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Mom in ALF. Medicaid approved.

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Theres a mortgage on the house, right? If so, i'd suggest you asap see if your state allows for a waiver from the SOC mom curragony  pays the facility (like her SS$) to instead pay the mortgage. Some states do this - TX does. It needs to be applied for and the $ is for the exact amount of the mortgage & paid to mortgage holder. It seems to be time limited, like 6 mos. & mom/DPOA will likely need to provide a Realtor listing agreement & MLS listing report. So no FSBO nonsense. Makes sense so house doesn't get foreclosed on. Seems not to cover taxes, insurance. Those things family fronts & without anticipation of repayment (from the act of sale) as medicaid will likely consider any $ from mom as gifting. You can appeal gifting determination but facility will likely want someone in the family to sign a private pay contract in order for mom to continue to stay.

As far as a way around this, choices are slim. Maybe family - through a legit business - could be able to place a workmans lien on the property. Lien has to be paid to lift the cloud on the title. There was someone on AC who did this as BiL did property management & had contract with elder. House was dealt with as regular client & since not paid, workmans lien filed. Now if elder continues to keep home, then once they die things can be dealt with in probate court. Family could enter costs paid as a claim against the estate. MERP could also enter thier own claim. The lien - if your state places these when elder is alive -  then could become a claim against the estate.  All gets sorted out via probate laws. If your state does level of claim by class, executor related costs are usually a priority claim over medicaid / MERP.
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When it comes to Real Estate Agents, such questions are out of the scope of our work field. We have to tell clients to contact an Elder Law Attorney or Real Estate Attorney for the answers.

Also such situations are not part of a house Sales Contract. Families have to settle such matters after the house has gone to settlement. Usually once the parent has passed and if there is any money left over you maybe able to turn in receipts to Probate.
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I am in this situation. You cannot use any of Mom's money to pay bills on her house. I was told by Medicaid rep that even if I keep immaculate records, I was not guaranteed my money back on the sale of the house. At that time, Medicaid will stop and then your in the "spend down" at that point again. Money can only be used for "personal" things. You cannot take money out for taxes, utilities or insurance. You need to talk to Medicaid about this. I was told by my lawyer NOT to pay anything. Right now my disabled nephew (another story) is living in Mom's house and paying utilities but I am in the process of finding him a place to live. Once that is done, I am turning the utilities off and shutting the house up. I will let the Township or Medicaid have it. If the house doesn't sell by your Mom's passing, Medicaid will put a lean on it at that time. That lean will need to be satisfied at time of sale. If there is money left over, then you can probably get your money back.
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Who do you expect.to reimburse you? The government which is already paying for her medical care? Maybe there's a way to write that into the sales contract to pay you back but don't expect to get the money until the deal is done.
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