Nursing Home Medicaid and Transferring Assets

As a state coordinator for California, I am proud that Support For Home In-Home Care is a member of the Elder Care Matters initiative. The ethics of its members and the advice offered there is pretty darned solid. That continues to be true in an answer to a question posted by an attorney, Kevin Pillion, Esq., to the question, “Can I transfer my assets to my children just before I go into a nursing home and still qualify for Nursing Home Medicaid?”

Kevin’s answer is pretty straightforward:

Probably not. Under the 60-month Lookback Rule, eligibility for Medicaid may be denied if the person going into the nursing home transferred assets for less than fair market value within 60 months before his application for Nursing Home Medicaid benefits.

And be very careful about giving away assets: once you have given away your assets, you cannot get them back by legal action. Don’t rely on your children to “do the right thing” and hold the assets for you in case you need them.

I am not an attorney, but the law on this point really is pretty clear. Additionally, I think Kevin’s second point is just as important. We are privileged to work with many great families, where the best interests of Mom or Dad are absolutely paramount. However, we have also worked with families in which there was abuse, financial and otherwise, in some cases requiring us to call in Adult Protective Services.

However, there is a third issue involved that, in my view, far too many strive to avoid. That is the ethical or moral or whatever adjective one wishes to use about is it “right” to look for ways to move assets around trying to save them for the family and force the taxpayer to foot the bill for long-term care. Personally, I have a real problem with that goal.

The safety net of government support is critical for folks who need it. If it is going to continue to be there, abusing it in order to provide a larger inheritance seems, to me at least, wrong.

What are your thoughts on this controversial topic?

Best wishes. Bert


One response to “Nursing Home Medicaid and Transferring Assets

  1. Kevin is simply wrong in his answer.

    In California there is a 30-month “look-back” period, not a 60-month. California also permits “stacked gifting,” which permits some gift-giving immediately prior to entering a nursing home. There is no penalty for transferring a residence to another, or to an irrevocable trust for the benefit of one’s children. There are many, many other exceptions that are based in public policy.

    Taxpayers with up to $11 million avoid estate and death taxes, plus there are many other ways for wealthy individuals to avoid paying income taxes, capital gains taxes, and estate taxes. Medicaid (Medi-Cal in California) was designed specifically for the middle class to avoid impoverishment of the healthy spouse, and depletion of average-size estates. Unless the legislature decides otherwise, it is the policy of the State of California to allow middle-class families to protect the assets of the elderly via planning giving and other estate planning techniques.


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