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I. How We Work in Washington. Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services. APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
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Great answers! Has anyone posted about transportation and waivers? It appears that only MRDD people can get transportation under the waiver? sorry to post here...just kinda lost. re Medicaid I get updates every week of new or changed Admin code. Who knows what is legal and not? I'd go straight to Medicaid and also speak to an Elder Law attorney. Some offer free 15 minutes.
Indeed, under federal law the state can only make a claim against property in which the deceased Medicaid recipient had a legal interest at the time of death. So if the house was sold or given away before then, the state cannot go after it (unless they had already placed a lien on it). See 42 U.S.C. 1396p.
I guess these comments are assuming that there was no transfer of deed at the approximate time Medicaid eligibility was granted. if a property was sold to family members, the Medicaid recipient would no longer be an owner of the property. at the time of sale, the owner would be the family not the recipient of Medicaid. in that scenario, perhaps there would be no threat of recovery of costs,nor lien
For TX, MERP's purview covers: -Nursing facility care (nursing homes aka long term care facilities) -Intermediate Care Facility for Persons with Mental Retardation (ICF/MR) Plus a whole bunch of Medicaid Waiver Programs: -Home and Community-based Services (HCS) -Community Living Assistance and Support Services (CLASS) -Texas Home Living Waiver (TXHmL) -Consolidated Waiver Program (CWP) -Deaf-Blind with Multiple Disabilities (DBMD) Waiver -Community Based Alternatives (CBA) -STAR+PLUS Waiver (SPW) -Integrated Care Management Waiver (ICMW) - Community Attendant Services (CAS) That is a whole bunch of acronyms! MERP also affects the costs of certain hospital and prescription drug services received and paid for by Medicaid. For TX, average yearly Medicaid bill for NH resident is 72K or a 72K MERP claim. And TX is a very low Medicaid R & B reimbursement rate of under $ 145.00 day. If you are on the East Coast where the NH rates are $ 300 - 400 a day, easily over 6 figures. Which is just a staggering amount of money, so you can understand why MERP is required. I just think the states have done a lousy job of explaining and presenting to Medicaid applicants & their families clearly what the consequences are for accepting Medicaid.
Reimbursement via "estate recovery" for payments the state made under Medicaid for a person's care are only sought for the period when the individual was institutionalized (or, if non-institutionalized, at least age 55).
Medicaid - although a joint federal & state program - is administered by each state in each state's own unique way but under an overall federal guideline. All states are required to have MERP - Medicaid Estate Recovery Program. How MERP runs in your state depends on your state laws on death, probate, property rights.
As Ferris said, check with your state's Medicaid program. For TX Medicaid, almost all Medicaid paid for services for elderly are within MERP's purview. So in addition to NH Medicaid, any mental health services are included as well as any "community based" health services. MERP does not affect Medicaid programs like any WIC programs though. All details are on the TX Medicaid DAD's site.
When they applied for Medicaid, there probably was a statement of the applicants acknowledgement of MERP. Whether or not they signed off on it doesn't matter, as it is an acknowledgement of acceptance. The state can place a claim or a lien on the property because of MERP. How the claim or lien is enforced is very much dependent on your state laws. It seems that often the claim or lien only shows up when the title company is doing it's search in the days right before the act of sale on the property. Some states title companies are now requiring the seller if over 60 to do some sort of statement as to whether or not Medicaid was provided to the owner / seller before title insurance will be issued. So how the property gets sold will make a difference if this is going to be an issue at the time of sale. If this is a traditional sell with a Realtor and the buyer is getting a mortgage, they will need to get title insurance and MERP will likely show up. If it's a quit claim to family, then it won't show up but can still be there on the property only to show up as a problem years from now when it is sold or used as collateral. In either case you don't want a MERP claim or lien to be an issue, you need to contact Medicaid before the act of sale to see what to do. Good luck and please post what Medicaid says.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
re Medicaid I get updates every week of new or changed Admin code. Who knows what is legal and not? I'd go straight to Medicaid and also speak to an Elder Law attorney. Some offer free 15 minutes.
-Nursing facility care (nursing homes aka long term care facilities)
-Intermediate Care Facility for Persons with Mental Retardation (ICF/MR)
Plus a whole bunch of Medicaid Waiver Programs:
-Home and Community-based Services (HCS)
-Community Living Assistance and Support Services (CLASS)
-Texas Home Living Waiver (TXHmL)
-Consolidated Waiver Program (CWP)
-Deaf-Blind with Multiple Disabilities (DBMD) Waiver
-Community Based Alternatives (CBA)
-STAR+PLUS Waiver (SPW)
-Integrated Care Management Waiver (ICMW)
- Community Attendant Services (CAS)
That is a whole bunch of acronyms! MERP also affects the costs of certain hospital and prescription drug services received and paid for by Medicaid. For TX, average yearly Medicaid bill for NH resident is 72K or a 72K MERP claim. And TX is a very low Medicaid R & B reimbursement rate of under $ 145.00 day. If you are on the East Coast where the NH rates are $ 300 - 400 a day, easily over 6 figures. Which is just a staggering amount of money, so you can understand why MERP is required. I just think the states have done a lousy job of explaining and presenting to Medicaid applicants & their families clearly what the consequences are for accepting Medicaid.
As Ferris said, check with your state's Medicaid program. For TX Medicaid, almost all Medicaid paid for services for elderly are within MERP's purview. So in addition to NH Medicaid, any mental health services are included as well as any "community based" health services. MERP does not affect Medicaid programs like any WIC programs though. All details are on the TX Medicaid DAD's site.
When they applied for Medicaid, there probably was a statement of the applicants acknowledgement of MERP. Whether or not they signed off on it doesn't matter, as it is an acknowledgement of acceptance. The state can place a claim or a lien on the property because of MERP. How the claim or lien is enforced is very much dependent on your state laws. It seems that often the claim or lien only shows up when the title company is doing it's search in the days right before the act of sale on the property. Some states title companies are now requiring the seller if over 60 to do some sort of statement as to whether or not Medicaid was provided to the owner / seller before title insurance will be issued. So how the property gets sold will make a difference if this is going to be an issue at the time of sale. If this is a traditional sell with a Realtor and the buyer is getting a mortgage, they will need to get title insurance and MERP will likely show up. If it's a quit claim to family, then it won't show up but can still be there on the property only to show up as a problem years from now when it is sold or used as collateral. In either case you don't want a MERP claim or lien to be an issue, you need to contact Medicaid before the act of sale to see what to do. Good luck and please post what Medicaid says.