Many people who are referred to elder law attorneys come to their first meeting and say something like, “the lady at the nursing home told me that Mom is qualified and she can handle the application but we need a QIT.” It may, or in many instances, may not be true that the applicant needs a QIT. But, the family should know that just applying for Medicaid doesn’t do anything to protect against loss of the estate to Medicaid estate recovery. This is because getting qualified is not even half of the job that Elder Law attorneys do for their clients. The larger part is the planning, repositioning and sheltering of assets so that the spouse, and family, does not loose everything upon the patients death. This important work, estate preservation, cannot be done by anyone except a licensed attorney at law.
Until recently, Nursing Home administrative staff were not allowed to help anyone get qualified for Medicaid other than to give them an application form and tell them they might need a QIT. They were allowed to give out information about attorneys who handle Elder Law cases and would usually give out 2 or 3 brochures. They did this because Medicaid eligibility is the surest way of them getting paid month after month. Some would give this advice early so the family would not incur complete loss of the estate, some would give it only after all of the cash was gone having paid the private pay rate for care until the account was empty and they became concerned about future payment.
Two years ago the Federal Regulations were changed slightly and they authorized nursing home personnel to assist an applicant with applying for Medicaid. All this means is that the Nursing Home can fill out a form, they still cannot give advice on how to preserve an estate. This was a clever move on the part of the government. Knowing that nursing homes want to get a patient qualified and permanently settled in the home as soon as possible, and knowing that families would not know any better, they created an environment where the uncounseled are led by under qualified into filing applications that effectively spend down an estate after the fact because nothing was done to prevent Medicaid Estate Recovery. The result of uncounseled Medicaid eligibility is usually the complete decimation of inheritance.