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She has Alzheimer's, only son unmarried has always lived with her in the house. Her spouse is deceased and there are no other relatives. House is in her name only.

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It all depends on the circumstance. I want to mention first that Medicaid itself won't take the house. When the mother dies, the state can put a lien on the house in order to recover some of the money spent on LTC. The decision whether to do this or not depends on several things. If the son is disabled, he will be allowed to stay. If he provided at least 2 years of full-time care that allowed the mother to stay out of the nursing home, he MAY be allowed to stay. Or if losing the house would create a serious financial hardship, he may be allowed to stay. Some states will not put a lien on the house if one these conditions are true. Other states will grant a life estate, but seek recovery if the son were to move or die.

If the son has been living there and working full time at his own job outside the home, chances are that the state will put a lien on the house after the mother dies.
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Thank you that clears this all up, he was a caretaker for her.
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Her son might want to contact an attorney specializing in Elder Law to determine how best to proceed with the house ownership issue. For example, does Mother need to will it to him?
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What will happen is very much interdependent on how your state Medicaid program works; how MERP is bring done (by state or outside contractor); and your states laws on probate & property.

For example, TX has an outside contractor for MERP as does about another 2dz states and they approach this as debt collectors & will require documentation for any exemptions, exclusions, etc. For the caregiver exemption, the son would need to provide a letter from the elderly neighbors MD or social worker as to what services were needed and were provided. Letter on their letterhead stationary with state licensing info......now whether this is easy to get done or not just depends. No letter = no exemption.

Another sticky is transferring the property. If she dies with no will, then she died intestate. Most states have intestate deaths such that all assets escheat to the state. Son would have to do a lineal heirship to become heir but as state is in control they really are in control of the estate. It's not the best position for family to be in.

If there's a will with son as heir, then he does probate, or small estates affidavit or muniment of title. MERP has to make a claim against the estate. Son and others can also have their own claims. Just what path is best, really depends on laws for your state. As others have said, he needs to meet with an elder law attorney to come up with best option.
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