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Old 09-08-2011, 12:36 PM   #21
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I understand donheff ...and I suppose I was trying to understand just what the OP was wanting or doing as I saw his "buying" as potentially not helping the asset situation... if , indeed, it is an exchange of cash for the value of the house. Do you or does anyone know if "selling" rather than "gifting" to your children exempts someone from the look back? In other words...isn't selling also considered "dumping assets"...or does that fall in a different category?

As others have said ....knowing the medicaid exclusions is important.
A transfer under medicaid is a transfer whether as a gift or for cash. I think you're missing the point-- the caregiving child exception is used to shield a transfer from medicaid resources or look-back. But if one transfers the residence for cash to the mother, the case becomes a resource for medicaid. It's in her resources. The idea behind the caregiving child exception was to encourage simple transfers of the deed to a child, typically, gifts! There are tax consequences to the "gifting" so that's why you need competent elder care counsel!
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Old 09-08-2011, 12:51 PM   #22
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A transfer under medicaid is a transfer whether as a gift or for cash. I think you're missing the point-- the caregiving child exception is used to shield a transfer from medicaid resources or look-back. But if one transfers the residence for cash to the mother, the case becomes a resource for medicaid. It's in her resources. The idea behind the caregiving child exception was to encourage simple transfers of the deed to a child, typically, gifts! There are tax consequences to the "gifting" so that's why you need competent elder care counsel!
I thought that was what I said in my first post...so. you might want to re-read my first post....
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Old 09-08-2011, 03:18 PM   #23
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Here is some information from the Dept of Health and Human Services. It is labeled with a 2005 date. I do not know if it is the latest publication... rules and regs change... there might be updates or changes.

This is a fed document and Medicaid is run by each state. So you still check with the state Medicaid office.


Medicaid Treatment of the Home: Determining Eligibility and Repayment for Long-Term Care
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Old 09-08-2011, 03:46 PM   #24
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As I understand it gifting (whether within the unified tax credit or taxed) will not work to gain eligibility for Medicaid.
At the risk of being tiresome, I'll reiterate my reservation about the assumption in this discussion that the spend-down requirement for Medicaid eligibility includes your house. I don't think it does. That doesn't mean that there is no reason to somehow contrive a transfer of ownership of the house before it becomes necessary to start Medicaid, because Medicaid can put a lien on the house, and after the Medicaid recipient dies, enforce that lien to reclaim what was spent on a nursing home, taking the house if necessary.
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Old 09-08-2011, 04:36 PM   #25
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I thought that was what I said in my first post...so. you might want to re-read my first post....
Well, you did say that in your first post, but if you had read my post #6, you would have realized that you just simply regurgitated what I said in my first post.

In fact, both you and donheff just reiterated what I said in post 6-- though I must admit donheff might have said it better.

What got both you and donheff sidetracked was your post #18, where you responded to donheff's apparent confusion over "gifting rules" which morphed into confusion over medicaid eligiblity over transfers.
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Old 09-08-2011, 04:45 PM   #26
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At the risk of being tiresome, I'll reiterate my reservation about the assumption in this discussion that the spend-down requirement for Medicaid eligibility includes your house. I don't think it does.
You don't have to "spend down" (i.e. sell) your house to qualify for Medicaid. But, other than a few exceptions (house is retained by a spouse, dependent child, or the care giver child we have been talking about) after the Medicaid recipient dies the state can take reimbursed costs out of the estate -- there goes the house. The bottom line is that the non-caregiver siblings will only be able to inherit the proceeds left after the state gets it's share.
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Old 09-08-2011, 04:56 PM   #27
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... after the Medicaid recipient dies the state can take reimbursed costs out of the estate -- there goes the house.
Yes, that's what I said.
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Old 09-08-2011, 06:06 PM   #28
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Yes, that's what I said.
Yup, I see I was responding to the first sentence without reading the next. In my defense, I was traveling about 12 hours returning from Verona and was more foggy than my normal obtuseness.
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Old 09-08-2011, 07:32 PM   #29
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Well, you did say that in your first post, but if you had read my post #6, you would have realized that you just simply regurgitated what I said in my first post.

In fact, both you and donheff just reiterated what I said in post 6-- though I must admit donheff might have said it better.

What got both you and donheff sidetracked was your post #18, where you responded to donheff's apparent confusion over "gifting rules" which morphed into confusion over medicaid eligiblity over transfers.
Not really Chris C....although I may not have said it...whatever I said...was with the understanding that there was a standing point or question "that others made" regarding whether the value of the house would be taken into the calculation of assets. Chinaco's link helped clear that up somewhat...depending on the state regs.
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Old 09-09-2011, 06:18 AM   #30
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In fact, both you and donheff just reiterated what I said in post 6-- though I must admit donheff might have said it better.
I am clear headed his morning after a good nights sleep. Glad I was coherent, even if redundant.
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Old 09-09-2011, 05:18 PM   #31
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Follow the excellent advice from these folks!

OP-

My sister and I are currently going thru a similar experience with our mom. We're providing home help now so she can stay at home as long as practical. After that, we will likely start her in a private pay assisted living facility but, have investigated and begun taking steps to ensure she can access medicaid facilities and services if/when needed, as her assets will not last indefinitely. Based on our experience to date (still learning as we go), these are key steps:

1. Contact a good elder care attorney; it's well worth the $$$ as noted by an earlier poster. Martindale is a good on-line rating service.
2. Contact your state agency on aging. They are a tremendous resource to learn the ropes.
3. Enlist help from your siblings as appropriate.
4. Ensure you have your 'documents' in order (will, general POA, living will and/or medical POA, DNR order if appropriate, copies of all your parent's key docs, etc.). Do NOT delay this!
5. Don't listen to those who would try to guilt you into bankrupting yourself by not applying the law as structured to use available benefits (more below).


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I did a quick Google search and it does look like a transfer can take place to a care-giver child to take the house out of the Medicaid calculation (at least in some states). I think it is entirely appropriate for OP to take advantage of such clauses and does not constitute dumping the liability on the tax payer any more than people sending their children to public schools takes unfair advantage of childless taxpayers.Medicaid..
I agree completely with donheff. There are many such 'transfers' which occur and, IMHO, we should be mindful of them and how we each (or those we care about) benefit from them, before criticizing others' choices. Just a few examples that come to mind:
A. Non-working spouses who collect 50% of their working spouse's SS, even though they've never paid into SS.
B. Parents who send their children to public schools, subsidized by childless taxpayers ( per the above post).
C. Older SS recipients who receive several times more in payouts than they ever contributed to SS.
D. State taxes which support state colleges and universities; same dynamic as "B" above.
E. The survivor benefit from SS.
F. The medical benefits used by the poor, in certain states, but, paid for by the taxes of others.

My personal tally of this short list is that I have paid for more of them than I will use but, gladly so because they make society a better place to live - which actually a benefit huh...
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Old 09-09-2011, 07:06 PM   #32
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1. Contact a good elder care attorney; it's well worth the $$$ as noted by an earlier poster.
I don't know about that. I had a couple of conferences with attorneys about my mother's estate and providing for her expenses in old age. In both cases, the attorneys pitched trust arrangements which would bring them a fair amount of money, but which I later concluded would not be in my or my mother's interest. They seemed to be very careful in fully informing me about any aspect of the law that might affect my interests, but if I was stupid or ignorant about something material, they seemed to feel no obligation to clue me in. That was my tough luck. I don't think you can trust an attorney to act in your interest, except in a narrow, legal sense.
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Old 09-09-2011, 09:45 PM   #33
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I don't know about that. I had a couple of conferences with attorneys about my mother's estate and providing for her expenses in old age. In both cases, the attorneys pitched trust arrangements which would bring them a fair amount of money, but which I later concluded would not be in my or my mother's interest. They seemed to be very careful in fully informing me about any aspect of the law that might affect my interests, but if I was stupid or ignorant about something material, they seemed to feel no obligation to clue me in. That was my tough luck. I don't think you can trust an attorney to act in your interest, except in a narrow, legal sense.
It's funny. I've read other people complaint's about attorneys in a similar vein. My experience, on the other hand, is just the opposite, and I've found attorneys to be very helpful, including both work and personal interactions. It could be just my luck. It could also be I'm clear with them and know what their role is in my decision process.

There is absolutely no doubt in my mind that a qualified attorney (elder law and taxes) can be of enormous benefit to midnighter777.
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Old 09-09-2011, 10:20 PM   #34
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I don't know about that. I had a couple of conferences with attorneys about my mother's estate and providing for her expenses in old age. In both cases, the attorneys pitched trust arrangements which would bring them a fair amount of money, but which I later concluded would not be in my or my mother's interest. They seemed to be very careful in fully informing me about any aspect of the law that might affect my interests, but if I was stupid or ignorant about something material, they seemed to feel no obligation to clue me in. That was my tough luck. I don't think you can trust an attorney to act in your interest, except in a narrow, legal sense.
Think of it from my side of the coin. I believe a consumer, who lacks legal training, is generally a very poor judge of legal talent. Medicaid and estate planning practice is a specialty area. I'm a lawyer, been one for over 33 years, practiced in a lot of areas and been privileged to work with many outstanding lawyers during my career. But I'd be a poor judge of legal talent in certain legal specialty areas though I'd probably be a better judge than someone without my legal training in most of these specialty areas. Additionally, some of the specialty areas are even baffling to specialists who practice in the area. For example, I used a highly regarded specialist for the estate planning/medicaid issues my family was facing -- my expert got one issue wrong and so did the Government officicals involved in adjudicating the issue. We finally got it right after the Government officials reconsidered the matter -- and it all had to do with valuation and treatment of the life estate my Mother retained in the homestead she left to her caregiving child -- an answer difficult to parse out of the Medicaid guidance and regulations.

I'm very hard on my own profession, much harder than you can imagine. Yet, a number of consumers are highly ignorant of the practice and many become the lawyers worse nightmare of a client.
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Old 09-09-2011, 10:24 PM   #35
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I hope we have succeeded in working out who was right and who was wrong in these matters.

This board's standards must be upheld.


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Old 09-09-2011, 11:05 PM   #36
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Think of it from my side of the coin. I believe a consumer, who lacks legal training, is generally a very poor judge of legal talent.
I don't doubt that. And I didn't intend to cast any doubt on any attorney's legal talent. (Actually, you know, I don't think I did.)
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Old 09-10-2011, 07:39 AM   #37
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Absolutely. No reason for someone who manged to save thru their life to have to pay their last penny whereas those who chose to spend every penny are cared for by government at the savers' expense.

The right thing to do is not dependent upon what others do.
I can hear my dad now

"If Johnny jumps off a bridge....."

Hey folks....buy some stinking insurance. There are all kinds out there. A lot will pay for in home care (some even hold the money in a sort of escrow account in case you change your mind or don't use it).

Lastly...ask your mom if she thinks its wise to save for a rainy day? Then kindly and respectfully tell her that it's raining and it's time to start spending that rainy day fund.
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Old 09-10-2011, 01:10 PM   #38
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I don't doubt that. And I didn't intend to cast any doubt on any attorney's legal talent. (Actually, you know, I don't think I did.)
Sorry if I misread your intent. But when you cast, as I interpreted from your post, an aspersion on a lawyer's basic, fundamental tenet of legal practice and ethics -- competent and diligent representation of the interests (not just legal) of the client -- how else am I to take your post?
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Old 09-10-2011, 02:26 PM   #39
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Thanks for all of the advice here as many of us are making decisions as we assist our elderly loved ones.

A separate 'thank you' to those who addressed the 'tax-payer' comment. For some, it is acceptable for corporations ("corporations are people, my friends") to exploit tax loopholes but ordinary flesh and blood people are demonized for it.
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Old 09-10-2011, 04:23 PM   #40
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So you think the tax payer should pay for you mother's care so you can keep your inheritance?
TJ
Looks to me like the OP is working to develop an understanding of the law and work within in. Not much different than taking advantage of every available tax deduction IMHO . I admire the fact s/he is taking care of the mom. I've seen so many elderly people forgotten in nursing homes.
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