My
mother went from private pay to Medi-Cal pay in her nursing home January 1,
2013. She now has zero money and all of her Social Security goes to the nursing
home … Should I sell [her] home and effectively turn all of the assets over for
her care or wait until her death, at which point Medi-Cal will take the
proceeds from the sale of the home anyway?
The move to a nursing home is a
major life transition for all family members. It is often a difficult
adjustment going from the comforts of home to a care facility. In addition,
there is the issue regarding whether to retain or keep the home given the
unpleasant knowledge that the home may ultimately pay for nursing home care
either way.
This dilemma was the focus of a
recent Q&A in ElderLawAnswers via
the question, “Is It Better to Sell a Medicaid Recipient's
Home Now or Wait Until Her Death?”
Essentially, by receiving
Medi-Cal you make certain agreements as to costs and, in the case of nursing
home care, the deal often hinges on that most valuable of all assets an elderly
person is likely to own: their home. True, it is possible to liquidate and sell
the house just to pay for the nursing home care. Although this often reduces or
eliminates the costs for maintaining and insuring an empty house, this also
means giving up Medi-Cal benefits until the sale proceeds have been expended
for care.
On the other hand, Medi-Cal will
remember your choice whether you sell the home and private pay until spend down
or if you to continue receiving benefits in lieu of such sale. If a family
member attempts to sell the house after the Medi-Cal recipient loved one
passes, then Medi-Cal has a lien on the sale proceeds (limited to the amount
Medi-Cal paid for the care of the Medi-Cal recipient). Either way, the home is
subject to pay for nursing home care or to reimburse Medi-Cal for the cost of
care.
The answer to the question posed
to ElderLawAnswers hinges on more
than a few factors. That said, in most cases Medi-Cal payments will be less
than private pay, sometimes a great deal less. Consequently, the resulting lien
may be less of a burden than selling the house outright!
Is there something else at work,
however? Notably, is the family home worth keeping in the family? These are
situations that require some delicacy. There is no one solution that addresses everyone's situation. Each family's circumstances are unique, therefore, the family must take the time to look at all options in order to make an informed decision. For this reason, it is extremely important to consult with an elder law attorney, who has experience in this area of the law.
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Reference: ElderLawAnswers
(updated October 17, 2013) “Is It Better to Sell a Medicaid Recipient's
Home Now or Wait Until Her Death?”