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Darla3 Asked September 2018

Caregiving and Medicaid denial. Do people have luck at appeal hearings?

Been living with mom since divorced 12 yrs ago. Mom has multiple health issues and numerous surgeries. In oct 2014 mom put the house in my name. April 2018 mom had to be placed in a NH due to safety issues and dementia progressing. I am now in the battle of my life, due to long term Medicaid denial due to the 5 year look back. I am a nurse, they have gotten irrefutable evidence from her doctor and many others that my care has kept her out of a NH. I now have an elder care attorney to fight this for me at a fair hearing. I am soooo stressed. Do people have luck at these hearings??!!

Darla3 Sep 2018
Thank you all so much. The letter was on the doctors letterhead. Yes the house was only signed over 3/1/2 yrs ago and there is a 5 ur look paid period. Mom had absolutely no other assets. No pention. Only social security that now goes to the NH. Absolutely no other transfers as she was approved for medical Medicaid but not long term. I’m trying to prove I have been her primary caregiver; ex: took care of all meds. B/P monitoring, and insulin and glucose monitoring. Not to mention home post op care after numerous surgeries instead of rehab. My hours ate part time 20hrs per week. When I’m at work, either my neighbor or boyfriend would stay with her. Unfortunately the stress continues. The hearing is not till sept 28th. These two people will also attend and testify at the hearing.

igloo572 Sep 2018
What are the reasons for ineligiblity?
The house transfer to you within the 5 yr look back is one.
But there’s could be others as well, like commingling of financials so there appears to be other gifting transfer issues besides the house between the 2 of you?
Do you still work full time or did you these last few years while living & caring for your mom?
Did she write checks or other unaccounted for cash withdrawals within the 5 year (Summer 2013) that could have piqued medicaids interest?
did you get a SW letter as to care needed?
The MD letters did they put any ICD codes on the letter and letter was on their stationary with state licensing #?
the House is value high? Like 550k - 750k range?

whats your understanding of the reasons?

could there be a eligibility issue due to not “needing” skilled nursing care? I had this with my mom as there was a CF with the initial intake onto her admit paperwork as to her medications and Co-morbidity p. Medical Medicaid at need appeal whole different maze.

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wally003 Sep 2018
hi don't have any help with that. but curious when your hearing is? hate to think you are so stressed for the next month? What does your attorney think? Maybe he can offer some peace of mind.

JoAnn29 Sep 2018
Your problem maybe Mom signing over the house within the five year period for Medicaid. The house may have to revert back to her and then you show you were living there as her caregiver. That way you can remain there as long as you pay the taxes, utilities and upkeep. At ur Moms passing, a lean will be attached by Medicaid. If u sell the house (at market value) the lean will need to be satisfied.

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