Estate Recovery

JUNE 13, 1994 VOLUME 1, NUMBER 29

A nursing home resident may qualify for and receive ALTCS benefits even though she owns a home and other exempt assets. Upon the death of the unmarried nursing home resident, however, the state may have a claim against the recipient’s estate for recovery of benefits paid during her life. When Congress made changes to the Medicaid program last fall, they included a provision that requires states to actively seek reimbursement from the estates of deceased recipients.

Congress specifically suggested that states might seek to recover from joint tenants and others who receive property by virtue of the death of recipients. Arizona has graciously declined to accept Congress’ suggestion.

According to new regulations just adopted in Arizona, the “estate recovery” program will pursue only those assets constituting the probate estate. This means that assets held in joint tenancy, or accounts naming a beneficiary, will not be subject to estate recovery. It also means that some planning options, such as sale of the elder’s residence to younger family members while retaining a life estate, will be even more attractive under the new rules.

The estate recovery program will most often be important with reference to the elder’s family home. Of course, transfer of a remainder interest (or transfer from the elder’s name into joint tenancy with children) will cause other problems. Either the transfer must be compensated at its fair market value (generating cash which will cause eligibility problems until it is spent) or it will result in a transfer penalty period. Still, planning options are increased, particularly for married applicants and for those who placed property in joint tenancy years ago.

Home Aide Shortage

Wall Street Journal, June 1, 1994

“Work-family juggling acts are being upset by a shortage of reliable home health aides.

Rising demand for aides to care for aged, disabled or ill people in their homes has made it the nation’s fastest-growing job, the Labor Department says. But poor pay and benefits and the hard tasks required are breeding shortages and turnover as high as 50% in some regions.

Just as child-care problems erode productivity, a tardy or absent home health aide can force those who oversee a family member’s care to miss work. ‘It’s a very serious issue for employed caregivers,’ says Barbara Lepis, director of the Partnership for Elder Care, a nonprofit consortium of 10 employers and the New York City Department for the Aging. Even if they get to work, family members may have to ‘spend all their time on the phone, patching together something for mom,’ she says.

When Elizabeth Kutza’s aged father moved in with her, she spent most of one summer at home because she couldn’t find a home health aide. The first person she hired quit after one day, and others were unable to lift her father or lacked transportation. She finally found someone to work part time. ‘I got almost nothing done. I was a nervous wreck by the end of the summer.’ says Dr. Kutza, director of Portland State University’s Institute on Aging. Qualified aides ‘are not easy to find and not easy to keep.’

Home care agencies, which have grown by nearly 50% in the past five years, can reduce turnover by screening and training aides, but many charge an hourly fee of several dollars that is added to the $4.25 to $8.50 an hour received by aides. Members of the National Association for Home Care, a Washington, D.C., industry group, are studying techniques to reduce turnover, among them improving benefits, including child-care aid.”

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