My parents lived in a home in NY State. My Mother has alzheimers and is in a personal care home (private pay) in Pennsylvania. They have about 200,000 in liquid assets and own a home together that is worth about $450.00. Her monthly payment is $3200 per month. Is it accurate that medical assistance will only pay her PCH (nursing home) fee if she is in the county nursing home and that because of the estate recovery act, that the amount paid by medicare will be paid back from her estate but if the liquid assets are not enough the additional owed will only occur when the surviving spouse (who is living in the home) also passes away?
The issue is not Medicare; it is Medicaid. Medicare is an insurance based program tied into the Social Security system. One's assets do not come into play. Also, it pays for very little long term care. Medicaid is the needs based program which pays for long term care costs. Estate recovery is the law which can place a lien on the property even if it is outside of Pennsylvania. If your father is relatively healthy, he is entitled to the home as well as one-half of the liquid assets. The rest needs to be spent down, but it does not all need to go to a nursing home. Also, medicaid covers most nursing homes, not just county run facilities. Run, do not walk, to an elder law attorney. His or her fee will most likely come out of the funds which would otherwise go to a nursing home. Good luck.
This response does not constitute the establishment of an attorney-client relationship. It is also not to be taken as firm legal advice as such would be contingent on a full inquiry by the attorney into the complete background of the facts and circumstances surrounding this matter. The response is meant to be a helpful guide to a question in a manner which reflects the limited information provided by the inquirer.
Medical assistance or Medicaid only pays for nursing home care, not a personal care home or assisted living facility. If your mother moves into a nursing home, she would have to meet eligibility requirements for Medicaid. It would be best to meet with an elder law attorney to discuss asset protection planning before your mother goes into a nursing home. If your mother moves into a nursing home and pays privately initially and if the facility accepts Medicaid (which most nursing homes do), your mother could stay in that facility. She would not have to move to a county nursing home. If she ends up receiving Medicaid and then passes away, the Department of Public Welfare would have a claim against her estate (estate recovery). However, if she has no estate, there would be nothing against which to recover. You should seek legal advice about these complicated issues as soon as possible. There are ways to protect assets for your father and to use them for your father's benefit.
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