If your parent/grandparent is is a nursing home

[riverwalker]

and on Medicaid, be forwarned.
My Dad died 18 days ago. He was a WW2 veteran and former POW. He was never on Medicaid, had VA coverage and disabiity. However, my Mom who died in 2008 was on Medicaid for her nursing home stay. They had no home, just rented, and had a tiny blue=collar savings, they spent down, followed all the Medicaid rules. Like most lower-middle income folks, they had no fancy "estate planner" to hide assets in the Cayman Islands, heck they wouldn't do it anyway. They were just hard working poor people who never asked for anything, until Mom had a stroke, we coped as long as we could until she finally needed skilled care.
Today, while my Dad's body is barely in the ground, we get a letter saying that the state "estate asset recovery"
would like $108,000.00 from his "estate" to pay for my Moms nursing home care prior to her death in 2008!
Fortunately, they have nothing to go to probate, there is no "estate" but if, for instance they had a home to sell, ALL of it's proceeds would go to "payback" Medicaid, even years after the fact. They wait until the surviving non-Medicaid spouse dies, then place a lien. I was not aware of this and shocked to get the letter at how fucking cold hearted this country has become.

[Honeycombe8]

1. It sounds like it's just a form thing that's done.

Probably because people hide assets or maybe have money later. Legally, I guess they have a right to reimbursement from the sale of a home or other property, or they wouldn't send out the letter.

I guess that's cold, but I view it as more of a business thing. This happens when someone else pays your bills. They want to get reimbursed, if they can. But I might feel differently, if I had been the one to get the letter.

[femmocrat]

2. Throw it in the trash and forget about it.

They are nothing but blood-sucking leeches. You are not liable for your parents' "debts"... and as you say, there is NO estate left.

We are going through something similar with my (recently deseased) sister's meager "estate". Sorry... there is no money left and her run-down house remains unsold and will probably end up in foreclosure. I just can't deal with these money-grubbing creeps. I imagine them all looking like that evil little cartoon character, Mr. Burns, rubbing their greedy hands together.

[Blue_Tires]

4. +1

some companies actually make an industry of preying on the bereaved with 'old debts'

[BadgerKid]

9. Apparently there are "filial support" laws.

"In addition to Pennsylvania, 29 other states (PDF) have filial responsibility laws, including California, Ohio, Rhode Island and Utah.

The laws vary from state to state, but generally they require adult children (usually those at least 18 years old) to provide financial support for their indigent or poor parents. Some states, like Utah, look to others - like the parents' brothers and sisters - if there are no children or the children can't pay."


http://elder-law.lawyers.com/You-May-Have-to-Pay-for-Your-Parents-Care.html

[marybourg]

3. I don't understand why you think

this is unfair. If your parents had money tied up in a house that one of them was living in while the other was institutionalized at taxpayers' expense, why should not the taxpayers be reimbursed when the home-dwelling spouse dies? It seems fair and more than reasonable to me. And I' m sure it will to you also if you substitute my parents for yours. And my desire to inherit my parents' home equity, while you bear the expense of my mom's nursing care stay.

[pnwmom]

7. I agree. Why should people who can't afford their own house have to pay the Medicaid costs

of people who die with a fully-paid-for house in their estate? Why isn't it okay for the state to seek reimbursement from the estates that have remaining assets?

These people didn't have a house, but it sounds like that was just a form letter -- nothing that really applied in this case.

[exboyfil]

5. Just wait Pennsylvania has already sued under

a filial responsibility law. I tend to agree with the government getting back the assets of those who go to Title 19. If you have an estate, then protect it with Long Term Care insurance. Filial responsibility is a whole new ballgame. My grandmother is in the nursing home in my state (I have control of her financial affairs). Needless to say she has nothing (never has in her life). It does keep me up at night thinking that Iowa has a filial responsibility law and what would happen if the state decides to enforce it (goodbye college for the kids and my retirement).

No way we as a society can handle what is coming. My grandmother's nursing home is $72K/yr. She only gets and signs away about $15K/yr for the care (over $50K shortfall). She has been in the home five years now (probably $250+K for the nursing home alone not counting the hospital, doctors, drugs, etc). She has probably hit $500K in expenditures on Medicaid. Needless to say that would easily wipe me out if I was responsibile for it.

At the end of the day there is no free lunch - just who is going to pay is the question. We are already not paying our bills (if you zero out the defense budget we are still 300 billion dollars short this year). Additional revenue from eliminating the Bush tax cuts would help close the budget gap, but what about the growth of future spending. Medicaid is going to grow like crazy as more and more indigents go into nursing homes.

[pnwmom]

8. Yes -- those filial responsibility laws are unfair. I hope the states never turn to them again,

but I think we both heard about a recent case. Scary.

[PRETZEL]

13. "Medicaid is going to grow like crazy as more and more indigents go into nursing homes."

Gary Alexander who heads DPW in Pennslyvania just did exactly that with the changes he made to Pennslyvania's Aging Waiver Program which is a Title 19 funded program.

Essentially what he did, in the name of cost savings (and sarcasm isn't even appropriate here) is adopted a model where the role of Pennsylvania's Area Agencies on Aging, who have administered this program since the Waiver was started, are now starting to question whether or not it's feasable to even continue participating in coordinating care for PA's Medicaid eligible consumers.

The whole purpose of the Aging Waiver Program was to allow our elderly citizens to remain in their homes by providing high quality care and hands on care management. Medicaid beds are hard to get as it is in nursing homes.

[exboyfil]

19. No one care giver could meet my grandmother's

current needs. She needs two caregivers for the most basic functions (restroom and shower). She has to be hand fed and tended too constantly. Nursing homes offer economies of scale that cannot be matched in a home care environment. I am not an expert in this situation, but unless family members are willing to sign up to offer the care (impossible in my case since I work full time) the only economical approach are nursing homes. Even with a family member available you have situations like my grandmothers that requires two skilled CNAs to tend to her needs. Being in a nursing home allows the CNAs to attend to everyone without the transit time and lack of monitoring which would be associated with a home care situation.

[PRETZEL]

27. I'm not saying that there aren't situations where nursing home care

isn't the best option. I agree with you that in your grandmother's case a facility would be a better option than staying at home.

And, yes you're correct, a major aspect of the program is the family and community resources that are needed. That's part of the care plan.

[A Brand New World]

6. Same thing happened to my mother-in-law.

She died with $300 to her name, other than personal clothing and knick knacks. We sent $100 of that money to her other son who lived out of state to enable him to come to her funeral. He had stage 4 cancer at the time & had no money either. We had to turn over her bank account balance to Medicaid because of her being in a nursing home & so we ended up paying the $100 ourselves for his gas. We aren't destitute & would have done it anyway. We were just surprised that they care about that little bit of money but they do.

[lunatica]

10. Credit card companies are relentless about surviving family paying off debts left by

deceased parents too. It's insane.

[trof]

15. How are offspring responsible for parents' debts?

[lunatica]

16. They aren't, but that doesn't stop the endless calls

from 'debt collectors' hired by the credit card companies to harass surviving offspring with dozens of calls a day. I know this from personal experience.

[trof]

21. What happens when you tell them to eff off?

[lunatica]

24. They call you back

[SteveG]

23. I can also confirm this from personal experience

In 1998 my adult son passed away after a bone marrow transplant went bad. He had his own insurance, but it was capped at 1 million dollars. The final hospital bill topped $1,250,000. The hospital and later bill collectors tried for over 5 years to collect this money from me or my ex-wife. Now, since my son was not a dependent, they had no real claim on us, but it was a real pain in the butt, and they finally gave up, but each new collector had to be provided with a new copy of the death certificate.

[malaise]

11. Deepest sympathy

I hope they don't come after you and your siblings.

[sammytko]

12. Didn't they tell them or you this when they were placed on medicaid?

Our mom is on a home and we know it's a possibility.

[mainer]

14. If there is no estate left, then there's nothing for them to collect

And (unless you're in a claw-back state) that should be the end of it.

But if they had a home with any remaining equity, then yes -- its value would go to pay their medicaid bills. Because medicaid is financed by the taxpayer, and taxpayers shouldn't have to be stuck with the bills of a patient who has assets that can later be collected.

[vankuria]

17. I recieved the same letter when my Mom passed

If there are no assets left you have nothing to worry about. In my Mom's case she had no assets, I filled the form out indicating this and never heard anything more from them.

When you are grieving the last thing you need is people driving you nuts with money issues. My condolences on the recent passing of your Dad.

[sorefeet]

18. It still boils down to OVER PRICED

These are for profit care facilities and should not be, just like our medical and prison systems in this country. Canada pays half of what we do yearly for medical per person. Thats the American way to steal every penny ya can. Just double or triple the price for the same outcome.
In the end I guess your just a commodity, cash flow for a corporation and some with an estate are a jackpot.

[exboyfil]

20. My grandmother's nursing home is

not a for profit and the quoted price for retail care (probably not what the government pays) was $72K/yr.

[KamaAina]

22. Home- and community-based services are superior alternatives to nursing homes

there are programs generically called "Money Follows the Person" that can help your loved one live in his or her own home instead of a soulless, corporate nursing home.

Your local Center for Independent Living should be able to help. Find yours here:

http://www.ilru.org/html/publications/directory/index.html

[PRETZEL]

26. That's what the Aging Waiver Program is here,

it's an HCBS for nursing home eligible who qualify for medical assistance but choose to live at home as opposed to a facility. There are a couple of test counties in PA that are doing MFP but it's not state wide, yet.

And it is much more cost effecient for an individual to stay at home than it is to stay in a nursing facility.

[moriah]

25. This is why my grandmother, who recently passed....

.... had the house transferred into my mother's name immediately after my grandfather died in 1992. She went into a nursing home on Medicaid about three years ago because she was too fragile and yet insisted on trying to do yardwork.... too many broken bones. She could have broken something simply trying to get around the house, as her only fall wasn't when she decided to go try to mow the grass.

In a way, I hope that Mom does something similar here soon -- while I don't anticipate her going into nursing home care any time soon, she *does* have osteoporosis pretty bad. I'm not saying I want it to go in MY name -- I'd actually think my sister and brother-in-law would be better ones to have the title, since they live closer. And we are a close family -- there's no way we'd boot Mom out. Of course, Mom hasn't decided whether or not she's going to sell the house -- it is getting pretty old and needs some foundation work. But I don't want the family to lose that house just because she had to go into a home in 20 years or something, and if you transfer assets too soon they will consider the transfer void.