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The best way to avoid the house being pursued as a recoverable asset is to set up a Ladybird Deed immediately (prior to your loved one's death) - this sets up the home to go directly to a named individual in the deed upon your loved one's death, and keeps it out of the hands of probate or the state.
Not just NH. And for anything within that list paid by Medicaid once over age 55 and after a set day in 2005 (or 2006 - this fun little tidbit depends on when your state did their DRA compliance for MERP) For those who have had lots of medical issues even before going into a NH, the $ amount could be staggeringly high.
Within the letter, it will state something as to how MERP runs under your state law & that state is required to do a collection. Like for MERP TX letters, it states as "allowed in a Class 7 probate claim". There could be a separate sheet with an "invoice " with whatever Medicaid paid. The $ amount may want you to have a stiff drink too. Read letter to see exactly what you need to do next. Maybe going on-line to download a form & fill out to show assets or lack of assets. Or perhaps the form is attached to the "intent to file". Whatever the case, there will be paperwork done & filed to moms MERP #.
If mom has no assets, then case closed. Some states have a form that is a "Release of MERP claim" - if your states does one, it is an important document to keep along with death certificate.
I will suggest that you want to do whatever to ensure that:
- if mom has a bank account, it's done POD to you. So upon her death, you can go & close (or have it become the estate of account if need be)
- moms personal needs account at the NH is spent down on a regular basis. This $ is a probatable asset, if you find that probate is needed.
- if mom has a life insurance policy, just double check who the beneficiary is. If mom has gone through Medicaid application, it probably has a person ( you or a grandchild) as the beneficiary, so no issue for probate. But it could possibly have her estate as the beneficiary & this little factoid got overlooked by Medicaid. If so, then the insurance payout becomes a probatable asset for her estate.
The way the MERP letter reads (at least for TX MERP) is very much like a demand letter from a debt collector. It is not a warm & fuzzy condolence card.
Now if and when mom passes, Medicaid MERP will file a claim against mom's estate. For example they could put a lien against her house or bank accounts. In your case, she does not appear to have assets to come after.
Just be sure you do not sign any hospital or nursing home forms agreeing to be responsible for her bills.
https://www.agingcare.com/articles/medicaid-repayment-of-nursing-home-estate-recovery-150497.htm