<p>Yes, the loan has to be paid back. It’s phrased “not dischargable on death” of, in this case, your mother. I had a link here earlier, with an example I think.</p>
<p>Here it is- and from a NY attorney <a href=“http://estateplanning-elderlaw.com/resources/medicaid-promissory-notes.php”>http://estateplanning-elderlaw.com/resources/medicaid-promissory-notes.php</a></p>
<p>Medicaid has many state-based rules, so an elder care attorney in Nevada might not be too useful, dharmawheel.</p>
<p>This is another from a NY lawyer <a href=“Medicaid and Promissory Notes: The Challenge Continues - Cona Elder Law”>http://www.genserlaw.com/content/medicaid-and-promissory-notes-challenge-continues</a></p>
<p>I’m kind of uncomfortable with the promissory note concept in general – it seems like a direct way to subvert the intent of the Medicaid rules, which is that you are supposed to exhaust your own resources before relying on the taxpayers to pay for your nursing home. This all seems like rewarding kids while meanwhile sticking it to the taxpayers. </p>
<p>I may just be grumpy.</p>
<p>First let me say, LasMa, thank you for commenting on my post and indicating that you enjoyed reading it. I find it cathartic to write here and deep down feel that in this story, some peculiar and remarkable things are happening that are worth sharing. But I have a lot of self-questioning about being on the page so much, so I hope I am not giving others pain!</p>
<p>But case in point, by pursuing this narrative and having HImom step in to ask questions about the Promissory Note and getting a second opinion, an awesome thing just happened.I did some internet research and called a law firm on Long Island that covered Promissory Notes extensively on its web page. I just got off the phone with one of the attorneys, a young woman. I told her my concerns and how I wished for a second opinion; and right there on the phone she outlined for me, in detail, how and when Promissory Notes come into the picture of Medicaid planning, how they are perfectly legal and do protect assets, and reassured me that my elder-care lawyer, whom she knew by reputation, would guide us properly when the time came. There are certain stages and circumstances that have to be met. The attorney gave me free advice over the phone! Here is the link, HI mom; as a lawyer yourself you might be interested:</p>
<p><a href=“Promissory Notes and Medicaid Planning - Cona Elder Law”>http://www.genserlaw.com/content/promissory-notes-and-medicaid-planning</a></p>
<p>LasMa, I just wouldn’t ask my mom to pay for a second opinion. That fee to the Poland Employment Agency of $2,100 was a hard hit, and the caregiver’s first payroll will be drawn from my mother’s checking acct electronically tomorrow. </p>
<p>The lawyer’s mistake in not seeing that the figure for salary was too low on my cost sheet during our first meeting caused a great waste of time, money, and caused me a lot of stress and aggravation (setting up payroll, workman’s comp, much more… But do you remember the story of the “mistake day”? When I shook hands with her and asked How are you? She said, I just came from my husband’s memorial service. They had been married almost 30 years, and he died on July 1.I told her I was so sorry. I was her first appt after the service. It was probably one of the worst days of her life. She should have taken the afternoon off. Yesterday I brought a sympathy card and left it with her secretary but she came to the desk and got it, opened it and read it, and gave me a hug.</p>
<p>LF, I’ll look carefully at the first link you posted. The second link you posted is the firm I just called. Evidenty this is a turbulent issue…luckily we are not there yet.</p>
<p>Editing: all are worth reading. Especially since it’s a complicated matter.
It’s good you are getting good feedback on your attorney. Seems she has yet to lay it all out in black and white. At that point, see the downs, as well as the ups.</p>
<p>I just read your first link. Very tricky stuff! Both links are from the same law firm, the one I just called. The attorney explained to me that there is a delicate ballet about the timing of when the Promissory Note is drawn up and the elder moves into a NH. Something Medicaid is certainly watching closely, and something else I will need to stay current with as things evolve and possibly change. </p>
<p>Arabrab, this does not fill me with glee; it makes me uncomfortable too. I’ve been hysterically trying to be “correct” from Day 1 when I discovered that a lot of “legitimate” care-giver agencies were farming out their caregivers as “independent contractors” which is totally WRONG–they are EMPLOYEES. And I delved deep, and tried to do everything correctly, and still missed the laws on minimum wage/overtime, etc. Curiously, the articles I downloaded with careful information about how elder care givers are employees did not discuss the rules of salary. I had to find that info separately, from web links people kindly provided me with here. If the caregivers-as-employees resources I printed out went right on to discuss minimum wage/overtime requirements, I wouldn’t have made the mistake. </p>
<p>Dharma - has something been going on behind your back?. You were told that the primary objective of the meeting with the lawyer - not your objective, but the lawyer’s - was to get the promissory note in place. Since there is no reason to do that unless the decision to move to AL/NH had already been made, what did she know that you didn’t?</p>
<p>All the websites say that part of the Promissory note scheme is that the person going into the AL/NH has to transfer all of her assets to others - half as gifts, half as a loan in return for the Promissory note. Is your mother willing to impoverish herself and trust you and your sister to care for her? Are you willing to take that on?</p>
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<p>I could not agree more with this. Medicaid is supposed to be for people who are actually poor. It is not supposed to be for people with considerable savings to give their kids/grandkids an early inheritance and pass their nursing home costs to the taxpayers. Every Medicaid dollar that goes to nursing homes is a dollar that doesn’t go to Medicaid’s primary advertised purpose of medical care for poor children and families.</p>
<p>In any case, you can move your mom to AL and sell the house without signing a promissory note. You can keep putting that off forever if you want, it just means your mom’s bills get paid from her own account.</p>
<p>oldmom - yes, we thought FIL had hit a low point Friday and was ready to accept help. He seems to have rebounded over the weekend. Sometimes I think the new anti-depressant is working too well. He seemed less defeated-sounding yesterday, but that doesn’t mean he’s any better able to take care of MIL. Just less down about it. </p>
<p>I would not transfer any assets to your sis at this point–she has shown by her actions that she wants no part of anything to do with your mom and your should plan to proceed alone. I would really be cautious about anything to subvert Medicaid, as I have heard of and know many who have had BIG penalties trying to avoid Medicaid law. One of my friends was an eldercare attorney and said he NEVER dabbles in Medicaid advice and has rarely seen anyone successfully impoverish themselves to qualify for Medicaid. Perhaps in HI it’s tougher than in NY, but I would proceed VERY cautiously and all legal bills should be your mom’s, since they are about HER legal issues and HER assets, NOT yours. Indirectly, it will lessen funds available for inheritance and care, but the bills are HERS.</p>
<p>Good luck in whatever you decide–hope things continue to improve and hope your mom does continue to agree to live in AL and have her home sold. Would move on those things immediately and think a bit more about the promissory note.</p>
<p>FROM LF:</p>
<p>Yes, the loan has to be paid back. It’s phrased “not dischargable on death” of, in this case, your mother. I had a link here earlier, with an example I think.</p>
<p>Here it is- and from a NY attorney <a href=“http://estateplanning-elderlaw.com/resources/medicaid-promissory-notes.php”>http://estateplanning-elderlaw.com/resources/medicaid-promissory-notes.php</a></p>
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<p>Actually I missed that one–it is 2014–I printed it out to read tomorrow, too tired now. </p>
<p>Momof JandL, I can understand your feelings. But the lawyer didn’t say the point of the reason was to “get” the promissory note, but to “discuss” it. She knew that as her clients, even if my mother stayed with an eldercaregiver, she would return to a NH sooner, or later, and that’s when the Promissory Note kicks in. I feel comfortable about the point of the meeting. But I truly share your feelings about Medicaid being meant for the poor.</p>
<p>Actually I wish this Promissory Note thing didn’t exist or I wish it would just go away or be defeated. We entirely spent down MILs assets and none of us is unwilling to do the same for my mother.</p>
<p>Just had a long phone interview with an intake coordinator at the AL and we have to wait till the 22nd for an interview. Depressed by the thought that my mother “won’t like it” and then having to take her on a tour of ALs.</p>
<p>Can’t your mom have a tour and dinner before the 22nd? I think the sooner after she had her meltdown at the attorneys the better. I’d also try to have at least a few that will accept your mom ready as backups, just in case and just show her three that will accept her. The one attorney recommended and perhaps two others, period. Good luck! </p>
<p>By the way, why isn’t the AL place that she LIKED one of the options for her? Do they have space and will they continue to accept her if she spends all her assets and ends up on Medicaid? If they are willing to accept her as full-pay and continuing on as Medicaid, I’d consider that the 1st choice and work to make that happen. The lawyer’s recommendation could be #2 and some other place could be #3.</p>
<p>I’d also definitely put any talk of promissory notes on the far back burner and deal with getting your mom into AL while she’s agreeable, since she has proven herself very changeable and difficult to work with.</p>
<p>^Think that was the expensive NH? </p>
<p>Darmawheel, whatever legal advice you get, your mother’s funds should pay for it. You are doing it for her, not for yourself.</p>
<p>Even the expensive NH would be OK if they will accept her once her assets run out–that is the big Q–which places will accept a person full-pay and allow them to stay via Medicaid once assets are exhausted?</p>
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<p>Yes, I agree with this. My family was given information on how we could set up some tricky, but legal, mechanism to shield Mom & Dad’s assets so that they would qualify for the VA Aid & Attendance benefit. This is supposed to be for retired veterans who can’t pay for their care. We decided not to do it for this exact reason. Legal, yes. Morally right, not in our opinion.</p>
<p>Yes, the other thing to consider is that these “tricky” maneuvers are known to backfire more than a few times. The person who “gifts” and gets promissory notes can have a very hard time getting someone (like sis) to actually deliver and pay up. Is mom going to pursue legal action against her? What would mom be living on when she has to sue sis to collect? What happens if sis decides to blow thru whatever she gets? Lawsuits can take a very long time and create huge rifts that never heal.</p>
<p>I’d really work hard on getting mom into an AL that will work for now with her assets and keep her once she has spent all her assets and will be on Medicaid. Moving only once will be MUCH easier and better for everyone involved. Forget about the RM entirely and once mom is settled, find a realtor, list the house and invest the proceeds in a safe investment for mom’s care.</p>
<p>That’s true too, HImom. The more complicated a thing is, the more ways it can go wrong. </p>
<p>Dharma, don’t get yourself entangled in a multi-pronged legal deal, especially one that involves other parties who may or may not keep up their end of the bargain. Keep it simple. HImom’s second paragraph is a clear, straightforward blueprint for you. </p>
<p>Too late in NY here for me to digest and respond with acute attention, but I will attend and respond tomorrow. Many useful posts for me to read and ponder. I will just say (to 3932, I think it is), the place my mother “liked” was a NH at $15,000 a month. The elder care lawyer soothed her down to consider AL at a place in a nearby town. and NOT at this point consider an expensive return to the NH.But to me, as a daughter, it is painful to feel that she feels she needs the level of comfort a nursing home affords. But every morning is “a new day” and some days are much better than others. Friday we go for shoes. The earliest we can visit he AL, unfortunately, is, if I remember correctly, is Fri the 22. The guy, Vincent, went over with me all A’s assets and will prepare for me a cost breakdown. I just want my mother in a safe AL, house sold, assets depleted–fine–I don’t care about a “Promissary Note” and wish I had never heard of it. That is not the kind of people we are. I will reread all posts carefully tomorrow, thank you and good night!</p>