Preparing a Medicaid application to qualify a loved-one for benefits to pay for nursing home care is a difficult and often long, drawn-out process. Detailed information regarding assets, income and expenses must be gathered and documented, including transfers for less than fair market value made by applicant or spouse within the 60-month “look-back” period immediately preceding the filing of the application. Nursing homes typically help their residents with this. But that assistance does not include protecting assets for spouse and family. Facilities help with the paperwork after applicants have spent themselves broke. An elder law attorney experienced in Medicaid planning will first implement an asset protection plan and then follow up with assuming the burden of preparing, documenting and filing an application.

Submitting an application without an attorney’s help is not a good idea. Any unexplained expense may be treated as a disqualifying transfer of assets, and many planning steps — such as trusts, transfers to family members, and family care agreements — are viewed as suspect unless properly explained. Moreover, the process generally takes several months or more as Medicaid keeps asking questions and demanding further documentation for the answers provided. Failure to timely qualify for Medicaid often results in an unpaid nursing home bill because the applicant is broke. In Pennsylvania, adult children are legally responsible for those unpaid nursing home bills and can be sued and held liable even if they received none of the assets nor even participated in the application process. But the children are not liable for the cost of their parents’ care if Medicaid is granted from the point at which the applicant’s assets are exhausted.

Hiring an elder law attorney to qualify for Medicaid can be quite expensive. However, given the high cost of nursing homes, if the law firm’s assistance can accelerate eligibility by even one month, that will generally cover the fee. In addition, the payment to the attorney comes out of funds the applicant would otherwise pay to the nursing home since that part of the money not protected for family will have to be spent in any event, whether for nursing home or for legal fees.

Contact Vasiliadis Pappas Associates for help if you have a loved one in a nursing home. It’s not too late as long as not all of the nursing home resident’s money has been spent down.