How do we write a personal care contract for Medicaid?

Rredmudd asked...

How can I get help in writing a personal care contract between my elderly father and myself that meets requirements of Georgia Medicaid on transfer of funds lookback rule (in that monthly compensation payments are not subject to any penalties.) My father desires to live in my home and requires daily assistance. He agrees to pay me monthly a sum of $2700 (which he has paid previously in a assisted living care facility.)

Expert Answer

The key thing Medicaid will want to know when it considers payments your father has made to you is whether those payments were the fair market value of what he received for them. In other words, will the $2,700 per month he pays you be a reasonable amount for the care, shelter, food and other things you provide him. The fact that you will be charging him the same amount as he paid the assisted living facility may be a good indication that the amount is fair and reasonable, but only if you provide him with the same or better level of care as he received in the facility. If, for example, he got physical therapy, nursing care, social activities and other things at the assisted living facility, that may amount to more than what you are providing him at home. On the other hand, you may be providing him with more personal care than he got in the assisted living facility, for example, or more personalized attention, or a more comfortable physical setting.

One way to help ensure that Medicaid considers your father's payments to you to be fair and reasonable is to spell out in your personal home care contract with him exactly what you are providing him for the amount he pays. This should include a description of the accommodations you're providing him, the number of meals you pay for and provide, other things you pay for or do for him, and the specific number of hours per month that you provide him with personal care. The personal care should be described in particular and should include help with the normal activities of daily life such as eating, bathing, using the toilet, walking or other exercising, getting in and out of bed, and managing and taking medications or other health-related treatments. (You don't have to spell out how much of these activities you provide each day, just what kinds of things you regularly provide for him during the month, and the total number of hours per month you provide him with personal attention.) If privately-hired personal care attendants in your area of the country make $20 to $25 per hour (the national average) and you spend (for example) 80 hours per month providing your father with personal care, you will have properly "earned" $1,600 to $2,000 of that $2,700 per month just in personal care. The additional value of the accommodations and food you provide him would easily make up the rest of the $2,700.