My mother needs a nursing home, she has $26,000 gifted to me 2 year ago, she has spent 12,000 for care etc. Does Medicaid need receipts?

I live in the state of Oklahoma. One of the first thing My Mothers Attorney told me is that if she ever needed Mediciad. I will have to show 5 years of her finance and to keep all receipts .

In Ohio, yes.

Thanks for the info, we live in Wisconsin it probably is the same here.

The 5-year look-back period applies in all states.

I think the gift is going to create some issues, such as a penalty.

Are you working with an elder law attorney?

Jeanne is spot-on in that you need to work with an elder care attorney.

Medicaid is a needs based entitlement program that is jointly federal and state.
(This is unlike Medicare which totally a federal run entitlement program) Because Medicaid is a joint program, it has an overall federal structure & requirements BUT it is administered by each state, so each state puts it's own spin on how Medicaid is managed and how applications are reviewed and vetted, appealed, etc. Also how MERP - Medicaid estate recovery program - runs is very dependent on how your state does probate or other death laws. Some states run an efficient and easy to understand program and others not so.

Under the overall Medicaid rules, $ that is transferred or gifted from the Medicaid NH applicant to anyone can be subject to a transfer penalty. "CAN" is the key as penalties do not always happen. Remember when they apply for Medicaid, they have to be able to provide an initial 3 -6 mos of all financials with some states requiring 12 months BUT the state has the ability to review 5 years prior. When you apply, you basically sign off for an all access pass (without the collectable lanyard to show you were w/the band!). Transfers are likely to surface, especially real property assets (house, cars, boats) as the local assessors dovetail their data with the state. (The only thing I've heard that is under the radar is oil & gas revenues, which is probably about how those are structured in ownership and payout). When that happens the Medicaid recipient can get assessed a transfer penalty and you have to prove that the transfer was for their care or needs or the penalty will be applied. Say a house is gifted and sometime in the next 5 years, mom needs to go into a NH and cannot afford private pay, then when she applies for Medicaid, there can be a “transfer penalty” imposed by the state on paying for her care. Each state’s penalty % is different as its dependent on the each state’s NH reimbursement rate. For Texas it’s $ 148 a day as TX rate is low. Say mom's state is 5K a mo NH average and house value was 100K, then it’s 20 mos that you will have as the penalty period if you transferred the 100K to pay for grandchild's college fund. But say you can show that 50K was spent on home health care and 50K to grandchild college fund, then penalty is 50K. One sticky aspect of transfer is that often, it doesn't show up in the initial review so mom gets in the NH on Medicaid and all is kum-ba-ya, then months later you get a transfer penalty review with a very tight timeframe (like 14 days) to comply and provide data or mom get's booted off Medicaid AND the NH gets the letter too so they will want you or whomever signed off as financially responsible to ensure that they will get paid if the penalty is valid. This is a total panic situation and you just want to be prepared to deal with it IF the 12 K surfaces.

Now 12K is a very small amount and if any of that $ was used for mom or for mom's property you need to be able to document it as much as possible so you reduce the penalty. The caseworker is likely not going to be difficult on this, they are looking for bigger fish than 12K. In the future, I'd suggest, that whenever possible any checks need to be written to a business, like Sue Smith - Caregiver rather than Sue Smith.

We had a transfer issue with my mom's application for a check written to her mechanic as she wrote it to him rather than his business. I found the receipt (this was in year 4 of her lookback too) and faxed it over to her caseworker. Problem solved but I had like 72 hours to do this or her application would go into the inactive file which you want to avoid. Hope this info helps!

Also call your local welfare office. Asked for an employee who works in Mediciad for the Elderly.
What was your Mother physically condition when she gifted you. Meaning did she know then she was ill and knew she would have medical expenses that she couldn't afford or did she have an accident that is now causing her unexpected expense. There are certain circumstances Medicaid will allow. I hope I am making sense.

susy51 my mom's health was pretty good 2 1/2 yrs ago when she gifted the money, she has macular degeneration and really had a hard time even signing her name, let alone reading. I guess what I did wrong was put the money solely in my name, and her name wasn't on the account, but I used it for her care, dental, personal home care, cleaning, somebody to give her medication everyday, stuff like that for the 2 yrs before the nursing home, she had celluitis in her legs and couldn't control it so it was er, then hospital and then nursing home, she had been getting dementia also; so the safest place for her is in the nursing home. But the state would not accept of my receipts for home care etc., because the account was in my name. The local state agency was not very nice about it, badgered me with questions on the phone for over 45 minutes, I finally told them to forget that I ever sent the receipts in. My only hope was to shorten the penalty period before she was eligible for medicaid, so she would have a little money left for some dental care etc. It was very upsetting, hope nobody else has to go through that. I think state and county workers for the elderly could have a little more compassion for the caregivers, we go through enough on a day to day basis, especially with a mom that has dementia. Mom will be 99 in a few months, but all her money is gone now with care before and now the nursing home, so it is what it is. Just had to vent about the worker that called and questioned me so much, I know they have a job to do but I was certainly upset about the way she questioned me.

Yes, you need receipts.

I have receipts that I have saved and sent in, the state worker questioned me because I didn't have mom's name on the bank account along with mine, so she was saying this was my personal checking account and not my mom's money, it is just too messy, I guess I just messed the whole thing up. It is was it is. I was just upset she talked to me the way she did, very judgemental of me. I told her I have not been through this before. She said well you should have hired an attorney back in 2010, guess I should have. Lesson learned the hard way.

The bottom line is mom had a 123 days penalty period, had private pay for that time, and now she is broke. She has just been approved for medicaid and her social security check will also go to the nursing home except for $45. a month for her personally. Mom should have taken care of this several years ago but she didn't.

Niksma - thanks so much for posting an update on what happened to you in dealing with a transfer penalty. It is just so important to share your story.

WHen you first posted last year, I thought that for sure for the amount of $ involved the caseworker wouldn't get too worked up. Boy was I wrong. I imagine that it was the solely yours bank account that was the big hurdle that there was no way around to overlook. My transfer penalty was about my mom's car and right towards the end of the 5 year look back. I got it resolved but really a couple of weeks of rushed paperwork, notary work etc. Do you think that if you had an attorney doing this for you, they would have approved her without a transfer penalty?

It isn't personal but they could have handled it better ...or nicer.

You know my mom is a couple of years younger than your mom. If they live long enough no matter what they have planned for, saved for, or done, it is the sad truth that they will run out of $ eventually and will need a NH; and the caregivers will run out of steam. Unless of course they are generationally wealthy, which if you are on this site isn't very likely. We do what we can.

My mom is in Texas & her monthly is $ 60, you said your mom's is $ 45 a month.
Do you mind letting us know what state she is in? Thanks.

Thanks igloo572 for your response, my mom lives in Wisconsin. I don't know if I would have had an attorney if the end result would have been different. I hope someone in my shoes will learn from my mistakes, I just wish the county elder workers would have been more informed about situations like mine, they didn't have a clue what to do, just told me to spend down all the money on things for her, which in the end didn't matter, she still had a penalty. And I am still upset with the state worker that called me. Thanks for your reply I really appreciate it. Yes I wish I was wealthy I would have hired a caretaker for mom to stay in her apt. forever, our home isn't elder friendly, so living here wasn't a choice. I really don't think I could have handled taking care of mom 24/7, wouldn't have been good for the marriage either. Thanks again.