Early in my career as an elder law attorney, I attended a
talk given by the administrator of a local nursing home. This happened almost
30 years ago, but I remember it well. Some events just stick in your mind.
The subject of the talk was what you
should expect when you enter a nursing home. At the end of the presentation,
the administrator took questions. One senior citizen raised her hand and asked
an important question – “what happens to my home when I run out of money to pay
for my care? Will I have to turn it over to the nursing home?”
The administrator answered by saying that when you use up
your savings, you have to sell your home to pay for your care. As a young
attorney who had spent a lot of time studying the laws related to paying for
nursing home care, I knew that the administrator’s answer was wrong. When you
exhaust your ability to pay the full cost of the nursing home, Medicaid will
step in and pay for your care. You don’t have to sell your home. Medicaid rules
allow you to keep your home.
I also understood that it was to the nursing home’s
advantage for people to sell their homes to pay for their care rather than go
on Medicaid. That is because nursing homes can charge residents who pay
privately more than they can charge once the resident goes on Medicaid. So, to
maximize its profits a nursing home will usually want to have as many “private
pay” residents as possible.
The nursing home and its residents have a fundamental conflict
of financial interest. Yet, most nursing home residents and their families rely
on the nursing home for advice about payment rules and Medicaid. I felt it was
important that seniors at the talk knew that the law protected their homes when
they entered a nursing home, so I raised my hand.
When the administrator called on me I stood up and said that
I thought that her answer to the question of what happens to your home when you
run out of money was not entirely correct.
(I was trying to be tactful). I
said that the law provides that you can retain ownership of the property where
you resided when you entered the nursing home and still be eligible for
Medicaid assistance to pay the cost of your nursing home care. The
administrator gave me one of those “looks that can kill” and moved on to the
next question. After the meeting ended she came over to me and said, “Look Sonny,
we are trying to run a business here. Don’t you be attending any more of my
meetings!”
Fair enough. I did not attend any more of her meetings. But
I did start setting up public presentations on my own so that I could explain
the payment rules to seniors and their family members. I didn’t want people to have
to rely solely on the information they got from the nursing home. And I’m proud
to say that over the years I was been able to protect the homes of many dozens
of residents of that administrator’s nursing home.
I have to be careful here because I think that these days most nursing home
employees do try to provide people with as accurate information as they can. But
nursing home administrators, admission directors, and business office managers
are not lawyers – you can’t expect them to fully understand the laws that
protect the home and other resources of their residents. In fact, many of the better nursing homes recognize this and recommend that their residents meet with an
elder law attorney to discuss payment options and Medicaid rules.
But many families still try to "go it alone" with only the limited direction they get from the nursing home to guide them. They need to be aware of the nursing home’s conflict
of interest: the longer a resident is in private pay status rather than on
Medicaid, the more profit for the nursing home. Smart consumers don’t rely
solely on the nursing home for information about paying the cost of care. They get
advice about their rights and options from an expert elder law attorney who is
working just for them.
In 1985, when I attended the administrator’s talk, the
average cost of a month in a nursing home was under $1,400. Today it’s soared to around $8,000
a month. Few families can afford to
bear that kind of cost for long. Most long term nursing home residents
eventually go on Medicaid. They need to know that their home is still protected:
they can keep it by filing the right paperwork with the Medicaid office and getting
Medicaid assistance to help pay for their care sooner rather than later.
Unfortunately, the protection of your home is not quite as good as
it was in 1985. In 1994 a new law called Medicaid
Estate Recovery came into effect that can force the sale of your home after
your death in order to reimburse Medicaid.
Estate Recovery applies if you get Medicaid funded long term
care services in a nursing home. It also applies if you get Medicaid help with
long term care at home through the Aging
Waiver or LIFE
programs. Pennsylvania’s Estate Recovery Department recovered over $36 million
dollars last year, mostly from the sale of homes, so this is a real concern.
There are ways to plan in advance to avoid Estate Recovery. If
you want to protect your home for your family, planning with an expert elder
law attorney is critically important. The sooner you start that planning, the better
your family’s chances.
If you or a family member needs long
term care or may need it in the next five to seven years and you reside in
Pennsylvania, you can get up to date advice from the lawyers at Marshall, Parker and Associates. They can
show you how to protect your home from loss to health related costs during your
life and from Estate Recovery after your death.
And Marshall, Parker and
Associates is holding no cost seminars throughout
northeastern and central Pennsylvania and offering free office appointments where
you can learn about your rights and options. Call Melissa at 1-800-401-4552 or
visit the Marshall, Parker and Associates website at www.paelderlaw.com for more information.
If you don’t reside in Pennsylvania, you can find a list of
Certified Elder Law Attorneys in your state through the website of the National Elder Law Foundation.
Further Reading
1 comment:
Great post. I am writing a paper on nursing home billing and nursing home care so I have been doing as much research as possible. Thanks for sharing Jeff, this was very helpful!
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