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A Long Term Care Mess (Part 3)

My posts the past two weeks have been about Mary’s problem caring for her stepmom, June after her dad died. Last week I told you that we needed to file a guardianship action. 2 doctors needed to examine June and sign affidavits stating that in their medical opinion she was incompetent. A court appointed attorney then was assigned to represent June. Our guardianship application also included an assertion on June’s behalf to her right to the elective share. We also had to provide notice and copies of all court papers to Mary’s sisters.

Because guardianship hearings can take 60 days or longer to schedule in some counties we needed to request temporary guardianship in order to allow Mary to move June to another facility. Since she had no assets of her own, I had to make the facility comfortable that while we could not pay them yet, once the elective share was determined we would immediately make payments.

That by itself, however, was not enough to assure the nursing facility. They also asked us when we could expect to qualify for Medicaid and if there would be any Medicaid penalties resulting from any transfers for less than fair value. That required Mary to quickly gather together 5 years of records for us to review and determine the likelihood of a penalty. Because the accounts were all in her dad’s name, Mary could obtain the necessary statements as the executor of his estate without waiting for guardianship.

At the same time, we needed to zero in on the amount of the elective share to determine when we would likely spend down to less than $2000. This was important because we needed to be certain of a seamless transition from private pay to Medicaid. Any gaps would leave Mary with a nursing home bill and no money pay for it. This was a little tricky because certain expenses are deducted from the estate before calculating the elective share – some expenses that we didn’t yet know. We also needed to be sure not to give June more than her elective share amount at the expense of what Mary and her 2 sisters were entitled to from Dad’s estate.

Suffice to say, there were a lot of moving parts but we accomplished it all. I was able to document very carefully for Medicaid the elective share amount which they at first disputed. It was a mess that we worked through but it’s also a cautionary tale for families who have not planned for the possibility of care and don’t have any documents in place for aging loved ones.