Gigi, one of the exemptions for the house is if a relative has lived there as a caregiver, thus keeping her out of a nursing home for some time. Since this is a really Big Deal for your brother, it would be more than worthwhile to use some of Mom's money (is she in spend-down mode?) to consult an attorney specializing in Elder Law, and see about setting things up in the most advantageous way.
If they are in a LTC facility & on Medicaid, when they die Medicaid is required - by federal law - to attempt a recovery of costs paid. The recovery amount would be a debt against the estate of the deceased. It is NOT a debt of their family.
Happens via MERP or MERS (Medicaid estate recovery program) that is done either by state employees within some division of state govt (like could be HHS or could be comptroller) OR done by an outside contractor (biggest one is HMS which does dz+ states). If your elder is likely to die and end up with after death assets, imho, you really need to carefully go over all the various exemptions and exclusions to MERP and meet with an MERP familiar probate atty well in advance of their death. A lot of what can be done after death will be very dependent on how your state approaches property and probate laws as to how successful family will be in dealing with recovery imo.
Gigi - is it that your elder wants to keep their home?
My brother has had to live with her for almost four as her care giver because of her mental health she could no longer live alone. His health is not doing well and now she needs to go to a nursing home. After her death could he continue to live in the house if he paid the payments or would the house have to be sold to pay back Medicaid?
If there are payments to be made, does she have a mortgage or a reverse mortgage? If parent passes away, mortgage company will call the note. If a reverse mortgage, there are rules about repayment. It’s worth consulting an attorney to see what equity mom has, what payments are needed to be made, and what exemptions are available. Brother will need documentation of his caregiving and needs of mom that lawyer can make sure is completed correctly.
Happens via MERP or MERS (Medicaid estate recovery program) that is done either by state employees within some division of state govt (like could be HHS or could be comptroller) OR done by an outside contractor (biggest one is HMS which does dz+ states). If your elder is likely to die and end up with after death assets, imho, you really need to carefully go over all the various exemptions and exclusions to MERP and meet with an MERP familiar probate atty well in advance of their death. A lot of what can be done after death will be very dependent on how your state approaches property and probate laws as to how successful family will be in dealing with recovery imo.
Gigi - is it that your elder wants to keep their home?