Georgie...first off, in your instance they have to be lucky enough to find someone trustworthy, clean and willing (and capable) of doing the care giving for 55.00/shift (not likely in many parts of the country as Jeannie says)... 1540 a month x 2 shifts a day still = 3080 or 3 shifts in come cases - 4620.00. Why do this when dad can have 24/7 care, including a nurse on duty, at an assisted living facility for the same price? It just doesn't add up...it will cost more and medical care not included...
Might be worth checking into if you live in an area where nursing homes are over 7000.00/mo but in those areas you'll still be hard pressed find anyone trustworthy, willing, dependable and capable willing to work 12 hours a day for less then 100.00. Then there's the fact that you then become the employer and so have to deal with employee taxes and such....you can't expect your senior to take care of the paperwork. No, you must not have had to deal with what my brother and sis in law went through. All is good now, and dad is in a safe place. With all that he has against him medically, we couldn't be happier, even if might means he will have nothing left to pass along to us kids.
Bnnk...that was a good price for a Nursing home for your FIL. Here in NW Arkansas it's between - 5000.00-6000.00/mo depending on the nursing home ratings so 10 weeks would have run him around 11,000.00 give or take. Home health for 2 shifts a day plus meals would have cost your FIL that at home and family would have had to cover the 3rd shift plus deal with any medical issues. Home care is simply not the answer in cases where the senior is unable to do much for themselves and NH's are not as they are in Buffalo NY...14,000/mo is more then ridiculous Pam. In this case, everyone would save $$$$ by hiring someone to cover 3 shifts per day at 100.00/shift, if they had the money. This would be when in-home health care around the clock would make sense.
Bnnk54- regarding MERP & heirs / beneficiaries, just what position the state has will be very interdependent on what your state has regarding property laws, probate laws and state administrative codes related to medicaid. MERP may not be first or even happen.
Some states do not allow for unsecured liens to be placed on property. Like a Mortgage co as a secured creditor can place a lien but medicaid is not a secured creditor so cannot.
MERP may not necessarily be ahead of heirs. Heirs may have exemptions and exclusions to recovery which can be filed and reduce or eliminate recovery. It totally falls on family or heirs to determine this, then file and with documentation. Each heir has to do their own. So if house is 100k and 3 heirs, and 1 was caregiver exemption, 1 low income exemption, then recovery is only on the 33k that the 3rd heir with no exemptions owes to get release. Family then works it out internally to pay off the 33k and own the house. MERP bill could be 200k but it s limited to whatever the value is of the estates assets. Heirs not responsible for amount over estate asset value at time of death or as filed in probate and signed off by judge.
If the elder has been on NH medicaid then someone has been paying on all the costs on the empty house since day 1 of NH stay. Those costs can probably under states administrative code be exclusions to the Medicaid tally but family need to document every penny and submit to state or it's outside contractor. Family can do an agreement or promissory note with elder as to those costs to be secured debt which could become a lien or probate claim.
MERP could find its outside of cost-effectiveness for recovery. Federal guidelines- I believe- are assets over 3k or a recoverable estate over 10k. Low value property with exemptions or exclusions by heirs and probate opened could be under.
Also if probate opened, then however probate runs for assets of & claims against the estate is the system to which all must follow. For example, for TX probate its a level of claim by class and MERP is a class 7 class; class 1 - 6 which includes executor costs, funeral & burial and other secured claims are ahead of a class 7 claim in being settled; credit cards are class 8. Very different Recovery from a state where all claims are equal.
Some states seem to not persue recovery if property is below a certain value..... like for MS it seems to be only done for property over 65k assessor value.
Family & heirs have to be proactive to deal with MERP. If they do nothing, do not respond to merp's NOI (notice of intent), file no exemptions or exclusions; do not track & documents costs; or open probate, etc. then the state or it's outside contractor for MERP then assume a claim or lein can be filed and it is cost effective to do so and it will happen. Dealing with MERP can be done but will not be simple and will have costs of both $ & time and runs a risk of not being able to do the follow through needed as your elder could live another 6 mos or 6 years.... and the heirs situation can change as well over time.
Might be worth checking into if you live in an area where nursing homes are over 7000.00/mo but in those areas you'll still be hard pressed find anyone trustworthy, willing, dependable and capable willing to work 12 hours a day for less then 100.00. Then there's the fact that you then become the employer and so have to deal with employee taxes and such....you can't expect your senior to take care of the paperwork. No, you must not have had to deal with what my brother and sis in law went through. All is good now, and dad is in a safe place. With all that he has against him medically, we couldn't be happier, even if might means he will have nothing left to pass along to us kids.
Some states do not allow for unsecured liens to be placed on property. Like a Mortgage co as a secured creditor can place a lien but medicaid is not a secured creditor so cannot.
MERP may not necessarily be ahead of heirs. Heirs may have exemptions and exclusions to recovery which can be filed and reduce or eliminate recovery. It totally falls on family or heirs to determine this, then file and with documentation.
Each heir has to do their own. So if house is 100k and 3 heirs, and 1 was caregiver exemption, 1 low income exemption, then recovery is only on the 33k that the 3rd heir with no exemptions owes to get release. Family then works it out internally to pay off the 33k and own the house. MERP bill could be 200k but it s limited to whatever the value is of the estates assets. Heirs not responsible for amount over estate asset value at time of death or as filed in probate and signed off by judge.
If the elder has been on NH medicaid then someone has been paying on all the costs on the empty house since day 1 of NH stay. Those costs can probably under states administrative code be exclusions to the Medicaid tally but family need to document every penny and submit to state or it's outside contractor. Family can do an agreement or promissory note with elder as to those costs to be secured debt which could become a lien or probate claim.
MERP could find its outside of cost-effectiveness for recovery. Federal guidelines- I believe- are assets over 3k or a recoverable estate over 10k. Low value property with exemptions or exclusions by heirs and probate opened could be under.
Also if probate opened, then however probate runs for assets of & claims against the estate is the system to which all must follow. For example, for TX probate its a level of claim by class and MERP is a class 7 class; class 1 - 6 which includes executor costs, funeral & burial and other secured claims are ahead of a class 7 claim in being settled; credit cards are class 8. Very different Recovery from a state where all claims are equal.
Some states seem to not persue recovery if property is below a certain value..... like for MS it seems to be only done for property over 65k assessor value.
Family & heirs have to be proactive to deal with MERP. If they do nothing, do not respond to merp's NOI (notice of intent), file no exemptions or exclusions; do not track & documents costs; or open probate, etc. then the state or it's outside contractor for MERP then assume a claim or lein can be filed and it is cost effective to do so and it will happen. Dealing with MERP can be done but will not be simple and will have costs of both $ & time and runs a risk of not being able to do the follow through needed as your elder could live another 6 mos or 6 years.... and the heirs situation can change as well over time.