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1sweetchild Asked March 2014

Can Medicaid take all the money in joint bank accounts for nursing home care?

I have taken care of my father and he has lived with me for 7 years. About 4 yrs ago, he added me as a joint owner on his bank accounts. I also took care of my mother for 2 years before she passed. If I didn't take care of my father, he would be in a nursing home. If his condition worsens to the extent I can no longer care of him, can Medicaid take all of the money in the joint bank accounts for nursing home care? We live in NC. Thank you.

jeannegibbs Jan 2017
Is her monthly income enough to pay for the facility?

Msviviangrace Jan 2017
The thing is she has a good amount of money in her savings. Because she gave this money as gifts, she cannot go into a home. It's ridiculous.

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jeannegibbs Jan 2017
Msviviangrace, money given away within 5 years before applying for Medicaid will disqualify the applicant for a period of time. There is no rule or law that the recipients have to give it back (in many cases it has long been spent) but that is one solution. Then the money would be used for Mom's care until it runs out, and then she would be eligible for Medicaid. Or family members (or friends -- anyone willing) can pay for mom's care until she is eligible for Medicaid.

Medicaid is a needs-based program. (I don't think it should be, but that is beside the point.) The purpose behind this 5-year lookback is to prevent someone from realizing they are going to need care and quickly giving their money away so they can say "I'm poor. I need financial help." The idea is they should use their own money for their own care as long as they can, and only call upon tax payers when their money runs out.

Please understand. I am NOT saying this is what your mother did. I believe that you knew nothing about such rules. Many folks wind up in this situation, without any intention of cheating taxpayers! But that is what the rule is about.

Msviviangrace Jan 2017
My mom is a widow. She is looking at going into an assisted living. A year ago she gave us 5 kids $5000, plus Birthday and Christmas money. She has $25,000 left. the home (PA) said she had to return this money before going in. a year ago we had no idea this would happen. Is this right? She gets a monthly income in

mh257700 Nov 2016
my husband is on Medicaid and in a nursing home with dementia. I'm having difficulty getting his social security direct deposited income (currently deposited to our joint checking account) transferred to his single account (required) without taking him in the social security office in person to make that request. He is not physically able to do this so does he have other options. I have a durable power of attorney that is not recognized by social security so what are his options at this point.?

Guestshopadmin Nov 2016
talk to a lawyer experienced with elder care and Medicaid as all states are different

Guestshopadmin Nov 2016
5 years look back

Joieee Nov 2016
Please respond quickly so that nothing illegal is done?...

Joieee Nov 2016
At this point we are not considering a nursing home, but may do so in the future.???

Joieee Nov 2016
How far in advance do savings/checking accounts need to be transferred into or under someone else's name to avoid Nursing home from taking these funds. If funds are transferred to another account under someone's name other than patients name. Is there a time limit where this is acceptable to do & the money be safe?

Kalebm Aug 2016
My husband is on Medicaid and in a NH. . .he receives SS and 2 pensions every month. I receive a small SS amount every month which is directly deposited . . .I was told I must keep no more than $1,600 per month in the joint acc't. So after paying rent utilities from the joint acc't there is $ left what can I use it for? Can I transfer $ into my acc't ?

pamstegma Aug 2016
Jessie502, If she died today on the 4th of the month, she still has to pay for those four days. The amount to pay is in the contract.
Billy2016, Hospice does not pay for the nursing home. So he has to pay from his personal funds until he has less than 2K. Adding her to the account does not make a difference; he has to use that money.

billy2016 Aug 2016
My brother in law is in between nursing and hospice right now and they are trying to see if he needs to pay for his room. He has a money market account list with his name or his sister. this was just done about a month ago. Can Medicaid take these funds with it listed as or not and?

jessie502 Jul 2016
I just need answers to the question I just posted, please.

jessie502 Jul 2016
my mom just passed in a nursing home, she had a personal account at the nursing home from a 100 dollar retirement fund from where she worked most of her life, the nursing home wants to take another month's care from her personal account, is this legal?

Jdub143 Jul 2015
This is a related question regarding medicaid payback: my dad had to enter a nursing home and after his funds were spent down went on medicaid. He passed last year but my mom is still living. meanwhile, while dad was still alive, mom recieved proceeds from the sale of her moms home. We put this moderate amount into a bank account joint with me, just so i can "look after" but it is all her money. When she passes i understand she will have to payback medicaid for the amount they paid for dads nursing home care. So, can they take this money that is hers (remember its joint with me but not mine---she wanted this saved to help send grandkids to college)? What can medicaid "take" as payback? Thank you!

1sweetchild Apr 2014
Thank you for your post LadeeC. The caseworker this last hospital stay did talk to us about options including hospice ( if the C Diff didn't respond to treatment. He has been on the Difficid about 10 days now. He has 4 more days of treatment. His diarrhea has stopped and hopefully the c diff will be completely resolved soon. Lord willing, his discharge date will be 4/19.

LadeeC Mar 2014
This isn't really an answer to your specific question, but it IS something to consider, going forward. One of the criteria for hospice care is the number of visits the patient has in hospital, over a specific time period. First, please don't let this scare you .. it doesn't have to mean 'terminal' .. Second, hospice can provide services and palliative treatments that the regular healthcare profession doesn't/won't and is often more successful (since it can be provided at home, with visiting aids, nurses, and even doctors, AND you can get respite). When/if he sees improvement, they'll discharge him from hospice care to his normal physician/care team. It's worth considering.

Mostly, I point this out for two reasons: he's non-compliant with the rehab anyway, and two, he'll get YOUR care at home. Often they heal faster/better in the home environment than in the SNF, even if they don't get the PT (which, btw, YOU can provide or dip into the savings and have someone who specializes in PT come out once or twice a week), the home environment is so much more conducive to healing. I had our PCP state to us, very clearly, "The hospital is NOT the place to heal." It's not. Whether it's a LTCF or SNF or general hospital. Forgive me, but the first two are parking lots and the second is an airport terminal (nothing derisive about the personnel, my experience with people is GREAT .. it's the institution(s) that is(are) broken).

Best wishes for a good outcome and keep us posted on how he's (and you are) doing!

lsmiami Mar 2014
Yes, Medicaid will see joint accounts as his. More importantly, it sounds like it was his money to begin with as you mentioned he added you to HIS accounts. If you have in the past, immediately stop depositing any of your funds into his account.
Pam and Igloo give you good advice. Try to plan ahead.

1sweetchild Mar 2014
Yes, Daddy has had recurring C Diff since December 2013. Truly, I don't believe they ever got rid of it. His had an exacerbation of CHF in January, he was admitted and then went to rehab. C Diff began in the nursing home. He was discharged from the SNF, I had him at home one night and I had to take him to the ER. He spent 11 days in the hospital and then went back into rehab at another SNF. He was at rehab for 30 days and was discharged and again I had him home one night and had to take him to the ER. He was in the hospital for 8 days... He was d/c'd from hospital Saturday and is back in rehab. Thank God, Daddy had a hospitalist that listened to me this time and he placed Daddy on Dificid. Dificid costs $2800 for 14 days treatment.

igloo572 Mar 2014
1sweet - you have a lot to deal with. Although it may seem hard to accept this, the fact that he has funds really gives you & him so many more options for care. Dad can hire home-health care; he can pay for respite stay if you & hubs need to do a vacation away from him. Dad can go to the dentist and pay for services without worry. Your not in the trick bag where there is only 1 NH who will take him and it is scary or that he needs thousands of $$ of private pay dental work. Dad has options.

? - when he goes in for what seems like a revolving hospitalization followed by rehab, what is happening? Is he having a recurrent C. Diff or just what is the point source of the hospital/rehab stays? I'd pause and really look hard at this and then speak with the social worker @ the rehab facility about what is their take on what his near future is like. At some point in time rehab will not be a possibility (as you mention he is noncompliant), so what happens then? If any of the rehab places can work for him to become a long term stay resident, I'd really suggest you start considering that option.

The reality for most elderly is that eventually the level of care that they need is best in a facility and the ability of the caregivers just runs out, so they have to move to an LTC. And if they live long enough, they will run out of money unless they are generationally wealthy. So they have to apply to Medicaid to pay for their NH stay. Average NH annual cost is 75K, the money is just gone in a few years. You have to plan for the application to Medicaid in all reality.

ANother ?, if he is living with you & hubs now for several years, why keep his house? How does he own the house, like is in a long-established trust or is it just a traditional ownership? Does it make sense to keep the house??; is the cost of maintaining the house at all an issue for dad right now?; is there a good reason to keep it? Can you do all costs on dad's house this for the next few years without a strain on your & hubs finances and your & hubs time?

You need to realize that IF dad in the future does apply for Medicaid, he can keep his home (by & large in most states) an an exempt asset but the property will have to remain his homestead and there is the possibility of a MERP (Medicaid Estate Recovery Program) claim or lien on the property after his death. If you go this route, imho you kinda need to plan on keeping the property for the rest of dad's lifetime and keep detailed expense reports on it as you will need to do your own claim against dad's estate to be reimbursed in probate & to be taken off the MERP Medicaid tally. If you sell it now or if you sell it a after dad is on Medicaid, then all the proceeds from the sale are on Medicaid's radar and they will expect all to go for his care. You can do a lien to be reimbursed from the proceeds at the act of sale of the house but you really have to be organized and work with the Realtor on all this way in advance. It imho is way easier to deal with this as your own claim against the costs of managing the estate in probate. If you do decide to continue Dad's house ownership, keep in mind that MERP is ultimately a legal process done via probate. If you are executrix of the estate, you really can have a lot of latitude to determine how things get paid and at what timeframe.

1sweetchild Mar 2014
Yes, My Daddy has lived in my home for the past 7 years. My husband and I do almost everything for him... including personal care and bathing, food prep, medication, doctor visits, pay his bills (with his money), take care of his home and yard including repairs. His house has been empty for 7 years. This has been very difficult, I work a full time job. My husband is with him while I am at work. 7 years ago, decisions had to be made quickly. Daddy was fine, driving, taking care of his house, yard and medicine.. plus he took care of my mother. He would take walks daily. He took a stroll around the church grounds and then proceeded to cross over the railroad tracks, his foot slipped and his head landed on the railroad track rail. He had a traumatic brain injury, he suffered from a subdural hematoma. On the day he fell, I not only had to emotionally cope with his life threatening condition, I had to move my mother into my house. She was not able to care for herself. I did not have extra space so I placed an air mattress in the living room until I could get something permanent worked out. Daddy has never been the same. He was so sharp and active. Daddy was the one who always had my back.... now I have his. This was very hard to accept. He has short term memory loss. For example when I get him ready for the doctor, he will ask "Where are we going." and 2 minutes later he will ask me "Where are we going." He has no concept of time and doesn't understand why we need to hurry for anything. He is often noncompliant and at times becomes very aggressive. But, he is my daddy and I have done everything I could to keep him out of a nursing home. He has been in the hospital 3 times this year already and it is only March. He is currently in the hospital and will have to go to rehab for 30 more days. He hates being in rehab and he is noncompliant with physical therapy. I desperately want him to get better and get back home. He was very wise and put back money all his life... Thank God. It is a shame that the system would take everything he has if his condition worsens to the place that I can no longer take care of him.

igloo572 Mar 2014
Oh another thought, it sounds like dad is living with you. The house is yours.

If this is correct, then realize that if Dad goes into a NH on Medicaid, he is fully expected to pay all his income as his co-pay (his SOC - share of cost) each & every month to the NH. He can keep a small personal needs allowance ( $ 35 - 90 a month). If you have been needing dad's income or assets in order to make ends meet to maintain your household, then that money will not be there anymore. If this possibly is the situation you will find yourself in, I would run not walk to an elder law attorney to see if your dad can do a personal services contract for you to be able to pay for your caregiving or for rent from dad to you for his living with you. This is not a DIY project either as it has to be able to be vetted by Medicaid in the future and without a transfer penalty. If this is your situation, you are not alone, this story comes up again & again on this site……where a daughter (almost always a female) left a job and moved in the parents for unpaid caregiving for years & years and now parents need higher level of care & she finds herself with limited financial resources and their parents income has to be paid to the NH under Medicaid rules. You need to do whatever now to be compensated for caregiving if at all possible so that you aren't in this situation if you can help it.

igloo572 Mar 2014
OK so who's money is going into the joint account? Who's SS #? If it is just dad's SS or retirement income or other long term $ asset, then it is all his money and all subject to spend-down IF in the future your dad needs to apply for Medicaid.

But if you are depositing any of your money into the account, then you are co-mingling funds and this is a totally sticky problem IF he applies for Medicaid. As the entire sum in the account will be viewed as his and subject to spend-down. As you are his child & not his spouse, there is no "community spouse" set aside of assets (up to 112K in most states) or diversion of income (like for MMNA - monthly maintenance needs allowance).

So what's what in the "joint" account?

As an aside, SS hates commingled accounts. If they find that it's happening, they may require that you become your dad's "representative payee" for his SS income and there is reporting required……SS does an investigation too. Often when they go into a NH, the NH then becomes the representative payee

pamstegma Mar 2014
Medicaid allows the patient $2000 or less in the bank. If he goes into a Nursing Home, they will take all of his SS check to pay for it, and make up the difference in NH cost. They will allow you to stay in his home, as you have been caregiving over two years. You need your own income to pay the mortgage, utilities, taxes etc. Since you have time to plan, separate your money from his, two bank accounts, one in his name, one in yours.

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