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Old 01-22-2016, 11:26 AM
 
1,196 posts, read 667,148 times
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I think people are beginning to realize that depending on Medicaid for SNF payment is risky indeed, particularly for initial placement. Those Medicaid beds have often been filled by patients already there who have paid with their own resources for several years. Plus it will only get worse with the leading edge of boomers entering their senior years.

We found when our mother was ready to transfer from the hospital into a rehab facility, which also had other levels of care, we were handed a multiple page financial application. They are afraid of getting "stuck" with a person who will go on Medicaid, to put it bluntly. Luckily we had our choice of top facilities with her assets, income, and LTC insurance. She was 95 and they were still looking for at least 3 years of private pay.

We have great concern about an older family member who signed over her home, basically her only asset, to her daughter who convinced her she could "simply" go on Medicaid in the future. She is now very vulnerable as the 5 year time frame has passed.

One other caution - hospitals give you a very short time now to get your patient moved to another facility. Our neighbor was informed that her husband had been moved on their authority (to a less than ideal facility) when she did not make arrangements within 48 hours herself. She was frantically trying to find somewhere but hospitals are concerned about their bottom line. He was placed 45 minutes away, which was difficult for her to drive.
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Old 01-22-2016, 11:43 AM
 
6,894 posts, read 7,300,512 times
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^^ This is why the correct kind of planning is so vital.
It's called asset PROTECTION, not spending. That way they are still available to benefit the elder IF they're needed. But have been transferred in case they can be protected.

If you transfer 3 years of private pay money out of the person's name, and just keep it. The money IS still there for the person's needs. If a person has five years of private pay assets, and you only keep two in their name, and the facility wants three years -- fine give back the third year's worth. But if you can get into a ability with just two year's worth of money, then the rest is protected. And worst case scenario if you don't' make it past the 5 year looked back -- OK at least you tried.

As long as the money IS STILL AVAILABLE somewhere…... you have options.
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Old 01-22-2016, 12:29 PM
 
1,196 posts, read 667,148 times
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Quote:
Originally Posted by selhars View Post
^^ This is why the correct kind of planning is so vital.
It's called asset PROTECTION, not spending. That way they are still available to benefit the elder IF they're needed. But have been transferred in case they can be protected.

If you transfer 3 years of private pay money out of the person's name, and just keep it. The money IS still there for the person's needs. If a person has five years of private pay assets, and you only keep two in their name, and the facility wants three years -- fine give back the third year's worth. But if you can get into a ability with just two year's worth of money, then the rest is protected. And worst case scenario if you don't' make it past the 5 year looked back -- OK at least you tried.

As long as the money IS STILL AVAILABLE somewhere…... you have options.
This would be a possible alternative if you have a completely trustworthy person to transfer money to. My parents had gifted money to my sibling and me over a number of years so I know it is an option.

But even then, what if that person is in an accident and is sued? What if they get divorced and the spouse claims a portion of the money? What if they lose their job and need the money for their family? These were all points their lawyer brought up. Their lawyer made sure they knew that once the assets are out of your name, you lose control.

In the case I know of, the daughter who got title of the home has no intention of using it for her mother. She fully expects Medicaid will totally pick up the tab. She wanted the home for her own retirement planning.
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Old 01-22-2016, 02:06 PM
 
Location: Ponte Vedra Beach FL
14,628 posts, read 17,950,422 times
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Quote:
Originally Posted by shamrock4 View Post
This would be a possible alternative if you have a completely trustworthy person to transfer money to. My parents had gifted money to my sibling and me over a number of years so I know it is an option.

But even then, what if that person is in an accident and is sued? What if they get divorced and the spouse claims a portion of the money? What if they lose their job and need the money for their family? These were all points their lawyer brought up. Their lawyer made sure they knew that once the assets are out of your name, you lose control.

In the case I know of, the daughter who got title of the home has no intention of using it for her mother. She fully expects Medicaid will totally pick up the tab. She wanted the home for her own retirement planning.
All extremely important points. And what if a child dies before you do? And possibly remarries?

Also - it can even be hard for parents to know what their kids might do. Now or especially 15-20 years down the road.

The most important thing to remember is if you give money away - YOU DON'T OWN IT ANYMORE. And have no control over it. Robyn
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Old 01-22-2016, 02:24 PM
 
Location: Columbia SC
9,004 posts, read 7,770,007 times
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Quote:
Originally Posted by Robyn55 View Post
All extremely important points. And what if a child dies before you do? And possibly remarries?

Also - it can even be hard for parents to know what their kids might do. Now or especially 15-20 years down the road.

The most important thing to remember is if you give money away - YOU DON'T OWN IT ANYMORE. And have no control over it. Robyn
My wife died recently and I have been "changing stuff" around such as my will, beneficiaries, etc. As much as my son will get the lion's share and as much as I do trust him, I must be in the ground first before anyone cashes in. As Robyn said, who knows what can change.
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Old 01-22-2016, 02:37 PM
 
Location: Ponte Vedra Beach FL
14,628 posts, read 17,950,422 times
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Quote:
Originally Posted by shamrock4 View Post
I think people are beginning to realize that depending on Medicaid for SNF payment is risky indeed, particularly for initial placement. Those Medicaid beds have often been filled by patients already there who have paid with their own resources for several years. Plus it will only get worse with the leading edge of boomers entering their senior years.

We found when our mother was ready to transfer from the hospital into a rehab facility, which also had other levels of care, we were handed a multiple page financial application. They are afraid of getting "stuck" with a person who will go on Medicaid, to put it bluntly. Luckily we had our choice of top facilities with her assets, income, and LTC insurance. She was 95 and they were still looking for at least 3 years of private pay.

We have great concern about an older family member who signed over her home, basically her only asset, to her daughter who convinced her she could "simply" go on Medicaid in the future. She is now very vulnerable as the 5 year time frame has passed.

One other caution - hospitals give you a very short time now to get your patient moved to another facility. Our neighbor was informed that her husband had been moved on their authority (to a less than ideal facility) when she did not make arrangements within 48 hours herself. She was frantically trying to find somewhere but hospitals are concerned about their bottom line. He was placed 45 minutes away, which was difficult for her to drive.
We experienced much of what you did. Like the multiple page financial application. We avoided filling that out by showing the SNF a list of my FIL's income and assets - and then signing a written guarantee that if he ran out of money - we would pay the bills.

You're right about the 48 hour notice thing as well. We didn't know anything about SNFs when my late FIL suddenly needed one after a stroke - and spent 3 frantic days finding a place after we found out we'd be getting a "48 hour notice" in a day or two. We were given a short extension on the 48 hours because - although we found a bed in a good place - we had to arrange an ambulance transfer between North Carolina and Florida (which we did ASAP - but it couldn't be done over a weekend). The hospital person we dealt with was so great about helping with the discharge/transfer that I sent her a nice floral arrangement as a "thank you" .

Unless one has a living spouse - I pretty much detest the concept of "Medicaid planning". If you have money - not only should you pay your own way because it's the right thing to do IMO - but you should want to pay your own way because not being able to pay your own way limits your choices. When one does have a living spouse - I can understand the desire and possible need to plan for that surviving spouse. Although I don't have a clue how this would best be accomplished given that various people are in various financial situations and states with different rules/laws. Some ideas possibly worth exploring off the top of my head would be paying off any mortgage debt on a house (houses seem to be exempt assets) - buying (deferred) annuities for the benefit of spouses - maybe LTC and/or life insurance (about which I know nothing) - or even perhaps titling assets in the name of one spouse or the other. I do suggest consulting with an experienced lawyer in one's state to explore the possible options - and taking it from there. Robyn
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Old 01-22-2016, 03:01 PM
 
Location: Ponte Vedra Beach FL
14,628 posts, read 17,950,422 times
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Quote:
Originally Posted by johngolf View Post
My wife died recently and I have been "changing stuff" around such as my will, beneficiaries, etc. As much as my son will get the lion's share and as much as I do trust him, I must be in the ground first before anyone cashes in. As Robyn said, who knows what can change.
Remember to change all those IRA/401k/etc. beneficiary forms so they conform with the wishes expressed in your will. Especially if you have a bunch of accounts here/there/everywhere. It's something a lot of people forget to do. If you have some small accounts here and there - perhaps now is a good time to consolidate them into larger ones.

Note that if your late wife had any form of retirement accounts - get to your accountant like yesterday. To find out the best ways to deal with them (I have given my husband strict instructions to talk with our accountant as soon as I am cold and my body is disposed of should I predecease him - there's a lot of complicated MEGO stuff when it comes to spousal retirement accounts).

I am as trustworthy as any daughter/DIL could be - and I have managed my father's and my late FIL's money pretty much non-stop since 2002 under completely unfettered POAs (I am trustworthy because I have a lot more money than either of our fathers had and my conservative investing style is suitable for old people). But I would never and have never advised either to give away any large amounts of money* to anyone - for any reason - including "Medicaid planning". Our fathers were both children of the "Great Depression" - and to the extent that they were frugal and saved some money and/or had some good fortune in their financial lives in a variety of ways - why should they spend their money on anything except improving the quality of their old age in whatever ways they would like or need? Robyn

*OTOH - I have never objected to them gifting relatively smaller amounts of money - say a total of less than $10k/year or so - to family members who need money (siblings - grandchildren - etc.).
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Old 01-22-2016, 03:21 PM
 
Location: Ponte Vedra Beach FL
14,628 posts, read 17,950,422 times
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Quote:
Originally Posted by ansible90 View Post
No. My point is that when you are young and just starting out, you would be unlikely to be able to save any substantial amount for retirement. As I said before, most retirement savings didn't come early in my life - couldn't do it then.

You said a 25 year old should put away $5000 a year to benefit from 40 years of compounding. I'm saying that is probably unrealistic for most.

Luckily, even with most of my savings coming later in life/career, 20+ years of compounding worked out pretty well too.
OK - well let's start saving at age 30 for 35 or more years . My husband and I actually started making very good money in our late 20's - but perhaps we were unusual. And the lowest we ever made after we got married in 1973 - in our mid-20's - was a bit over $20k/year.

I think several kinds of taxes can be a real drag in terms of net income/savings. Income taxes (both state and federal) - maybe property taxes too. I don't worry about saving today as much I did when I was 35 - but taxes are always a consideration. So is the COL in various areas. Lifestyle considerations as well. I am almost always cold these days when the temp is < 60 - so I think south California and south Florida would have the best weather for me. OTOH - I don't care for things like the COL or especially the traffic/crowding in either part of the country these days. When we left south Florida - it was because - although we had everything there - it was miserable driving to most places. Can't say south California is any worse - but it's not much better. There's no perfect place IMO. Robyn
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Old 01-22-2016, 07:01 PM
 
Location: Cushing OK
14,547 posts, read 17,569,443 times
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My dad ended up in a nursing home after we moved him back to California. But Dad was dying of cancer, multiple tumors, and had lost his mind. He didn't remember mom was dead, or know who I was. He made up his own memories which were real to him. Eventually he didn't really see me when I came to visit, lost inside his head.

I can't see how the family could have cared for him. And it wasn't dad, not anymore. I still hated that he was there.

Then there was my grandmother. She had a stroke, and eventually got where she could leave the hospital. She was in a nursing home, and hated it completly. She had her mind, if not her body. We'd moved and were not as close to the rest of the family, but my aunt took a bedroom and made it hers, and she came home with them. She had a nurse visit and occasionally had to have tests, but she was happy. She had family around her when she died, very suddenly, from another stroke.

My grandmother would not have wished to go on trapped in a facility. For Dad it was the only option, but then Dad wouldn't have known any difference. Grandma did and would have and if my aunt couldn't take her we would have.

My worse nightmare would be to stuck in such a place. I've spent time in the hospital and asked when I could go home from the second day on, and then when I figured out they were dragging, said I was going to check myself out. I bought my house, small and functional, so should it be needed, there's another room. So long as I could fight, I'd be insisting I go home.
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Old 01-23-2016, 09:22 AM
 
29,815 posts, read 34,900,894 times
Reputation: 11735
Quote:
Originally Posted by shamrock4 View Post
This would be a possible alternative if you have a completely trustworthy person to transfer money to. My parents had gifted money to my sibling and me over a number of years so I know it is an option.

But even then, what if that person is in an accident and is sued? What if they get divorced and the spouse claims a portion of the money? What if they lose their job and need the money for their family? These were all points their lawyer brought up. Their lawyer made sure they knew that once the assets are out of your name, you lose control.

In the case I know of, the daughter who got title of the home has no intention of using it for her mother. She fully expects Medicaid will totally pick up the tab. She wanted the home for her own retirement planning.
Bada Bing!
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