Okay, I am NOT trying to ignite a firestorm here, nor am I looking for a moral perspective (I have a priest already, thank you!).
But REALISTICALLY speaking, do you honestly think that Medicaid has the time, resources, woman power, or even ability, to look into what assets someone has?
Can they REALLY determine if you have a bank account? How do they know if you have stocks?
OBVIOUSLY they can tell from public records that you own a house. However, stockholders names are not made public are they? And I don't think that the bank is either, is it?
I have grave doubts that Medicaid can "find" everything there is to find. After talking with someone who had: a car (and didn't tell Medicaid about this) and a bank account (and didn't tell Medicaid about this) and went to school and got loans (and didn't tell Medicaid), this information was NEVER "caught" by Medicaid. Admittedly, this was about 2 years ago, but still fairly recent, don't you think? I also know someone else who is doing the same thing and hasn't been caught.
No, I am not suggesting Medicaid fraud, I am simply asking a question. Anyone here ever not told Medicaid about an asset they or someone else has, and then either been caught or no?
So the asset is available and you should think about a withdrawal schedule that meets your needs and avoids Medicaid. The biggest problem with Medicaid is that many states require you to give up your MD's and go to managed care.
To start with, each case worker is audited by supervisors who try to make sure that the applications are being carefully processed and properly approved.
If someone does fail to disclose the true extent of income and assets on a Medicaid application, and it gets past the case worker, the applicant can be assured that their State Medicaid agency will be swapping data with federal and state taxation agencies (IRS, state revenue departments) and other government departments. The bank and other financial institutions file annual reports on all of your accounts with the IRS and state revenue department. All this data is sifted and matched up with any public benefits payments you may be receiving.
It may take time for the data matching to detect a problem, but eventually the problem will be found.
In addition to the routine data matching programs within the state Mediciad agency, states have independent auditing departments which select and focus on certain Medicaid programs. The auditors learn to identify gaps in the application process, and follow up on applications that appear in the screens they set up to hold the Medicaid agency and the applicants accountable.
Data matching applies to all government benefits programs. If an applicant for a VA Aid & Attendance pension "forgets" to mention a bank account on an application, the account will eventually be matched to the applicant and the VA will impose an overpayment for all the money during all the months it had provided reimbursement for care.
It is unfortunate that the government must expend resources on the review and investigation of public benefits expenditures, but without these systems, more people would try to abuse the system, and there would be even less available for people who truly need the help.
We all have a duty to fully and honestly disclose the truth on applications for benefits.
Understand that once mom is on Medicaid & in a facility, she is REQUIRED to do a copay of all her monthly income less a small personal needs allowance ( ranges from $ 35 -105 a mo & varies by state). Mom will have no-none-nada of her $$ ever to pay on any costs on her home anymore. If you - for whatever reason - want to have mom continue to keep her home, then you will need to pay all costs on the home from day 1 of Medicaid and then through probate and deal with however your state does MERP ( estate recovery). In my viewpoint, keeping your folks empty house is like paying for all costs on a 2nd or 3rd home but without any guarantee of ownership; so it runs a risk. Most of us cannot afford a 2nd home or like risk; but if you do & have the purse or pocketbook to afford the house from now till past death whether its 6 mos or 6 years and then through probate, then go for it. If there is still a regular mortgage on the home (horror of horrors!!), this could be quite a lot of $$ each mo on moms house.
Big Brother is always watching..
One problem that comes up with trusts seems to be that folks hear they can do a trust and they think "it's in a trust so no worries!"! But the trust has to have its own reliable source of funding for the items in the trust over time. A trust is its own legal entity and has costs associated with that entity & needs an income steam to pay those costs. Like say you put grannies house in a trust...so how is all the costs on the house, like taxes, insurance, utilities, etc going to be paid? And paid year after year? If grannie ends up in a facility, she may not have extra $ anymore, so then what? to me & just my non-legal, non-financial professional opinion, is that a trust requires long term financial planning with resources to have the trust work.
So Sra, what are you trying to do??...is it that mom needs a NH and mom has assets & you are trying to find some magic way to hold onto her assets for yourself or for her? If its for her, mom can do a special needs trust for her $ allowed by Medicaid in most states but the beneficiary of the trust will be the state. An elder law atty can tell you what the SNT options are for your state. If its retaining liquid assets for you, that isnt gong to happen as the lookback will find the transferring of moms $.
If mom has a home, that might be able to be kept as an asset & be inherited as per valid will but this approach will require that you pay for all costs on property from now till mom dies and then go through the probate process and deal with MERP. This approach runs risk, and most people are risk adverse.
I want to emphasize that it's been quite a while since I've worked w/land contracts, and they weren't very commonly used in the transactional law firms for which I worked.
At the time of the balloon payment, your sister would normally execute a Deed C, which is a deed that conveys title but excludes any encumbrances for which the purchaser (your sister's stepson) may be responsible. For example, if he pledged his interest in the land contract and the property as collateral for a loan, the Deed C would exclude that from clear title, since your sister, the owner, wasn't responsible for it.
It's kind of a peculiar situation since your sister really does own the property but is selling it to someone who also has certain rights, but not full ownership.
I'm not at all knowledgeable about Medicaid, but I would say from a legal standpoint the house even though it's being sold on land contract would still be considered her house and an asset for Medicaid evaluation purposes.
I think though that the value of the house would be hard to determine, since (a) she has ownership but a portion of the sale price has been paid, and (b) it will change monthly with each land contract payment, a portion of which is applied to the principal paydown.
So the value of her investment would, I think be the market value less the amount paid by her step-son, proportionately. I.e., if his payments total 40% of the sale price under the land contract, Medicaid might consider that he held a 40% ownership and your sister held a 60% ownership. Again, that would change with each payment.
That's supposition though; I'm applying what I know about land contracts and real estate, but as I emphasize, I am not at all knowledgeable about Medicaid asset determination, especially in a land contract situation.
Here 's my thoughts:
because of the existing contract to purchase on the farm I'd bet that her application will get reviewed by a higher level Medicaid staffer than the initial caseworker....and she needs an elder law atty to "shepherd" her application. Her income sounds low enough that it's under the amount. But the farm could be an issue. I don't know about farms but for ranches, they can be an exempt asset even if they are huge (TX ranches are done by sections as you need a lot of land for grazings and could easily be a dz. sections which is over 7,000 acres) as long as its a working ranch. That it is a "working" ranch seems to be the key to being exempt. Farms & ranch income are common enough that there is a ? specifically on ranch income on the annual renewal for TX Medicaid.
If the contract wasn't done by a real estate attorney & so was a more casual agreement, it could have issues to start with. really to be on the safer side, I'd gather up all her & your legal (DPOA, MPOA, old wills, etc) and get all reviewed & updated by elder law atty and have them deal with her application & the paperwork that I'd bet the state is going to need above the usual paperwork.
Do you know if the contact was done as a SCIN (self canceling installment note) if she died before the balloon? These are often used for property sales between family. Medicaid, well, I'd bet they hate those.... But probably something needs to happen to be written to be an adjunct (just what I'm not sure) or whatever to the existing contract so that the stepson doesn't face a Medicaid claim or lein on the farm after your sister dies that could be an issue for him down the road.
I'm going to PM one of the members who has insight on contracts to see if she can come up with ideas as well.