Can Medicaid make me leave the home my mother owns and I live in as her caregiver?

Medicaid does not take houses from people. A Medicaid recipient is allowed to own a home, but after the recipient dies the state may recover their costs from the sale of the home.

As I understand it, there is an exception that you'd be interested in. If a child or grandchild has lived in the house and provided caregiving services such that the entry into a nursing home was delayed, then the recipient can give the house to that child or grandchild, either immediately or through a will.

An obstacle for many people is that all of Mother's money will go toward the cost of her care. She will not be able to pay taxes or insurance or otherwise maintain the house once she is in the NH. Will you be able to do that?

She can "spend down" the little money she has before going into a nursing home. Perhaps she could pre-pay the house insuranve for a few years. Or have a new roof put on if the house is about to need it.

I'm sure you are trying to conserve money, but I think it would be a good use of some of Mother's funds to consult with an attorney who specializes in elder law. You'd get the straight scoop on you remaining in the home and good advice about what to spend money on before applying for Medicaid.

Good luck to you!

As the first response says, Medicaid does not take people's houses. What they do is place liens against houses. That being the case, it would seem that you would be able to stay in the house until such time as it was sold, but when it is sold, the state would be at the closing, first in line, to recover their share of the money, whether it's part of the sale price or all of it. The advice of a lawyer who specializes in elder law is very important in situations such as this.

Comma - neither the state, the nursing home, hospital, etc want "momma's house", what they want is whatever proceeds or $$ from a possible sale of the house. The key is "possible sale". This is going to be a bit long. My mom is in NH and still has her home (empty) in TX and I will have to deal with MERP in the future:

What you would be dealing with is MERP - a federally required aspect of Medicaid. MERP is Medicaid Estate Recovery (or Recoup) Program (or Policy). MERP, as is all things Medicaid, is administered by each state as Medicaid is joint federal & state program. Because each state does this differently yet somehow the same, each states law on property rights, death law, how probate is done makes a huge butt difference in how MERP is run. So what flies in TX might not in AL. When an individual goes onto Medicaid for NH, they agree to MERP, whether or not they sign off a document on MERP.

MERP is federally required to have several different exemptions for the properly homesteaded property. Most states have MERP such that exemptions can be done only if the property is maintained as a homestead. If your state does a homestead exemption, then your mom (or you for your mom) needs to file for the homestead even if she is living in a NH. For my mom, we do an annual letter in which she states her desire to return to her home when she gets better. This was my mom's attorney's suggestion.

In most states IF the person living at the house was the caregiver for a full 2 years prior to the property owner's going into a NH, then the caregiver can get an exemption from MERP. You may have to prove that you were a caregiver -so if you had a full time job, you might not get the exemption as how could you have done both. Another exemption could be for family living at the home but who were not caregivers but if they were forced to leave the home would be out on the dole and qualify for other state supported housing - this type of exemption will have a formula based on your income and tax filings. But you have to file the exemption within a very specific time frame with MERP to get the exemption. Exemptions are not automatic. MERP seems to be very papertrail oriented so you should start keeping documents now for the eventual MERP filing after mom dies.

Another exemption is for any and all expenses that family or interested party spent to maintain the empty but still homesteaded property of the Medicaid for NH recipient. WHomever spent the $ on the empty house (insurance, repairs, utilities, lawn care, taxes, etc) can let MERP know within the specific time frame, that they will seek reinbursement from the estate for any & all expenses on the home. This amount gets deducted from the MERP tally. I & another family member pay for all for my mom's empty house and will file a claim against her estate in probate. If we were living at the house, we could not claim these exemptions.

My mom is in TX and TX MERP info is all on line although there is some grey area on the submission dates. In TX, which is a claim probate state, MERP is a class 7 claim so is behind classes 1 - 6, so MERP is somewhat lower than other states.
Other states, which are lein states, the MERP lein can be on equal footing with all other liens on the estate so MERP is usually higher in those states. So your states spin on law makes again a huge butt difference in how MERP is done. For example, in Mississippi recent MERP challenges have successfully have it so that the first 75K of a homesteaded property is exempt from MERP but you still have to file for an MERP exemption and maintained the house w/homestead exemption with the county assessor. Also if there is no will, then mom would have died "intestate" & some states law is such that property owned becomes property of the state until lineal heirs are established via the courts or other legal. Messy!

Some states have MERP done by state employees while other states have this contracted out. The states who have outsourced MERP have a higher rate of MERP done as their pay is related to getting $$ from the estate.... in other words the outsourced contractor is really a debt collector. This can be a real nightmare to deal with as it often is with debt collectors. If you want more insight on this Google Randy Drewett. His website is filled with all kinds of MERP & HMS (the contractor for TX & other states) & elder law info that is easily readable. Randy's based in TX. Now I bet there is a Randy Drewett type in Alabama. No I don't know him and my mom's attorney is in a whole other part of the state.

imho you & mom should go to see an elder care attorney before she enters the NH. At this point, if NH admission is looming large, I'd just leave the house however it is owned legally and plan on filing the MERP exemptions after mom passes. Remember you will need to pay for all the the house as all of mom's $ must be paid to the NH less whatever is her states personal needs monthly allowance (for Texas it's $ 60 a mo, which is basically hair salon for my mom!)
If you don't have the following done, IMHO you should have the following done:
- Durable Power of Attorney (not just POA)
- Medical Power of Attorney
- Living Will &/or Advance Directives (DNR) - NH may require this for admission
- Declaration of Guardian in Event of Incapacity
- HIPAA Waiver (umbrella/general one)
- Will or a Codicil to update an old will

The Declaration of Guardian is one that most don't have - this is really important to be done as it sets whom mom wants in her current & cognitive state to be her guardian(s). Once they get a dementia that can change on a whim due to their changing mental abilities.

I'm a firm believer in having an elder care attorney take care of all this. It will not be expensive as most is done by the paralegals. You do want to go in prepared with the information for the documents (e.g. the residence located at 123 ABC street, aka parcel #5678; Ann Smith, wife of John Smith, with the info on all the births, deaths & prior marriages) as well as valid ID for the elder. If the decisions have been already made, this should all simple, straightforward paperwork. Should take 1 - 2 hrs for intake & then 1 hr a couple of days later for the signatures to be done.

If mom has assets, then all this should be paid from her assets. This is important if you ever get challenged on who is DPOA or end of life issues. If you pay for all, and you benefit, then other family could go to court to find it a coerced document.

By letting MERP know you have & will file for an exemption, MERP can evaluate whether or not it is even worth doing a recoup on your mom's estate. For a property with a low value & a claim it might not be really cost effective for MERP to spend the time. In TX the MERP recoup % is low compared with other states, but I think that is mainly due to MERP being a class 7 claim and unless the house is worth a significant amount of $$$, the value of the home will be used up from the Class 1 & 2 claims so not much $ left for Class 7 claims.Just my opinion.

MERP -Medicaid estate recovery gets to the heart of the issue of who should pay for long-term care -- the public through the tax-supported Medicaid program, &/or users of long-term care through their personal resources, including those remaining after death. Amounts collected from Medicaid recipients' estates are not insignificant in absolute terms. They do, however, pale next to total Medicaid spending for long-term care. And it's only going to increase, given that Medicaid is available only to those with very limited resources and the state of US economy.
In a way, the fact that so many people are poverty level will decrease the amount of MERP because many heirs will be able to do hardship exemptions.

At my mom's NH wing, there are 9 ladies in their 90's & all of them have 1940-1950's era homes & all have decades of delayed home maintenance to some degree. All but 2 sit empty. I don't think any of them can sell for the assessor value. MERP wasn’t well thought out. If states get super aggressive on it, then family will let momma's & gran's house go to rot as there will be no benefit for them to spend $ to maintain. Even if you want the house or live in the house, it is to your advantage to let it decline in value so you can get a low appraisal to enter in probate. If family walk away from homes because of MERP, just what are states going to do with a ton of old homes with old people stuff in them that likely has a decade ++ of delayed maintenance? MERP came about 2000-2002 when housing was all a go-go. Totally different real estate conditions now & for the near future.

I have just gone through this with my mom and went to an elder law attorney to get it done right. There is a rule/law if you have been a caregiver for your parent for at least two years, which prevented them from entering a nursing home, there is a way to put the house in your name. Mom's attorney did a life estate deed for us. I have the deed to the house with my name on it. Mom is in a nursing home now and has enough money to pay for her care for several years. If medicaid allows them to own a home, then it won't matter to us. I have taken over all the expenses related to the house, we shared them prior to her being admitted to the nursing home. I plan on continuing to live in the house for a very long time. We spent several sessions with the attorney to get this done. I would only go to an elder law attorney, they know their stuff and it changes all the time. I have two siblings who are attorneys and they didn't prepare us for any of this, that isn't their specialty.

If your mother has Medicaid and is at a nursing home level care, then she is eligible for home care funded by Medicaid and does not have to go to a nursing home. According to your states own website "Medicaid covers home care services for Medicaid-eligible persons of any age who meet the admission criteria, based on a reasonable expectation that a patient’s medical, nursing, and social needs can be met in the home.

Home care recipients must be unable to leave home under normal circumstances, be unable to function without the aid of supportive devices, require special transportation assistance and have an illness, injury or disability that prevents the recipient from going to a doctor’s office, clinic or other outpatient setting for required treatment"

In the end, the simple advice is to get a lawyer. As mentioned, an estate or elder care law attorney. I noticed a comment about 'spending down' which you have to been very careful about. It is traceable when a person does that and that just goes on the tab too. Every state is different and every person's financial situation is different. These are huge decisions that can't be made based on what someone else has experienced because there are just too many nuances to list here.

Paula, Stressed, Jenn - I'd be careful with any transfer of assets and have very good legal counsel that is certified in elder law in your state to advise you.

If the house is gifted or transferred at less than market value and sometime in the next 5 years, mom needs to go into a NH and cannot afford private pay, then when she applies for Medicaid, there can be a “transfer penalty” imposed by the state on paying for her care. Each state’s penalty % is different as its dependent on the state’s NH reimbursement rate. For Texas it’s $ 148 a day as TX rate is low. Say the state is 5K a mo NH average and house value was 100K, then it’s 20 mos that you will have to private pay. If you’re doing it 2012, then until 2017, the transfer penalty applies. Property ownership is all recorded and Medicaid will eventually find out. What I have seen happen is that, the transfer does not come up in the initial Medicaid review, which most often in 3 -6 mos of financials. So mom gets into the NH and all seems kum-ba-ya. Then months later (when the assessor filings get dovetailed with the overall state system) the property transfer surfaces and you or whomever signed mom in as financially responsible get the penalty letter. You face having to clear the penalty within 30 - 60 days or figure out how mom will be private paid in the NH or move her out. This is a total panic situation to be in. Dealing with transfer penalty means getting a good attorney.Pay now or pay later but you need good solid experience legal who knows your states law.

Look up "Lady Bird" deed as it applies to your state, then contact an attorney.
My mother added my brother and I to her deed via the Lady Bird deed several years ago and it is protected from liquidation for Medicaid and/or Probate. Upon moms passing, my brother and I will decide what becomes of her home as we will both own it. Till then she can enjoy her homestead knowing that her children will become the next owners.

I looked up a bit of Medicaid law and you can keep a home and a car. The Lady Bird deed also known as an Enhanced Life Estate Deed would be your best bet. There are a lot of income and asset limits so you might want to go on Alabama.gov and look up Qualifing for Medicaid. This is usually a very hard process and lawyers know ways around the law so your best bet is to find an Elder Law Attorney in your area. To find one go to naela.org (National Academy of Elder Law Attorneys) to see who is certified in Elder Law. Don't do anything without the advise of an attorney or you could lose eligibility for months or years.

Thank you all so much for the wonderful support and information. I'm less scared about being put out of my home, and I have a plan of action - starting with seeing an elder law attorney.