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Abstract

In this Note, the Author uses In re Guardianship of Domey (2008) to highlight the problems associated with Medicaid eligibility, costs of long-term care, and any duty of a guardian to their ward relating to Medicaid eligibility and the protection of assets for distribution to others. The Author argues that imposing a duty on guardians to propose Medicaid spend-downs is necessary to achieve adequate protection for the ward facing an indefinite term of long-term care. The Note provides background on Medicaid, nursing home care costs, and methods of financing nursing home care through both private-pay and government benefits. Additionally, the background on the current Medicaid transfer laws, Medicaid planning strategies, and an overview of Medicaid planning initiated by guardians are discussed. An appendix provides a sampling of each state’s guardian statutes and cases discussing guardian-initiated estate planning and Medicaid spend-downs.

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