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ELDERLY FAMILY OWES 2 YEARS COUNTY TAXES AND IS IN A NURSING HOME. HAS A LEIN ON HOUSE FROM DEPARTMENT OF MENTAL HEALTH AND HYGIENE.
WHICH ONE CAN LEGALLY COLLECT FIRST?

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Is it the situation where it is an elderly couple, who owned their home, and moved from their home to a NH where Medicaid is paying for their care? And the home has essentially been abandoned?

If so, imho, there are really 2 different things happening and neither DMH&H or county tax assessor really collects first as their position is quite different:
1. TAXES: All the elderly couple's monthly income less their personal needs allowance must be paid to the NH. Which leaves no $ to pay for upkeep of the house. Family or relatives can pay for the taxes and all other upkeep on the house. Then upon death can file a claim on the estate to be reimbursed for those costs. If you have any interest in the property, you should think about paying the delinquent taxes and interest as it could go to tax sale. The county doesn't want the property, it just wants the taxes whether you pay it or someone pays it at tax sale. Now paying the taxes doesn't mean you actually have title or ownership to the property because.....

2. DMH&H & MERP: When they went into the NH, they or their representative signed off or acknowledged that their assets are subject to MERP - Medicaid Estate Recovery Program, which is required to be done in order for Maryland's DMH&H to get Medicaid. MERP can place a claim or lein on the home which will have to be removed in order to transfer or sell the property. This is done after the Medicaid recipient dies and usually through probate court if they have wills. If you paid taxes or other items for the house, then you present your claim too.

Now if there is no will, then they die "intestate" which in most states means the state comes in and turns the property, after proper legal notice, up for sale & all proceeds go to MERP to reimburse Medicaid for what they spend on the NH.
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