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Health & Fitness

How is a Medicaid Nursing Home "Gift" Problem Fixed?

When an older person is penalized for Medicaid nursing home or assisted living benefits, there are solutions.

This is the Million Dollar question. Once a person has made a gift innocently or not, how is the problem fixed.

First, it is important to understand what the problem is. Medicaid penalties only begin to run when:

1. A person is in a nursing home or at home and applies for Medicaid benefits;
2. If that person is single, generally, his or her assets must below $2,000.00 and if the person is married her or she can have no greater then $2,000.00 and the spouse at home must be below his or her spousal resource limit.

The problem occurs when a person is in a nursing home, has only $2,000.00, and is penalized for Medicaid benefits. For instance: If I give my daughter $10,000.00 thinking its "ok" because my plumber told me so, when I apply for Medicaid, I will be penalized for $10,000/$239.41 or 41 days. I do not have the money to pay a nursing home for 41 days (in New Jersey I could need over $12,000.00 to pay for 41 days.

Where do I get the money?
What will happen if I do not get the money?

Solution 1 - My daughter can give me back all the money. When I write "all", I mean all. If my daughter, in the example above, gives me back $9,999.99 I am still penalized for 41 days. Only if she gives me back all the money will my penalty be erased.

This is fine if my daughter has the money to give me. But what if she does not have the money? What will happen?

Not necessarily in order, the nursing home will sue me and my daughter. They may follow the notice procedure required in the State of New Jersey and seek my discharge. Or the facility will be stuck with me, without payment, for a period of time.

Now in this example, my daughter may have the money to give to me, but what if I made charitable donations, paid caregivers illegally, or commingled my money with my daughter? The outcome is the same - unless every penny "given" away by me is returned to me, I will be penalized by Medicaid.

If you are a caregiver and would like to learn more about house calls or other home care services, please visit the website of the Coalition on Family Caregiving at www.cfcares.org. The Coalition on Family Caregiving, formed in 2003, is a group of community-based organizations, businesses and individuals whose mission is to assist family caregivers by offering support, education and information on resources and services.

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