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I realized the end game wasn't pretty before I retired. Had seen several families go broke from elder care. The state actually takes your home when you go into state nursing home.
I had 3 years to go before retiring. I had a company profit share account that I had slated for very old age. Once I found out what assisted livng cost were. Today, not years later when I would need it. I did some quick math.
That money would pay for about 4.5 months of private pay elder care for me. Or if I left work today. Instead of 3yrs later. I could squeak by and quit working.
I figured when they came to me at the nursing home to say hey you gotta go. Your cash is gone. Your headed to a state facility. I wouldn't care if that happened to me in May or August.
I spent that money on retiring 3 years earlier than planned.
Eh - there are ways that they won't take the family home. If someone will still be living there - it can't be taken.
Eh - there are ways that they won't take the family home. If someone will still be living there - it can't be taken.
The state can and will sue to collect.
The Medicaid Estate Recovery Program (MERP) recoups this money by filing claims against any assets a Medicaid recipient held an interest in at the time of their death, such as their home. However, if a senior died without any assets (or with very few assets), then there is no way for the state to be repaid.
As a very basic example, say Mom was in a Medicaid-certified nursing home for two years and the state paid the facility $4,000 each month for her care. Once Mom passes away, MERP will file a claim against her estate in the amount of $96,000 ($4,000 x 24 months). If Mom’s house was still in her name at the time of her death, then it will have to be sold to repay the state the $96,000. Any proceeds exceeding the $96,000 can then be distributed in accordance with Mom's will (or the state’s intestate succession laws).
The Medicaid Estate Recovery Program (MERP) recoups this money by filing claims against any assets a Medicaid recipient held an interest in at the time of their death, such as their home. However, if a senior died without any assets (or with very few assets), then there is no way for the state to be repaid.
As a very basic example, say Mom was in a Medicaid-certified nursing home for two years and the state paid the facility $4,000 each month for her care. Once Mom passes away, MERP will file a claim against her estate in the amount of $96,000 ($4,000 x 24 months). If Mom’s house was still in her name at the time of her death, then it will have to be sold to repay the state the $96,000. Any proceeds exceeding the $96,000 can then be distributed in accordance with Mom's will (or the state’s intestate succession laws).
We still have the family house. My mom was in a nursing home under Medicaid.
We did have to turn over her SS and the pension she received from my dad's CS work.
But after we did all the paperwork and she passed away, the state sent us a letter letting us know that we could keep the house.
4% of seniors go to nursing homes, roughly 1.5 million according to Google.
.
Did telephone the nursing home when my husband lived there. The business people very kind, I would be notified a month ? before Medicare stopped after 3 months ? He died 3 weeks after living there.
Telephoned, as I received all kinds of information from people trying to assist me.
I believe that is not a good reading. The article does seem to focus on Wisconsin but I suspect what happens is that some vulture fund or the like buys up the assisted living facility. The facility is underpriced because they have a Medicaid contract and have beds that are not generating much income. The new investors go in with the strategy of extracting more money out of the facility. Out goes the Medicaid contract and in come higher paying customers. The problem of freeing up the lower-priced (Medicaid) beds is simply one step in their strategy. Of course, you could also have low reimbursement from Medicaid making it a question of viability for these facilities. Either way, the strategy is the same - free up low paying Medicaid beds and get full paying customers in them. That's what is in motion and the article is reporting the human side of it.
I believe Wisconsin is where the writer focused on or a State that might be early in the cycle of the phenomenon described above either due to the (lack of) laws or happenstance. The change in ownership / new investors / profit or financial viability considerations are what drives it. That is not limited to Wisconsin. The increasing demand on the (shrinking?) Medicaid budget leading to payments not rising with inflation, increase in costs due to inflation and availability challenges, and the unregulated nature of the assisted care contracts with a patchwork of laws that differ across the States but are sorely lacking create a perfect climate for what is being reported to happen.
"Wisconsin has among the most aggressive programs in the country, recouping more than $31 million in state fiscal year 2020, according to the report. That year, Wisconsin recovered an average of $5,277 from 6,005 estates, the report said, with the highest recovery at $181,540. "
"Wisconsin has among the most aggressive programs in the country, recouping more than $31 million in state fiscal year 2020, according to the report. That year, Wisconsin recovered an average of $5,277 from 6,005 estates, the report said, with the highest recovery at $181,540. "
I am sure the information is correct. [And, I am all for estate recovery for Medicaid expenses.] But, I am not clear how it explains the fact that assisted living facilities in the state are evicting people on Medicaid. And, according to the article, the problem is by no means limited to Wisconsin. Couple of quotes:
"Kate McEvoy, executive director of the National Association of Medicaid Directors, said states want to give elderly people options outside of nursing homes but are squeezed between restrictions on how Medicaid money can be used and the high costs of assisted living.
“This has been a challenge in what has primarily been a proprietary, market-driven model,” she said.
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"The industry blames evictions on insufficient Medicaid funding. Reimbursements, made under federal waivers that allow states to spend Medicaid dollars for elderly care outside of nursing homes, are not keeping up with rising costs, industry representatives said.
“Chronic Medicaid underfunding is not sustainable and is limiting participation as well as driving many providers out of the waiver program, reducing access to care options,” said LaShuan Bethea, executive director of the National Center for Assisted Living trade group.
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"But evictions have become so common that some states, including New Jersey, have enacted policies to curb them.
"A wave of 73 million baby boomers is hitting an age where they are likely to need more day-to-day care just as profits for ALF are "threatened by a shortage of staff and big spikes in labor costs, inflation that is jacking up the costs of goods, and higher interest rates."
"Meanwhile, occupancy rates continue to lag behind pre-pandemic peaks."
"A wave of 73 million baby boomers is hitting an age where they are likely to need more day-to-day care just as profits for ALF are "threatened by a shortage of staff and big spikes in labor costs, inflation that is jacking up the costs of goods, and higher interest rates."
"Meanwhile, occupancy rates continue to lag behind pre-pandemic peaks."
Exactly. That's what is going on - and it is not a Wisconsin only phenomenon. Wisconsin might be on the front end but that's all.
One thing that I didn't see mentioned in the article is that people are living longer, but not necessarily healthier or more physically fit longer.
So more older people living longer needing care longer.
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