FIL is in rehab, Will go into SNF on Sept. 19th. Need to file the medicaid application for him. Have a meeting with the financial staff 13th. They have offered to help with the medicaid application. FIL has 2 trusts, a revocable trust established in 2013 to handle every day expenses (checking accounts) and an irrevocable trust in March, 2018 to tranfer assets to his daughter. So, both trusts were established over 5 years ago. I have read online not to let the nursing home file the medicaid application. Any suggestions? Don't want to make any mistakes. FIL is in South Carolina. You can file the application online, but the parts about trusts is a little confusing to me. Thanks for any help.
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!
If you have an irrevocable trust that you are not even a trustee on, do you have to disclose it?
My understanding is that the assets of the trust are no longer yours and the only issue would be that the trust pays you something on a regular basis. Creating income to you.
Thank you for answering this.
Always great to read your incredible advice.
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.
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.
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
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.
By the way if FIL is a Veteran make sure that he dies not missing out on benefits that he may be entitled to.