Texas nursing home Medicaid is generally not one of the easiest things you will encounter. However, there are some common mistakes other people make that you can avoid which will make your case a little bit easier and a little bit faster. One common mistake I encounter is how a potential Medicaid applicant’s money and income is handled before, during, and after the Medicaid application.
When your parent applies for nursing home Medicaid you are going to have to produce documentation to the HHSC. You are also going to have to explain any withdrawals or transfers out of accounts with their name on it (especially cash withdrawals). In order to simplify things for the HHSC caseworker and help your parent’s Medicaid case I recommend people do not co-mingle funds and accounts with their parent. This means that the only withdrawals coming out of your parent’s account should be for their bills and the only transfers from their account should be to another account that is also theirs.
Once you begin to co-mingle funds with your parent and the HHSC sees withdrawals and transfers going to family members directly or to pay for expenses that belong to other family members you are opening up an entire can of worms that I recommend avoiding whenever possible. The reason being once a handful of questionable transactions are discovered in the account history then the HHSC begins to dig a little deeper and look a little closer to make sure they are not missing the chance to impose a Medicaid penalty.
One huge fact that a lot of people forget about when they co-mingle funds is the HHSC has a legal presumption on their side that all transfers from a Medicaid applicant’s account for less than fair value create a penalty; the burden of proof is on you to prove the transfer is not a penalty and you better have the evidence to overcome that presumption. If you do not, the HHSC can impose a penalty and leave your parent with nobody to pay the nursing home bills that are piling up leading to a possible eviction.