Will Medicare/Medicaid nursing facility take our home?

LostDIL,
The last we heard on Sept 24th you told us you had appointments with attorneys and that you actually owned 2/3 of the home. I am wondering if you have already had that appointment, and what they may have informed you. Would love an update if you are still on Forum and if you have already seen that attorney.
Best of luck.

Contact an attorney specializing in these areas.
Call Medicare / Medicaid.

While well intended responses here, you want to get accurate information directly from the sources.

The nursing home can't take anything per se. It depends on government requirements / financial structure. Talk to an attorney.

LostDIL: Retain an attorney.

To me this is more than a Medicare & Medicaid issue, it’s more an overall financial issue coupled with future healthcare cost concerns.

Re: prior to 2018 house owned by MIL and owned by her outright, correct? So no mortgage or HELOC or other lending using it as collateral, correct? The action to do this involved going to courthouse and submitting documents (hopefully done via a Warranty Deed but could have been a Quit Claim deed) so house is now titled and owned 1/3 each (MIL, your hubs & You). Was this done?
Does your & hubs drivers license history show you living at the home since 2018? Its your legal residence? No rent?
Does property tax bill have 3 names on it? Are property taxes broken down btwn MIL with her own exemptions and then you & hubs with your own exemptions? Does homeowners insurance also show each name on it?
OR was this more casual and no paperwork filed at courthouse??? So in the records its still her name only?
I'm asking because if this was done & filed at the courthouse in 2018 and the changes now reflected in tax & insurance bills etc., as it’s a full 5 years from 2018, MIL would be beyond any gifting of her home as an asset ineligiblity penalty placed by KY LTC Medicaid program (it is this program that pays for custodial care in a NH aka skilled nursing care facilities); and you live there without paying rent to MIL.

State still will ask for MIL financials to ensure 2K nonexempt assets and $2829 or less mo income ($ amount set by most States) and that btw 2019 to now no other gifting of assets by her. If you 3 all commingled how house bills are paid, payments will probably have to be segregated to show caseworker that MIL only paid her 1/3 share. Otherwise it can pose gifting & eligibilty issues.

for Estate Recovery, yes 2/3 is yours but 1/3 is hers, so should she go into a NH her 1/3 ownership would still have an attempt by the State to recover costs Medicaid paid for her care. Done via MERP or MERS and exemptions and exclusions to it. How to deal with it is realistically attorney work and as it’s an after death attempt, you need an attorney who is experienced in Medicaid Estate Recovery, KY property rights and probate laws as well. It can be dealt with imho. But this happens all after her death…...

The bigger issue - if your own finances are very narrow - would be IF you & hubs on y’all’s own can afford the home for possibly years.
Why? It is because the LTC Medicaid program requires MIL to basically give all her mo income (like her SSA $) as a copay or Share of Cost (SOC) paid to the NH. She will have no-zero-nada of her $ to pay a penny on that house she is still 1/3 owner of. All property costs from Day 1 LTC Medicaid filing till maybe a couple of years postdeath & MERP or probate dealt with, will be all on you to pay on a house that you do not yet own outright. If her SSA income right now is needed to keep the household afloat, her having to do a required SOC once in a NH will place you, your hubs in a financial crisis.

If an elder or their family, are all insistent on keeping the home while elderly owner is in a NH and on LTC Medicaid, it can be done. But the POA and potential heirs had better be able to pay all property costs with an emergency fund for an undetermined time with the risk that things may not work out as planned. Not everyone is comfortable with risk.

You need to consult an attorney that specializes in elder law. You will see how "attentive"the person at the nursing facility is. They will ask how much $$$ your MIL has in her bank account, what assets does she have. Don`t be fooled, they are figuring out how much they can expect to take from you. The people in the elder care industry are well rehearsed, scripts are memorized. I went thru all that with my father, right down to home hospice when he passed away.It`s been months and I am still getting bills from all types of medical "specialists." Some of the hospital bills are for treatment when he wasn`t in the hospital! When I ask for an explanation the person on the phone cancels the bill! It`s all about the money. Get a good elder law attorney, it`s a necessary evil.

Much good advice on this forum! Have your Mother-in-Law seen by a social worker and placed in memory care in her area. Dementia is only going to get worse, and MIL can live for years like that. She can use her Medicaid when funds run out, not your money. And, your husband needs to get back to work to support your household, your family and life.

You could look into Hospice. Hospice doesn't mean the end, but they have many different services that they offer at no charge to her (Medicare covers it at 100%). The services would depend on what her needs are, which would determine how often someone would need to come out. They have aids that can come to bathe her, nurses to administer meds, and aids that can come and sit with her while you go out to eat, they offer PT, OT and ST as well and can help with any medical necessities she may need such as say a hospital bed, walker, shower seats, anything like that. If she is on any medication, they will evaluate that and see what they can provide her through them so that you don't have to pay for prescriptions. I have had them come out recently to evaluate my mom recently and the things they can help with are wonderful!! They would keep her as a patient until the end, and your mom would not have to go into facility care and you would not have the burden of losing your home, as she can reside in her home until she passes. They will continue to evaluate her as she progresses and will make necessary changes to accommodate her needs as she progresses.

You can always go to an elder attorney for a consult. I did this - cost an hour of his time I could ask as many questions as I wanted in one hour and he answered them. It was the best $400.00 I spent. Remember he will be knowledgeable in the laws for your state. Take a deep breath everything will be okay - great that you have found this site and know I have said a prayer for peace for you and your family. Hugs

Medicare is not in play here but Medicaid is and is run by each state, and somewhat differently.
My sister moved into my mom's home 12 years prior to going into a NH, paid by Medicaid. They do go after assets down to the state minimum but in her case a family member living in the home would be allowed to stay indefatigably.
And my sis wasn't on the deed, just mom.
My sister got advice from a elder care lawyer specializing in Medicare for our state.

If your MIL did this property deed back in 2018 it's older than the 5-year Medicaid lookback period. The shares that you and your husband own are Medicaid-exempt. The share that your MIL owns probably isn't.

You're not going to lose your home. One-third (your MIL's share) may have to be liquidated in cash and spent-down on her care in the nursing home. This means her equity in the home (1/3 its value) will have to be taken.

Of course, there are ways around this. If there is medical documentation that she has dementia and couldn't be left alone for the last 18 months for one day, you and your husband if you provided that 24-hour care have a right to charge her for it. Yes, you can bill her. It may even come out to more than what her 1/3 share of the property equals.

Go to a lawyer who specializes in elder law and estate planning. They will figure this out. It will be worth whatever you will have to pay them.

It's ridiculous that old people buy property and insist that their names be on the deeds or keep property in their names. I know why they do it because they see it as a kind of insurance policy. An insurance policy that will ensure their family keeps them out of a "home" if they want to inherit. It doesn't though. Usually a family will forgo any potential inheritance and place a LO if their needs become too much for them to handle at home. What a shame.

OP you ask what would happen if a husband and wife shared property and one had to go into a facility on Medicaid (as far as I know MediCARE does not cover LTC, only MediCAID for those who cannot afford to pay for their own, and the requirements are pretty steep). In the case of a husband and wife, there are provisions in place for married couples that are not there for other relationships.

Now, I'm going to agree it is a good idea to speak to an elder care attorney. For a number of reasons. You are her POA, but is it actually invoked? How was it written - does a doctor (or two) have to deem her incompetent in order to invoke the POA (in other words are you managing things for her with her permission/at her request rather than under legal terms?)

Because the property was transferred to the new deed in 2018, you are beyond the 5 year look back for that portion I would assume, but her remaining share of the house would be considered an asset - so that is why I suggest you talk to an elder care attorney.

If she is still mentally competent it may also be possible for her to transfer the remainder of the deed to your husband under the child caregiver exemption. https://www.medicaidplanningassistance.org/child-caregiver-exemption/

But if she is no longer competent she can't do anything legally at this point.

It is only if she needs Medicaid within 5 years that the house would even be part of the picture - because in many cases - people need to sell their home to pay for LTC. If she does not have the funds, they will want her to spend down her assets and because her biggest asset is tied up with other people, talking to an elder care attorney is your best bet.

Anytime someone's finances are tangled up - even just in an asset, it is a good idea to have a legal review to be safe.

a little confused, you say there is a survivor transfer (I am assuming a TODD, Transfer on Death Deed) but then you say you already own 2/3 of the house

Is the TODD on the remaining third? If you do own 2/3 already then the state cannot go after that .

The could have an interest in the remaining third, even with a TODD on it, but that alone cannot force you out of house. You would have option of buying state out or state would get their share when house is eventually sold.

That said, see a lawyer, but if you do indeed own 2/3 outright they cannot force you out of your house

LostDil, NO, you would not lose your home if you MIL goes into a facility on medicaid.

When you download the application from your local Department of Health and human services it will probably have a section about her being in need of a facility that was averted by her family moving in and keeping her out of the system (not those exact words) if it doesn't, ASK the social worker about that. Some states have criteria that allows a child to keep the house if they kept her out of a facility. They will not attempt MERP.

Even if your state doesn't have that program, you will not lose your house, the most the state can recover is 1/3 of the property value, but, this recovery doesn't force you out of your home, it would put a lien on the property that would need to be paid at the time of sale.

Hopefully igloo572 will chime in, she is the resident expert on how this all works.

God Bless your family for all you have done and do for your MIL. May you find a place that meets her needs and gives her great care.

Yes, I think that you may indeed lose your home to pay for your mother's care, unless she is independently wealthy without it. When your mother enters care her assets go to pay for her care. Her home can be kept and her car can be kept, but if she has not enough assets for her care and wishes to stay private pay she would have to sell her home. As you are not on the deed until her death you would have nothing to say about that.

She could keep her home and collect Medicaid when liquid assets run out, but you still would not get the home until Medicaid did recovery of invested finances via "clawback".

Your example here serves as warning that those who give up home and job to move in and give care often end up homeless, jobless and without a job history.

What SHOULD have been done all those years ago was a shared living contract in which you and mother attended an attorney to see how much you would pay to live with HER when she didn't need you and how much "shared living costs" monthly she would pay YOU when she did need you.

To find out exactly where things stand now I would attend a good elder law attorney with all your papers and deeds and the details of assets. You don't want to either divulge private info to strangers nor to count on strangers having the best advice for you. That I know of, none of us are attorneys and that's what you need now. It may be you are stuck in caregiving if you wish to inherit this home, and as there are other siblings I hope this thing is AIRTIGHT as they will want equal portions and may be willing to fight for them despite having done nothing to deserve them.

Good luck.

Yes, this is a vary by state and how aggressive the state is with Medicaid Estate Recovery Program (MERP). Strongly agree with other and seek legal advice with an eldercare lawyer and only an eldercare lawyer. You want someone who specializes in the Medicaid long term care regulations for this matter.

This is what I found after doing a google search:
A Survivors Deed is treated differently than a Life Use Estate deed.

A life use deed, also known as a life estate deed, and a survivorship deed are both legal documents that can be used in real estate, but they have different purposes: 
Life use deed
A life estate deed grants the owner the right to use and live in a property for their lifetime, and then transfers ownership to another person or entity when they die. This type of deed can be used to protect the property from nursing home liens and to avoid the property being included in the Medicaid recovery process of the owner. 

Survivorship deed
A survivorship deed transfers property ownership to the surviving co-owners when one of them dies, without the need for probate. This type of deed is often used to ensure that the property is distributed equitably among the co-owners. There are three types of survivorship deeds: joint tenancy, tenancy by the entirety, and community property. 

Good luck.

I would suggest you talk to a Medicaid caseworker. There are Ladybird deeds and life estates. Medicaid has a 5 yr lookback and anything done within that lookback could be null and void. The house is an exempt asset when the recipient is alive but once they pass its an asset that can be used for recovery. There is a caregiver allowance but you must show you were living with and caring for this person in their home of residence. You may also need to show that you can afford the taxes, bills and upkeep on the house. If allowed to stay in the home, upon MILs death the house is now an asset. A recovery letter will be sent to you asking about assets and at that time you declare the house and again may need to prove u were a Caregiver. The lien will be placed on the house. If you sell, leave or pass, the lien becomes due and the house sold. Not sure how this works when one spouse is the caregiver and the other not or both are. Again, you need to talk to a caseworker.

The idea is for MILs home to be sold to fund her care in Memory Care Assisted Living. If you apply for Medicaid to fund her care on the taxpayers dime, MERP will likely put a lien on her home to recover the costs of that care. It's unfortunate you did not see an Elder Care attorney before you moved in with MIL and took on such a huge task.

I agree this is a question for an estate attorney or elder law attorney since the Medicaid rules can vary by state.

What does a survivors deed mean? That she still owns it but you get it after death? If so, then Medicaid could potentially lien it, but that is a question for an elder care lawyer.