Agreements that Medicaid reviews closely
When someone applies for Medicaid to pay for long-term care, transfers of money or property made during a look-back period can be reviewed, and a transfer for less than fair value can lead to a period of ineligibility. A personal care or caregiver agreement, in which a family member is paid to provide care, is one way families address this, and these agreements are examined closely. The questions usually focus on whether the arrangement was documented before the care began and whether the pay matched what the care was worth. Payments for care given in the past without a prior agreement are often treated as gifts. New York's rules for home care coverage have been amended and their effective dates moved, so the current look-back rules for community care need to be checked at the time of planning.
Admission papers and the guarantee question
Nursing home admission agreements are long and often signed in a hurry. Federal rules bar a Medicaid- or Medicare-certified facility from requiring a third party, such as an adult child, to personally guarantee payment as a condition of admission. The documents may still ask a relative to sign as a responsible party, and that language can carry duties to apply the resident's funds properly. Read what you sign and ask what each signature line means. Keep copies of the full agreement, financial statements, and any correspondence with the facility's business office.
Before anything is signed or moved
A useful first conversation looks at the person's health and likely care needs, current assets and income, and any transfers already made, along with existing powers of attorney and health care proxies. We discuss whether a caregiver arrangement, a trust, or other planning makes sense in your situation, and how the state's right to seek recovery from certain estates may affect it. If an application has been denied or a penalty assessed, there is usually a short deadline to request a fair hearing. Medicaid eligibility is decided by the agency, so our role is to help you prepare a plan and a file that can stand up to its review.
