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22.1.3 Nursing Home Definition For ERP purposes, a "nursing home” is a place that provides 24-hour services, including room and board, to three or more unrelated residents who, because of their mental or physical condition, require nursing or personal care more than seven hours a week. This includes SNF, ICF, in-patient psychiatric facilities, and Facilities for the Developmentally Disabled (FDD). A "nursing home” does not include: 1. A convent or facility owned or operated exclusively by and for members of a religious order that provides reception and care or treatment. 2. A hospice, as defined in Wis. Stat. § 50.90(1), that directly provides inpatient care. 3. Community waiver residence. 4. IMD. 22.1.4 Liens DHS will not file a lien on: 1. Non-home property. 2. Homestead property sold by land contract. 3. Property outside Wisconsin (see SECTION 22.1.4.2 OUT-OF-STATE PROPERTY). 4. A mobile home or the land it sits on when the member does not own the land. DHS may file a lien on: 1. A home and all property used and operated in connection with that home. 2. A mobile home and the land it sits on, when the member owns the land. 3. A home placed in a revocable trust (see SECTION 22.1.4.8 HOMES PLACED IN REVOCABLE TRUSTS). 4. Life estates created on or after August 1, 2014. When a home is sold, DHS uses the lien to recover certain payments for Medicaid services provided as listed in SECTION 22.1.2 RECOVERABLE SERVICES. The lien’s value is "open ended.” The lien’s value increases as the amount of recoverable Medicaid services paid accumulates. Payment of the lien is made directly to DHS. Do not accept any payments relating to liens filed by DHS. Contact the ERP Estate Recovery Specialist if the member’s home is sold within 45 days after the Notice of Intent to File a Lien is completed. The lien has no effect until filed. Example 1 Aaron applies for Medicaid on March 6, 1995. He has a home and his circumstances require a lien. The IM agency sends a Notice of Intent to File a Lien on March 10, 1995. ERP staff cannot file a lien until April 24, 1995, because of the required 45 day waiting period. Aaron's legal representative sells the property on April 10, 1995. Recovery of Aaron's Medicaid payments by a lien on that property is not possible as the property was sold before a lien was filed. The IM agency contacts the ERP Lien Specialist to report on the home’s sale. 22.1.4.1 Notice of Intent to File a Lien A Notice of Intent to File a Lien must be sent when a Medicaid member meets all the following criteria: