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Caregiver's rights to obtaining father's home. My younger brother and his girlfriend have been living with my father for the past 2 years, who is showing signs of early dementia. My sister is the POA.

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There is some excellent information coming from this posting. To the original question about ownership, Ferris brought up a good point. No one can assume ownership without changing the deed or upon inheritence.
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pstiegman: I have actually lived here since 1997. I moved back home because I was sick. Since then I have cared for an ill aunt, brother in law and father until they passed away. Now I am caring for my Mom who has dementia. How do I prove I have been caring for them? We had Mom's trust updated about 3 years ago and i was named DPOA in it but the care giving started many, many years ago and just progressed from one person to the next. Because I was home and on disability everyone just assumed I would be the caregiver which is what happened.

It is kind of hard to talk to Medi-Cal about the situation since Mom is not a Medi-Cal patient.... would they even waste their time to speak to me? In my experience in the past I did not have a good case worker and she told me that I probably knew more than she did!!! She did not even know the difference between Medicare and Medi-Cal....true story!

Igloo572 seems to understand Medicaid better than anyone I have ever known! If she doesn't work for them she probably should or work as a consultant!
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Holy Cow, discuss your situation with Medi-Cal. They may allow you to stay in the home, but they will not forgive the lien on the property. They need to see proof that you have lived there as a caregiver for 8 years.
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Igloo572: Would you clarify something for me regarding MERP and what you have stated in your reply.

My mother is cared for by me at her home 24/7. We had to have the sewer torn out and new put in. Since they tore up so much of the driveway, we had the rest torn out and a new one put in. She also has termite work that needs to be done.

I have been her caregiver for about 8 years and my father before her. I live here in her home along with my daughter and have since 1997.

If Mom should have to go into the nursing home in the future, could I stay in her home and would all the repairs to her home be acceptable by Medi Cal ?

I am confused as to how that works. Your knowledge is amazing!!!
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Mburkett -Jessie has brought up very, very important issues as to just how complex Medicaid rules can be. The caregiver may have to provide documentation as to their full-time caregiving (so no other job) and a letter from the applicants MD that the care they provided kept the applicant from a NH for 2 years prior. My experience is that most MD's do not want to write those type of letters (also this tends to be true for competency letters) as there are all sorts of legal issues involved.

There are 3 kids? Yourself, Sissy the DPOA & brother who lives @ the house, correct? Now before you all even start to think about who gets the house, I would recommend that you all take a long & hard look at what dad's needs are and what dad's financial situation is. With the Holidays & the New Years upon us, this is a good time to do this as perhaps you all are together and decide to make Dad's long term life plan a family new years resolution.

It is my experience that if they live long enough, they will eventually run out of money to pay for their care whether @ home or in a facility AND the caregivers will run out of steam in providing care….SO the family (usually the POA) will have to apply for Medicaid to pay for the NH that Dad eventually goes into once he is at the point of needing "skilled nursing services" which is what a NH is and Medicaid pays for. Now you all may be in a state that also allows for Medicaid for AL, so the Medicaid application and review may be even sooner.

NH run between 5K to 15K a month and the states (which run Medicaid under a joint state & federal guideline) have to do a look back on all the assets of the Medicaid applicant. The lookback can currently go back 5 years. For my mom's application it was 3 years & 6 months of detailed financial data and almost 5 full years of real property ownership. Real property is homes, land, cars and the ownership and transfer of ownership on them is recorded at the local level by the county or city tax assessor which in turn goes into the state database. This is mucho importante to remember if you all do any "sale" or "gifting" of Dad's house to brother. Doing something like this or even some type of life estates, are viewed by Medicaid as something that can trigger a transfer penalty inquiry for Medicaid. You really don't want to do something now that can lead to a transfer penalty later. Transfer penalty issues are totally sticky to deal with and a total panic situation for family and usually need elder law attorney to deal.

NH Medicaid program is very expensive for the states, so the state has to look at making the applicant pay almost all their assets towards their care first & foremost before the state will pay a penny. In general, they have to be impoverished with less than $ 2,000.00 in nonexempt assets. Now their home is an exempt asset, but upon their death, the home becomes a non-exempt asset and subject to MERP - Medicaid Estate Recovery Program. MERP is totally interdependent on your states' law on probate and property rights. Some states have outsourced MERP and if your state is one of those, the company that does this for about 1/3 of the states, approach MERP as a debt collector and pretty aggressive.

Also realize if they go into a NH, the state expects them to do a co-pay or co-responsibility of their monthly income (like their SS or other retirement income) to the NH. This seems to come as a surprise to family too. So there will be none of dad's monthly income $$ to pay for anything on the house. Brother & gf or you or Sissy will have to pay for everything on the house (taxes, insurance, etc) for the period of time that Dad is in a NH and continues to own the home. This could be totally financially "do-able" for your family if the house is paid off and has been maintained & kept up by Dad. But if it is like most elder's homes, it has years of delayed upkeep which can be expensive which family will have to pay for. None of this money spent on the home can be deducted from MERP - Medicaid Estate Recovery Program - as bro & gf are living in the home and so are getting a direct benefit of Dad ownership of the property (free or reduced rent). If the house is empty, then the costs to maintain the property can be deducted from MERP as long as they are documented and are reasonable (so monthly grass cutting is OK but putting in a sprinkler system is not). If there is a mortgage, the costs could be quite a lot of $$ each & every month that dad is in a NH. If dad did a reverse mortgage, a RM is due in full when he moves into a NH.

Now since none of us have a crystal ball to see the future, what to do? I would suggest that you all have a talk about what Dad's state is. Dementias can take a long time to be at the point of needing the services that a NH does. Some dementias can take a decade or more to get to that point. My mom has Lewy Body Dementia and really it wasn't until her mid90's that she moved from IL to a NH. While those with Alz, it can come much much sooner. Add to this whatever other health issues Dad has and you can come up with some sort of idea of whether you all are looking at needing a facility in 2 years or 10. And if brother & his girlfriend are prepared to go the long haul in all this. (I wouldn't count on them doing this forever just in hopes of getting the house.) Then add to that what Dad's finances are and go to see an elder law attorney to come up with a plan. Use the session to update all of Dad's legal too (he needs to have a will) and perhaps freshen up the DPOA & MPOA. If your state allows for a "Guardianship in Case of Incapcity" to be done, get one of those too. (This is good for those situations in which nana or paw-paw in a fit of pique & being pissy decides they are removing you from being their POA as it gives you some leverage in reinstating your POA's)
The key to having options with Medicaid is to do as much long term planning as possible. Good luck & Happy Holidays!
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Unless your father has signed over the deed to your younger brother, no he will not automatically get ownership of the house. Sit down together and discuss your family issues and get them resolved before he needs professional care.
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If your brother is an heir to the property and he has providing at least two years of full-time caregiving to his parent, he may be entitled to continue living in the house. First, he has to have been residing in the house and have no other primary residence. Second, his staying there must have been what kept the parent from having to go to a nursing facility. If your brother meets the federal criteria as a caregiver, the state may let him stay. Some states grant what is called a life estate, while others will allow the caregiver to keep the house outright. If a life estate is granted, a person may continue to live there, but if they move, the state is able to sell it to recover money.

Did you brother work? This could disallow him from receiving the house, since he couldn't be a FT caregiver and work. Another thing that could be a stumbling block is that you wrote your father is in early dementia. Generally people in early stages of dementia can live independently unless there are other physical problems. It may be determined that your brother being there was not useful in keeping his father out of a nursing home.

Check the federal exclusions to the Medicaid recovery of real estate and see if your brother fits the criteria. Good luck! Maybe igloo will be along soon. She is an expert in Medicaid recovery.
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Your younger brother will NOT have ownership because Medicaid looks at all the assets back 5 years (2008) and demands a full accounting for every penny. Indiana may not demand the property be sold if your father intends to return to it at some point. Should he die, the state will put a claim against the estate, and the nursing home may sue if there are upaid bills. Generally these homes are sold upon the death of the patient. Of course, there is nothing stopping your brother from purchasing it at a fair price.
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