This is not a question post but an informational post regarding Medicaid LTC application and the responsibilities of the POA and rant/vent.
My uncle has been in a nursing home since July 2024. Preceding this he suffered a fall that required surgery and IP rehab. Unfortunately, rehab didn’t progress successfully and he is unable to walk or do many DLA that are required for discharge. He was living alone in his house as life use tenant but deemed an unsafe discharge and was transferred to the LTC wing. He was self pay until NYS spend down requirements were met and now is Medicaid LTC pending.
I am his POA. I hired an eldercare attorney to guide be through this process and am so glad I did spend the fees from my uncles account (allowed expense for spend down) because this has been the most time-consuming event for me. The five years look back is NO joke. Medicaid LTC processors scrutinize everything. No hiding money, no expenditures over $2,000 with out proper receipts, do not have a pattern of withdrawals, Pension statements required. I set up funeral, gravestone, paid his medical bills and nursing home expenses for almost a year now. Not to mention the upkeep of his allowed vehicle. Phew, the entire process is like forensic accounting and almost a full time job on top of my career and family responsibilities.
The application was processed Nov 3, 2024 with application date Nov 1, 2024. On January 29,2025 the attorney contacted me with additional information and a list for cashiers checks that are non allowed if I can not provide receipts. Again, the original sleuthing found that my uncle has been gifting large amounts in increments of over the $2,000 (this red flags the expense to Mediciad and requires receipts) of money to a goddaughter that “loves him like a father” and it is sad but I could see it coming that she hasn’t visited him since she found out that his annuities were surrendered to get to his allowed spend down amount. Even though I am irate that a 50+ year old woman would take large gifts from an elderly man that only 4 days before was discharged from a hospital stay in October 2023 (this is what preceded his February hospitalization) and have at times felt like I should file elder abuse charges my POA duties do not end because he is still alive. So with a total >$26,000 non allowed expenses in the form of gifting, my uncle will incur a 2 month penalty before Medicaid LTC will begin. Luckily, he lives in NY so he is able to have enough to cover this GAP in coverage. But, He is devastated that he is essentially broke.
Thanks to this forum and searching past posts I was not surprised with this outcome. I am glad that I did find this forum to ask questions, read up on elder care and prepare myself for the inevitable.
People ask us questions, and often we have no answers. We send them out to "do the research" and I have to assume they do it. But they never come back to help others on this Forum by telling what it is like, what it is all about, and how important all these things are to know for our own future.
Yup, they mean business. You as POA did so well/are doing so well, but they WILL check things out.
I heaved a sigh of relief when I heard it was ONLY two months. And that he HAD that money. But I am certain he is devastated.
For those of us who can afford to gift, then we had better sit down and say to ourselves:
"OK, I want to put Grand through college. But I need to document each payment I make and make it clear with checks, receipts and etc. And I had BETTER know that I can still (in California) have enough money to pay care memory care 25,000 a month memory care for two years." Because one bonk on the head with a falling paint can would do THAT in a second." And the money will begin to FLOOD out.
I really appreciate you took us on this journey, both as a POA and as representing the person you are caring for. He's so very lucky to have you and your hard work and advocacy. I was POA/Trustee for my bro. He had to be the best organized most meticulous man in the world, and his records made all things in his life easy for me, or relatively so. But boy, the first year of all that? WOW. Just wow......
And this is just to join AMC in saying that these things can happen in a second. Keep good records. Let people know where everything is. Be certain you do the best you can with paper trails. Know something can be dumped in your lap in second. It all started for me the day Desert Regional called saying "Hi. You know we have your brother here with us, right".
No. I hadn't had a clue.