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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?

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The only receipts I kept were for things I bought Mom and reimbursed myself by check once a month. Put the receipts in an envelope with the check # and date. Moms bank statement was my proof, the money came in the money came out. Any large purchases, yes keep the receipt. But grocery receipts, tithes to the Church are regular monthly deductions. You are going to need proof of any large deductions, like a remodel. They look for something out of the ordinary. Keep those statements. 5 yrs worth. If online, print them off. For a fee my bank has copies of the checks with the statement. Made it easier for the caseworker when wondering about the amt of a check.
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I assume you are POA. So you have to keep all these records in ANY event.

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.
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Make an appointment with the Elder Law Attorney to strategize the financials and to stick to the laws in his locale.
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As others have said, getting with a competent elder care attorney licensed in your State is important, as each State has some different things to consider and do. NOT knowing is not a defense, there is no do over.

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.
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I wonder the same thing. Mother is currently handling her own money, with me checking in to make sure utilities are paid. She does some debit card Shopping for groceries, dollar store, copays. But she also takes out about 100 in cash per month, and no telling where those receipts are. Will this be a problem?
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As I prepared for my moms Medicaid process, I found the most difficult was 5 years of bank statements.. you would think that would be easy but the bank was out of state.. I would get only part of what I asked for, and have to reorder.. I also was fortunate to get the ledger statement from my moms mobile home rent.. her bank statement just showed the large dollar deductions..

my mom passed just before our appointment to apply fir Medicaid..
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babsjvd Jul 2023
also possibly call your county office of aged and disabilities office.. they probably will be able to give you guidance
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What happened to the responder's ID (User name)?
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JColl7 Jul 2023
Looks like the responder’s name is only showing at bottom where you can “reply to” that person. Wonder if that’s a permanent change or a glitch??
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When I was mandated to meet a guardian ad litem (GAL) during conservator process, and with mom's elder attorney I had to bring records of current assets in stocks, mutual funds, and checking (only used for her expenses even though I was a co owner). Try to consolidate to 1 bank account and 1 credit card to make saving bills. Only save the big bills as a single purchase if over $600 because that is where the GAL scrutinized. Save the check register as well. Just keep then in yearly files and compile any statements in calendar order just in case you have to pay a professional to do it. You can also keep an excel spradsheet with pages indicating income and outgo in calendar order. It takes about 15 minutes of my time a month once set up.
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.
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It kind of depends on what state you live in. We live in Ohio we applied for Medicade and were turned downed , but our person that we applied for qualified for what they call Passport. We received all the benifts for Medicade passport which is great We ge a caregiver three times a week and meals delivered every Monday. It's been a real pleasure. Its called Passport. We live on Social Secruity alone bot it was more thean what we would have qualified for.
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In our state the Medicaid application also asked for a record of any closed accounts and how they had been handled. For example, if a bank accout was closed where did the remaining money go? If stocks or property were sold, where did that money go? On the aplication we lised those and showed where the funds went, e.g., closed bank account at XX bank, trnsferred $$ to checking and $$ to savings at YY bank. The narrative statement could be backed up by the bank account records. My husband was POA for his brother when it came time to do the application, and had been for about 4 years. We had managed to put together the previous 4 years of bank statements we got the earliest year from the bank. For the application, we only needed to submit copies of the 12 monthly bank statements from the most recent year, plus only one monthly statement from each of the prior 4 years (it was for the month when the application was being filed, in his case March). Same for his IRA and brokerage accounts. Because my brother in law had been self pay in a nursing home for I think 3-4 years before going on Medicaid, it was easy to document where all his income and asset spend down went during that time--it went for his care plus the expenses of maintaining his home until it was sold. Proceeds from sale of his home, car, and a small boat went right into his bank account to pay for care during the spend down period. We never had to show any receipts as it was pretty self evident from the checking account records where the money was going. For the period prior to entering the nursing home, we didn't have to supply any receipts as there wasn't anything that raised red flags in any of the account records.
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Simple make sure you have no assets. It’s all about money
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If you haven't met with an Elder Law Attorney, make an appointment ASAP.
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Quite frankly, I would not waste my time. Who knows what the system will require 5 or 6 years from now.

Keep records that you would normally keep for filing your taxes and that should be sufficient for whatever is required later.
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Many people assume that Medicaid is a free program. Medicaid is a program that is supplemented by taxpayers’ dollars and it is therefore not a free program. Medicaid is a joint Federal and state government program that is in place to help with medical costs for certain people with limited income and resources. Medicaid will investigate every asset and resource, including trust funds, wills, etc., just to make sure that people are not hiding funds elsewhere in order to apply for Medicaid. My daughter works for the Medicaid program and she does a thorough investigation before qualifying anyone for Medicaid.

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.
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LisaMachelle: Perhaps you can pose your questions to an elder law attorney now OR in 5 to 6 years. Collect receipts on the off chance your father will even require Medicaid. You also may be able to garner information on Medicaid.gov.
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