This is so wrong! Unfortunately it happens more than you would think. You expect an individual to be protected with a Power of Attorney, but oftentimes seniors lack a strong and loyal support system. They end up relying on a family member, neighbor or acquaintance that may not have their best interest in mind.
Let me talk a little bit about how this relates to Medicaid, VA and what we do here at Legacy…What happened in this case could affect eligibility for Nursing Facility Medicaid & the VA Pension with Aid & Attendance.
I’ll preface this by saying this is an extreme case. There are typically more subtle transfers rather than blatant stealing. Also, the Veterans Administration & Medicaid Policies view what is called “Transfers of Assets” (TOA) differently. They also differ in the amount of time they are allowed to look back for these transfers (Medicaid 60 months – VA 36 months). There are various transactions that could be considered TOA and would result in ineligibility. Most people are not familiar enough with VA or Medicaid Policy to understand everything that would be considered a transfer, so this can happen with a good support system in place as well. They inadvertently make financial decisions not realizing they’re jeopardizing eligibility. Someone is admitted to a Nursing Facility and an application for Medicaid and / or VA becomes necessary, but they are horrified when the application is denied. This can result in a large debt owed to the facility if the applications have been pending long.
As far as the article is concerned: For Medicaid & VA purposes, the funds taken from the account would be considered a TOA because they were withdrawn and NOT used for the applicant’s benefit.
VA: The VA will calculate a penalty period based on the amount transferred ONLY if the total amount of the transfers added to the applicant’s current assets would have made the applicant ineligible. The VA does have exceptions in place for misappropriation of funds or fraudulent activity committed against the veteran.
Medicaid: The state automatically issues a penalty of a period of ineligibility depending on the amount transferred. Medicaid reviews the bank statements in black & white policy. They would see the transfer and issue a penalty. They cannot simply allow it because they were told there was a good reason. They would need to document that reason was allowed by Medicaid Policy. It was not in this case.
Of note: In order to obtain eligibility for Nursing Facility Medicaid after the penalty has been issued, the applicant would need to file for hardship. This typically requires the applicant / representative to file a case with Adult Protective Services, write a letter stating that the disbursed funds were not authorized, file a police report and charges against the person, and make every attempt (even by legal means) to recoup the money before Medicaid would waive the penalty. The individual in the article was incapacitated, so the state intervened. The state would process everything on the applicant’s behalf and Medicaid would most likely waive the penalty.