Question: After my mother was divorced and had lived alone for several years, she had surgery and began going downhill. Because she had no one else to turn to, my wife and I moved into her home to help take care of her -- which we did for more than two years. Several months after her surgery, mother was doing fine. Then she had a stroke, was hospitalized, and was eventually placed in
a nursing home.
While in the hospital, mother transferred her home to me because I had cared for her. When she applied for Medicaid, although the state found her qualified medically and financially, it imposed a 32 month penalty because she had transferred the house to me. I had been told by the social worker at the hospital that if I lived with my mother and took care of her for two years, she could transfer the house to me without a penalty. We went through an appeal and lost. We don't have the money to fight it any longer. Now we must mortgage or sell the home to pay for mother's care for 32 months – more than $100,000. Where did we go wrong?
Answer: You went wrong by accepting legal advice from a social worker at a hospital. If the home had remained titled in your mother's name, it would have remained an exempt asset and your mother would have qualified for Medicaid -- subject, of course, to what is called estate recovery -- that is, the right of your state of residence to go against the property at your mother's death in order to collect the amount of Medicaid benefits paid to her.
The two year provision the social worker told you about is contained in federal law and state regulations and allows an exemption from the penalty when a Medicaid applicant transfers a residence to a child who (i) lived with the applicant in the house and (ii) furnished care which was essential to help
the applicant avoid institutionalization for at least two years.
Although we don't know all of the facts of your situation, it appears that while you may have lived in the home for the requisite period of time, you probably did not prove that the care you provided was instrumental in helping your mother remain at home and avoid going to a nursing facility.
In these very complex situations, it is essential that no transfers be made without the assistance of a qualified elder law attorney -- not a social worker at a health care facility or, for that matter, anyone else.
Taking The NextStep: Our readers are still confused about how long-term nursing home care is paid for. Many assume that Medicare, the federal health insurance plan for the elderly, pays for long-term care. Except under very limited circumstances, this is incorrect. There are three basic ways in which long-term care can be funded: (i) Long-term care insurance; (ii) Private payment by the patient or his/her family; and (iii) Medicaid -- a means-based program for low income persons, regardless of age.
Funded in a joint arrangement between federal and state government, Medicaid is administered by state government. To qualify, individuals must meet both financial and medical criteria which vary from state to state. Of the more than 32 million Medicaid beneficiaries, more than 4 million are age 65 or older. The cost of long term care on a private pay basis ranges from $2,500 to $7,500 per month depending on your state of residence. Because of the tremendously complex planning issues involved, we suggest that you get more information from The National Academy of Elder Law Attorneys which can be reached at
