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By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington. Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services. APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid. We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour. APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment. You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints. Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights. APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.I agree that: A.I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information"). B.APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink. C.APFM may send all communications to me electronically via e-mail or by access to an APFM web site. D.If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records. E.This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year. F.You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
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Medicaid will want records documenting what her money was spent on so that they can tell that it was not gifted, starting with statements from all of her accounts for the five years. I've heard of no standard amount that gets to avoid scrutiny.
Monthly $1,250 checks on the first of each month with a memo that says room and board will be more plausible than a single check for $15,000, and they will likely look closely at caregiving costs. What you'd really like to be able to show is a caregiving contract specifying hours and duties consistent with her doctor's description of her ADL or cognitive needs, along with payroll tax records.
Document what you can. Reconstruct records using her doctor appointment records, and your own credit card and banking records if necessary.
Medicaid does not expect the elder to live on air. Medicaids evaluation on their application for LTC Medicaid will reflect the cost of living for the elders state or their city. It needs to make sense based on where they were financially 5 years ago and over 5 years time to now find themselves impoverished and at the $ 2,000 maximum for non exempt assets (for most States).
How the 5 year look back is done depends on your States LTC Medicaid program management. What seems to be happening now is 12 full months of bank & all other financial statements based on date of application then every 6 months back 5 years. Medicaid is also going to want details on any property (land, home, car) owned and sold in past 5 years. Details on any life insurance and any funeral / burial policies. Plus current “awards letter”, like the document from SSA sent out in Nov that states to the penny what they will be paid for the incoming year.
Most NH will have a list of items needed for LTC Medicaid applications. For a lot of states it is the NH that takes the elders documentation and adds their own room&board bill and submits all to the caseworker assigned to their facility or zip code. Often a NH will themselves evaluate the documents to determine IF they will accept the elder as a “Medicaid Pending” admission or will require them to be private pay. If you are new to this, please please ask the places you are looking will do Medicaid Pending as many do not.
But back to look back $: Let’s say avg cost of living in your state $1,500.00 a mo. So if a widowed & now medically needing skilled nursing care mom back in 2017 ended her year with 20K in savings and did not have a home, is paid $1200 a mo SSA as her only income & pays you $ 1K a mo as her rent or share of cost to be a member of your household; for that mom makes sense to now be @ 2K & “impoverished”. BUT if a mom ended her year in 2017 with 20K then sold her home in 2018 for $320K and gets $1200 a mo SS and pays you 1K a mo as share of costs and now finds herself at 2K and impoverished, that does NOT at all make sense. This mom should have at least 200K as house sale $$$.
Caseworker has 5 years of records to take data from and use in an equation to quickly determine if #s seem amiss. Caseworker can in a few keystrokes search State database by your moms name and SS#. If something should seem amiss, then in my experience they review the last year to see if a pattern of spending that makes sense to now be impoverished. Like mom has extraordinary medication costs, lives in a higher rent apt, have in home caregivers they are private paying for, $$$ paid for dental care. If $ still doesn’t make sense, then the application is flagged for deeper review. Go through her financials before applying to see if there flat are things that look hinky and do what you can to get documentation as to why they are an ok spend down.
My mom had a car within the look back & wrote checks to mechanic not in the existing Business name but in his name. I found receipts so it matched up and not an issue.
If you flat know your mom did gifting, personally if it was me, I would not try to DIY her application but have mom hire & pay for from her $ a elder law attorney to shepherd her Medicaid application. Good luck.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
Monthly $1,250 checks on the first of each month with a memo that says room and board will be more plausible than a single check for $15,000, and they will likely look closely at caregiving costs. What you'd really like to be able to show is a caregiving contract specifying hours and duties consistent with her doctor's description of her ADL or cognitive needs, along with payroll tax records.
Document what you can. Reconstruct records using her doctor appointment records, and your own credit card and banking records if necessary.
How the 5 year look back is done depends on your States LTC Medicaid program management. What seems to be happening now is 12 full months of bank & all other financial statements based on date of application then every 6 months back 5 years. Medicaid is also going to want details on any property (land, home, car) owned and sold in past 5 years. Details on any life insurance and any funeral / burial policies. Plus current “awards letter”, like the document from SSA sent out in Nov that states to the penny what they will be paid for the incoming year.
Most NH will have a list of items needed for LTC Medicaid applications. For a lot of states it is the NH that takes the elders documentation and adds their own room&board bill and submits all to the caseworker assigned to their facility or zip code. Often a NH will themselves evaluate the documents to determine IF they will accept the elder as a “Medicaid Pending” admission or will require them to be private pay. If you are new to this, please please ask the places you are looking will do Medicaid Pending as many do not.
But back to look back $:
Let’s say avg cost of living in your state $1,500.00 a mo.
So if a widowed & now medically needing skilled nursing care mom back in 2017 ended her year with 20K in savings and did not have a home, is paid $1200 a mo SSA as her only income & pays you $ 1K a mo as her rent or share of cost to be a member of your household; for that mom makes sense to now be @ 2K & “impoverished”.
BUT
if a mom ended her year in 2017 with 20K then sold her home in 2018 for $320K and gets $1200 a mo SS and pays you 1K a mo as share of costs and now finds herself at 2K and impoverished, that does NOT at all make sense. This mom should have at least 200K as house sale $$$.
Caseworker has 5 years of records to take data from and use in an equation to quickly determine if #s seem amiss. Caseworker can in a few keystrokes search State database by your moms name and SS#. If something should seem amiss, then in my experience they review the last year to see if a pattern of spending that makes sense to now be impoverished. Like mom has extraordinary medication costs, lives in a higher rent apt, have in home caregivers they are private paying for, $$$ paid for dental care. If $ still doesn’t make sense, then the application is flagged for deeper review. Go through her financials before applying to see if there flat are things that look hinky and do what you can to get documentation as to why they are an ok spend down.
My mom had a car within the look back & wrote checks to mechanic not in the existing Business name but in his name. I found receipts so it matched up and not an issue.
If you flat know your mom did gifting, personally if it was me, I would not try to DIY her application but have mom hire & pay for from her $ a elder law attorney to shepherd her Medicaid application. Good luck.