When your loved one enters a nursing home and needs Medicaid to help pay for care, you’ll likely receive recommendations about who should handle the Medicaid application process. Board-certified elder law attorney Kellen Bryant explains how to determine whether you should work with the nursing home’s recommended person or seek your own professional assistance.
The answer depends on your specific financial situation and the complexity of legal issues involved in achieving Medicaid qualification.
When the Nursing Home Can Handle Everything
Simple Financial Situations
If your loved one has minimal assets and no outstanding legal issues that would prevent Medicaid qualification, the nursing home will often handle the entire application process for free. This makes sense for the facility because:
- They want to ensure they get paid for their services
- Simple applications require basic document gathering rather than complex legal work
- Their staff is experienced with routine Medicaid applications
In these straightforward cases, the nursing home may also refer you to someone they will pay to assist with the application, again ensuring they receive payment for care services.
When You Have Freedom of Choice
Complex Financial or Legal Situations
When your loved one has more substantial assets or faces legal hurdles to Medicaid qualification, you have complete freedom of choice in selecting professional assistance. In these situations, you should consider:
- Looking for an elder law attorney experienced in long-term care and Medicaid planning
- Evaluating professionals based on their specific expertise rather than nursing home relationships
- Considering the complexity of legal instruments or strategies needed for qualification
Understanding the Legal Landscape
Recent Florida Legal Decision
A recent Florida decision regarding unauthorized practice of law has clarified important boundaries in Medicaid-related work:
What Requires an Attorney:
- Creating legal instruments needed for Medicaid qualification
- Providing legal advice related to qualification strategies
- Any legal work required to achieve qualification
What May Not Require an Attorney:
- Actual preparation of the Medicaid application forms
- Gathering required documentation and materials
- Interfacing with the Department of Children and Families
This legal clarification helps families understand when they need attorney-level expertise versus administrative assistance.
Key Questions to Ask Yourself
To determine whether to work with the nursing home’s recommendation or seek independent assistance, analyze your specific needs:
Financial Complexity Assessment
- Does your loved one have significant assets beyond basic allowances?
- Are there multiple types of assets (real estate, investments, life insurance)?
- Has there been any gifting or asset transfers in recent years?
- Are there spousal considerations if your loved one is married?
Legal Issue Evaluation
- Do you need legal instruments like trusts or asset restructuring?
- Are there title issues with property or other assets?
- Do you need legal advice about qualification strategies?
- Are there family disputes about asset handling?
Making the Right Choice
When to Accept Nursing Home Assistance
The nursing home’s help may be appropriate when:
- Assets are minimal and within Medicaid limits
- No complex legal work is required
- The application is straightforward document gathering
- You’re comfortable with their level of expertise
When to Seek Independent Professional Help
Consider hiring your own elder law attorney when:
- Assets exceed Medicaid limits and require planning strategies
- Legal instruments or restructuring is needed
- You want comprehensive legal advice about options
- The nursing home’s recommended person lacks necessary legal credentials
- You’re uncomfortable with potential conflicts of interest
Understanding Potential Conflicts
Remember that nursing home staff and their recommended professionals primarily want to ensure the facility gets paid. While this often aligns with your interests, there may be situations where:
- More creative legal strategies could better protect family assets
- Alternative approaches might better serve long-term family goals
- Independent legal advice reveals options not discussed by facility staff
The Bottom Line
Your choice should depend on the complexity of your situation and your comfort level with the expertise available. For simple cases, nursing home assistance can be efficient and cost-effective. For complex situations involving significant assets or legal planning needs, independent elder law attorney guidance ensures you receive comprehensive advice tailored to your family’s specific goals.
The most important factor is ensuring whoever handles your Medicaid application has the appropriate expertise for your particular situation and any legal hurdles you may face in achieving qualification.
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Author Bio
Kellen Bryant, Esq.
Founder
Florida Bar Board Certified Elder Law Attorney, Kellen Bryant focuses his law practice on advising and helping caregivers with a particular focus on asset protection and preservation from long-term care costs, creditors, and predators. Kellen Bryant is AV Preeminent® Rated, meaning his attorney peers rated him at the highest level of professional excellence. Kellen Bryant was nominated and selected as a Super Lawyer, Rising Star: 2022.
