OT: Nursing home payments

**bhutch65** · 03-26-2011, 12:09 PM

I have a neighbor who has recently had mini strokes that have diminished his capacity. He desperately needs to receive care greater than his wife can handle at home.

He was a successful surgeon and has many assets that are unprotected and they are concerned about losing them. They are putting off nursing care until these are better protected. Thinking they will have to use their assets first. The man was very nice and I would like what's best for him. He was the only family member who wasn't money conscious. The others all want their portion.

Is there a resource that I can use to find out more about their financial options. The time they are going to wait seems to be a long and they are not going to chance losing any assets.

Thanks

**CYKOFAN** · 03-26-2011, 12:21 PM

I think the family better talk to an estate lawyer that knows how medicare works in a situation like this. My wife's parents went into a nursing home several years ago and though they had several hundred thousand in assets, it doesn't take long to eat that up at $11,000/month. We're just glad medicare will be there when their money runs out so they can feed the nursing home monster and it won't eat up our assets too. I know there's a way to protect assets so medicare pays for the care, and a lot of people do it, but I think you have to get something done well before the care begins. They better see a lawyer that knows how it works.

**cloneswereall** · 03-26-2011, 12:39 PM

Originally Posted by CYKOFAN

I think the family better talk to an estate lawyer that knows how medicare works in a situation like this. My wife's parents went into a nursing home several years ago and though they had several hundred thousand in assets, it doesn't take long to eat that up at $11,000/month. We're just glad medicare will be there when their money runs out so they can feed the nursing home monster and it won't eat up our assets too. I know there's a way to protect assets so medicare pays for the care, and a lot of people do it, but I think you have to get something done well before the care begins. They better see a lawyer that knows how it works.

This. My family was paying around 5K a month for care for my grandpa until the fact that losing the farm came into play and we found ways we could remodel parts of the house so that he could use stairs and things at home.

**aauummm** · 03-26-2011, 12:47 PM

Originally Posted by bhutch65

I have a neighbor who has recently had mini strokes that have diminished his capacity. He desperately needs to receive care greater than his wife can handle at home.

He was a successful surgeon and has many assets that are unprotected and they are concerned about losing them. They are putting off nursing care until these are better protected. Thinking they will have to use their assets first. The man was very nice and I would like what's best for him. He was the only family member who wasn't money conscious. The others all want their portion.

Is there a resource that I can use to find out more about their financial options. The time they are going to wait seems to be a long and they are not going to chance losing any assets.

Thanks

Some home health care may be covered by Medicare:
Medicare.gov - Medicare Coverage Search Results

**jsb** · 03-26-2011, 12:50 PM

I assume you are talking about taking money out of their names and using Medicaid for the nursing home coverage?

Probably not going to work real great for him. If had wanted to get money out of his name, they probably would have had to start moving stuff a while ago because the gov't will look 3 years in their past.

They are going to have to dip into their savings/inestments to pay for this nursing home care.

**BoxsterCy** · 03-26-2011, 01:29 PM

Originally Posted by jsb

I assume you are talking about taking money out of their names and using Medicaid for the nursing home coverage?

Probably not going to work real great for him. If had wanted to get money out of his name, they probably would have had to start moving stuff a while ago because the gov't will look 3 years in their past.

They are going to have to dip into their savings/inestments to pay for this nursing home care.

This looks to be the right on answer.

**GoCubsGo** · 03-26-2011, 01:53 PM

Is there any reason that a former surgeon wouldn't pay for their own care? I'm sure he's a nice guy and all, but you want to help him hide assets from the government so the general population has to pay for this guy's care that he can otherwise afford?

**CYKOFAN** · 03-26-2011, 02:08 PM

Good point GoCubsGo. As a surgeon you'd think he'd have made many millions over his working career. Nursing home insurance is too expensive for many people but you'd think he could have afforded it, unless he had some medical history and couldn't get coverage. I'm sure he's a nice guy but there are a lot of people in far worse predicaments as nursing homes eat up their assets.

**Stormin** · 03-26-2011, 02:21 PM

Originally Posted by jsb

I assume you are talking about taking money out of their names and using Medicaid for the nursing home coverage?

Probably not going to work real great for him. If had wanted to get money out of his name, they probably would have had to start moving stuff a while ago because the gov't will look 3 years in their past.

They are going to have to dip into their savings/inestments to pay for this nursing home care.

I believe it is a 5 year look back now. FIRST thing you should do is to determine if he indeed needs to go into the nursing home. If it is inevitable the sooner you plan the better.

I would definitely talk to a lawyer that is experienced in such matters. The expense for this lawyer can come out of the spouse's half that is in the nursing home. You will need to do a division of assets. This is kind of complicated. There is a determination of assets that would go to the spouse not in the nursing home. Next comes the Spend Down phase. In Iowa the Home is exempt from the other spouse that is in the Nursing home. Nursing home spouse can use their assets to upgrade the home for the other spouse. Upgrade the car. Etc., etc., etc. FOLLOW the rules. You will be checked up on.

We went through this procedure with my In-laws. You will burn through a lot of money on the nursing home. But a lot of assets will be preserved for the benefit of the non-nursing home spouse. Best advice I can give is to get a good lawyer experienced in such matters. Since the fee is paid for out of the Nursing Home Spouse's half, it really isn't costing you money for that valuable advice. Good luck.

**bhutch65** · 03-26-2011, 04:10 PM

Originally Posted by GoCubsGo

Is there any reason that a former surgeon wouldn't pay for their own care? I'm sure he's a nice guy and all, but you want to help him hide assets from the government so the general population has to pay for this guy's care that he can otherwise afford?

I agree. I'm not defending their actions, only want to find a better way. They do have many dollars and an ongoing income with business related to continuing education for surgeons. The money grubbing has alot to do with their children. 2 of their lifestyles are supported by the parent's business.

I realize what should be done but was looking for a different way I had not thought about.

Thanks

**kilgore_trout** · 03-26-2011, 04:25 PM

Self reliance is a scarce commodity these days...

Originally Posted by GoCubsGo

Is there any reason that a former surgeon wouldn't pay for their own care? I'm sure he's a nice guy and all, but you want to help him hide assets from the government so the general population has to pay for this guy's care that he can otherwise afford?

**GoCubsGo** · 03-26-2011, 05:29 PM

Originally Posted by bhutch65

I agree. I'm not defending their actions, only want to find a better way. They do have many dollars and an ongoing income with business related to continuing education for surgeons. The money grubbing has alot to do with their children. 2 of their lifestyles are supported by the parent's business.

I realize what should be done but was looking for a different way I had not thought about.

Thanks

That is non-sensical. You "only want to find a better way". What does that mean? Aren't you talking about finding a way to make the government pay for his care?

**Stormin** · 03-27-2011, 09:34 AM

Originally Posted by GoCubsGo

That is non-sensical. You "only want to find a better way". What does that mean? Aren't you talking about finding a way to make the government pay for his care?

Not really. In terms of the couple, only 1/2 of the assets are to be used for each spouse's care. That is where the Division of Assets comes in. The Law is quite clear on what is and what isn't allowed. And the surviving spouse is not necessarily compelled to live in complete poverty and desolation because of the misfortune of their spouse needing long term nursing home care.

Rest assured that the couple in question will be spending a very large amount of the total assets for the long term care of the nursing home spouse. And any income that is attributable to that spouse will be used to pay for the spouse's care. That Includes SS and other income and retirement accounts until all are exhausted.

So, in reality, the individual may never go on the government. The children that are currently being subsidized will now be on their own. The 5 year look back ensures that any money given to them that is deemed excessive must be repaid to pay for the nursing home spouse if the individual needs government assistance within the next 5 years.

Checking into the care and rules concerning Nursing Home payments and assets has more to do with the welfare of the non-Nursing Home Spouse than anything else. I guess your solution is to leave the non-Nursing Home Spouse completely desolate and poverty stricken. What happens in those cases, is that the surviving spouse is then so broke that they then just go on the government as well because their income and assets is such that they have no alternative but to go on Title XIX and go to the Rest Home themselves even though they may not necessarily need to do so.

The costs of nursing home care are staggering. A small fortune doesn't last long at all.

**acgclone** · 03-27-2011, 09:47 AM

If he has money, there's no reason you and I should foot the bill for him. That is exactly what you're proposing.

I see no reason why someone that has accumulated a lot of wealth should find a loophole that allows him to go on welfare.

**acgclone** · 03-27-2011, 09:51 AM

Originally Posted by Stormin

The costs of nursing home care are staggering. A small fortune doesn't last long at all.

Why should the tax payer foot the bill for any part of this "small fortune" that it may cost for care, before all of their assets are exhausted?

This is exactly the reason why people try to accumulate wealth. So they have security. However, there is no reason that their kids are entitled to this money, while the surgeon is in a facility at the tax payer's expense.