Author Archives: Sarah R. Watchko, Esq.

Nursing Home Medicaid and Estate Recovery: Will They Take my House?

suburban house

This is one of the most common fears our clients have as they plan for the future and long-term care.

At a glance, the answer is easy: No, if you need Medicaid for nursing home care, Medicaid/the State/the Nursing Home does not take your home when you enter care.

Nursing Home (“NH”) Medicaid has financial limits that must be met for eligibility, but the value of an applicant or spouse’s  home – if less than $552,000 – will not be counted towards that limit. Note that this value limit is the rule in Georgia, but not necessarily in other states.

If an applicant meets the other financial requirements and has a home worth less than $552,000, then he or she can still be eligible for NH Medicaid without having to sell or give away the home.

However, when a NH Medicaid patient dies, the property in his/her name upon death is subject to Estate Recovery by Medicaid. This means the State seeks reimbursement from the patient’s estate based on how much it paid for the patient’s care. There are a number of exceptions to this rule, and notably, that recovery cannot occur until the patient’s spouse is also deceased.

Only that property titled in the name  of the patient at his/her death is subject to Estate Recovery. In some circumstances, this leaves options for pre-planning that can protect the family home for the patient’s family. As always, it is best to seek professional advice regarding available options when Medicaid is a possibility.

Image © pyzata –

This is not intended as legal advice.  This post and the information contained herein have been prepared for educational purposes only.  The information on this blog does not constitute legal advice, which would be dependent upon the specific circumstances of a particular case.  In addition, because the law can vary from state to state some information on this site may not be applicable to you.


Paying for Assisted Living


I help many clients with questions about paying for long-term care and specifically, assisted living.

Assisted Living” has no single definition. It generally means housing in a communal setting together with support services to help individuals with the activities of daily living. These activities may include eating, bathing, dressing, using the restroom, getting in and out of a bed or chair, walking, medication management, food preparation, and household tasks.

When people need additional help to perform these activities but not the 24-hour medical oversight provided in a nursing home, Assisted Living is appropriate. However, the costs are high. According to the latest Genworth cost of care survey, the average 2015 cost of Assisted Living in metro-Atlanta was around $36,700 per year, or $3,060 per month. Anecdotally, I have observed even higher costs when additional services are added to the basic care provided by the assisted living facility.

Not surprisingly, many worry about how to pay for this. Medicaid for long-term care in Georgia only covers skilled nursing care, so most individuals in assisted living are not eligible. This leaves three options for payment:

  1. Private Pay (i.e. paying out of pocket)
  2. Long-term Care Insurance
  3. VA Pension for eligible veterans and spouses of deceased veterans

As you can see, there are not many options. In some circumstances, especially when people do not have sufficient savings to cover their costs for a long period of time, long-term care insurance can be invaluable. When that is not an option or doesn’t cover everything, the VA benefit can provide an additional $1,000 – $2,000 or so per month, depending on whether the veteran or spouse is applying, and the number of dependents. However, there are many financial requirements to VA eligibility, and the VA must determine that applicants lack “sufficient means” to pay for their own care, based on their income, assets, and life expectancy.

Our firm is proud and honored to help aging individuals and their families navigate the ins and outs of paying for long-term care, including assisted living. If you have any questions for yourself, a loved one, a friend, or a client, please don’t hesitate to give us a call. We would love to help.

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What Happens When the Money Runs Out?

contract nursing or retirement home

The cost of nursing home care in the Atlanta area is around $70,000 per year for a shared room, according to the 2015 Genworth Cost of Care Study. This is expected to increase at a rate of 4% per year. Many seniors and their families worry – reasonably so – about what happens when such care is required and the money runs out.

The only government benefit available that fully covers long-term skilled nursing home care is Medicaid, a federal program implemented by individual states. Federal law sets the parameters but allows the States to regulate Medicaid within those parameters. So, there are many differences in the Medicaid program from state to state.

Many believe that one has to be entirely impoverished to have Medicaid for long-term care. However, the program allows recipients to keep certain resources (including the homeplace, generally) and in Georgia, a community spouse can keep over $100,000 and some of the couple’s income. Tax-qualified retirement accounts (IRAs, 401Ks, and the like) are also protected in Georgia, for the most part.

Many skilled nursing facilities have both “private pay beds” and “Medicaid beds”, but pursuant to federal law, these are identical and the care received must be as well. As with most things, there are great skilled nursing facilities that accept Medicaid patients, and not so great ones. Long waiting lists can also be an issue.

Finally, after the death of the Medicaid recipient, his or her assets are subject to recovery by the state in the amount spent on his or her care. However, in some cases this can be avoided.

The take-away here is to understand that as for now, there are long-term care benefits available to those whose funds run low, and planning ahead can help seniors protect the assets they have left.

Don’t Mess with Miss Watkins

Funny turkeys

First, Happy Thanksgiving from the Elder Law Update!

Having trouble focusing at work on this pre-holiday workday, as you dream of turkey and pumpkin pie? A former employer of mine used to send us home early with “Turkey Brain” 🙂

To help distract you from the work you really should be doing, check out this video of Beverly Watkins – born c. 1939 – performing at Northside Tavern in Atlanta, Georgia  in April (here, celebrating her 76th birthday):

I had the pleasure of seeing Miss Watkins perform last weekend, and she was AWESOME. I encourage you to check her out!

And, as we celebrate and give thanks this week with family and friends, young and old, may we all remember that dreams and passion have no age limit!

Image © adrenalinapura –

Have you heard of the Grandparent Scam?

Aged woman talk on phone

Several years ago, a friend of mine’s grandmother received a tearful call from her grandson, a young adult. He told her he was in Canada, had run into trouble, and needed her to send money immediately. She wired the money and subsequently informed other family members. Only then did she find out that her grandson was not in Canada and had not gotten into trouble. She’d been scammed.

Many seniors are targeted in this and very similar scams, and it is not difficult to imagine why. They are particularly susceptible to loneliness and often eager to hear from family, their hearing may be failing making it hard to recognize voices, and the call triggers a strong emotional reaction that may overcome reason. Moreover, the scammers are sophisticated, able to trick the intelligent and educated as well as the vulnerable.

Through the years, we’ve come to realize that although an email from the Prince of Nigeria promising to send us large sums of money sounds pretty nice, this is a scam and few fall for it. Hopefully, spreading the word about the Grandparent Scam will have the same effect.

If you or a loved one has been the victim of the scam, you can file a complaint with the Federal Trade Commission online or by calling 877-382-4357, and sign up for scam alerts at Scams can also be reported to AARP’s Fraud Watch Network, where you can also sign up for fraud alerts.


Image © Alan Lucas –