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Both parents have been put in a nursing home. They still own their house. Does the house of those put in a nursing home have to be occupied by one of the spouses who own the home to be able to keep the house?

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Probably. But depending on how nursing home is paid for, personal funds or medicaid if this is no money, the house will either end up being sold to fund the care or to pay back medicaid. Talk to an attorney in your area. If there is no way to rent or occupy the house it's going to become a financial liability.
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If Medicaid is part of this situation, you may need to talk to an attorney. In general, Medicaid allows the house to be owned while the owner is in a nursing home, but they may place a lien on the house after death in order to recover funds paid for care. If a child has lived in the home for a period of time to care for the elderly parents and prevent them from needing nursing home placement for a while, Medicaid generally will allow the child to keep the home. This varies from state to state.

You need to consider whether this is the right thing to do financially, whether Medicaid is in play or not. Someone will need to pay the house expenses including utilities, taxes, insurance, lawn care, snow removal and upkeep. Insurance will be expensive and difficult to find because most insurance companies will not insure a vacant house. My late MIL finally agreed to sell her house after the insurance was cancelled and we could not find an affordable replacement policy. You should arrange for someone to check on the house frequently to make sure that there has not been a leak, a broken window, storm damage, etc.
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Vicki, your parents can still have in possession the house, and that is because sometimes a parent will be able to move back in.

If you know for sure your parents won't be moving back in, there is always the option of selling the property, but that would need to be worked out with Medicaid because Medicaid will have a lien on the property. Check with an Elder Law attorney the best route to take with this. I would recommend selling, if possible.

If you plan to hold on-to the house, and you don't want to place a renter or another relative in the house, you can do what is called "winterizing" the house, which means turning off the water and draining all the pipes. A plumber can do that for you. Winterizing also means no heat or air conditioning, so depending on where you live, if the summer are hot there could be chance of mildew.

Unplug the refrigerator and prop open the door of both the refrigerator and freezer, otherwise mold will grow inside the unit.

And as akdaughter mentioned above, you will need to notify your parent's home insurance carrier, there will be a large increase in premiums because the home is vacant. The carrier could also deny the insurance.

Hope everything works out for the best for you and your parents regarding this.
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When vandalism became an issue, we realized it was time to sell the vacant house. Vacant houses deteriorate faster anyway. We got everything mechanical in tip-top shape and sold the house "as-is". We did no decorating i.e. paint, carpet, etc. No one in our family wanted to live in the house (rural area) and Medicaid isn't an issue. The house was paid for so the money just went into Mom's bank account and is being used for her personal care.
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Should have said we were paying a ton of money for insurance because the house was vacant, and of course were keeping the utilities on so that we could keep the heat and air on and water for the toilets and such when we were there. We had to keep the lawn mowed, but couldn't keep tools there because of the aforementioned vandalism and theft, so eventually we hired people - more expense. Had to continue tree trimming, leaf raking, lawn watering - we are happy to be out from under all that extra work.
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How is the NH being paid for?
If its private pay by your parents and there is all sorts of $$ available for them to pay for their home and all it's costs and to pay for the NH, then keeping the home is more a question of someone in the family going by to check up on house and having really good neighbors to alert family of concerns.

Do a rough annual cost on the house, look at the majors (roof, electrical, etc) to see their status, then the costs on the NH and go over their income to see what & if the funds are there for another 3 - 5 years. Lots of folks continue to keep their home even when in a facility. It's a matter of money and determination.

As other have mentioned, you may need to pay for a speciality insurance policy - it would be a vacant dwelling policy which covers fire as the basic coverage. They are expen$$ive. You need to get them through an independent agent as the State Farms of the world in general won't touch a vacant dwelling. If the property is old (so not to current codes) or has had a claim in last 3 or 5 years, you may find it hard to get. Ditto if there is not current coverage so there is a seamless overlap from old policy to new vacant dwelling policy. Vacants seem to be based on sq footage of the house with a base value of 100K. If house is low value, you probably can't get a vacant dwelling done. In full payment on vacant too, no months premiums or discounts or so it seems.
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If your question is asking whether Medicaid will continue to pay care costs for your parents, the answer depends on how they hold ownership of the house. If they have full ownership (known as fee simple in legal jargon) Medicaid regulations in your state will determine how long before Medicaid requires the property to be sold so that the proceeds can be used for their care. Different regulations apply if they had a more limited form of ownership (example: life estate).

Whichever form of ownership applies in your case, you can save equity value if you follow the regulations and plan. Spending down is not the only option, even in a crisis situation where both spouses are admitted to a facility. Talk with an elder law attorney practicing in your area.

If your question is about the practical aspects of holding onto a vacant house, other aging care.com community members have pointed out how risky that can be. Homeowners insurance will not cover a vacant house, and if something bad happens the losses can be significant. Vacant dwelling insurance is more expensive than homeowners, but your must pay those premiums if you want to protect the property. Vacant swelling coverage is limited, and there will be inspections, but you can't afford not to have the coverage. Talk with your parents' insurance agent.
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Now if Medicaid is involved for paying for their NH, its a whole other matter.

Medicaid by & large allows for them to keep their home as an exempt asset for the rest of their lifetime. Now although this sounds just dandy, the issue is they are required to do a co-pay of all their income to the NH by Medicaid except for a small personal needs allowance (varies from $ 35 - 105 a mo). They will have no - none - nada - zilch of their $ to pay on anything "house" from here on out. Family will have to pay on all. If the house is modest and paid for, the cost could be manageable. If there still is a mortgage or has a high HOA fees, it could be quite costly.

Then once they die the house becomes a non-exempt asset and subject to recovery by MERP either by a claim or a lien on the property. Now all states have exemptions and exclusions to MERP - Medicaid estate recovery. You need to see if you state has an exclusion to the costs of maintenance on the home; if so you will have to keep meticulous records on all this to file as your own claim or lien on the estate and deducted from the MERP claim. You need to look into how probate is done in your state as your costs paid on the home may be a higher level of claim against the estate from MERP's claim. Keeping the family home is a lot like having a 2nd or 3rd home but without the assurance of ownership so runs a risk. Most of us cannot afford a 2nd home or deal with risk easily.

Like all things Medicaid MERP will be interdependent on your state laws. This likely means going traditional probate to do this with it's costs and legal run. If the home is worth a lot, it could be that you will never have enough of your own costs to come close to the value of the home to offset MERP's lein or claim. But if you have the deeper pockets & like risk, go for it!
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