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Does florida have an "expanded medicaid recovery program" that will look into estates put into trusts? Mother ended up in nursing home before medicaid 5 year look back. Somehow sibling got her on medicaid, which now pays nursing home (think he filed caretaker exemption)
I'm trying to help him figure out if medicaid will do recovery of mom's assets upon passing. I've read Florida does not do "expanded medicaid recover". And there's homestead exemptions. Can anyone clarify if medicaid will come looking to recover , here is the situation :
mom sold house and sold money markets,($600,000) less than 5 years before going into nursing, at siblings prompting, as he offered take mom in for rest of her life if they build a big house for sib, wife, mom to live. Sib never sold small primary residence (kept for rental) so used all moms money to build new house, mortgage free. The new house is in a Revocable Trust naming sib and wife. Sibs assumption is FL medicaid recovery cannot touch any assets in that trust, and upon mom's passing it will smoothly become his and wife property.
I told him I'm not so sure he's in the clear. Mom owned money, from her house sale and money markets and that was before 5 yrs was up for medicaid look back. Sib had house built and stuck it in a revocable trust naming he and wife. So maybe he's in the clear from medicaid?
I know FL also has some homestead rules? and care exempt rules. But sib never moved into "mom's house", she was the one who moved into his primary residence, bringing her money with her. Then he built house that was deeded into Trust in sib and wife name. He also did hide the address of new home he built from everyone, utilities, bills even relatives were told to use PO box. I'm not sure he's done everything up and up and told him medicaid may come looking. But I've also heard FL medicaid isn't as exacting as other states (i'm in north and they do collect!)
Any advice is welcome as to if you think medicaid will be able to recover mom's money for nursing home payments. Thanks
Also any thoughts on if any legal troubles may ensue.

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See an attorney. It doesn't sound like this is okay as it is very complicated and but only an attorney can review all the details and give better answers.
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There is a stiff penalty from Medicaid when they find out what was done during the 5 year look back period. Hiding assets is precisely what they look for.
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This brother's problem, not yours, as far as I can tell.
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He needs to talk with lawyer.
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It is so NOT YOUR PROBLEM, make that your mantra.

I hope you are not your moms POA, if you are you need to resign that responsibility asap and do it via a USPS certified letter to whomever is the POA and with the return registered receipt. If you are her POA please pls do a post as your being POA needs to be addressed.

here’s my guess….
- you as the dutiful daughter are worried this series of cockups by your brother and his wf will place mom into being found ineligible for LTC Medicaid and mom will find herself facing a 30 Day Notice to have to leave the facility, right? & you’ll be saddled with this?
- this drama is all fairly recent, isn’t it? What’s the timeline? The exact timeline is mucho importante & you need to do one imho,
- It not been 2 years that mom has been in a Nh/SNF, correct? When did she go into the NH? and did she enter directly from being in a home OR did she enter via a post hospital stay?
- do you know that for sure mom is fully on LTC Medicaid or is she possibly in the “Medicaid Pending” phase? The billing at the Nh should know this BUT if you are not POA, they - in theory - cannot tell you. I will say this, billing can be quite chatty in person as they really don’t get visitors and you probably could find out.
- mom sold a property and bro used all this property sale $ and moms investment $ to build a house that is titled into a Trust? Was 600K, right? When did all this happen? The cashing in on the investments/ money market funds were when? And was the MMfunds all in a bank or did mom have $ with a financial advisor/ brokerage house?
- so it sounds like mom still owns a different and separated house that still titled lin her name and legally it still recorded as her primary residence with her name attached to it? Right? Is there still a homestead exemption on it? Property is somewhat modest, like very much under 550K/600K in its most recent tax assessor state, right?
- and this home is currently being rented, correct? The rental $ is going directly to your bro’s wallet, isn’t it? There’s no IRS filing on it as rental property done by your mom, correct? Bro did not disclose that it is being rented in moms LTC Medicaid application? Any idea if being rented at somewhat close to market rates for its sq footage?

Do you know if bro did the paperwork for the Trust, for the filing onto his new big house, etc all DIY / googled off the web for all filing at the courthouse? Or did he actually have an elder law / trust atty do any of this. Maybe a real estate attorney?
fwiw You should be able to armchair detective onto the courthouse to find the recordings on both moms property and the house bro built.
Usually All filings / recordings are available as an inexpensive download…. Like Deed of Trust $6.50, building permit $10.00. If it were me I’d spend the $ to get whatever on both properties so you know exactly what’s what and when. Can you do an update as to the filings on the property.

fwiw Trusts are private so you & I cannot see the Trust document but if the Trust was used to be an owner of something those details have to be in the recordings. You can follow what he did via the Trust & it’s actions this way. Ditto for stuff owned by LLC and Inc, although those will have filings with Sec of Sate for who are the agents/ directors / partners. Most Sec of State corporate database to search are open & free but ya can’t print it or do a download u less yiu pay. You can do a screen shot with your phone. Yiur bro sounds like a real scammy character, if I were you I’d search FL sec of State database to see if his or his wfs names come up. Do her maiden name too.

Will there be issues in the future???
yeah and my thoughts on that I’ll do in a separate post. But there is going to be an annual renewal for her LTC Medicaid and also there will be a State internal PARIS match done on your mom. Fwiw “expanded Medicaid” refers to ACA not MERP.
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I think the word here is revocable. Different than irrevocable? If she got Medicaid, he must not have told Medicaid a house had been sold within the 5 yr look back. Building a house and using her money is a no no. That money could be used for her care. Medicaid may never find out about it. Not sure how deep they research. I think a lawyer was used who knew nothing about Medicaid. I also think, your entitled to any money that was not spent for Mom for her care.

This is brothers problem. You can either let it go or report him. I would just let it go and let the pieces fall where they may.
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Part 2. Medicaid is a HUGE # of programs: happy teeth vans 4 preventive dentistry @ schools under CHIP; breast pump loan outs for nursing moms under WIC/W&MH; health insurance for low income folks to cover hospital, lab, doctor costs; community Medicaid which deals with ancillary costs at a PACE & In Home Health services; LTC Medicaid that pays custodial care costs in a NH. Plus whatever programs a State wants to match up their State coffer$ with their % of federal Medicaid $ to pay for health related programs for residents of their State who are “at need”.

MedicAID varies wildly by State. MediCARE totally different as it’s health insurance, is federal & we pay into FICA for it.

Most (abt 70%) in a NH, on 3 programs: Medicare & Medicaid as health insurance (“duals”) & LTC Medicaid which pays custodial costs. Most enter a NH as post hospitalization rehab patient paid by health insurance (Medicare pays 100% first 20/21 days). Then determined not 2 b able 2 go home so segueway from rehab patient on health insurance to a resident on custodial care in a SNF. Custodial cost is private pay, LTC insurance or LTC Medicaid if eligible. Eligible = basically impoverished & 3-5 yr lookback on assets to determine.

Medicaid $ has requirement that in order for a State to use their % of fed $, have to abide by federal guidelines. Fed guidelines set via a PL - Public Law - & laws could be decades old plus tweaked by future PL. Some States take guidelines 100%. Some do their own tweak as conflict with preexisting State laws or guidelines pose cost/benefit issues for compliance. For these, States do administrative code to address such issues. Also States do data sharing… caseworker has access to courthouse records… btw programs (PARIS) and btw federal agencies (IRS, CMS). Search depth State dependent. Tech is out there for in just a few keystrokes, caseworker can find stuff.

This last part is to me imo mucho importante in this drama of your mom as eventually her name, SS#, title / ownership on real property will surface. May take time but will surface and become an issue for her getting “at need” benefits when do not qualify. I’ll do another post on what might happen.

Fwiw “Medicaid Expansion” refers to option States have had as to accepting $ from the feds to allow for folks who are not quite dirt poor enough to now qualify for Medicaid as health insurance. If a State takes expansion the feds cover the costs at a % rate that diminishes over time. Those that qualify go onto a sector of ACA / Obamacare with a premium based on income. Done via health care marketplace.

10 States have not taken Medicaid expansion, mainly So States / very GOP states….AL, GA, FL, SC, MS, TX. Close to 2.5M who would have Medicaid as health insurance if expansion done.

Expansion has NOTHING to do w/Medicaid’s estate recovery (MERP). If your Bro thinks this, he’s an idiot or he’s blowing smoke up your skirt.
Feds have required all States since 1990s to have a system to try to get a recoup of expenses paid by the LTC Medicaid program. It was scattershot, most not bothering. Pretty much anyone filing for LTC Medicaid last millennium got on it. NH did not cost what they do now; roughly 50/50 NH that took LTC Medicaid & those that didn’t. Folks better off would go private pay as no way they were living with the great unwashed. & they/their fam could afford NH.

Then jump in costs in 1990s. Way more filing for LTC. More NH participating. State Medicaid + Medicare $$$ getting hit. To deal with cost containment, Bush did DRA / Deficit Reduction Act 2005 which requires tight & specific financial & medical “at need” eligibility PLUS requires an attempt to recoup via MERP all costs paid on LTC Medicaid (and any other Medicaid program if a State wants too) if over age 55 when filing. Medicare 2ndary payor requirement part of DRA.

LSS MERP required as part of LTC Medicaid. How done subject to States administrative code. Zero to do with “expansion” ime.
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If you want access to property records in Florida, here is what to do:
Google this: (Fill in name of county) Florida Property Search
Your computer will go to Property Information Lookup or something like it.
Choose Search Type. This will be Owner, PCN (which is Property Control Number) Address or Account Number.
Then you'll be asked for House Number, Name, etc. Fill in what you can.
Click Submit.
You will be taken to the property records for that property. Property records are public information. You do not have to pay someone to find them for you.

Since you don't know the property address, you should use the names it could be recorded under, such as John Brother Smith, Mom E. Elderly, or any other family member who might be a registered owner, for instance sister-in-law. For a trust, it might be Smith Family Trust, but since the search turns up all Smith property, inspect all the properties listed for a hint. The trust might be called the Smith-Elderly Family Trust, for instance. So keep doing different searches until you find what you're looking for.

If there's a business involved and it holds property in Florida, go to search.sunbiz.org
Florida businesses must file certain reports yearly. So if property might be held by brother and sister-in-law under an LLC, for instance, search their names to see if either of them is the manager of one. Search mom's name. A business might have a made-up name rather than their names. Or not. You can look up known addresses for mom, brother or sister-in-law at both sunbiz.org and Florida Property Search and see what you find.

Good luck.
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