Should I have not requested a waiver of the social security overpayment?

If dad is going to be seeking for LTC Medicaid to pay for his stay in a NH, and as dad has moved out & now living with you & your family, ask the attorney what the legal ramifications are for his being able to have his fully owned home as an exempt asset for LTC Medicaid eligibility.

By & large Medicaid allow them to continue to own their home as an exempt asset even if they move into & become a NH resident. They continue to have their drivers license with the home address, have all their banking, SSA, IRS, etc still showing the home as their legal address. They file homestead exemption on the property. Have bills, mail, etc. continue to go to the home. All to show that it is still his home and a “right of return” document is done annually.

It sounds like your getting things of his moved to your address. If he’s now showing your home as his new legal residence, Medicaid could consider his old home as a nonexempt asset which will have to be sold at FMV with the proceeds from the sale used completely in a legit spend down by him BEFORE Medicaid will ever have him eligible. Find out clearly from the atty just how Medicaid for your state looks at this.

Also find out how your States MERP (estate recovery) runs for placing any services done after age 55 that Medicaid paid for onto the overall tally recoverable via MERP.
If he already has received Medicaid community based services that fall under recovery, find out from the attorney if those need to be repaid at the Act of sale of the home should it be sold while he is alive.

If Sissy-who-lives-in-the-house did caregiving for disabled diabetic dad, and she was anticipating the caregiver exemption to MERP or if there are other siblings who also anticipate their own exemptions to MERP, they will not be happy if you do things that take the home out from their future & could challenge your guardianship.

Please keep in mind that once dad goes into the NH & applies for Medicaid, he is required to do a copay of basically Almost all of his mo income to the NH. He will have zero $ to pay anything on the property. If you are appointed guardian, you will be responsible for dealing with property & it’s costs. Sissy could challenge your wanting her paying rent as she was a caregiver for him for 2 years before he went into the NH back in January / February. Sissy did not have a FT job, right? She probably can establish Medicaid caregiver exemption. I’d suggest that you stay open & civil with Sissy. If she was living there for years and years, she knows what dads funds were spent on, how bills paid, when repairs done, what medical problems happened & how dealt with and when, perhaps years ago.

You’ve only have had Dad since sometime this summer and you’re already looking to get him into a NH. Sissy lived w dad for years, possibly decades, before she had him he enter a NH Jan/Feb (March?). You very well might need information Sissy has knowledge of to deal with creditors, transfer penalty issues with Medicaid.

Sorry, it took me a minute to get back to this one to update. I have more work cut out for me next week.

According to the attorney, when you become guardian or conservator, things that took place before you took on the role are not retroactive but the court could possibly call on you if they have questions about something (buy you/I would not be held responsible. Anything that happens moving forward would fall on you because you took an oath to protect to the best of your ability.

Social security says they're not going to pursue the issue with the overpayment. They're holding dad responsible and will just take it out of his check monthly for as long as possible. The attorney says we may pursue in small claims court for reimbursement but says we will take things as they come and right now we try to figure out what went wrong at the nursing home (why they did not take over his ssi payments) and to see how the money was spent in the bank.

So we did a temporary durable poa so that we can get the banking info, records from the nursing home, and other financial documents. I see now on some of the credit reports and some loans they reported him as deceased. So that may be a big reason to keep him away from his home as well.

I'm still taking the steps needed to get dad set for the nursing home. However, in court, I'm not sure they will say he is incompetent to make his own decision. He is not all the way out of the game mentally.

Answry; I want to preface what I am saying with respect for all that you have done for your parents and your attempts to right the tilted ship that is your family.

I would step away. If the state steps in and takes control, or if sibs step up and direct things, whatever.

If you try to control this $hit$how, you are going to end up damaged both emotionally and financially. Your PARENTS were responsible for planning all of this years ago and they abdicated that responsibility by not getting their financial house in order.

It is tough being the smartest person in the room.

I was not the rep payee when the overpayment occurred. I'm sure siblings have a plan to get out of having to pay. I don't know if this is reportable as financial fraud but plan to find out from other sources and am meeting with the attorney again today. That's my understanding of SS benefits as well (his sole support) but *ell I guess not.

Dad did not apply for any homeowner's program. I confirmed with sissy and she says she applied for this program (something with FEMA) on her own. She only needed dad to sign so she could get a loan to cover labor. Again, if he will not be getting some of the benefits of his home, even for a short while, I don't see a reason to have him do anything.

I appreciate the help and input.

Answry, were you his Rep payee when the over payment occurred?

If yes, you need to get the authorities involved if your sibs took his money, because they are gonna hold you responsible if you were Rep payee. Actually you need to get the authorities involved even if you weren't, because SS is for the sole support of the recipient and they can't legally take any of it, even if he was home they can't take it for their benefit.

Dang lady, what chitshow this is for you.

Edit: the house will lose it's exempt property tax status if he doesn't live there. He gets that benefit, not his offspring.

Answry, your dad has been assumed competent all this time.

Did he appoint any of his kids POA? If someone was POA when he was in the NH, then that person should have paid the funds to the NH from Dad's SSI and whatever other income he gets.

Has APS ever been involved? Is this reportable as financial fraud?

The approximate $1400 bill is from his social security monthly benefits that were still paid out to a bank account shared by the daughter that lived at home with him and the other trouble maker son. According to the case worker, dad will be held responsible although he was in the nursing home. The ones that used his money will not be held responsible.
 
Regarding losing his benefits, they said the overpayment and me requesting he not have to pay back (waiver form) did not cause that letter. So they are working to see if they can get that issue resolved and him resolved.
 
Dad is not delinquent on property taxes because he is in exempt status. All utilities are still in his name. I also got a call from sissy last week (that pissed me) saying they got money from the government to get the roof fixed but needed to pick dad up to get money to cover labor. How rude and ugly when he, according to two siblings, still can’t come back to his own home and I’m willing to put money on all those applications were in his name.

So the approx $1400 bill is from the NH to Dad for his 2 month stay from earlier this year?
and
The NH has gotten zero-no-ziltch of the payment required by Dad as a Medicaid LTC applicant or Medicaid Pending resident AND the NH has also not gotten any payment from the State via Medicaid as well?

Is this correct…..The $1400 is strictly 100% a bill from the NH?

Dad needs to pay that bill in full and you need for the NH to accept the payment as “paid in full, in totally for Jimmy Smith Jones for his stay in 2021” & do this ASAP.

Dad was legally required to do a copay of basically all his income (SS $) he got paid during the time he was in the NH earlier this year if he applied for or sought to have Medicaid pay for that stay.

if it’s not paid, the NH will turn it over to collections AND if dad did not do the follow thru to get onto LTC Medicaid then the bill does NOT have to remain at $1400. NH can bill him for full private pay rate at the NH as he stopped the application for LTC Medicaid. If this NH’s pp rate is $8500 a mo, then collections can be looking to get $17,000.00 paid plus interest and fees. Debt collectors will seek a judgement against dad. Judgement gets placed on his home (unless your in FL or TX where property right are pretty sacred). That judgement will have to get paid off to ever sell his home.

Debt collectors will try to get you or Sissy to pay the debt as well.

Whether Dad didn’t do the follow thru or Sissy didn’t do the whatevers back earlier this year for LTC Medicaid, paying bills, etc. doesn’t matter. He’s living with you, you’re seeking guardianship, it’s yours to deal with now.

Have dad get $1400 from his bank account and get a cashiers checks for the amount in full and get this to the NH ASAP with a paid in full letter for them to sign. That atty you’ve paid a retainer for can do this for you. Your gonna be beyond pissed, if your about to sell his house, have an Act of Sale scheduled only to find out that the Title Co. has found clouds on the title due to judgements and debts and it queers the deal.

Also in detail go thru all of dads bills to see just how much debt there is. Check w tax assessor too, too see if he’s delinquent on property taxes. If so, that is a whole other set of seriousness.

Sorry to those who got confused and speculated wrong!
 
[For dad to have gotten moved and quickly from a hospital to a behavioral hospital unit is way way unusual. He had to present with something significant for this to have happened.] He did present with something significant – anxiety and not sleeping because he was being on point that he was going home. You not taking me home – keep rolling toward the door in my wheelchair. You not taking me home, well I’m not getting in the bed. You are not taking me home, so I am going to yell each one of your names at the top of my lungs. Dad was being very angry with this and on a daily basis and still does now except meds don't allow him to become over the top. 
 
So hospice mentioned the behavior unit and went to work trying to help us get this done and unfortunately it took two tries because the first hospital did not cooperate.
 
At any rate, I’m not an abuser and would not allow my husband to abuse my father or my father to abuse my husband or me. APS has an open invitation to our home and they can look in all the records (financial and medical) and see the before care when he was in his home and the nursing home and now.
 
[Back to this post.] The nursing home still says no money came to them. They only used Medicaid and Medicare. So I’ve made contact with SSA again, and wait for them to call me back. The attorney stated to reapply right away for Medicaid because if SSA decides to investigate it could take days or months.

I left a message for the attorney saying I want to drop that application for guardianship/conservator and pursue other options but only if it will hold up since dad has dementia. Thought dementia patients could not sign.
 
The attorney knows the dynamics, but since the letter on missing money and what you’ve stated, no thanks! Dad just will have to be back at a nursing home and I’ll still try to oversee his care.

Truly a messy situation. Thanks all! I may try to see if I can get the money back I put down for the guardianship and see if another attorney can help me navigate the Medicaid application.

Part 2.
Heres what imo could be future problems:
1. Insurance- I'm assuming dad fully eligible for Medicare. So any bills to Medicare are getting paid.
but
if he has Medicaid for secondary health insurance & it’s cancelled, those vendors paid by Medicaid will likely have payments clawed back. They will send new bills to dad. You need to get dad reinstated for Medicaid as his secondary insurance to Medicare ASAP, so that the vendors can rebill. Or you/dad pays the bills.

2. Transfer penalty- if dad is likely needing to go back into a NH for him to get LTC NH Medicaid, dad will need to submit up to 5 years financials. 5 years.
If his bank statements have checks written to Sissy-that-lives-in-dads-house or you or other siblings, or on debts owed by Sissy, etc. or bigger (over $500) written to cash, all those posed penalty issues for Medicaid. caseworker can ask for documentation as to each questionable transfer & if you cannot do this within couple of weeks, penalty gets placed on LTC Medicaid application. Penalty is by days based on amount gifted. If you find out that dad has gifted, please pls realize this means someone will have to caregive for him @ home till he is beyond past penakty period or someone has to private pay for dads stay at NH. If dad gave Sissy $ last March, that means May 2026 to be beyond a penalty. May 2026…. a l…o…n…g time.

3. Dads house -how are bills on dads home getting paid? If dad is using his SS $ to pay for meds, is there $ to pay all property costs on house he doesn’t live in anymore? Is this sustainable?

House can remain an exempt asset for dad lifetime if he applies for LTC Medicaid but will be required to do a copy of whatever mo income he gets from SSA less $30. Family will end up having to pay all property costs till beyond the grave. Is this at all feasible?

Are you expecting to sell house OR for Sissy to pay rent?
If Sissy can show she was a caregiver for 2 years before NH admission, she can be eligible for caregiver exemption for Medicaid recovery after dads death on home as an asset of his estate. & Medicaid can waive rent being required to be income paid to dad ea month. If she considers this to be an existing agreement between her & dad, Sissy may oppose your being named guardian if you r planning on selling house. If she wasn’t working full time and since dad went onto SSI, she’s been there while he has been disabled with SSA records to show this. She likely can show she was there for caregiving. She can drag this out if she wants to, needs to or just like being petty. Meanwhile if your guardian all paperwork and bills coming to you.

4 Guardianship- why guardianship rather than POA?
If you become his guardian, dealing with all this falls to you. You’ll be appointed by the court. You can’t say, “not my fault, I didn’t know, it happened before I was guardian” or “dad was under Sissys oversight at the time”. It’s all yours, everything from the past is yours. If Sissy won’t move out, you’ll have to deal with getting her out. If there are Medicaid penalties they r yours to deal with even if you were not the person gifted $. If property taxes aren’t paid, it’s yours to deal with.

Personally I wouldn’t become his guardian, I’d let it fall to Sissy as she lives in his house, she is getting the benefits of dads $, she has been his point person & knows where paperwork is. Let this become her problem. If dad did any gifting, he could have years of penalty placed against being eligible for NH Medicaid. I’d suggest that you look in detail on dad financials before ever being appointed guardian.

Also Sissy doesn’t have belligerent combative relationship that your husband & your dad have. As you posted earlier, it’s in dads EMS & ER records that they physically argued. Another ER visit by dad with any injuries, likely APS will be called in to evaluate. Not a good look for a guardian or their spouse.

Try to work something out with Sissy if you can.

So convoluted. Is this kinda timeline for your dads situation?
- Jan 2021 dad on SSI lives in his fully paid off home w/daughter. Dad supports this daughter financially (1 of 8 kids). Dad on SSI, MediCARE & Medicaid. His SSI income $ 730 or so a mo?

- Feb 2021, dad breaks ribs, is hospitalized then to rehab at a NH. All covered by Medicare. This is correct, right?
? Did dad stay in the NH after he was released from rehab? So went from NH rehab patient (Medicare) to a LTC skilled nursing care resident (private pay, or LTC Medicaid) in the NH? It sound like he was in the NH for 2 or so months after rehab ended. Is this right?
If that happened, someone maybe did a LTC Medicaid application for dad for those 2 months & this is very different than his Medicaid as health insurance coverage he gets as part of his SSI.

This IMO is pretty important cause if he stayed after MediCARE rehab benefit ended (tends to be after 20/21 days), it would have started a caseworkers delving into dads financials as part of his LTC Medicaid application. If dad is showing in his bank statement that he is gifting Sissy $, or paying Sissy debts, he will have a transfer penalty affixed to ANY yes ANY LTC Medicaid application & the penalty will make him ineligiblity for LTC Medicaid in a NH for months if not years. If he has a home, the letters from the state on this would have gone to his home address back in March. You need to find out just wtf happened last Feb & March & maybe April for his care and how billed ASAP.

- Spring - summer 2021, dad at some point returns home. Dad deteriorates @ home so goes to live w you & hubs. Hubs & dad are oil&water. You decide to file guardianship & get an atty to start this

- Early Sept you call EMS to take dad to ER as out of control belligerent. You tell staff he & hubs argue big time. Dad evaluated for & paperwork done 4 hospice. Dad sent home after 5 hrs.

- few days later, dad back to hospital. This time placed into a behavioral unit at speciality hospital. Hospice application rescinded.

- mid Sept, dad discharged back to your home on new meds.
MediCARE hopefully paid for all of above.

- now, dad living w you but it’s untenable situation btw dad & hubs, so you r anticipating dad going to need a NH. Your guardianship hearing is coming up. You have letters canceling dad’s Medicaid and SSI and dad owes $1400.

is this kinda it in a nutshell??

Here’s my guesses: $1400 abt 2 mo SSI @ $700+ mo.
guess #1: He filed for LTC Medicaid & signed off for NH to be payee back in Feb/March. NH had 2 SS cycles paid to them. He is required to do a copay of ALL his mo Income to the NH less only a small PNA aka personal needs allowance. If his PNA was $30 mo and if NH gets the SS$ directly usually the PNA $ stays at the Nh & is used to pay for barber shop & this uses all PNA up ea. mo. & why NH says has zero $ of his. Then I bet SSI paid him also for that period. NH isn’t giving $ back as he was required to do the copay. So he owes SS the $.
or
Guess 2. Waiver was to have his income releasec from copay requirement and iwas disapproved. If copay was NOT paid, he owes that SS $ to the NH. If SSA paid twice, he owes SsA the overpayment.

Exactly which Medicaid program has he been determined to be ineligible for?
Exactly which waiver did you file for him?
and
to whomever exactly is $1400 owed to? Letter is from SSA right?

If he applied for LTC Medicaid, I’m pretty sure SSI stops cold as he doesn’t need that SSI $ to enable him to live at home as he’s now a full time resident in a NH. When that happens, I think, you go from SSI to regular entitlement based SS payment. ITRR is spot on that you can’t be getting 2 public assistance payments which LTC Medicaid would be one and SSI would be the other.

But I think you gave other issues that will be huge problems…

part 2……. Next

I think Isthis is correct. If SSI is Supplimental Income he can't have Medicaid paying for his care in a NH and SSI too. His Social Security goes towards his care in the home.

Being on Medicaid for health insurance is not the same as Medicaid paying for a Nursing home. The criteria is different. Your sister had to apply for Medicaid to pay for his NH.

As said, you need to call Social Services and get this straightened out.

Supplemental Security Income (SSI) is a State program. As is Medicaid that goes with it automatically.

Social Security and Medicare Dad paid into based on his work experience. These cannot be taken away. He is entitled to Medicare at the age of 65. SS he can take anytime between 62 and 70 even longer. When he takes it depends on how much he receives. At 62 he only receives 75% based on his work income, depending on his birthdate, for me age 66 was 100%, age 70 135%. Social Security does not over pay. You get the same every month. In Jan there is an increase of some 3%.

I think you applying as his payee has nothing to do with the letters you received. It has to do with ur sister applying for Medicaid to pay for his care in a NH. She should have contacted Social Services and told them of the change. He probably will need to pay SSI back. How you go about that is between you and your Dads caseworker.

So sorry you are going thru this. I hope we have explained this well enough so you understand how everything works.

I would find out if him being in a NH disqualifies him from getting SSI, it seems that it would as Medicaid and SSI are both public assistance programs and it doesn't make sense that both are paying for the NH.

I would also question them about if the sister did something to muck up the waters.

My dads social security payment was not going to be paid the month he moved to my home because they didn't have a valid address for him. His exthang didn't put a change of address in when they moved, her lifestyle continually caught up with her and they moved regularly with no forward. Praise The Lord I called and they informed me of the issue or which knows what would have happened. They will discontinue payments if they don't have a valid address.

I responded to one of ur posts back in June. I think your Dad was in rehab so I don't see how Social Security got involved if Dad was only there 2 months?

I explained at that time that Medicare pays for the first 20 days 100%, 21 to 100% 50%. Did Dad sign up for Medicaid to help offset the cost of his care? Did the NH request that he turn over his SS to help offset his care?

I don't see how Social Security could over pay since they are not directly involved in paying for rehab care. You get the same amount every month.

When you say SSI do you mean Social Security or Supplimental Income that Medicaid health insurance usually comes with. SSI and Social Security are two different things. Now I could see having a problem with them. Thats a Social Service dept thing.

You need to first find out what the problem is. How he was overpaid. To do it, I would see if I could have an appt with either Social Security or Social Services. (I know that the County dept I got to Social Security and Social Services are in the same building). This way you are face to face with someone. I find that doing by mail rarely gets u anywhere. A Phone call would be next to face to face.

I would start with the agency saying his SSI and medicaid could be stopped.

The overpayment amount is over $1400 which would have taken about a year to be repaid. I was asking that it be waived because he was without fault (he was in a nursing home when the overpayment took place and I was not over his finances). But then, that letter came saying they were going to terminate his SSI and Medicaid.

Yes, I have an attorney for the guardianship process but they are not moving fast enough for me and especially not now. No income and no Medicaid mean more problems for papa and me. No nursing home without Medicaid. No personal care aids without Medicaid. No going home without income to pay bills.

So that's why I wonder if I should have just made the payment without asking them to waive the overpayment. I am his representative payee.

Monday is not getting here fast enough. Going to read more on those websites.

This might help:

https://www.washingtonlawhelp.org/resource/how-to-fight-an-ssi-or-social-security-overpa

Or this

https://legalaidnyc.org/get-help/government-benefits/what-you-need-to-know-about-social-security-overpayments/

Answry, I don't know what sort of waiver you are talking about.

What was the payment that was going to be deducted from Dad's check?

Are you using a lawyer for the guardianship process?

If you are not using a lawyer, I would take all of these disturbing letters to your nearest SS office and see if you can get this straightened out.