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LovingPOA Asked September 2023

If my Mom is on Medicaid and her ex is ordered to pay her spousal support, does that count as income that the nursing home will take?

She owes money to her lawyer and they want that money. I don’t want to file for it if it is going to mess up her Medicaid approval. We live in Illinois if that helps. There are liens against her house for bills that she owes the attorney, so we can’t even sell it.

igloo572 Sep 2023
Loving, what 2 do?? Walk away & certified mail atty house keys.
300Large in atty liens! I’m guessing property has a “charging lien” attached. Way different creature than workman’s lien (eg roofing or construction co placed for unpaid work) or judgment lien on unsecured debt (credit card, medical debt, NH bills - which NH can do should things go badly if LTC Medicaid gets revoked).

Please Google “charging lien” for Illinois, to see how these run.

Your mom signed off a contract with a law firm to allow for this for work they did. It looks like in IL, charging liens are securitized. That imho is a big deal, like super BFD! Securitized debt usually limited to mortgages or HELOC. Fwiw means anything with securitization, absolutely 100% cannot legitimately have title - aka ownership - transferred without securitization being lifted / paid / cancelled/ removed. Yes, mom may technically own property as mortgage paid &/or awarded to her in a divorce so only in her name. But lien keeps it from having a clear title. So should you do & even file/record any paperwork to move ownership of the house, it will be invalid. Fraudulent. A law firm will not take this lightly, just sayin’….

So your mom - now in a NH on LTC Medicaid - cannot transfer her house to you, grandkid or Trust without the lien/debt being dealt with. No paperwork valid without lien being satisfied as securitized debt. Whomever holds securitization can force it to be sold. Looks like IL allows for 7 years + 1 for this to happen. Somewhere sometime someone at that law firm will be doing what is needed TO FORCE IT’S SALE ahead of that 7 years. They may not need her signature on any of this, depending on how charging liens roll in IL. Realistically you should be prepared for house to revert completely to the law firm as it’s negative to the debt.

Similar to what a bank/mortgage company can do when you stop making payments, they do a foreclosure process (usually after 3-5 months of unpaid) and do Notices in local paper and then they take over the property, evict if needed & property is sold.

Doesn’t matter what her Will or Deed reads; the lien holder isnt going to wait till she dies, they are going to take over the asset in the near future. Mom would have to live 8 years post lien placement to have it dissolve. Not likely.

None of this drama so far involves LTC Medicaid as mom ok on owning her empty home as exempt asset under LTC Medicaid rules. Only after her death does it become nonexempt subject to MERP attempt. Medicaid does not care about her debts
HOWEVER
Should she / you try to change title, LTC Medicaid could consider it an attempt 2 transfer assets to grandkid, Trust, whomever as an attempted “gifting. My guess is they would do a resources inquiry & suspend Medicaid eligibility while that happens.

That she is on LTC Medicaid of little concern to law firm. Medicaid debt recoup is done via Estate Recovery (MERP) & a required attempt after death action on Estate assets. Securitized lien placement priority over anything unsecured; plus law firm not waiting for her to die to do anything as they can force a sale in the near future.

To me, house is a 300K+ lost cause. Paying costs on empty house (taxes, insurance, utilities, etc) with this much debt has no upside. Or is there something abt the house makes this make sense to spend on?

HOUSE is NEGATIVE EQUITY to a LIEN.

Personally, I’d be more concerned that Medicaid will discover resources (alimony owed) due to mom not pursued. And does an inquiry on that.

For why not getting interest from other attorneys, probably when any firm look at courthouse filings & credit checks, they see: law firm lien 300K + interest, homestead 260K, owner on SSA income (cannot be attached), owner on LTC Medicaid = impoverished, inactive garnishment, future MERP issues; there’s no win.

Pay attention to the mail & legal Notices in newspapers as that law firm will act on the lien.
AlvaDeer Sep 2023
So thankful for you being around to answer these, Igloo. I hope this OP will see an attorney. They badly need information, and this is how it ends up a total mess when people try to avoid good solid information.
Fawnby Sep 2023
Of course the house can be sold. You pay off the attorney liens with proceeds from the sale of the house.

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igloo572 Sep 2023
What Fawnby & ITRR posted are spot on. House absolutely can be sold, Alimony is income.

I think you might want to go over IL LTC Medicaid rules for income & assets & resources. They are going to fully expect an applicant to make use of all due to her…. So if an applicant is due alimony or an inheritance, that’s a resource. Now if her ex won’t pay, that’s a different issue. If alimony takes her the income max, she won’t be eligible. IL - if I’m not mistaken- is $1215 income max but $17,500 assets.

On the house, If you were somehow thinking or hoping that your mom could continue to own & keep her home while be on LTC Medicaid in a NH, yes, that is allowed under LTC Medicaid rules. Medicaid by & large allows a property that is a primary homestead to remain an exempt asset for their lifetime.
HOWEVER
the rub with that plan is that once mom is on LTC Medicaid she is required to do a copay of almost all her income (alimony included) to the NH less IL $30 a mo personal needs allowance. Mom has zero, nada, no $ so someone in the family will have to pay all property costs on that house still in her name & with whatever law firm liens & till beyond the grave. Could be years. Because after she dies, State is required to attempt a recovery of all costs paid via estate recovery / MERP. If heirs have exemption’s, exclusion's to MeRP or other reasons that it makes sense to deal with that house, & have the wallet to pay costs and don’t mind the risk, go for it.

But if a mortgage, or other debt on it (those attorney liens) this may not make any sense to do. Cause you’ll have all that debt plus paying for property taxes, property insurance, utilities, maintenance, etc. And still end up having to deal with estate recovery and paying for legal needed for that after death cost.

If you’re thinking about renting….. should be a current FMV for rentals & that’s income to her; AirBnB it, that’s income to her.

What those liens mean is that they are encumbrances on the title that will have to be paid in order for the property to get a clear title. House has a cloudy title. Say legal owed $45,678.90. At the Act of Sale, house sells for 200K, that $45K paid to the attorney by the title company doing the paperwork for the Realtors. Not a big deal, super common. Whatever $ left after paying Realtors, fees etc., is hers 100% so ineligible for Medicaid as it’s “income” that month & an “asset” for all the months after till she spends down to be impoverished again.

Out of curiosity, how did she enter this NH from the hospital….Like as a post hospitalization rehab patient? Or custodial care resident??
Is push for doing a LTC Medicaid application coming from the NH?? Like the NH is somewhat concerned about her paying her bill on time??

If it is, & not to be harsh, I’d really suggest that you make them aware of all her financial & legal issues asap because - I bet - your mom is waaaay over resourced for IL LTC Medicaid limits. She won’t be eligible, and if the NH is “helping / doing” the application for her, they will be royally p.o.’d to find out what they thought was a straightforward “she’s poor” Medicaid filing is anything but. so….If she is abt to run out of $, imho you need to get her house sold by a Realtor asap & at as close to FMV as possible. No FSBO nonsense. Medicaid will want it sold at FMV which tends to be what last tax assessor bill placed it for value.

if the Realtor tell you it cannot ever even come close to selling at FMV, that’s a different question to ask on this forum.
LovingPOA Sep 2023
They liens on the house exceeds its value. The house has over $300,000 worth of leins on is, and the appraisal only came back at $260,000.00 At this point, we don't even know what to do with the house. Do we just transfer it into a Trust for my 9 year old Son to live in it, or does my sister just move into it. Her and I are listed as the Grantees when my Mom passes away. It is paid for, but there are Mortgage Leins on it from the attorney bills that are owed. I don't even know if I want to move forward with the Garnishments in regards to the Spousal Support, if it is going to make her ineligible for Medicaid.
They are who is paying her Nursing Home bill. She doen't have any money but the $30.00 per month that the nursing home gives her out of her Restidential Fund Account. My sister and I pay all of the bills on the home because she get to keep it.

If we just keep it in the family, and we are on the Deed as the Grantees, then can we just keep the house in the family or Deed it to my son for furture use. I guess I am wondering that as long as we don't sell it, then wouldn't we be able to keep it since her Will and Deed was done before she moved into the Nursing home?

We can't find anyone to give us any kind of clear answer.
I don't want her divorce screwing everything up. It's just all so upsetting. We were going to sell the house to pay the attorney leins, but there are more leins that what we can even sell it for. I am at a loss as to what to do.
JoAnn29 Sep 2023
Yes, the spousal support is income. Does he pay it? If not than that may cause a problem. Because if he owes and pays in one lump sum, that now would be money that has to be spent down. If the support is recent and Medicaid knows nothing about it, they need to be told.

As said, you can sell a house with liens. That is the whole purpose of a lien. To guarantee the lien holder will get paid at the sale of the home. Does Mom own the house outright? How was the divorce decree written up concerning the house? Mom has to have clean title to sell it. And by Medicaid do u mean for health or Mom is getting it for "in home" care or care in a NH. The house may need to be sold at Market value. If in a facility, the proceeds would need to be used for her care. If health or in home care, the proceeds may effect her getting medicaid until the money is spent down.

You really have a lot going on and probably need an elder lawyer but that you probably can't afford that. I would call Office of Aging and see if they know of someone who can help you make the right decisions.

AlvaDeer Sep 2023
Alimony is assets. If your mother's alimony isn't reported that is hiding assets. See an attorney for options.
BarbBrooklyn Sep 2023
Alimony is income, not an asset, I believe.
my2cents Sep 2023
Why do you think you can't sell the house just because of liens? Liens are just paid out of the proceeds before balance is distributed to her. That money would be used to pay for her nursing home bed until it runs out and then, just before running out, she applies for Medicaid to pay for the bed again.

Actually, as a Medicaid recipient, you are required to pursue monies owed to you. Yes the money counts toward her Medicaid income.

It really comes down to using her money and obligated payments now to pay for her care or pay later after death when it's time to sell the house. Ex: You keep things going like they are while Medicaid keeps a tally of what the state paid towards her care. She dies and the house is part of the probate, so Medicaid sends a claim (it was the MERP form she signed to get into the NH) against the estate. Probate has priorities on who gets paid first with asset proceeds. Maybe atty comes first, maybe Medicaid comes first. Either way, you sell the house for XX dollars and Medicaid claims even more than that as what they paid to take care of her. Medicaid and/or attys get all the money from sale of home.

Medicaid is for people who qualified because of little to no income/assets. That's why they don't let you give away money in prior years before applying and why they want you to pursue such things as court ordered payments. Do it on the up and up now and you won't be dealing with it after her death.

Isthisrealyreal Sep 2023
Yes, alimony is income. Why not ask her social worker and get the ex to pay what he owes?
LovingPOA Sep 2023
So would it be better to just let the alimony go.
I don't want her getting kicked of of Medicaid because she makes $2,200 a month instead of $1300.00. This is such a mess with him divorcing her because he didn't want to pay for her Nursing home bills after 22 years of marriage. It has let my sister and I in such a bind because he took all of the money and left.
Isthisrealyreal Sep 2023
LPOA, IL allows Qualified Income Trusts (QIT). this is the route you should take for your mom and get that alimony paid to her and pay her care bill with. FYI, a nursing home doesn't take anything, they are paid to care for our loved ones, big difference.

Sorry but, I think her dirtbag ex-husband doesn't deserve a break. Divorce her because he doesn't want the bills AND she gets a house with over 300k worth of attorney liens. What a piece of garbage he is.

Call an elder law attorney and ask about setting up a QIT for mom. This will ensure that mom qualifies for medicaid. Let that house go to the attorneys, you guys are throwing good money after bad.
igloo572 Sep 2023
ITRR, spot on!
I imagine the divorce litigation law firm is duly p.o.’d with the mom as a client (& whomever POA and family involved in decision making as well) as they (the attorneys) managed to get a garnishment through the divorce settlement. There’s existing court orders with a pile of $ winking at them that is NOT being acted on.

The law firm - imo - is not going to cut them a break once they go into seizure mode on that 300Large lien that they hold. If it is a securitized lein on the house as that’s how done on charging liens in IL, they can & will force a sale. It’s a law firm, they know exactly how to do it. Nothing the mom can do to stop it short of paying 300K. Illinois isn’t a big pro-property rights state like FL, MI & TX are.

There might could have been some predatory atty behavior in all this. Bad options suggested & taken. But at this point, way too muddled to deal with that.
Dupedwife Sep 2023
Yes, Medicaid will count alimony as income. It’s advised here that you should put your mother’s money into a Miller trust or what is known as a QIT. This is good advice, but just a word of caution that Medicaid scrutinizes trust funds also to make sure people are not hiding other source of assets or resource in those trusts. Also, you mentioned that there’s liens on the house that were placed by your mother’s divorce attorney. Were these liens placed on the house before she went to SNF? Does Medicaid have a lien on your mother’s house also? Normally, Medicaid will be the one to place a lien on the recipient’s house and upon death of the recipient they will seek to recoup their money, but perhaps the divorce was before she went to the SNF and that’s why the divorce lawyer got first dibs on the house.

My advice for you is to consult an elder law attorney who is very versed in Medicaid rules and regulations as your mother’s situation is beyond what you and your sister can handle.

Best of luck.
my2cents Sep 2023
Medicaid doesn't put liens on the primary residence - that house is not even counted during application process. However, after death they do have ability to file claim amount of costs they paid against assets/money left over in a probate. All applications contain a MERP form that applicant signs agreeing to the Recovery.

Yes, agree that this person needs to talk with elder attorney. There are certain trusts that can be set up or other information that would be of note for the family.
iameli Sep 2023
I could be missing something here. So many are advising OP to consult an attorney. But won’t any prospective attorney be aware that prior legal bills aren’t being paid, and, if the mother is on Medicaid it’s very likely she doesn’t have money to pay them? Wouldn’t they require a pretty good sized retainer before they’d do anything? And where is that going to come from? OP? Why wouldn’t they just walk away from this whole mess? It doesn’t sound like they have anything at all to gain. Let the house go to the law firm. Let the state go after the alimony awarded to the Medicaid recipient.

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