How do I properly modify the purpose section of a caregiver agreement to reflect updated care responsibilities?

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Liz

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For the Purpose section, you can strengthen and clarify the language by avoiding wording that suggests the arrangement is tied to remaining in a private residence. Instead of stating that the agreement exists “to continue to live at home,” you could say:

“This Caregiver Agreement is intended to provide supplemental, non-medical support services to promote the Care Recipient’s comfort, wellbeing, dignity, and quality of life while residing in a long-term care facility.”

This framing makes clear that the services are supportive in nature and consistent with facility residency, which is important for Medicaid review purposes.

Regarding the Medicaid lookback, documentation is critical. Federal Medicaid law requires states to review asset transfers made within the five-year lookback period under 42 U.S.C. § 1396p(c). Payments made during that period must be for fair market value services; otherwise, they may be treated as uncompensated transfers, potentially triggering a penalty period.

To protect against that risk, you should:

Keep a signed written caregiver agreement in place before services are performed.
Maintain detailed invoices showing dates, hours worked, and specific services provided.
Keep receipts and bank records documenting payments.
Ensure compensation is consistent with fair market rates for similar non-medical caregiving services in your area.

States evaluate whether payments were legitimate compensation or disguised gifts. Thorough records demonstrating that all funds were spent for reasonable, market-value services that directly benefited your mother significantly reduce the risk of Medicaid imposing a transfer penalty during eligibility review.

If you’d like, I can also help you review the compensation structure to ensure it aligns with fair-market standards or suggest language that better protects against lookback scrutiny.

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Modify caregiver agreement.

Lexi, Chatbot

I understand that modifying a caregiver agreement can be a sensitive issue. What specific changes are you looking to make to the agreement?

Purpose section.

Lexi, Chatbot

Are there any particular concerns or issues you've encountered with the current caregiver agreement?

Yes.

Liz

Hi there! My name is Liz and I’ve been an attorney for more than a decade, and I am here to assist with your legal concerns. So I can best help, what concerns do you have with your caregiver agreement?

Under the Purpose section III, it states “to continue to live at home.” My mother is in a Skilled Nursing Facility and will be placed in Long Term Care as she has nowhere else to go where care can be provided.

Liz

With the agreement, what care would the caregiver provide?

I would provide taking care of her financial affairs, bringing her personal items, food, errands, taking her out for walks in a wheelchair, emotional support, clothing, laundry, etc.

Liz

Rather than a caregiver agreement, have you considered power of attorney?

I already have that, but I’ve been advised that in order for her to apply for Medicaid, she can only have limited funds. By securing this agreement, I could move her funds to an account to pay for incidentals, bills, and reimburse myself for monies I’ve paid out of my own account.

Liz

With those funds, will you establish a trust? For Medicaid, they can look at transfers done within the previous 5 years to determine whether assets have been hidden. You can create the agreement and modify the purpose to reflect that it is to provide care beyond the day-to-day care provided at the facility.

There is limited money — approximately $15,000. I need to move her items out of her apartment, purchase a cremation contract, hire a moving company to move items into storage, etc. I think a trust is necessary. Just trying to cover expenses I will have without losing her funds to Medicaid.

Liz

A trust is not necessary.

Understood. Prepaying for storage could also be done. Purchases made for fair market value on necessary items are usually excluded from the lookback.

Back to my original question on the agreement I purchased — I would like to change the wording in Section III (Purpose) from “continue to live at home and prevent Care Recipient from moving to a residential or nursing care facility” to something relative to my current situation.

Liz

Understood. How can I assist? The forms are templates, so you can make changes.

I want to know what wording to use instead of the above that I could type into the agreement.

Also, in the lookback, if I have receipts for funds withdrawn from her account, is that sufficient?

Liz

“This Caregiver Agreement is intended to provide supplemental, non-medical support services to promote the Care Recipient’s comfort, wellbeing, dignity, and quality of life while residing in a long-term care facility.”

This framing makes clear that the services are supportive in nature and consistent with facility residency, which is important for Medicaid review purposes.

To protect against that risk, you should:

Keep a signed written caregiver agreement in place before services are performed.
Maintain detailed invoices showing dates, hours worked, and specific services provided.
Keep receipts and bank records documenting payments.
Ensure compensation is consistent with fair market rates for similar non-medical caregiving services in your area.

If you’d like, I can also help you review the compensation structure to ensure it aligns with fair-market standards or suggest language that better protects against lookback scrutiny.

Liz

Also, in the lookback, if I have receipts for funds withdrawn from her account, is that sufficient?

Liz

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