Posted on 10/23/2006 10:24:56 AM PDT by SmithL
To foot the bill for Mary and Lawrence Henkel's nursing home care, her children sold everything their parents owned except for the Donelson, TN home the couple had lived in since 1967.
"That was my father's dying wish - to hold onto the house, live in it, take care of it," said Nashville resident Judy Clifford, 66, one of three Henkel children. "That's what he told me, and he gave the house to me."
Now TennCare wants to sell the home to help recoup the roughly $288,000 that the state says it paid to take care of Mary Henkel in the nursing home before she died in February 2003 at the age of 81. Her husband had passed away years earlier.
The Henkel children, who value the home at $110,000, aren't alone. They're among families across the state being asked to give up the family home as TennCare redoubles its efforts to recoup some of the roughly $1 billion a year that the state pays for nursing home and other long-term care.
State officials say they're merely doing what is required by the federal government. And they point out that Tennessee isn't nearly as aggressive as some other states in recouping the money spent on long-term care.
"We're talking about a very emotional time in someone's life or in the family situation, and of course it's something that we wouldn't be unsympathetic to," said Marilyn Wilson, a spokeswoman for TennCare. "If we are going to provide Medicaid coverage, we must actively engage in estate recovery efforts."
It's a common practice for TennCare, the state's expanded Medicaid program, to go after the family homes of nursing home patients who have passed away. Generally, by the time a nursing home or long-term-care recipient gets on TennCare, the patient's family has spent down all of the family assets, except for the home.
TennCare tries to recover money when patients are 55 or older and received long-term care. It will not go after a property if a surviving spouse still lives in the house or a minor child or a child who is considered disabled by certain federal requirements lives there.
Bigger push
The state is stepping up its efforts to get properties on at least two fronts.
In April, TennCare hired an Atlanta-based outside consulting firm to help find properties that deceased long-term-care recipients passed on to their heirs without going through probate. And when it does find the property, it's going to force open an estate.
Under Tennessee law, the property can pass to the heirs without going through a probate court. But if TennCare finds out about the property, it can petition the court to force open an estate, which is what happened in the Henkel case.
The Tenncare Bureau also is looking to the state's highest courts to extend the time that it has to petition a court to get the property.
State law says all creditors have 12 months to file a claim on an estate.
Last month, Davidson County Probate Court Judge Randy Kennedy sided with another family in a fight over a home because he said TennCare waited too long to make a claim. The case was the first of several different ones in Nashville, including the Henkel case, in which TennCare forced open an estate more than 12 months after the patient died.
"We are going to appeal these cases, and the reason why is that of course both federal and state law requires that the state engage in estate recovery, and so as lawyers for the state we are duty-bound to assert all of the legal arguments available to us that support the right to recovery," said acting Attorney General Michael Moore. Moore, whose own mother is in a private nursing home, said he knew how exorbitant the cost of long-term care was.
TennCare argues that it shouldn't be bound by the statute of limitations because it involves public funds.
But experts in probate law disagree and say the one-year rule applies to TennCare.
"I don't know anybody who would disagree with Judge Kennedy's ruling," said Jeff Mobley, a Nashville attorney and an expert in probate. TennCare, he said, has asked the legislature in the past to extend the statute of limitations and is always asking for more ways to recover the money.
Paying for care
The money the Bureau recovers is only a tiny fraction of what the state pays into long-term care.
About 32,000 people on TennCare receive long-term care on any given day, spokeswoman Wilson said. On average, TennCare recoups $14 million a year of the money spent on that population. Last year, more than $1 billion of the program's overall $7 billion budget went toward long-term care.
The state generally has about 500 estate recovery cases per year, Wilson said. It's too early to gauge how successful the outside consultant will be in efforts to recover money.
Tennessee's estate recovery program is actually middle-of-the-road and nowhere near as aggressive as some states, Wilson said, specifically citing others that require nursing home patients to sell their property before they die.
But the practice of taking the family home still comes as a devastating blow to the children of the patients, one legal expert said.
"There is a sense of unfairness about it," said Tim Takacs, a Hendersonville attorney and expert on elder law. "People will come into the office here before Mama's on Medicaid and it's like, 'All she's got is this little house, and she lost her health, she lost her husband, she lost everything else, and now they want the house, too.' ''
Takacs thinks there should be an honest debate about what people should pay and what the government should pay.
He and Mobley, the probate lawyer, say people also need to do a much better job of planning for the high costs of long-term care and not wait until a family member is in a nursing home.
"We like to have people come in before they are in a crisis," Takacs said. "It's never too late to do something. It's just when they don't do anything, that's when they're likely to get an estate recovery claim."
I personally think that if a person has assets to pay for his/her own care, then they should pay. Why should a person with a 500K house and a million bucks that was all transferred at the opportune time be entitled to Medicaide? They shouldn't. It should be a means tested benefit with no free lookback period.
bump
I sold my mom's house for her medical care. I don't think the taxpayers should have to pay for her if she has assets.
I think the family home should be exempt from any equation.
There is every reason for society to keep property in the family and keep the family "off the street."
All this does is lead to estate planning where the home is pre-planing quick claimed over to the family.
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Proudpapa
>>>I happen to be a LTC insurance specalists. If freepers have detailed questions about how these policies work or how to find a good reputable specialist in your area, just let me know. >>>
I work in Commercial Insurance, but am aware of LTC. I wish I could have talked my father into purchasing it a while back, but he was stubborn and saw many other things the money could have been spent on. Now he is paying $2200 a month for Assisted Living. He's wishing he listened
So you sold your house so those without a house and who are here illegally would benefit from your mother's lifetime of work.
>>>I may be in the minority here but I see nothing wrong with the state trying to recover some of the care costs of patients. It's taking nothing from the patients, only their heirs and at that, only money that's owed to the state.
I agree, as long as there are no minors.
Sounds like he's getting off easy. Around here (Washington State)care costs $3-7,000 per month.
In the vast majority of cases you are talking about adult children who are self-supporting. How is keeping property "in the family" a benefit to society when society has to take the hit when the bills come due?
My neighbor's children make more money, yearly, than everyone in my neighborhood (except the medical resident who is married to a medical resident). Why should these adults get the benefit of a $200,000 house while the rest of us, with far fewer assests of our own, pay their mother's bills?
The specific instance I am thinking of and mentioned is the family home where the family actually uses the house for the family. (the son or daughter who moves in and did take care of mom or dad or both)
I don't think this is really an issue for envy politics.
There is no reason the successful should be more penalized that those who are not. It is the government's way of making everyone the same level of destitute.
I think an adult child who has forgone income to care for the parents is a special case. There are ways to safeguard the home if that is necessary.
There is no reason the successful should be more penalized that those who are not. It is the government's way of making everyone the same level of destitute.
I think people should pay their bills. That some people do not, does not relieve me of my obligation. This is the freeloaders way of stealing from me to enrich their own pockets.
Yeah, I don't really understand how they got the $280,000 of free medical care in the first place without having to sign something over.
I am suffering now because I wouldn't sign over my last assets to get some help with some serious medical problems. If I had done so, I would be living on the street.
I am just SOL on everything I thought I would have been covered for or qualified for after working more than 30 years and paying taxes. I hoped and expected to keep on working another 30 years, but now it's not possible.
You're not alone. Asset dumping in preparation of extended care for an elderly parent is a pervasive problem with Medicare, Medicaid, and I guess even Tenn Care. It is selfish and defeats the purpose of the program --- to care for people who CANNOT care for themselves. The rules for asset dumping are known, and those who don't even take time to read the rules, think of what's gonna happen to their parents deserve to be left out in the cold, so to speak. All their selfishness does is dump the burden of caring for their parents off on the rest of us...
They may have 'played by the rules' but they sure didn't live by them. For gosh sakes, these rules for long term care aren't secret....they just didn't think ahead far enough. And, I"m sorry if that sounds harsh, but where does it say that someone's lack of preparation becomes OUR problem?
Hell, you ought to see how aggressive they are in the UK and we have 'free' medical care here. Hahaha!
"The family can't have their possessions grabbed by the state, but I don't see any problem in using the ill person's assets to pay the tab."
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The thing that caught my eye was the state looking at family members if the transfers didn't go through probate. I'm all for the ill person's assets paying the bills, but it seems that if the ill person's estate wasn't transferred just right the sales may be negated and the assets seized.
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