What questions do I ask the Estate lawyer ?

Q: I moved in with my mom about 2 years back. We got my name on the home, so this is all done. My mom is in her late 80’s and I have two brothers on SSI. I know about the 5 year look back period. One of my brothers still wants our mom to help support him, I have explained to her I do not have an issue with this- however, I told her if she needed care from Medicaid, then what funds she give him, the money has to come from some place so I would have to pay it. I am not willing to support my brother. So, what do I need to do to prepare for the lawyer- just state what I have said here? (South Fayette Twp., PA)

A: Consult with an attorney versed in Medicaid regulations. It sounds like you are aware of the impact of Medicaid in that money paid to the brother could be considered gifts or transfers without consideration during the Medicaid look back period of 5 years and render your mother ineligible for Medicaid benefits to the extent of the value of the unauthorized transfers. An attorney may be able to utilize a caretaker contract between you and she to shelter some of her money and advise you on how you can utilize your move-in caretaker status to possibly shelter your mother’s home from Medicaid Estate Recovery.

Can we pay ourselves for caring for our 90-year mother?

Q: Mom still lives at home. We have someone come in throughout the day but my three siblings and myself stay with her overnight and do 24 hour shifts on weekends. We’ve been caring for her for 3 years and have never paid ourselves because we didn’t know if we can do that. Also, if we are allowed, can we pay ourselves back? In the event she needs to go into a home and runs out of money and goes on Medicaid, will they come back on us to recoup the money that we paid to ourselves for her care? (Pittsburgh, PA)

A: Yes, as it stands now, if you have no written caretaker contract in place and you pay yourself as you go along, or try to pay yourself retroactively, this could potentially make your mother ineligible for Medicaid if she applies within the next five years. Medicaid would look at these payments as transfers for no consideration or fair value unless they are made pursuant to a written caretaker agreement signed by your mother if she is competent or by her Agent under a valid Power of Attorney.

Will paying family members for nursing care trigger a Medicaid transfer penalty?

Q: Grandmother was paying $14k/month to private homecare agency so I (grandson) moved in to take over her care before she ran out of savings. She has paid me $2,400/month for the same care, and I have reported the money on my taxes as income. She now needs to go to a nursing home, but will only be able to pay out of pocket for a few months. Over the 18 months I’ve cared for her, she has paid me a total of about $40k. I know that if she had just been giving me her money, we would not be eligible for Medicaid due to the transfer penalty. Is the transfer penalty still a risk given that she was paying me for a service that would have otherwise cost her much more? (Pittsburgh, PA)

A: Very possibly. Be careful. Caretaker payments to family members without proper documentation and receipts can raise red flags with Medicaid and yes can in fact be viewed as a transfer without consideration within five years of Medicaid eligibility. The fact that you reported the income on your tax return is important. You would be safer if you have a caretaker contract signed by grandmother in place that is the type of document approved by Medicaid. You should consult with an elder law or estate attorney before you do anything .

Do I need a Contract for Personal Service with my Elderly Parents?

Q: I am in the process of moving from my home in Pittsburgh of 28 yrs. to be closer to my Elderly Parents with Health Issues in Steubenville, Ohio. I have quit my job to be able to go back and forth every few weeks and sort and pack freely and my Parents are helping me by paying my bills, etc. temporarily. I am not caring for them, only getting closer in case I should need to. One Person says a caretaker contract is needed because of possible Medicare in the future, another says it shouldn’t be necessary until a certain dollar amount as a gift is surpassed. Can someone clarify please?

A: You really should consult with an Ohio elder law attorney. If your parents may need Medicaid assistance to pay for home care or nursing care in the future and an application to Medicaid may be foreseeable, you do need advice on how to draft a caretaker contract in compliance with Medicaid regulations. This way, the money paid to you as a caretaker, will not be subject to the Medicaid 5 year look back. An attorney may also advise you on other ways to shelter your parent’s assets while maintaining Medicaid eligibility.

Can a POA be a paid caregiver?

Q: If a daughter has a power attorney over her parents and has been told that the parents need a caregiver to live at home by a government official and the parents want the daughter to be the paid caregiver instead of a stranger, can the daughter pay herself from their money?   Can she pay a little less than what the agencies charge for 8-16 hours a day? If that is what the parents requested in writing? She also handles all their finances, groceries transportation everything it takes to live because they can’t do any of I on their own. Mother has Alzheimer’s disease and father had a stroke and is paralyzed on one side. Neither drives a car, cook nor can bath themselves, and they smoke cigarettes. (Blawnox, PA)

A: You should really consult with an elder law attorney who is versed in Medicaid law. He or she can review the paperwork and all the details. Generally, if the POA document allows the agent to be a paid caretaker, then such care is authorized. However, I am unsure of who the “government official” is and what specific directives this government person has given. If they feel you personally are qualified to provide this care, and do not need specialized nursing, I assume it is OK. I would highly recommend that you have your care authorized by a written caretaker contract which specifies the scope of your duties, hours and wages. This should be drafted with the help of an elder law attorney in the event your mother eventually becomes eligible for Medicaid so you can be paid and reimbursed by Medicaid.

Can someone with Alzheimer’s Disease sign a quit claim deed?

Q: I am a caregiver for an Alzheimer’s patient. I haven’t been paid for a year due to family of the patient mishandling of her finances. No one wants to care for her anymore now that all her funds are gone. I would like to know how can I protect myself so I don’t get cheated in the end, and someone be compensated for the job am doing. The only asset she has is her house and I would like to know if she can sign a deed or at least put my name on the title so I can have some say and not get kick to the curb after all my hard work

A: Having Alzheimer’s Disease doesn’t necessarily mean she is incompetent to sign a deed. However, if she is not competent she cannot sign a deed over to you. I am mystified as to how you are taking care of her and expecting payment without a written contract from her or her family. It is quite possible that at the end of her life, the family does not pay you. After she passes, if there is an estate opened, you can file a claim against the estate. If there is no estate opened, you can open one and file a claim against the estate or sue the family. In either case, you are swimming upstream without a written contract. You really need to get an agreement signed or you run the risk of not being reimbursed. If the family wants to pay you or wants to give you the house, it can be arranged legally. You should see a lawyer.