My mother was in a assisted living facility in NY and received community Medicaid. She passed and now they put a lien on her house for $54K? Am I wrong?

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In New York I think the law is a bit different. My mother was in a long term care facility were you can age in place. She was not in a nursing home. I have read that Medicaid must try to recover what is spent on long term care from the recipient's estate upon their passing but that there is no estate recovery for Community Medicaid expenses. I think there is a difference between Medicaid And Community Medicaid?
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Also each heir will need to qualify for their own exemption.

So say house is 300k tax assessor value & there are 3 heirs as per valid will. One is your disabled brother, so he fully qualifies for disabled exemption; then you -retired & low income so qualify for a different exemption; and then there's your sister married to big hedge fund manager, she won't qualify for any exemption. 54k lien will get placed and family has to work this out within themselves to get the 54 paid. Could get dicey if sissy won't cooperate......

If tax assessor value is whack, you IMHO need to get house inspected, perhaps get a structural engineers report and turn both over to appraiser to get a more valid appraisal of property which is enter into probate to determine value of assets of the estate. Often for elderly - since their taxes are frozen with all sort of exemptions - the house assessor value is whack as its based on comps of renovated recently sold houses in moms neighborhood unlike moms old unrenovated house bought decades ago. Mom didn't care as her taxes were fixed and she never filed appeals to increases to house assessor value which some municipalities increase every year by a certain % because they can. This is what I went through with my moms house; appraisal was VERY significantly less than tax assessor value. All this gives you negotiating area if you should have to deal with MERP.

You need to get appraisal, etc done probably within a year of death or within a few months of opening probate. Atty should know the exacts needed for NYS.
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Upon mom's death the house went from an exempt asset to a non-exempt asset. And it is an asset of her estate. As she was on Medicaid, Medicaid is required to attempt a recoup of all cost paid by Medicaid from her estate. This is called MERP. By applying for & receiving Medicaid, mom accepted all terms of Medicaid. Moms Medicaid tally was 54K - which is actually pretty low as a year in a NH could be well over 6 figures.

So what to do? Couple of things....
First I'd suggest you look to see if you or any other heirs qualify for any of the exemptions or exclusions to MERP. If so, then you will need to document and submit to MERP within the timeframe in the NOI (notice of intent) letter you got with the 54k figure.

Second If you or others have been paying property costs, those could be valid deductions from the 54k. How this is done varies by state. so start gathering up all receipts, etc on every penny spent on the property.

Now If mom died with a valid will, then whomever is named executor can open probate and MERP is dealt with as a creditor against the estate along with others. Merp is duly notifed as required by probate laws.

If mom died intestate, it's going to be lots more sticky as most states have intestate such that all assets escheat to the state so heirs have to do lineal heirship or other more involved legal; intestate is kinda disadvantageous for heirs.

Now if there is a valid will & you do probate, it changes how MERP is done as they as well as heirs must do everything within probate rules. How claims are paid will run on how your state laws are done. Like for TX, probate is a level of claim by class state, with MERP being a class 7 unsecured claim so all other classes (executor, property maintenance, other secured or class 1-6 claims) are paid first and claims can be paid proportionally or not accepted by executor if assets not substantive; could well be that if the property is low value that the estate does not meet the cost effectiveness or cost benefit criteria required for MERP. So MERP does not file a claim in probate. You then eventually request a release of the claim and then transfer the property as per will or sell it and proceeds done as per will and all this done in probate with judge signing off on orders, etc.

If you do nothing, do not respond to MERP, do not open probate....yiu can expect the state or their MERP outside contractor, to place a lien with interest on the property. To ever sell or legally transfer the property, that lien will place a "cloud" on the title which will need to be paid to ever move the property. what seems to happen, is that family ignores the NOI, doesn't do probate, family continues to live in house then a bit later goes to sell house....the title co finds the MERP claim/lien and in order for the act of sale to go thorough (and not piss off everbody and kill the deal) the 54k plus interest gets paid to state (so lien gets released) with only the balance less commission and fees paid to the legally determined heirs.

Out of curiosity, what is the most recent tax assessor value on the property?
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The house is subject to recovery after the person dies. It is only while they are still alive that the house is not counted as an asset.
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