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Java7922 Asked May 2023

Rehab release, AMA.

My mom told rehab staff she wants to go home AMA. She had 2 strokes a month ago, has not regained the ability to walk and is so shaky she drops her food while eating. Rehab is not ready to release her and talked her out of it. Our family does not have funds to pay for 24 hour skilled nursing at her home. She is currently on Medicare with a supplemental. Her income level qualifies her for Medicaid but she owns her home outright. Is anyone familiar with the state of NJ Medicaid requirements and if they in fact, do put a lien on the home if an adult family member is residing in the home and the adult family member would care for my mom at night.

Midkid58 May 2023
In some situations, leaving a hospital or facility Against Medical Advice is followed up by the patient being responsible personally for the entire hospital bill--insurance doesn't even get billed.

I checked myself out of a really poorly run hospital AMA, and I had my son, who is an attorney, call the billing dept and whatvere he said to them reseulted in my insurance paying the costs. The dr (I will call him one although he was totally useless) told me that if I did an AMA he would personally make sure I was 'stuck' with the entire bill. What kind of Dr does that?

Don't know if the same rules apply to a NH or care center. I just remember being so appalled at the lack of care (letting Iv's run dry for HOURS) no food being brought to me (I was literally foraging for food the whole time) and the fact that the hospitalist only saw me once in 5 days--what was the point of being there?

Java7922 May 2023
Thank you all for the helpful feedback!
AlvaDeer May 2023
Thanks for letting us know it was helpful to you, Java.

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JoAnn29 May 2023
Again, I live in NJ and have gone thru recovery. I received a recovery letter after my Moms death. If I had lived with my Mother and been her Caregiver for at least 2 yrs, I could have claimed Caregiver allowance which would have allowed me to remain in the home if I could prove I could keep it up. The lien would have remained on the house until I left, sold it or died.

Medicaid does not get involved selling houses. The family does that. I was responsible for selling Moms house. Medicaid was paid back because of a lien placed on it. I could have walked away from the home and Medicaid would have done nothing. It would have been sold in a Sheriffs sale for taxes and then Medicaid would get what they were do AFTER taxes were paid.

Once I received the recovery letter and responded that the house was up for sale, the next letter I got was the lien paperwork. It took 2 yrs to sell Moms house from that point. Not once did Medicaid contact me. After the sale, I got a letter saying the lien was satisfied.

I don't know what happened to the lady in Dupes story. Maybe she did not care for Mom the 2 yrs needed. Maybe she could not afford the upkeep on Moms house. Maybe she was not aware she could apply for Caregiver allowance. But my paperwork says nothing about Medicaid will be selling Moms house. Now my Mom owed very little because she was only on Medicaid 3 months. That may have something to do with it.
Daughterof1930 May 2023
Very correct JoAnn. Medicaid is not in the real estate business. They don’t sell or force the sale of homes. They do place liens so when a home is sold, and that home’s owner has used Medicaid funds, Medicaid can be rightfully reimbursed
Dupedwife May 2023
If your mother qualifies for Medicaid and she enters a Medicaid SNF, Medicaid WILL put a lien on her home to recoup just the money they paid out for her care after she dies. If an adult family member lives in the home and is not on the deed, Medicaid will sell the home to recoup their money when your mother dies. There was a similar case like yours in North Jersey where this lady’s elderly parents were living in their home and her father ended up dying so she moved in to care for her mother. Her mother eventually got sick and needed specialized nursing home care and she was admitted to a nursing home in New Jersey. Her mother eventually died and the lady received a letter from Medicaid notifying her that since her mother has died they will be putting her mother’s house up for sale to recoup the money they had spent on her while she was in the nursing home. Also, I recently saw a house for sale in Trenton, NJ which Medicaid is selling to recoup the money they spent on that patient who just died. Medicaid is a Federal and State funded program for people who are poor and those with limited income, and they WILL come after any asset once a patient dies.

You need to speak to an elder law attorney who will explain how Medicaid works.

Best of luck.

JoAnn29 May 2023
I am from NJ. If a family lives in the home and cares for Mom, they maybe able to stay in the home if they are the CG for at least two years and can afford to keep it up. This is if Mom ends up in LTC (long-term care) on Medicaid. The house is considered an exempt asset until the person dies. Then its an asset that can be recovered on. A lien will be put on the house. The caregiver maybe able to stay if again, they can't upkeep the house. If they are able to stay, the lien will need to be satisfied if they leave the house, sell the house or pass.

BarbBrooklyn May 2023
Since Medicaid differs widely by state, you really need to consult with a local Elder Law attorney or Medicaid Planner in the state concerned.

Daughterof1930 May 2023
Some of the info you’ve included isn’t consequential in the eyes of Medicaid. When a person uses Medicaid to pay for nursing home care, they have the right to place a lien on the person’s home to be repaid after the person’s death to recover the costs paid out, or a portion thereof, of that care. No action is ever taken during the person’s life. An adult family member providing care or living in the home does not matter unless they also are a deeded owner of the home. My mother lived in a nursing home following a failed attempt at rehab post stroke, and eventually used Medicaid to pay for it. I hope your mother’s rehab will go much better and she will recover many abilities soon

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