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."
You should make an appointment to talk to a financial advisor in the morning
Then there is a Lady Bird deed. Google that little gem.
I think the rub here is that the person who has no house because they maybe rented all their life loses nothing and their care is paid for. It rubs me to a certain degree also (well to a big degree) but when I was young I was told ownin a house was security to be sold to take care of you in old age if need be. I own and solely because I do the monies can be used.
Simple solution: Kids should not put their parents in nursing homes if they want the property. Caring for them no matter what their condition is the price they pay to inherit it.
If you don't like the current law, work to get it changed.
susie
ping
I agree totally.....
Trouble is, meeting the current legal standard for "caring for" your parents can easily run into hundreds of thousands of dollars, which most people don't have and/or don't want to blow on a futile exercise in stretching out poor quality of life for much longer than is natural. Most people who tried to "care for" their elderly parents on an out of pocket basis would end up in legal trouble, accused of elder neglect or abuse.
Yes, they are not places you would wish to place your loved one. I saw an article in our local paper today about a program in Vermont where the state pays $80 per day to a home (a relative) caregiver. They were saying it was cheaper than the $125 per day they had to pay to a nursing home and the care was much better. I plan to call my LTC guy and ask, if this becomes a common thing throughout the US, will my LTC cover a relative providing care in my (or their) home. It really makes a lot of sense. Many people want to care for their relatives but can't stand the financial hit. Since we (in the form of our government) are going to pay anyway why not get better care for the elderly for less cost if possible.
I care for my father 24/7. The financial hit is not that big a deal. The emotional hit will knock your socks off.
Medicare or the VA pays for his doctor's appointments, medicines, wheelchair, hospital bed, and most durable goods (oxygen, concentrator, etc.). We have an aid come in every week to help bathe him. Medicare pays for twice a month, if we want 4 times a month we pay the difference which is only $25 a visit.
Today he was assessed and placed on Hospice care. Medicare picks up the tab 100% and it is administered through the VA.
we got homestead laws in Florida that prevent this
God Bless You! I know it is a heavy emotional, as well as physical, burden. In our family we found hospice to be a wonderful resource. I hope you have someone to spell you occasionally, it is very important to look after your own health.
The financial hit is huge. It's just that you're not paying it. Though if you're physically capable of caring for him 24/7, then you are capable of full time employment, and are taking the financial hit of foregoing that -- something that people with children to support at the same time usually can't do. Under the type of scheme outlined in this article, the government can subsequently raid your father's estate to recoup as much of its expenses as the estate is worth. Meanwhile, your father would get no choice as to how his estate is being wiped out.
Bad assumption on your part.
I'm a stay at-home mom as well as a caregiver. Being a one income family is a choice and takes dedication but can and is done quite a bit.
"Show me just what Mohammed brought that was new, and there you will find things only evil and inhuman, such as his command to spread by the sword the faith he preached." -Manuel II Paleologus
"Show me just what Mohammed brought that was new, and there you will find things only evil and inhuman, such as his command to spread by the sword the faith he preached." -Manuel II Paleologus
"Show me just what Mohammed brought that was new, and there you will find things only evil and inhuman, such as his command to spread by the sword the faith he preached." -Manuel II Paleologus
"Show me just what Mohammed brought that was new, and there you will find things only evil and inhuman, such as his command to spread by the sword the faith he preached." -Manuel II Paleologus
Nobody suggested taking homes of the patient's children.
"Show me just what Mohammed brought that was new, and there you will find things only evil and inhuman, such as his command to spread by the sword the faith he preached." -Manuel II Paleologus
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