May 2023

In This Issue

Understanding Medicaid’s Look-Back Penalties, Exemptions and Exceptions

Yahne's Personal and Professional Corner

Coping with Caregiver Burnout

Approximately 53 million Americans provide unpaid care to another adult, and providing adequate care to a loved one requires over 24 hours per week on average, according to the Caregiving in the U.S. 2020 Report by the National Alliance for Caregivers and AARP. However, caregivers often devote so much time and energy to caring for a loved one that they neglect to take adequate care of themselves. This has become so prevalent that “caregiver burnout” is now a common term. Caregiver burnout is characterized by physical, emotional, and mental exhaustion that may be accompanied by a change in attitude from positive and caring to negative and unconcerned. Many caregivers even feel guilty if they spend time on themselves rather than on caring for their elderly or ill loved one.

Understanding Medicaid’s Look-Back Penalties, Exemptions and Exceptions

For an elderly person to be eligible for nursing home care, assisted living, adult foster care, or in-home care from Medicaid, they must have limited income and low assets. To prevent applicants from simply giving away their resources to relatives or friends in order to qualify for Medicaid, there is a “look-back period.” This is a set period of time prior to the individual’s application during which the Medicaid administering agency reviews all the financial transactions that the applicant has made.

If someone violates the Medicaid look-back period, he or she will be penalized by becoming ineligible for Medicaid for a certain period of time. This period is known as the penalty period and is calculated by dividing the dollar value of the transferred assets by either the average monthly or daily private patient rate of nursing home care in the state where the person resides. This calculation uses a penalty divisor or private pay rate that increases annually in accordance with the rising cost of nursing home care. It is important to note that there is no maximum limit to the penalty period. What happens if you are subject to the look-back period? The answer can be rather complex.