Robert C. Gerhard III’s Answers

Generally speaking, the Medicaid recipient's income (dad's income) would be due to the nursing facility less certain deductions. The cost of his health insurance is deducted from what of his income is owed to the facility. I.e., he can keep his supplemental health insurance in place, if desired. There are other potential deductions from income, notably a potential spousal allowance of income if your mother's monthly income is below her "monthly maintenance needs allowance." Absent...

Under Pennsylvania law, the duly appointed personal representative of your mother's estate has a legal obligation to request a statement of claim from the Department of Public Welfare's Estate Recovery Program. Before you become personal representative of your mother's estate, you or the person to take on that role should first consider what is going to be involved, and make some assessment as to whether the estate is solvent. The estate recovery claimi may not be as large as you believe, or...

It is true that a transfer of assets within the look-back could (will likely) give rise to a period of ineligibility for Medical Assistance (Medicaid) long-term care benefits. In my experience returning the money and funding a reasonable irrevocable burial reserve with a bank or funeral director has always worked. There are exceptions to the transfer penalties, although I do not know if any apply to your factual situation. It is true that you should only proceed with guidance from an elder...

There would be no recovery for Medicare benefits. If you are inquiring about repayment of Medicaid long-term care benefits through your state's "estate recovery program", then you should know that Federal law provides that estate recovery is not required during the lifetime of a surviving spouse. See, 42 U.S.C. §1936p(b)(2). Depending on your state's estate recovery law and regulations (which can not be more restrictive than federal law) there may be "postponement of recovery" and a need to...

The receipt of a lump sum is not counted as a resource in the month of receipt, but is counted thereafter. I believe you can get to the bottom of this by meeting with a local elder law attorney for a consultation. It should not be too expensive for a consultation, and you will be in a better position after the meeting to determine whether you should fight this or cut your losses. The elder law attorney might be able to make phone calls during the meeting to 1) the DPW caseworker, and 2) to...

It is difficult to answer this question without knowing more facts about the bill, so a first step would be to ask the nursing home to provide an itemized bill for what they are calling the "private portion." You have a right to that. I suspect "the private portion" is alleged unpaid income of your late father-in-law. When Medical Assistance (Medicaid) long-term care benefits are authorized, the approval notice (Form PA-162) sent by the Department of Public Welfare County Assistance Office...

I've pasted a link below where you can look into replacing lost savings bonds. To answer your question, he clearly needs to disclose known assets. If not disclosed and Medicaid benefits are authorized then "overpaymet of benefits" will occur whether or not you participated in the non-disclosure. In Pennsylvania the Office of Inspector General will investigate and pursue overpayments, even in the future, and even after your father's passing. Your state probably has a similar office charged...

Monies paid to a home attendant can be deductible in certain circumstances. I've included a link to I.R.S. Publication 502, that discusses deductiblity of attendants for maintenance and care of the chronically ill as medical expenses. I think an issue is that for this to be deductible for mom then the attendants must have been providing help pursuant to a plan of care prescribed by a licensed health provider. Check out Publicaton 502. Of course mom has compliance issues of her own given...

In general, a recipient of Medical Assistance long-term care benfits has an ongoing duty to report changes to the state Medicaid agency. In Pennsylvania the sale of the real property would need to be promptly disclosed to the Department of Public Welfare's County Assistance Office. In some states you may have the obligation to notify the agency that a given property has been listed for sale. (Hopefully the receipt of the inheritance was already promptly reported. If not then you'll want to...