Joy Kirkpatrick has made her career traveling around Wisconsin putting on seminars and forums about how farm women can empower themselves and transition the farm one generation at a time. One such informational involving transitions was about Medicare and Medicaid. The reason for this, she was, was the high price of skilled nursing care in Wisconsin, which averages $6,000-$8,000 per month, and the average nursing home stay is two to three years.
Rural families often have their assets built into their land, so the question is what happens when someone needs to be placed in a nursing home. Medicaid is made to pay for that skilled nursing care, but they may lean on those business assets in the land. Kirkpatrick said 2014 was when the state government became more aggressive about looking for which assets they could grab. A tool she mentioned are putting assets into a trust. In cases of gifting, there is that five-year look back period so recipients are not charged the full price of those assets. Liquid assets can be used as a buffer to business assets for some time.
Medicaid Asset Protection Trusts hold on to the trusts that families deem most critical to protect. These often involve a lawyer and a very strategic plan. It might involve a part sale and part gift to move some of the assets often and have cash available for the care needed. Kirkpatrick warns against people nearing retirement expecting Social Security, Medicare, or Medicaid getting them there. Medicare in particular she described as having many intricate rules such as if you have been in a hospital, needing to have been in so many days, must have been admitted instead of under observation, and only after being admitted to a skilled nursing care unit does Medicare pay for it. Even after these requirements are met, it only pays for maybe 100 days. She advised people in their 40s to start shopping around for their long-term care now to find how much it will cost and start putting away money or considering self-insuring.
