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1. They live in a nursing home or inpatient hospital and are required to contribute to the cost of care. (Individuals eligible under a MAGI group are not required to contribute to the cost of care and are not subject to liens on their homes.) 2. They own a home. 3. They are not expected to return to live at that home. Base this decision on the person’s medical condition. Their physician’s statement that they can reasonably be expected to return home is sufficient support for the person’s claim that they will return.

The physician’s statement should include a description of the diagnosis and prognosis for the member. A form asking for a physician to merely indicate by checking a box, etc., that there is a reasonable expectation that the institutionalized individual will return home is not acceptable or sufficient. Allow the physician a reasonable amount of time to provide this information.

When there is contradictory information (from a nursing home social worker, discharge planner, etc.) concerning the reasonable expectation of returning home, or you question the reasonableness of the statement by the member, family, guardian, power of attorney, or physician that the person will return home, consult with the ERP’s Estate Recovery Specialist. Do not file a Notice of Intent to File a Lien until ERP staff has checked with DHS medical consultants. If ERP determines there is not a reasonable expectation, ERP will send you a letter listing the reasons for this decision. At that point, if all of the other conditions described in this section are met, file the Notice of Intent to File a Lien. 4. None of the following relatives of the member reside in the home: a. Spouse b. Child who is any of the following: i. Under age 21 ii. Blind iii. Disabled c. Sibling, if the two following conditions apply to the sibling: i. They have an equity interest in the home. ii. They have lived in the home continuously beginning at least 12 months before the member’s nursing home or hospital admission. A copy of the completed Notice of Intent to File a Lien must be stored in the member's case file and sent to the following: • The member or their authorized representative • The Estate Recovery Program (ERP) office See Process Help, Section 12.18.9.3.1 How to Send the Notice of Intent to File a Lien. ERP staff delays further action until the period given to the member to request a fair hearing passes. If no hearing is requested, ERP staff will file a lien on the property with the Register of Deeds for the county in which the property is located. If a hearing is requested, a lien is not filed until approved by a hearing decision.