I have about 5-6 years of funds to take care of my dad comfortably from the sale of the equipment from his business. He is declining, he is middle to late stage dementia. Some days he seems more middle stage and other days looks like late stage. Anyhow he is in Memory Care. I don't think he will outlive his money. however I'm a planner. What if he does live long and I have to apply for Medicaid for him? Here is my question: Financial Records, what sort of receipts and documentation is needed? Do I need to keep Amazon and Walmart receipts? I realize they will want to look back in his checking and savings accounts to look for movements of money to make sure there was not gifting. I understand they will look back 5 years. What do I need to be doing to prepare everything so it will be easy to hand over for review for Medicaid eligibility?
You are certainly on the right track by spending down your father’s money and resources. It is very wise of you to ask this question ahead of time as it’s clear that you are planning for your father’s future. However, I think it’s premature for you to be bothered by this now as you stated that your father has about 5 to 6 years of funds to pay for his expenses. What you should do is continue spending down his money/resources but make sure you keep ALL the records of where the money was spent, even Walmart and Amazon receipts, as Medicaid will want to check to make sure the money was spent down and he did not hide it some place else. As the time gets closer, maybe a year before his money runs out, you should then consult an elder law attorney to guide you through the process of transitioning to Medicaid.
You are a good daughter in helping your father. Wishing you well.
Keep records that you would normally keep for filing your taxes and that should be sufficient for whatever is required later.
If he is getting close to requiring a nursing home or during the last 2 years of his funds. consult a geriatric care manager in your area. Start earlier than before Medicaid kicks in. Ask about Medicaid nursing homes that are good in the manager's opinion and visit them. The good ones have wait lists. Get him in at least a year early. In that way, when he qualifies for Medicaid and he is already a resident, he goes to the top of the waitlist for that Medicaid bed and he gets to stay put.
If dad is paying you, you can try to set up a contract if he is cognizent. Otherwise you can report it as income for your taxes to follow a paper trail. Again it it the big payments that raise flags.
my mom passed just before our appointment to apply fir Medicaid..
In general terms, document everything! Best to have receipts for everything and do NOT use cash. Hope you have a durable medical/financial POA (not the sprinting type) as well as other "end of life" documents already executed: advanced directive naming you as the "health agent," Will and or Trust documents.
Hopefully the primary banking account (checking?) you are on it already so you can "pay" via the bank's on-line payment mechanism (all have this now) or you can write checks. Move all funds to the one bank account -- consolidate so it is easier assuming there is NOT over $250K the limit on FDIC insurance. If over, that threshold just keep moving funds to the one account (draw down the others) to stay just under the $250K FDIC limit in the one making account ALL things will be paid from. This means, liquidating IRAs, 401K, etc.
Set up on-line access to all accounts so you can easily have access and can move things. Some financial institutions, will want to see the POA before they allow you access. Another approach if Dad is ok with it, set up a gmail email just for all this stuff (financial, perhaps later Medicaid application, on and on) that you have access to but it technically in his name so you can track and process all incoming things from the financial institutions. Once and IF you have to apply for Medicaid for him, as his agent States will allow you to have direct access to their platforms for the purpose of submitting documents and to receive documents from them.
For paying for things and in order to have a record of receipts, good to have a debit card tied to the primary bank account and then USE that debit card whenever possible to pay for things (order things on line, shopping, buying anything that is needed). Avoid use of cash as there is no real receipt. Also, it it critical to NOT shift, gift, transfer or otherwise "hide" any funds/assets as Medicaid has a 5-year look back provision. Your State Medicaid folks will required bank and all financial records, tax filings too, going back 5 years. Yes, get all the state, local and federal tax filings, gather all that too.
We scanned everything (tedious) 12 bank/financial statement for 5 years - 60 for each account. Did the same for all receipts, NOT logged in the main bank account such as checks. Did the same for all tax filings for 5 full years. So when it became time for me to file for Medicaid long term nursing home coverage; I could upload it all electronically to our State's Medicaid portal. That was much faster than trying to print, snail mail and hope the large box of documents made it to our State Medicaid office. Frankly, the staff generally like the electronic submission as that save them having to scan and upload which makes their process go much slower.
An elder care attorney can work with you on the spend down approach if you get to that point. Also, depending on some circumstances (narrow) special needs or other Trust arrangements may be a potential option.
Hopefully, the facility where your LO is is Medicare and Medicaid qualified! Check/confirm as Medicaid in most States will only pay for such facilities. There is a very limited number of AL Medicaid-type funds and there is a long wait list (years) for that. If your LO is NOT already in a Medicare/Medicaid qualified facility, you may have to move them so research that part now and perhaps consider a move before it becomes and emergency situation. Most of these M/M qualified facilities LIKE private pay at first as that is a sweetener to them to get into the best facilities.
Good luck with this, and you LO is lucky to have you/your foresight to plan. Most folks wait or do not know and it all becomes a hot mess emergency situation.
Just make the file box (I started with a colorful wine box) with each folder and dump it ALL in. Most important, as you say, are any bank records. They will look for movement of money usually over a certain sum, say 5,000. Keep all monthly statements and wrote on them what the items were for. For instance, amazon; medical supplies. Whatever.
As I said, as POA you are responsible for monthly records of every penny in and every one out.
Keep in looseleaf binder, copy for him (if he can even think of such things; my brother COULD) and copy for your records.
Receipts bundled by month, then year. Keep it all. If he makes it, if there is ever any question you can dump it all out on a judge's desk, Medicaid desk. They will be impressed.
I kept a diary as well. Composition book and no tear outs, blue ink and only cross outs.
Was "D. to hospital" and diagnosis" or D. to rehab. and day home" or for you "Sale of farm equipment at auction; 5,000.00 to account number." "D's truck donated", etc and et al. Simple to do on daily basis. I had two files, one for POA and one for Trust.
Good luck. It's a job. But do it well and you will have more than they ever want to see. Most important is the checking account monthly statements. That's what they will or may look at most closely. l they have a question? You have a DIARY with the answer.
Congrats on taking this on. It's a big job. You will be very proud of yourself.