Senior rights to property while receiving skilled nursing

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Latest post Mon, Oct 21 2013 3:41 PM by madirishman. 15 replies.
  • Mon, Oct 14 2013 1:19 PM

    • madirishman
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    Senior rights to property while receiving skilled nursing

    On behalf of my father who is 90 years old, I would like to know what rights my father has to owning property while being considered for skilled nursing care.  A year ago he was living in his home when he suffered some kind of blockage in his bowels and was sent to a hospital for evaluation.  To elinimate the condition after some time of evaluation, he received an illiostomy.  By last December he was transferred to an aissistance living facility.

    However due to numerous visits to a hospital for aspiration issues from choking on food he had exhausted his Medicare Acute care days (100 days).  By last June acting as his Power of Attorney (Attorney in Fact) for both financial and healthcare issues, I transferred him from a hospital in Indiana (same state as his residence then) to a VA facility near Pittsburgh, PA under Palliative care facility.

    In each case some form of skilled nursing care was considered yet due to his ownership of property (home), financial accounts in excess of $1500, whole life insurance policies that he does not qualify for Medicaid care without losing control of said property.

    It has now been determined that his medical condition has stabilized and no longer qualifies for Hospice or Palliative care in either VA or Skilled Nursing facilities without the loss of this property.

    I just would like to know if at this point is their any protection that can be done to either his real estate or his policies or IRA that would protect these items were skilled nursing care to be an option.  At the moment we are considering Home Hospice as the only option to protect his assets.  He is not wealthy by any means yet is slightly more than destitute or a pauper, so claiming these assets seem ok by the government even though there are beneficiaries or will intructions to consider on these assets.

    What can our family do?

  • Mon, Oct 14 2013 2:14 PM In reply to

    Re: Senior rights to property while receiving skilled nursing

    madirishman:
    so claiming these assets seem ok by the government even though there are beneficiaries or will intructions to consider on these assets.

    Sorry but the expense for your father's care comes before beneficiary or will interests especially since he is still living.  The government takes a dim view of asking the tax payers to foot the very costly bill for skilled nursing care so that family members can inherit an estate.

    Even if there were a way to retain the assets for the estate if there are costly bills for his care when he passes the estate has to pay those before any inheritance is disbursed. 

    "That's just my opinion, then again I might be wrong."  Dennis Miller

     

  • Mon, Oct 14 2013 2:17 PM In reply to

    • Drew
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    Re: Senior rights to property while receiving skilled nursing

    If he gifts away counted assets he essentially runs afoul of some serious claw back of said gifts into the equation and some rather nasty future disqualification time blocks .

    Avoid people who offer to sell you instant cure to move assets out of harms way.....do some serious homework ...spending down assets or conversion of assets to uncounted assets may work but its an area full of deliberate bear traps to get you to spend your assets before you qualify for public benefits.



  • Mon, Oct 14 2013 2:23 PM In reply to

    Re: Senior rights to property while receiving skilled nursing

    madirishman:

    I just would like to know if at this point is their any protection that can be done to either his real estate or his policies or IRA that would protect these items were skilled nursing care to be an option.  At the moment we are considering Home Hospice as the only option to protect his assets.  He is not wealthy by any means yet is slightly more than destitute or a pauper, so claiming these assets seem ok by the government even though there are beneficiaries or will intructions to consider on these assets.

    Understand that the basic idea here is that people ought to first use their own resources to pay for the care they need before the taxpayers end up paying for their care. Put another way, why should taxpayers have to foot the bill for his care to enable him to pass his home and other assets to his kids? 

    He may consult an elder law attorney for advice on his options, but there likely aren't a whole lot of things that he can do now to save those assets and still qualify for care paid by the government. The five year look back period for Medicaid benefits, for example, creates a substantial hurdle for guy who is already 90 years old with significant medical problems. You and he may in the end have to accept that he'll have to spend down his own assets before he qualfies for government provided care.

  • Mon, Oct 14 2013 2:40 PM In reply to

    • Drew
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    Re: Senior rights to property while receiving skilled nursing

    Got back and check details...many an IRA is not a counted asset, and only whole life with cash value over $2500 probably triggers a count...and I could probably convert a home to unavailable cash stream and in a sense get zapped for asset at low end of value structure ....lots of steps one might take to end  down the counted portions ..but at  age 90 the time clock may not be on your side?  Also if he has a decent pension his income may be to high.

     



  • Mon, Oct 14 2013 2:45 PM In reply to

    • madirishman
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    Re: Senior rights to property while receiving skilled nursing

    From what I gather from all who replied is that what we are planning to do (Home hospice) against the advice of the current VA facility where is he current is, is all we can do and protect his assets.  I am aware of using a Living Trust would have been the correct choice had my father followed my suggestion then a few years back. His mistrust of lawyers prevented that. I just think it is unfair that parents make promises to their children that in the end they can not keep about their legacy, when it all goes to pay for extending their lives. Our society (American) has no elegent way for elder people to die.

    My father's shortsightedness on his assets and care thereof, I know is a prevalent problem in America and its resolution is not shared worldwide.

    I appreciate all who responded. These responses only confirmed what I already had determined.

     

  • Mon, Oct 14 2013 2:53 PM In reply to

    • madirishman
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    Re: Senior rights to property while receiving skilled nursin...

    His SS benefit is $1750 or so, plus $550 so pension putting just over some limits.

    We may well end up exhausting his IRA fixing up his home in preperation for sale/rent. Just put in a water pump a few weeks ago. Still needs carpets and some small repairs.  One suggestion was to turn one of the smaller life insurance policies into a irrevocable policy in conjunction with a funeral home. I may pursue this. One of the policies is split benefit between my brother and I as beneficiaries. I am also considering cashing out the other one to assist with the financing issues with home if needed.

  • Mon, Oct 14 2013 3:20 PM In reply to

    Re: Senior rights to property while receiving skilled nursing

    madirishman:
    I just think it is unfair that parents make promises to their children that in the end they can not keep about their legacy, when it all goes to pay for extending their lives.

    The tax payers think it is unfair for us to pay for your father's care so that you can inherit an estate.  The assets he amassed are HIS to do with as he pleases and you have absolutely NO legacy until he passes and ALL the bills are paid.  Quite frankly your first concern should be for your father's care and well being and not what money you can preserve for yourself and your siblings.  By selling the home you could potentially have plenty of money to provide him with far better care than he would get on Medicaid.

    madirishman:
    Our society (American) has no elegent way for elder people to die.

    Our society has LOTS of ways they preserve the dignity of the dying.  That you have to actually spend the money you prefer to keep for yourself is not a reflection on the ethics and morals of society but is a reflection of your greed.

    "That's just my opinion, then again I might be wrong."  Dennis Miller

     

  • Mon, Oct 14 2013 4:22 PM In reply to

    Re: Senior rights to property while receiving skilled nursing

    madirishman:
    I just think it is unfair that parents make promises to their children that in the end they can not keep about their legacy, when it all goes to pay for extending their lives. Our society (American) has no elegent way for elder people to die.

    That reflects a sentiment that you think you are entitled to inherit what he promised. But in order for you to get anything, he must have something left to give you after paying all his bills. I hope you understand that what you are basically asking for here is for the taxpayers to fund your inheritance. Why should I or anyone else have to pay more taxes so that you can get an inheritance from your father? Do you want to pay more in tax to fund everyone else's inheritances, too? Our government would be much more expensive than it already is if that were the policy. 

    Yes, right or not, there are some ways that assets can be preserved if enough advance planning is done. But there is a cost to that. The person will not have those assets to pay for his/her care, and thus will only be able to get the care that Medicaid and other programs pay for. Have you actually seen the kinds of places he'd qualify to get into on Medicaid alone? They are not great. In some of the facilities the care is just short of abysmal. I tell clients thinking of passing their assets to a trust or in gifts to their kids so that down the road they'll qualify for Medicaid to first take a good look at what kind of care they'd actually get on Medicaid. I suggest they visit some actual facilities that readily accept Medicare only patients and then decide if they'd rather use their money to get better care for as long as possible or whether they'd be fine with Medicaid right off the bat when they need care. A number of clients after actually seeing the kind of care they'd get with Medicaid versus what they'd get paying for it decide they want to pay for their care to live as they'd like as long as possible before settling for the barely adequate care they may get on Medicaid.

  • Mon, Oct 14 2013 5:22 PM In reply to

    • madirishman
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    Re: Senior rights to property while receiving skilled nursing

    ClydesMom:
    madirishman:
    I just think it is unfair that parents make promises to their children that in the end they can not keep about their legacy, when it all goes to pay for extending their lives.

    The tax payers think it is unfair for us to pay for your father's care so that you can inherit an estate.  The assets he amassed are HIS to do with as he pleases and you have absolutely NO legacy until he passes and ALL the bills are paid.  Quite frankly your first concern should be for your father's care and well being and not what money you can preserve for yourself and your siblings.  By selling the home you could potentially have plenty of money to provide him with far better care than he would get on Medicaid.

    What I have bolded above of your comment, I am intending nothing of the kind.  I expect no legacy beyond what is left after paying his bills.  Skilled nursing however is beyond the cost of anybody w/o 7 digits of net worth.  I haver heard of nothing below $5000/mo.  A "spenddown" of a year or so and at 90 he would be "living under a bridge".

    My concern foremost is his care as his POA.  However, I am unable of my own funds as I am currently unemployed and seeking employment. We have been attempting to sell the property though as it is disrepair, we are now exploring ways to rearrange his assets to come up with some funds to do that.

    ClydesMom:
    madirishman:
    Our society (American) has no elegent way for elder people to die.

    Our society has LOTS of ways they preserve the dignity of the dying.  That you have to actually spend the money you prefer to keep for yourself is not a reflection on the ethics and morals of society but is a reflection of your greed.

    You got a lot of gall to consider doing their best to make ends meet "greed" when my wife and I are not much further away from "living under a bridge" ourselves!

  • Mon, Oct 14 2013 5:33 PM In reply to

    • madirishman
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    Re: Senior rights to property while receiving skilled nursing

    Taxagent:
    madirishman:
    I just think it is unfair that parents make promises to their children that in the end they can not keep about their legacy, when it all goes to pay for extending their lives. Our society (American) has no elegent way for elder people to die.

    That reflects a sentiment that you think you are entitled to inherit what he promised. But in order for you to get anything, he must have something left to give you after paying all his bills. I hope you understand that what you are basically asking for here is for the taxpayers to fund your inheritance. Why should I or anyone else have to pay more taxes so that you can get an inheritance from your father? Do you want to pay more in tax to fund everyone else's inheritances, too? Our government would be much more expensive than it already is if that were the policy. 

    Yes, right or not, there are some ways that assets can be preserved if enough advance planning is done. But there is a cost to that. The person will not have those assets to pay for his/her care, and thus will only be able to get the care that Medicaid and other programs pay for. Have you actually seen the kinds of places he'd qualify to get into on Medicaid alone? They are not great. In some of the facilities the care is just short of abysmal. I tell clients thinking of passing their assets to a trust or in gifts to their kids so that down the road they'll qualify for Medicaid to first take a good look at what kind of care they'd actually get on Medicaid. I suggest they visit some actual facilities that readily accept Medicare only patients and then decide if they'd rather use their money to get better care for as long as possible or whether they'd be fine with Medicaid right off the bat when they need care. A number of clients after actually seeing the kind of care they'd get with Medicaid versus what they'd get paying for it decide they want to pay for their care to live as they'd like as long as possible before settling for the barely adequate care they may get on Medicaid.

    I think you completely missed the point. My original comment was to my father for making a blind promise that he could not keep.  One he made to me when I was a child - Fifty years later or more.  Given the conditions of today, who can predict events 50 years into the future.

    Second you go on about ways of protection of assets. One my father did not consider or actually did consider and for one reason or another, rejected.  I have seen/visited some Medicaid funded facilities. One my brother is in is taking care his care by way of Medicaid funding.  His disability being a quadraplegic in definition in Indiana only amounts to a $1000/mo where at one point he was being forced into a spendown until my father stepped in and got a waiver.

     

     

  • Mon, Oct 14 2013 6:47 PM In reply to

    • harrylime
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    Re: Senior rights to property while receiving skilled nursing

    madirishman:
    I am aware of using a Living Trust would have been the correct choice had my father followed my suggestion then a few years back.

    By the way...  A living trust would not have been any help in this situation.

  • Tue, Oct 15 2013 11:48 AM In reply to

    • madirishman
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    Re: Senior rights to property while receiving skilled nursing

    How so?

    As I understand, if he had reorganized his assets within a Living Trust, they would have been protected. I admit, I am not a lawyer. So I am only going on information I have acquired through books. I do know the five year look back to be considered under Medicaid.

    In any case, my wife an I are planning for my father to come to our spare bedroom for home hospice care. This is the only viable solution that protects his assets as my father wishes. You really can't change the past.

  • Tue, Oct 15 2013 2:33 PM In reply to

    • harrylime
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    Re: Senior rights to property while receiving skilled nursing

    What is referred to as a living trust is a revocable trust. For purposes of Medicaid qualification, the assets in the living trust are available to pay for health care expenses.

  • Tue, Oct 15 2013 3:14 PM In reply to

    Re: Senior rights to property while receiving skilled nursing

    harrylime:
    What is referred to as a living trust is a revocable trust.

    Technically that's not accurate. The popular term "living trust" is essentially the same as the legal term intervivos trust, which means any trust created during the lifetime of the person creating the trust. It distinguishes it from a testamentary trust, which is a trust that is created by the will of the creator. A revocable living trust is just one type of living trust. There are also, as you know, irrevocable living trusts. While the revocable living trust is the most popular in many states for estate planning purposes, irrevocable trusts are also helpful in some situations, like some medicaid planning.

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