I'm in a similar situation as "Bob". I live in low income subsidized independent housing for seniors and people under 62 with disabilities. Prior to my 66th birthday, I was receiving social security disability payments which changed in name only to regular ss retirement payments. I've been on full medicaid since 2016. My sister died Sept. 2017 and in her will, I was not listed as a beneficiary. However, she apparently wrote a short letter to my daughter who is the executor and primary beneficiary of the IRA's and her checking accounts, that she wanted me to have a certain percentage of the amount my daughter inherits from the IRA. Since my sister was 76 at time of death she had to take a minimum distribution each year which rolls over to the beneficiaries that were written into the will...so they too have to take a minimum distribution amount each year taxed at 20% plus then pay income taxes on that amount each year. I was unaware of this until shortly before she died. I wanted to set up a medicaid trust to protect those assets however my daughter did not agree. Now she has given me cash for the minimum distribution based on her age (47) but the income tax is in a very high bracket due to her husband's earnings. I don't know how to safeguard this cash (about $3,200) while I spend it on dental work and therapies etc. that aren't covered by Medicare/Medicaid. I've been told to get a safe deposit box but I have concerns that while not totally illegal to put cash there if Medicaid found out, I would be in deep trouble. I don't make enough money to file taxes so the IRS wouldn't be looking for this. I also want to pay off my credit card but not bring suspicion about how I received that money. What can I do to protect this amount which may be all I ever get from her each year since it hikes their taxes up even more? Any suggestions???

Kalebm I have this same exact question. I will receive an inheritance this year and hope I won't have to pay it to the nursing home. It is strictly mine, from my family. Spouses name is nowhere connected. If (cs) inherits an amount that puts CS above the 2016 maximum resource amount I don't know if I must pay some or all to the nursing home, go through the disqualification process etc.
If I can obtain accurate information, I'm willing to sit down, discuss, and pay an attorney. Our community does not have any elder attorneys, only probate and estate planning attorneys. Of those I talked to they admit they haven't had to work this type of case. I understand the dilemma if the nursing home spouse receives an inheritance.
A community spouse's ability to keep an inheritance, received over a year after the nursing home spouse received Medicaid approval should be evident within Medicaid rules. While a maximum assets figure is available, there is no indication if monies received up to that maximum amount can be saved for the community spouse.

I am the community spouse. . .my husband was just granted medicaid he is in a nursing home. My brother died and left me an inheritance. . .can medicaid or the nursing home take this from me?

My mom passed away 7 months ago without a will & without assets she received Medicaid for 3 years. Now my uncle died & may have left my mother money or property, would that pass to her kids or go to Medicaid ?

A nursing is a government creation in order to acquire people's lifetime earnings in return for terrible care which US Prisons offer better quality. Think of nursing homes a roach motels--you check in but don't check out. It is society's polite disposal which neglect--and in some cases even abuse--will kill the person and the government sucks up all the assets. Welcome to healthcare in America. I know if I had the terrible misfortune I get so old I can't care for myself I'll simply pull some kind of crime in order to get put in the prison system and receive much better quality of care. It's that bad in America. The only good nursing homes are if you are well off and can afford one.

To IMBabci2 - I didn't mean to start a contentious dialogue, I think you just hit a nerve with me by calling trusts an abuse of the system and immoral, and I thought it important to explain how and why a trust was in place for my sister. I think Medicaid, nursing homes, adult family homes, and even Medicare processes are often difficult to understand unless you are tossed into the middle of them and forced to figure them out. Even then - they can be tough. In your first post, you stated that these nursing home occupants on Medicaid are most likely receiving Medicare, social security, possibly private insurance and pension. This is not true with social security and pension. Once on Medicaid, the nursing home patient's social security and pension payments are owed to the nursing home to offset any Medicaid payments. Medicaid knows exactly how much because the patient is required to provide previous bank statements, SS statements and pension statements as part of backup documentation in the approval process (this is done annually). These monthly SS and pension payments do go directly into the patient's personal checking account as usual, (since these payments follow the patient, not a facility) but are then owed to the nursing home. Except for $60, like in my sister's case. The only other funds the nursing home patient would be able to 'keep' would be a monthly amount equal to a payment for additional insurance, which would then be paid directly to that insurance company. I'm only mentioning this, again not to create an argument, but to point out that these processes are often misunderstood. And, finally, I don't personally know anyone who has put family assets into a trust in order to not have to repay Medicaid after the patient dies, but I'm sure it happens. As others have mentioned in this comment string, rewriting parts of the law might be needed but until that happens, at least from my experience, for the most part, the system works.

IMBabci2, I agree with you that our whole system of elder law should be restructured, and that is not a quickie project to make political points.

But people who are living within the current system are not "abusing" the system. The system may need changing, but to accuse people of abusing it when they are following the current rules is inappropriate.

I thought that a person on Medicaid who gets a gift could put it into a pooled trust?

@beentheremar Insulting me, a lower middle class, full time caregiver of a very ill elderly mother, is not productive here. You stated that with every system there is 'some' abuse. It is abuse that I was referring to. Attorney Heiser did not mention a circumstance such as your sister's which is clearly not abusive. He mentioned new cars and vacations which I regard as purely abusive. Medicaid Laws could be re-constructed with regard to those families with conditions such as your sister's. That is, for such truly needful use. Medicaid laws are poorly constructed for use in current times and with current technologies. Anything that assists the patient also assists the caregiver, whether it is a relative, friend, assisted living center, nursing home, adult family home, etc. Medicaid Laws could be re-written to coincide with inheritance monies used for patient care.
I am caregiver of my 80 year old mother, suffering from congestive heart failure, emphysema, liver cirrhosis, and mild/moderate dementia. Ten years ago, I saw that my mom could no longer properly care for herself. I chose early retirement, sold my home and purchased a home that also accommodates her needs and requests. I do everything for her, which is sometimes very difficult and frustrating, as her confusion often turns to anger and paranoia.
FYI: There are many wealthy families taking advantage of such trusts to avoid spending their own time and monies on their elderly parents. I am personally acquainted with several. They would rather 'enjoy' life rather than bear the cost, personal and financial, of their elderly parent.

Malsyc- Medicaid varies by state but for instance in ohio- you have to be completely unable to perform activities of daily living like - eating, dressing and toileting to qualify for in home service and not sure what that really covers. Check your state Medicaid agency for details. My parents aren't too able to do those well- but they recently didn't qualify- even tho they really barely can get their own selves fed healthy meals and are on the brink of an accident waiting to happen on their own- so we are trying to cover on our own and to pay visiting angels as much as able to help with supervision and feeding and cleaning and such. Medicare pays for some in home care for physical health issues such as rehab from a fall or edema issues- at a doctors prescription. Best thing for in-home funds is from Veterans Administration- if your mother is a veteran or was a wife of a veteran. Check aid and attendance benefit if so.

Also-
Great post earlier from beenthere- we may forget that Medicaid also covers seriously disabled people of all ages- but as described- there's still a lot of small things that add up quickly- not to mention the strain on the family caregivers.
Peace to that poster.

Great post.

I disagree with the commenter who said Attorney Heiser's recommendations constitute abuse. With every 'system' there will be some abuse, but I believe in this case the law is very well thought out, and in place to protect / help/ serve the truly unfortunate. My 'firsthand knowledge' example is this - My sister has been handicapped since birth. She has cerebral palsy and other serious health issues. Last year she moved into an adult family home because her health had deteriorated to the point that she required round-the-clock care. Since she is in a motorized wheelchair she needs to live where hallways are wider than standard, and bathrooms have proper turnaround space. It also needs to be a home (or facility) with ramps instead of stairs. These are things most homes do not have. In other words, I, as her sister, didn't simply 'choose' not to take care of her - (referencing the commenter's statement of 'family members being unable or unwilling' - which comes across as judgmental, uninformed and inconsiderate). My sister is on Medicaid. She has no assets and in order to be eligible for Medicaid she can't have any assets. Medicaid gives her $60 mo. for personal use - i.e. everything she might possibly need outside of her care at the adult family home and medical care. The adult family home does NOT take her to appointments, I do. And I am happy to do so. Her mind is perfectly fine and she likes to be independent whenever she can. She is able to go places on a small private bus. This is not free and Medicaid doesn't pay for this. When our mom redid her will after dad died, the Elder attorney suggested that any bequest to my sister be put in a trust. This was recommended because any amount my sister would receive in excess of $2,000.00 would make her ineligible for Medicaid. That is a paperwork nightmare, especially with someone who has a lot of health issues. To the commenter - if you have never applied for Medicaid, or had to maneuver through their processes, you have no business commenting about it. I have, and I can tell you Medicaid for the disabled is very strict, they require a lot of back-up documentation. And rightly so. It needs to be there for the people who it was designed for. The trust monies my sister might get after mom dies will be held by the trustee (me) and given to her in bits and pieces to help with her needs (neither of us is going on a trip with those funds, or buying a car). It will pay for BASIC needs. The adult family home doesn't buy her clothes. They don't cut her hair. These must be paid for outside of Medicaid. Her medications are paid for through Medicaid, but over the counter items are not - things like aspirin, cold medicine, vitamins, lotion. My sister also goes to church every Sunday which costs her $3.50 on the private bus. Her $60 mo. breaks down to less than $14.00 a week. Subtract $3.50 and she has $10.50 a week. If she were to receive a few thousand dollars in a trust from mom that she could use for the rest of her life and that would be used to pay for the above mentioned items, (and maybe a birthday card to send a friend, or to go to a movie once in a while, or to pay for her own funeral when the time comes) - this hardly seems like something 'immoral'. I think there might be a few 'rich' people out there who might take advantage of the system but I think there are far, far more people like my sister. And that's why the law is written in the way it is.

I realize how frustrating these challenges of inheritance are. I have worked in the elder care system for greater than 25 years. Any answer provided will have to be qualified in the state which the elderly person resides.

I read the answer regarding IN-TRUST, again there are some interesting interpretation at different levels (state, county and local). Knowing the correct information is possibly not in the highest level of concerns by the skilled nursing facility. It is really hard for any one person to say, even lawyers have to re-evaluate the answer in most cases.

Let me just say I am only too aware of the costs associated with any legal team. However, it is an action (asking the question of a lawyer). You will find COPES (published every quarter) a federal program that is tasked with interpretation of the laws on a federal level. Most counties will write guidelines in concert with this answer.

Questions of this could also be answer by NSCLC (National Senior Citizen Law Center). This is agency is independent from legislation, however will bring the answers to low-income seniors.

I am sure this seems like just a lot of teasers, I can assure you it is not. Your question has many answers depending on many things. One thing which comes to light immediately from your stated concerns is what about Uncle Bob. Well the least helpful of answers is the $50,000 could be taken by the DSHS to repay the ill inccured by your Mom. Another answer could be that Uncle Bob will have to pay his care until he reaches $2,000.00, then reapply for Medicaid. These are two of the most likely and neither is a profitable one for your family.

If you do go see a lawyer the answers will most likely be correct if the lawyer is practicing in the Elder Law. You can call your local Low Income referral service to be connected with a lawyer or you can go to your local Aging and Long-Term care agency (again at no cost to you) for a referral.

I found this informative. I disagree that it's immoral in this case. $50k is not wealth. I can see yes- immoral or just tacky-if the families are millionaires- yet sucking down govt hand outs. What i think is a shame is how our current system and health care and longer life spans and social situations and expectations of the current elderly- have reduced and diluted family wealth/assets able to be passed on and is further diluting the middle class. Dying younger was advantageous to preserving family wealth- harsh but true. Now family's should be starting to realize the end game and plan accordingly. Planning financially like decades prior to death. I think most honorable people would love to
Be able to pay from some huge pile of cash they have at end of life- but- most don't have that pile and can barely afford a lawyer or financial planner to help them.

My question is involved...at age 92 my dad told me he signed divorce papers for my son. I questioned my son and was told it was not divorce papers and it was none of my business. Dad lived alone at that time. I since found out that it was actually a line of credit using dad's house as collateral. Dad was diagnosed with Dementia 2 years ago. At the time of the mortgage signing there was nothing in his doctor notes about Dementia. I have POA for dad but the bank wouldn't recognize it. Elder care attorney said there is nothing I can do about the mortgage. Dad had to enter AL memory care a few months ago. The house had to be sold. In order to close on the house, the mortgage balance of $73,000 had to be paid. What happens if dad needs more specialized care in a nursing home? If they go back 5 years, they will see that a mortgage was paid off from the sale of the house and dad was not the borrower. I'm trying my best to make the son make good on the $73,000 but so far the elder care attorney says he doesn't have to repay it.

Can my mother qualify for Medicade before her entry to a nursing home, so maybe home care could be used? She owns nothing and lived with us.

Thank you for this very clear explanation.

I've seen it said before that the nursing home will pay to transport someone to appointments, but I don't think that is always true. Many live in small towns or rural settings and specialists may be located in the nearest city, not just across town. Non urgent patient transport can cost big money, especially two way transport.
And I am sure everyone avails themselves of every opportunity to save themselves money when they file their income taxes, no one wants to pay more than they have to. The fact that the well to do can afford accountants to take advantage of every legal loophole is nothing new, and seriously, if you were given the option to pay the money to the gov't or put it away for your future needs what would you choose?

I find it an abuse to the system that Attorney Heiser, and apparently the law, looks at a nursing home occupant's bequest as a 'family asset.' The nursing home occupant, whose family members are either unable or unwilling to be caregivers, is already receiving Medicaid and is most likely already receiving Medicare A, B, D/social security/possibly private insurance and a pension. The nursing home occupant is not being cared for by family members, but by the nursing home. I find it immoral for a family to manipulate a Trust so as to provide a new car for the family of a person that no longer drives as nursing homes take patients to doctors appts. Or for vacations to family members to visit the family member. The State's taxpayers, some of whom are caregivers themselves receiving far less compensation for their loving and often sacrificial care of their family member, continues to provide all necessary caregiving services via the Medicaid system. What this article describes is legal yet it is an abuse of the system often by wealthier families