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I. How We Work in Washington. Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services. APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
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V. Complaints. Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
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My Mother has died now Medicaid wants her entire estate. Of the 20 years on Medicaid she was only in convelescent care for 3 months when she broke her foot.
Why should you have to? Because that was the legal agreement Mother was involved in. I'm not sure how much you were aware of the conditions of receiving Medicaid, but state recovery from the estate is part of the deal. For most people, the house is the only asset that is left in the estate, and that must be sold and the state is entitled to be reimbursed for their costs.
This is instead of insisting that people sell the house before they can be considered eligible. They can keep the house and one car, but only until they die. It is not available for them to pass on to others.
As to why this should be true, well, I don't think it should be. I don't think that medical help for the elderly should be considered "welfare." But that is a social and political decision. As it stands, that is the way it is. Your mother received "welfare" for 20 years even though she owned a house. Now it is pay back time.
Fair? Suitable? The way it should be? Lots could be argued either way. But that is the way things are now.
Tom - I'm assuming that you have gotten a NOI (notice of intent) from either state or the states outside contractor that since mom was on Medicaid the state wants to be repaid for all services Medicaid paid for her. The letter will not be warm & fuzzy but more "we're sorry for your loss and heres what is owed". The correspondence will be addressed to you or whomever was on file as mom's contact person for Medicaid. There should be a $ amount and perhaps a multipage questionnaire & a specific date (30 - 90 out) as to when it must be returned. It is a form letter that was generated once mom's death was recorded by state and then her Medicaid tally dovetails to produce the letter, questionnaire, etc. It will be followed up with other letters and a multitude of phone calls very much from the playbook of what a debt collection agency will do. If your state uses an outside contractor (HMS & PCG are the 2 big ones), they will very much press the recovery; keep in mind that they get a % of the recovery $ plus fees and that whatever they tell you is from that vantage point….comprende? So is this the situation??
If so, what you are & will be dealing with is MERP - Medicaid Estate Recovery (or Recoup) Program (or Policy). Just how it will run & your ability / likelihood to have the house go as per the terms of your mom's will is very much interdependent on your states property & probate laws & administrative code AND your ability to be very detail document driven. AND imho - to open probate & be a determined & organized executor. About the interdependence on states laws, for example some states place the $ amount as a lien on the property from day 1 of Medicaid while other states it is an after death claim against the estate. Some states probate are Level of Claim by Class for priority while others are all claims are equal.
Some states Administrative Code allows for a deduction for: - all normal expenses of the vacant property (taxes, insurance, repairs, yard upkeep). If MERP does not allow for this or has issues with the expenses, you can submit all as a debt or claim against the estate in probate. - all caregiving paid for by family which kept their elder at home and off Medicaid. The "at home" can be at the actual home but also for paying for IL or AL. Again you need documentation (in detail) provided to MERP. - all sorts of other exclusions and exemptions exist….like caregiver, disabled heir, low income heir, family biz at the property, etc. You have to go through code & MERP/Medicaid website for info, It's not simple.
What is your probability of success??….well to me its going to depend on all sorts of factors: tax assessor value & actual value of house, documented & valid expenses you or family paid on the vacant property & mom's care, valid will & who the heirs are, exemptions, & your tenacity & wallet. It can be done, but not simple.
But before this gets too deep, I'd first suggest you look carefully into when mom went onto medicaid & IF all the services she got on Medicaid flowed from her eligibility determined from her original application 20 years ago. VERY IMPORTANT!
Here's why: Medicaid has had some sort of recovery ability since the 1990's Omnibus Bills passed BUT how states did this varied. Most applications did NOT have an "acknowledgement of participation" statement that informs the applicant that by applying for Medicaid you allow for MERP to be done. Recovery rates were low across the US with many states at zero as legally no way to enforce as no binding statement in the applications. Then in 2005 Bush signed in DRA (deficit reduction act) which required uniformity for Medicaid including recovery. Each state then signed DRA into their administrative code. It is only for applications for eligibility for programs done after DRA that now can be totally clearly subject to recovery as now there is an "acknowledgement of participation (for recovery)" within the application. You need to find out just what the dates were for any & all Medicaid applications done on your late mom. It could well be that all Medicaid services done before she enter a convalescent home were done on her old 1990's eligibility and only the last 3 months of Medicaid were on a new application for LTC Medicaid. If so, recovery can be only for those 3 months. If this sounds like a good possibility, post the details as some on this site will have specific ideas of how to deal with it.
Tom, first my heartfelt sympathy to you and your family.
One usually forgets that Medicaid is paid by the taxpayers and Federal funds to help those who cannot afford medical care such as doctor appointments, medical tests, rehab care, nursing home care, etc. Thus, the State needs to take from the Estate what they can for reimbursement. Otherwise the States would go bankrupt and/or our taxes would go sky high to help fund Medicaid. I am glad that we have Medicaid as it makes my own aging not so frightful as time passes and if I should need to apply for this service.
In Ohio, a lien is placed on the home from day 1 of Medicaid acceptance,as mentioned, On death, the Attorney General must be notified.
Ironically, to see how important in Ohio,it is to recover Medicaid costs, the state will probably be paying out a lot of money of 3 men who are accused of a crime are found innocent. They were in prison 20 years. If this happens, they could get wrongful imprisonment compensation that could be a lot. Ohio could be paying out a lot of money to these men, and would depend on Medicaid recourse to refill their coffers.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
This is instead of insisting that people sell the house before they can be considered eligible. They can keep the house and one car, but only until they die. It is not available for them to pass on to others.
Fair? Suitable? The way it should be? Lots could be argued either way. But that is the way things are now.
If so, what you are & will be dealing with is MERP - Medicaid Estate Recovery (or Recoup) Program (or Policy). Just how it will run & your ability / likelihood to have the house go as per the terms of your mom's will is very much interdependent on your states property & probate laws & administrative code AND your ability to be very detail document driven. AND imho - to open probate & be a determined & organized executor. About the interdependence on states laws, for example some states place the $ amount as a lien on the property from day 1 of Medicaid while other states it is an after death claim against the estate. Some states probate are Level of Claim by Class for priority while others are all claims are equal.
Some states Administrative Code allows for a deduction for:
- all normal expenses of the vacant property (taxes, insurance, repairs, yard upkeep). If MERP does not allow for this or has issues with the expenses, you can submit all as a debt or claim against the estate in probate.
- all caregiving paid for by family which kept their elder at home and off Medicaid. The "at home" can be at the actual home but also for paying for IL or AL. Again you need documentation (in detail) provided to MERP.
- all sorts of other exclusions and exemptions exist….like caregiver, disabled heir, low income heir, family biz at the property, etc.
You have to go through code & MERP/Medicaid website for info, It's not simple.
What is your probability of success??….well to me its going to depend on all sorts of factors: tax assessor value & actual value of house, documented & valid expenses you or family paid on the vacant property & mom's care, valid will & who the heirs are, exemptions, & your tenacity & wallet. It can be done, but not simple.
But before this gets too deep, I'd first suggest you look carefully into when mom went onto medicaid & IF all the services she got on Medicaid flowed from her eligibility determined from her original application 20 years ago. VERY IMPORTANT!
Here's why: Medicaid has had some sort of recovery ability since the 1990's Omnibus Bills passed BUT how states did this varied. Most applications did NOT have an "acknowledgement of participation" statement that informs the applicant that by applying for Medicaid you allow for MERP to be done. Recovery rates were low across the US with many states at zero as legally no way to enforce as no binding statement in the applications. Then in 2005 Bush signed in DRA (deficit reduction act) which required uniformity for Medicaid including recovery. Each state then signed DRA into their administrative code. It is only for applications for eligibility for programs done after DRA that now can be totally clearly subject to recovery as now there is an "acknowledgement of participation (for recovery)" within the application. You need to find out just what the dates were for any & all Medicaid applications done on your late mom. It could well be that all Medicaid services done before she enter a convalescent home were done on her old 1990's eligibility and only the last 3 months of Medicaid were on a new application for LTC Medicaid. If so, recovery can be only for those 3 months. If this sounds like a good possibility, post the details as some on this site will have specific ideas of how to deal with it.
One usually forgets that Medicaid is paid by the taxpayers and Federal funds to help those who cannot afford medical care such as doctor appointments, medical tests, rehab care, nursing home care, etc. Thus, the State needs to take from the Estate what they can for reimbursement. Otherwise the States would go bankrupt and/or our taxes would go sky high to help fund Medicaid. I am glad that we have Medicaid as it makes my own aging not so frightful as time passes and if I should need to apply for this service.
In Ohio, a lien is placed on the home from day 1 of Medicaid acceptance,as mentioned, On death, the Attorney General must be notified.
Ironically, to see how important in Ohio,it is to recover Medicaid costs, the state will probably be paying out a lot of money of 3 men who are accused of a crime are found innocent. They were in prison 20 years. If this happens, they could get wrongful imprisonment compensation that could be a lot. Ohio could be paying out a lot of money to these men, and would depend on Medicaid recourse to refill their coffers.