RocknaHardPlace Asked December 2015
I might have been wrong about PA look back?
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Live in PA. Thought any monetary gift given by parent to family would count during Medicaid 5 year look back, as parent had given during past 5 years one child thousands of dollars from a 3 way joint checking account held by parent and both children (account in place already much longer than 5 years). Seems this monetary gifting is not included under "transfers of assets" under PA look back, from what I can discover online. Will consult attorney, but would appreciate any input from folks at this site. Am asking because that child given money says I am wrong that I thought the amount of the numerous checks of money applied in PA to the 5 year look back. Thanks in advance.
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For my mil, also TX, there was a months long gifting inquiry on checks she had written to a state paid caregiver. Mil was writing checks so caregiver could go and buy her liquor and other items. Like $ 80 checks too. Quite the butt rash to reconstruct to be able to pass Medicaid....
Now maybe, just maybe, the gifting could be under PA Medicaid review radar. But if not, you as DPOA will need to private pay the NH whatever # of days penalty the gifts add up to if you want your parent to continue to stay in the NH.
I'd bet the "transfer of assets" mentioned in your states program online descriptive are referring to real property transfers - like home, land, cars - as those produce a documented paper trail from tax assessors, county courthouse to dovetail into the state database. So those are an existing file for the caseworker to easily access to look for transfers of assets. It's a separate category in the review. comprende?
So gifting was done....ok, so what to do.......what you might want to do is look into to try to figure out the transfer penalty formula for PA. So you and gifted kid can have an idea of what to expect. Each state sets its own daily room & board reinbursement rate paid to the NH. Like for TX, it's about $ 155 a day.which is low. This # is key to the penalty equation. So say, TX grannie gifted a nephew 25k, ths would mean a transfer penalty of 161 days of private pay. But if your state reinburses $300 a day for NH r&b, then the penalty period is about half at 83 days. The NH will get the ineligible due to penalty letter, so they will know about this & will fully expect & need to be paid. Money gifting Penalties - once discovered -are really hard to get around.
PA is a filial support state and individuals have been found fully responsible for their parents debt due to this in PA. This was the "Pittas" case and although it did not involve Medicare or Medicaid, it did show that at least for PA, the courts lean to making kids legally responsible to pay their parents 6 figure Rehab & NH debt.
About the application you downloaded, I don't know how PA does this but for TX, well they too have a downloadable application. BUT for both my mom & mil, each of their NH had a list of items that they (the NH) needed to accompany the application & their bill to the states ; & the NH reviewed these to determine IF they (the NH) would accept as "medicaid Pending" & the application was done at the NH right in advance of the move-in. The NH bed had to be on active hold / placement in order for the NH Medicaid application to even start to be processed. Ask the NH you are looking at as to what the system is for doing the application for PA & for the page / list of documents that need to accompany the application if that's the system for PA.
Now for community based Medicaid services, that application could be done on-line. I briefly looked into that when my mom had surgery when she was still living on her own at her home but it wasn't gong to work as her needs were immediate & just temporary. She paid for home health instead for a few months while PT was happening.
This site has a drop down list of elder attys by state btw.
Your the DPOA, right?
If so, then why is sibling getting their own atty? And doing this now? And speaking to hubs rather than directly with you?
Me thinks sibling fully well knows there going to be a medicaid ineligibility and a pretty significant penalty period on the thousands they got from mom. There's a pretty readable article on PA penalty by nick Lutz with Marshall, Parker & weber (Wilkes-Barre, Scanton, & Williamsport). Btw PA daily r&b is $ 293.15.
Tally up the $ given to sibling the past 5 years & divide by $ 293.15. It will give you a rough on the penalty period.
So could & would sibling private pay for the NH during the ineligibility period?
It's good you & hubs are fully aware of how all this works as you can hold firm that it's not your monkey. Just whatever happens you never ever sign off on any paperwork for mom. Make it your mantra......."sibling is the DPOA & you need to contact her on this; I have no legal responsibility".
& tell sweet sibling that it coukd be worse, PAs reinbursement @ $ 302.42 is pretty high, if this was a much much lower day rate reinbursement state, like TX which has it about $155 a day, it woud be double the penalty time period!