Nursing Home Crisis and Medicaid

For families with a loved one facing a sudden move into a nursing home or who have already entered a nursing home due to an illness or injury, the process can be overwhelming. With the cost of a nursing home exceeding $100,000.00 per year, Medical Assistance, Pennsylvania’s Medicaid, is a viable tool for ensuring your loved one’s cost of care is covered regardless of his or her financial resources.

Elderly Hospital

Medicaid only covers the cost for care in a skilled nursing facility, a nursing home. Medicaid does not cover the cost for care in an assisted living facility, personal care home, or at home. Wartime Veterans, or the spouse of a wartime Veteran, living in an assisted living facility, personal care home, or at home may qualify for financial benefits to cover his or her costs.

The Medicaid eligibility rules set limits for the total resources that an individual or couple may retain. This leads well intentioned medical and financial professionals to recommend “spending down excess resources” to qualify, often leaving a spouse and family with a fraction of the assets. However, this approach to qualification overlooks an opportunity to protect a substantial portion of the resources for the spouse living in the community and family, while becoming eligible earlier. By following the current Medicaid law, we can create a plan to reallocate the “excess” resources that would otherwise be spent on the nursing home care.

The Medicaid rules on gifts, such as paying for college tuition, a down payment on house for a family member, selling the house for $1.00, and charitable donations, over $500 in any one month in the preceding 5 years of applying for Medicaid will cause a penalty period to be assessed. During the penalty period, Medicaid does not pay for the nursing home care, leaving the applicant or the applicant’s loved ones to pay the $10,000 or more per month bill! We factor the prior gifts into the qualification process with the goal of protecting the most assets from nursing home costs.

The experienced attorneys at Mooney & Associates can help you navigate you through the complex relationships between the IRS, Medicaid, and Veterans Administration rules to protect assets for yourself and for your loved ones!