Should I let the nursing home help with a Medicaid application?

Are you his POA?

I would use some of dad's money to pay an Elder Law attorney to do the application if you want it done right and don't trust the Nursing Home staff.

I have done the app for my SFIL and MIL. It wasn't rocket science but you do need to have access to some of your FIL's financial and asset info, like banking statements, medical bills, personal info like SSN and birthdate, etc.

In my state (MN) anyone can be the representative to fill out the app for someone. You can download it from online and look at it to see if you need to pay $ for an attorney to help fill it out. I think that only what is outside the trusts matter to the app, but it may depend on his state or other factors so I would review the app to know if this is true or not.

If I were you I'd it out yourself if you are the PoA, just so that you know what's going on, plus you don't have to divulge your FIL's info to the facility. It's private, sensitive info and should be none of their business.

I would make an appointment with the lawyer who set up his Trusts and estate.

The Revocable Trusts are useless.Anything that can be revoked is not a protected asset when someone goes into a nursing home.

That will have to be transferred to pay for the nursing home until it is spent down. Revocable Trusts can be changed to suit payment needs.

It's okay to let the nursing home help with the Medicaid application so long as you supervise what they're doing.
Aways keep in mind that all nursing homes and care facilities lie to maximize their profits. They also try to take every dollar a person has up front even when they have no right to it, or when insurance is paying.

So, it's okay to let them help because it will get done faster. Consult the lawyer who set up the Trusts and keep him around too just in case.

If your father has funds in his revocable trust those funds stand to pay for his care. All trusts must be listed in applications for Medicaid.

See an elder law attorney to make application, and it sounds to me that there is money here. Medicaid will look seriously askance at any attempts to hide money and use taxpayer funds to pay out Medicaid (a program for care of the indigent) while there are funds in a Trust.

I was made Trustee of my brother's Trust when he was diagnosed with probable early Lewy's Dementia. His TRUST paid for his ALF. It was a wonderful place with excellent care and nothing that would ever have been paid for on the government's dime.

To me, if NH is reviewing FIL financials to determine if they will accept him as Medicaid Pending, then to me this is a definite NO. If your FiL has had Trusts done, I would not as the NH staff do not have the training to ever evaluate those type of legal documents as to whether they are LTC Medicaid compliant. Often even the Medicaid caseworker cannot pass judgment on an item as they do not have the training to evaluate an item, so either it gets kicked up to staff that does or a department that does or the applicant provides a second opinion*.
HOWEVER
If it’s that the NH is really only being a conduit for your Fil application (which you & your your hubs as as his dads POA is filling out) and also the required documentation to accompany FiL application, that’s a different story. So that it’s that Nh is taking all that paperwork then adding theirs and sending all to the State. Yeah NHs good on that. The caseworker contacts you directly if any financial issue’s afterwards.

This is more what the NH we dealt with for my mom & my MiL did….. they had a list of items absolutely needed to accompany applications. And lists as described varied even in the same State. Whatever…. anyways for my mom, I got the LTC application ahead of time and filled it out. Then day mom moved in early AM, got her set up and off to an activity, then I went to billing office and met with a regional staff who happened to be there. We together did a fresh application & she looked at all the documents I brought in. Every single item on the list the NH gave me, I had a xerox of to leave with them. Was over 100 pages. I made a list of these and had her sign off as received too (I’m OCD and pretty definite personality). The NH would in turn submitted these along with their initial intake paperwork and room & board LTC Medicaid bill. Then did the admissions paperwork which I signed as POA only and got a copy of every single page. Then paid a prorated copay for that month of moms income. Regional & I did a quick estimate based on moms awards letters from SSA and pension & that was what the copay was. Did not have the NH become her representative payee for SSA but did open a personal needs “trust” account at the NH for paying beauty shoppe kind of spends, maybe $100 or so. Took maybe 3 hours. Fwiw this place had several open Medicaid beds at the time so definitely to my advantage in rebuffing any sass from them. Remembering their not happy on the rep payee. One of the docs from my moms gerontology group was the medical director at the NH at the time and why it was chosen.

* If there is a question on an item being compliant, for us, the caseworker called us directly first then sent out a letter. Everything is very much time sensitive for response….. could be 7 days… could be 30. For my mom I had an issue with her life insurance policy. It was super old, ancient, paid up ages ago, like20+ legal double sided pages from the 1950’s and hard to tell if term or whole. Face value 1K. Caseworker not an insurance agent not licensed to do that type of work so cannot evaluate. He calls me to ask do I know. I don’t, but called a stockbroker to ask him to look it over; he holds insurance license and its term. He send me a letter with his licensing info and that it’s term, I get it over to caseworker, all good. Done in days. Mom can keep it as term. If it had been whole life, it would have had to be cashed in & spent down as those do have value.

My point in this is, those Trusts your FIL has, HAVE TO be evaluated by those who know exactly what type of Trust is. That’s legal training determined not done by billing department clerk.

My gut feeling is the NH is going to tell you the revocable is going to have to be spent down 100% & they won’t accept him as Medicaid Pending. & will require you personally to sign him in on private pay rates. Not sign as Trustee of the revocable. And I bet they will want a review on the irrevocable as well.

Hmmmm what to do, part 2

I personally wouldn't let them touch it - conflict of interest and they have an agenda that isn't favorable to the family. I hired an attorney to handle all of it and it was the best decision I could've made.

Part 2: So imho what you ideally want to do is delay this to get back with the law firm that did those Trusts for your FIL asap. Or if they are gone whomever those old partners went to continue their practice with.

You can do this by doing an Appeal of FiL discharge from his rehab from Medicare. The appeal needs to be filed asap. Go to the CMS website and look up rehab appeals process, Like today or tomorrow. It should buy you a few days if not couple of weeks. He - if I’m not mistaken - stays in billing limbo while his rehab gets re-evaluated. I never have had to do this, so maybe someone on this site has and can shed light on the process. You don’t want to drag on the appeals, its just to buy a bit of time, So you want to meet with the old law firm asap, to see exactly what can happen with that revocable and just how involved it’s going to be to cash or move funds.

Like if it does have to be cashed out, what is in this Trust may in & of itself have its own paperwork that has to be done to remove itself from the Trust that may not be easy or simple. Like if he has an investment in the revocable that “feeds” it $ (so there’s $ to write checks on) that investment will also have to come out of its Trust “naming” and get closed out and cashed out. Stuff like this is not always easy peasy and sure as hell the NH should not be doing any actions on your FIL legal.

Now maybe the NH is 100% clueless that your FiL has Trusts…. They think he’s just the average retiree with avg SSA mo income pf $1200 that has found himself now impoverished and needing to file NH LTC Medicaid. Then once they realize OMGawd multiple Trusts we can’t and they push the paperwork back to you and say “yes see your old attorney”.

But if they know he has Trusts and want to get all into his finances, that’s total red flags to me that this is a NH, well, is one I would not want to deal with. If you would please let us know what happens. & good luck!

No, do not allow the NH to do the application. If Dads assets were straight forward I may but the trusts may make it complicated. I would use an elder lawyer in ur situation. In my State you have 90 days to file, spend down and place the person. There is info that Medicaid will need. Even with a lawyer I would be on top of things. Me, I don't trust a financial clerk in a NH to know all the ins and outs of Medicaid.

Firstly, even though the revocable trust is more than 5 years, Medicaid will count this as a resource. Secondly, with your FIL transferring assets into an irrevocable trust to his daughter will send up a major red flag as Medicaid will believe that he’s trying to hide money in this trust.

You need to seek the advice of an attorney who is versed in how Medicaid works. Also, be prepared to show 5 years of documents regarding the trusts to Medicaid as they will want to peruse those documents with a fine-tooth comb. Another important factor here is that you should be aware that Medicaid needs to see these documents in a timely fashion or they will deny the claim. If you can’t get the documents into them in a timely fashion, you can always ask for an extension of the time to produce the documents. My daughter works for Medicaid in New Jersey and when she requests any document she expects to receive it in a timely manner.

Yes as they can get the process done faster

I live in Ohio and I let the nursing home help with my moms application. They need a lot of information but where my moms at they helped a lot because they deal with Medicade every day

You need to consult an elder care attorney about this. I believe the irrevocable trust is out of reach for Medicaid as those assets are not his. They are owned by the trust. I also think that once the assets transfer to your daughter they still have to stay in the irrevocable trust, but she can earn and live off the money from them. They can be multi-generational trusts and the instrument most very wealthy people use to protect their assets from creditors. A revocable trust is different. Your FIL is most likely the trustee of that trust, making the assets his. My father had a revocable trust. All revocable trusts become irrevocable at the original grantor’s death. But the successor trustee then controls the assets. So my dad died, he was the grantor and trustee, and now I am the trustee. Creditors could come after those assets and people can sue the trustee of a revocable trust. Not so with an irrevocable trust. But again, consult an attorney.

Yes, I had them help with the application for my BIL it was a lot easier for me to get all the paperwork needed for him since I was his rep payee. I have dealt with Medicaid before for a number of years but when it comes from the NH it goes thru faster.

Use an elderlaw/estate planning attorney to help you. Don't rely on the nursing home. The attorney will be well worth the money,

My mother's nursing home took care of everything, never even saw a bill. In retrospect, I am grateful for their efforts during the worst days of my life: they took the stress out of my pregnancy and let me just be a loving visitor.

Always great to consult an Elder Law Attorney.

Call me cynical but since one of the trusts is a revokable one I would let the attorney that did the trusts handle the paperwork for the Medicaid application.
By the way if FIL is a Veteran make sure that he dies not missing out on benefits that he may be entitled to.

Have an attorney file the Medicaid application.

markevans999: Retain an elder law attorney.

This is totally my opinion based on what I’ve experienced in the last nine years. If there was anything that I would do differently, it would only be that I would’ve done more research before I took on power of attorney I feel like that would’ve stopped so much I kept so many things from happening. I live in Texas, absolutely under no circumstances allow the nursing home to do anything without your full knowledge. When I first went to the nursing home with my mom always try to handle business before I take her there. I feel like the emotional stress and just the stress alone of having to put her in a nursing home is way overwhelming. I asked the admissions coordinator who applies for Medicaid I asked, do y’all or should I? At the moment with every bit of feeling she said, “oh no, we do that to take the burden off of the family.” I should’ve known then that was a big mistake because any and every opportunity they had they left me out of everything I have statutory durable, power of attorney and medical power of attorney all that is is $1000 worth of toilet paper! When they say take the burden off the family, they should’ve just said to keep the family out of the picture we do it, so we can screw them over real good. We were Medicaid pending supposedly here in Texas. It’s against the law to take somebody to court. I asked them to please explain the billing to me because it just didn’t make sense. They claimed it was self-explanatory, but the administrator himself couldn’t even explain it, I was way overwhelmed. Had a lot going on in my life on top of that so the only thing I need to do was tell him OK you’re not gonna like it but I’m about to give you a taste of your own medicine you won’t answer me I won’t answer you, so I didn’t . They went behind my back. Three of them is the administrator the Activities Director, and an admissions coordinator they told my mom pay her get out. My mom had a stroke in 2018 during a heart valve replacement surgery. She can’t say she can’t stand she can’t walk. They had her sign a letter that she had no idea what she signed at the time she cashed in her life insurance policy, and they got every last cent now there’s nothing to bury her with, they even include my power of attorney papers. A lot more things happened that were horrible. I found a different nursing home it would take her. Of course they’re all great in the beginning come to find out at the beginning of this year they haven’t received my mom‘s pension check that would pay to take care of her there at the nursing home room and board along with Social Security and Medicaid and Medicare. They haven’t received it in two years! How many stretching it a lot but I could even understand maybe two months but two years that’s absolutely ridiculous. Then all of a sudden become a 911 emergency that it be paid come to find out they called the pension place so many times different people mad I had that they completely shut it down and didn’t send out anything to anybody that forced this nursing home to have to contact me and had to include me or else they would’ve gotten anywhere. Now this whole two years they never said anything about it. They never brought it to my attention. Now it’s all of a sudden 911 emergency that it be paid even though she’s doing weeks without a bath they were over medicating her they lost her bottom, denture plate, mother everything already charged her for that and got the money. She still has doesn’t have any dentures now I found out that she can only eat puréed food because somethings wrong with her esophagus and I don’t believe what they’re saying because it just doesn’t make sense, nor have they shown any kind of proof to back it up. I love my mother dearly I want what’s best for her I can’t find an attorney that will touch it. State won’t do anything. Do you re-search please this was not to scare you or sound horrible only my experiences it’s almost like they force you to take them on your own hands . Prayers to you

My opine is NO, don't let nursing home file the Medicaid application. If you can, use the Elder Law Atty you used to set up the trusts. It will be less costly in the long run. Hugs.

Seriously, pay a professional, it probably won’t be that much and your peace of mind is worth every penny.