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Back in April, my mom got sick unexpectedly and we had to move her into a nursing home with hospice care. We literally thought she had less than a month to live so we transferred her car to her oldest grandchild. Now 7 months later, she is still around and doesnt seem to be dying anytime soon and we are running out of her money so we will have to apply for Iowa Medicaid. I know they will have a lookback and see we transferred the title to him. I was told we can ad my mom back on as a co owner and be fine. Has anyone else had experience with this or any advice?

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Also this is basically how a transfer penalty is done:
- moms State has a day rate they pay the facilty for her custodial care costs for those on LTC Medicaid program. Each State runs their programs so what’s what in my State will be different than yours.
- the item gifted has a value. Autos tend to go with Kelly Blue book #. For primary residence/ homestead, tends to be its last tax assessor placed value.

Let’s say in 2021 mom had her home with last assessor value of 300K gifted to a Son. Title goes fully from the mom to her Son. 100% gifting. Mom then moves into an apt, which she can completely afford from her SSA income so her POA has not worried abt her moms $; and all fine till mom has a bad fall in July. Her POA, which is her daughter, gets called as mom has had EMS take her to the ED/ER; mom hospitalized for hip break surgery and then discharged to a NH/ SNF for rehab. So far all her costs are billable to Medicare and her supplemental health insurance. Mom stops progressing in her rehab in August and unable to return to her old lifestyle so this mom stays at this NH and goes from a rehabilitation patient to a custodial care resident. This mom has no $ to private pay so files for LTC Medicaid in Sept. LTC requires 3-5 yr look back on her finances and the caseworkers search dovetails into State real property database and in detail. The application process takes somewhere from 3-5 months and she is considered usually “Medicaid Pending” during this. But every day she is adding onto a bill, which is kinda suspended till the application is dealt with.
HOWEVER
that gifting of the 300K house surfaces today at month 3 and a transfer inquiry request is sent to mom and her POA. POA has btw 14-30 days to resolve the situation or mom ruled ineligible with a transfer penalty.
AND
This moms State pays NHs that participate in LTC program $235.00 day rate reimbursement for custodial care costs. $235 is used to determine the period of time of the penalty. Penalty period is based on # of days. 300K house gifted = 1,276 days penalty period. Or 3.5 yrs.

What makes this especially difficult is from the date of her application filing to the date of the ineligibility determination this mom has built up a NH bill that is now due and that POA has to deal with it in someway if that mom has to stay in this NH. If it’s a 10K a month private pay NH and the ineligibility comes down in 3 months, that’s 30K that NH will more than likely require to be paid for her to stay there and then a financial responsibility agreement is done for her to stay there as private pay till she is past the 1,276 days of ineligiblity. POAs stuck with all this. If Brother is unwilling to help, he does not have to.

Transfer penalty are serious. If this is real property gifting, the records are flat at the courthouse and dovetail to the State system. Just keystrokes for caseworker to find out.

Y’all just have a car that all this would be based on, so the $ amount won’t be crazy like a house would be. But really in advance go thru mom’s financial to be sure there isn’t something else gifting that’s lurking. She would be red flagged right now due to that car. You want to absolutely make sure there isn’t other $ moves. If there are other giftings, it will put her and you into application Hades. The NH can be real sticklers as to not having any sense of humor with a resident once they go beyond 90-100 days in their application and it’s due to gifting. They can and will find a way to get her out. And they will seek out whomever in the family to place that NH bill onto.

You can of course find an Elder law attorney to deal with this. If mom has $ to spend down, she can pay for it. But if not, it’s on you as POA to cover the atty costs. LTC Medicaid is pretty narrow for its requirements. Go thru her stuff, you don’t want to be caught out if you can help it.
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Reply to igloo572
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You should have not done this just because of Medicaid but because that car is part of her estate.
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Reply to JoAnn29
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This situation is the prime example of why an elder care attorney is essential for Long term care knowledge.

In my experience with NYS, if the grandchild titles back the car with an affidavit from an attorney explaining the error it will be accepted when doing the 60 month look back and your LO will not be penalized. Otherwise, it is a gift and considered a penalized non allowed expense that will delay when Medicaid goes into effect.

FWIW, in NYS the long term care resident is allow to keep 1 car title and deem it medically necessary transportation. Once Medicaid long term care goes into effect the POA can add their name as a co-title ower. BUT, this is under an eldercare attorney expertise. My past results may differ depending on your state and state laws. If you are POA, I strongly encourage you to seek one.

Edit to add: The expense of the eldercare attorney should be taken from you LO account and it is an allowed expense.
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Reply to AMZebbC
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I’d suggest that you look at this from a wider perspective, are there possibly other transfers or gifting from her to others?
If you are her POA, have you gone thru her banking to see what’s what back to 2019 for any other $ moves by her? If you haven’t or you are not the POA, I’d really really suggest that before you / POA do anything else, do this and do it throughly. BEFORE doing anything with the car. Why? Well the caseworker is going to see the recent car title move and the tendency is to assume, if this happened… well it’s likely it happened before.

Transfer inquiry tends to be into any checks or withdrawals over $500 that do not fit her pattern of spending.

fwiw switching back to a Co-ownership won’t “cure” title transfer gifting issue. If car was 100% in her name as per title, it was 100% gifting of the value if her name revoked totally and now only titled in the grandkids name. Value usually is Blue Book value. Co-ownership still has 50% gifting issues. It doesn’t solve the problem, it imo makes it more complicated. Probably the best path would be grandkid would sign it back to grannie for zero $ and then POA sells it for its full Fair Market Value with the $ 100% going to asset spend down. But this is really something for a Medicaid casework to definitively answer as LTC Medicaid has maximum value amounts placed on homes and cars for them to even be viewed as exempt to start with. The caseworker would need to clear the actions taken.

Realize, if the grandkid - I assume is not a minor - has zero interest in doing any of this, has no inclination to give car back, they do NOT have to do anything. It’s legally their car.

There might be a way around this, but it won’t be pretty. It would be that the grandkid coerced Grannie into this - took advantage of a vunerable adult - and Grannie & her POA are willing to work with APS on this and then will file a police report as to this and do the follow up in court for the charges against him. However Grandkid can get an attorney and force depositions from everyone in this bad drama. A good atty will make your mom look like an idiot.

Whomever POA in this cockup has the fiduciary responsibility to have handled their moms affairs better & now it’s on them to deal with this. Even if grandkid suggested all this, the POA is responsible to ensure proper oversight. & if it ends up grandkid won’t budge, and a transfer penalty placed, then its on the POA to find a way to private pay for her care in the NH till penalty period is over and she can be eligible for LTC Medicaid. Or takes her mom out of the NH into her home to caregive till past the lookback period. Not a lot of options as LTC Medicaid regulations are very narrow.
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