegal were extremely helpful and knowledgeable with elder medicaid rules and case law. This has lifted such a weight off of my shoulders. I did not know what I would of done otherwise. My Mom is well cared for in the nursing home, it is a very nice place, very clean and very nice caregivers!

I would like to thank our attorney Bill and his paralegal Alyssa. They were both very wonderful and VERY professional, helpful, knowledgeable, courteous and responded to e-mails and calls in a very timely manner!

Thank you for this forum! It is helpful.

This was my original post earlier this year(Below),

I believe I specifically fall within the Medicaid "child caregiver rule". I moved in with my mom when she was in her late 70's. She is a widow. My father died in 1984. She was living alone and needed someone to assist her with activities of daily life and also wanted the security and companionship of someone she could trust. She just turned 87 and recently had a mild stroke. She cannot walk anymore, not even with a walker. She is currently a resident at a nursing home. I have durable power of attorney for healthcare and finances. She was removed from medicare because she plateaued and was not improving with rehab. We are currently paying private pay. That will not last long, I will be applying for medicaid coverage for my mom soon. When I was employed (I'm retired) I took FMLA (Family medical leave) to care for my mom at her home because she has a serious medical condition with her heart. I used up all the FMLA benefits each year while I was employed since about 2007. This was taken as time off without pay. I used up vacation and sick leave each year down to a few hours. My mothers doctor filled out the FMLA certification forms and faxed them in to the appropriate processing center each time FMLA re-certification was required. I was approved each time.

Will copies of these FMLA certification forms be sufficient "Proof" that my Mother required care and I gave her the care necessary that kept her out of a care institution until her recent stroke? (YES these forms were proof).

Do I still need a letter from my mothers health care provider even though the provider never "Witnessed" any of the care I provided? (Yes, a letter was generated by my Mothers doctor)

I have proof of continuous residency for the last 5 years, my old state drivers licenses, voters registrations, vehicle registrations, etc. (Yes, Submitted copies of each) Unfortunately no one came to visit my mom much while she was living in her home so there are no viable witnesses to the care I provided. (Note: A elder neighbor did eventually write a letter noting I had been living with my mom and providing care for her, This letter was very helpful.)

I would very much like to remain in her home and I am in her will as the recipient when she dies.

I live in the State of Washington.

 

40% helpful
peterpauljame answered...

well to all talking about this if our gov. would stop giving all are money to the forners we would not need help from the gov. the that our parents work so hard for should not go to help the forners and that is all I am going to say about that

 

80% helpful
Albert B answered...

Just a thought, Our government gives away billions of dollars of foreign aid to other countries. That money instead could be used here at home in the USA to finance care for our older true US citizens and Veterans.

A US citizen who has provided care for their parent and kept the parent home as long as possible and have meet the criteria of the "Child caregiver rule" Why should that child NOT be reimbursed by inheriting the family home if they meet the criteria and it's allowable by law? I was successful, I encourage others who have lived with their parent and provided car for them per the "Child caregiver rule" to not feel bad about saving the family home for themselves rather than the home be repossessed by the Government and monies given away to other countries or wasted on special interest programs that end up failing later.

Just make sure you have and or keep ALL valid documentation of the care you provided.

BTW, I am a honorably discharged US Veteran that volunteered (not drafted) during the time of the Vietnam war.

 

67% helpful
Cautious answered...

Re comment: "we need to spend our parent's hard earned money on THEM, not us!!! "

I would say that many parents would prefer to be cared for at home, but can't afford 24 x 7 care. Rather than spending their assets on a nursing home, they'd gladly be wiling to give those assets to their child in exchange for loving care by their child in the comfort of their own home. I'd guess that in many cases, when a child cares for a parent at home rather than putting them into a nursing home, the tax payers save money, even if the property later transfers to the child. Seems like a win win and the parent is much happier. We need to encourage these caring children, not criticize them? Ron

 

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An anonymous caregiver answered...

I believe a home should always be exempt from being taken by Medicaid or a nursing home.

 

50% helpful
geradpresely answered...

In my opinion the property should be registered on our parents name only. There can be a clause of transfer of ownership in case of death. Many people take their parents property for granted and then place them in nursing home. If you want to read more about property matters visit this site.http://www.kevinbradleyrealtor.com/

.

 

50% helpful
Luvmyhusband answered...

What about spousal support? What if you spent the last 11 years caring for and covering for a spouse whose mental capacity has diminished, and may ultimately end up in a nursing home? If Medicare/Medicaid expect to take income and assets, what's left for the wife to survive on?

 

 
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