Setting up a life estate in CHILD'S property?

[spencgr]

Originally Posted by 399083453

The nursing home didn't make those mistakes or decisions, individual people did. And they dont work at other nursing homes.
Some places have very good staff and some do not.

Not saying there aren't some great low-cost/ Medicaid only nursing facilities. While I haven't found one, they may be out there. But if you don't think that, as a whole, there is a HUGE difference in quality and care from the low cost places to the high cost places, you haven' t been down this path before.


And while most (if not all) places, even the best ones, are required to reserve beds for Medicaid patients, as mentioned above, these beds are almost exclusively taken by people who have paid cash for a few years.


I am EXTREMELY lucky that my grandparents had the foresight an ability to save for their future. Both needed advanced care for years and they had the means to get into a good place. At the same time, a good friend was dealing with finding a good place for her mother, who needed a Medicaid bed. Only one place within a 40 mile radius had a bed (and we live in a major metropolitan area) available for her. We compared stories on facilities, care, attention, attitudes of staff..everything. They could not have been more opposite.


Do some research...call around to facilities. See which ones have beds available for Medicaid and see which ones are open to paying patients. You'll see.....

[ocnjgirl]

Originally Posted by MismatchedSocks

How is it defrauding Medicaid? People use life estates for exactly this purpose- to transfer the home asset to their children upon death, thereby protecting the asset. I'm just asking if the same thing can be done if she buys one of the apartments in our multi-family home?

You really need to ask a lawyer this. Buying the space from you is going to raise some red flags. Make sure she pays what would be fair market value and not any more than that. If she pays more than what the price on the open market would bring, the excess could be classified as a gift (just like she can't sell you her house for $1.00). In brief reading on life estates though, it seems the 5 year look back still applies, so if she buys it and needs a facility within 5 years of when she buys it, she will still lose it.


We hired a lawyer to navigate the Medicaid process for my mom, and we found them through a local assisted living facility that had a "seminar" on Medicaid and estate planning in the evening put on by a local law firm that specializes in it. Many area facilities hold events like this on a regular basis, and you can ask the attorneys all the questions you want to for free. And get food as a bonus, lol. It's in sort of an open house format, with a short talk, all in all about an hour or two. Go to the websites of local places and they may have these events listed, or sign up for their mailing list.


I agree with the person who said your mom will have VERY limited options if you try to find a place that takes straight Medicaid right off the bat. My mom's assisted living let her stay once she was on Medicaid but she had to pay privately for 18 months first. The nursing homes I work in (they span the scale from "this place should be closed down TODAY" to "This place is fab, I want to live here!") also prefer private pay ability prior to Medicaid kicking in, and the ones who don't are usually in very poor areas of town.


That said, there is a work-around, where many nicer places will allow a rehab patient to transition to long term care even if they don't have money. We get a lot of people who spend 2 or 3 months getting rehab but in the end still can't go home, and they will usually try to let that person stay in the long term unit. They already made a mint from Medicare from that person, though. But that is hard to plan, as mom would need a 3 day hospital stay first and then need prolonged rehab. And certainly no guarantees they will let her stay, there would need to be a Medicaid bed available at the time.


Some people think they can make any bed a Medicaid bed and don't understand how they can "run out" if there are empty rooms, but each bed in a home has to be certified by the state to be a Medicare bed or a Medicaid bed. We have to turn away high-profit Medicare subacute rehab patients when we run out of certified Skilled Medicare beds, even if half the building is empty. State laws only require a small percentage of beds be certified for Medicaid, and some facilities may only have 5 out of 200 beds certified as Medicaid, so they don't last and most already have long term care residents waiting for one to be available, so they can be quite hard to come by.

My mom doesn't have a cent left, however she is in a really nice place that now costs over $9,000 a month (was about $4500 during the time she was paying privately) and all we have to pay is her SS and small $400 pension minus $40 that she gets to keep.


Even with her ability to private pay for about 2 years, we had only a few choices and hired a Geriatric care manager to find them for us. If she was already out of money at the time we were looking, we wouldn't have had any choices at all. She'd have had to go to a nursing home, and we would have had to take whatever one had an empty Medicaid bed they were willing to give us (most earmark them for rehab to long term care patients or use them immediately for private pay residents who are out of money) It is rare for a nice facility to just have an empty Medicaid bed sitting there waiting for a phone call from someone who needs one. If the only Medicaid bed available were 150 miles from us in a ghetto, that's where she'd be.