For Medicaid purposes how does one establish that they are the caregiver?

Regarding the two-year requirement: It is not that the house may be transferred to the caregiver after two years, but that you must be the caregiver for at least two years immediately prior to your parent entering the nursing home, where your care was medically necessary to delay your parent needing to go there. Thus, accurate and timely records of what services you supplied to your mother, plus a written assessment by your physician that BUT FOR your home care your mother would definitely have to be in a nursing home, is critical. Assuming you meet the requirements, then your mother can deed the house to you without it being deemed a disqualifying gift. I have a lengthy section in my book (www.MedicaidSecrets.com) that discusses the Caretaker Child Exception in great detail. Here is the actual statutory reference, which applies to all 50 states: 42 U.S.C. §1396p(c)(2)(A)(iv).

Leak. That is my understanding that the home can transfer to you after a period of two years. Pose your question to attorneys in your area on the website AVVO. You will receive responses at no charge, and you can also check out client and peer ratings of attorneys.

Just one more thing, do not be at all surprised if MIA sister of 20 years shows up and wants her half. There are many stories on this site about siblings that feel they are entitled to their fair share after not providing any sort of caring or responsibility for the parent.

Good luck.

I should add that I am not seeking to be paid as her caregiver so there is not a paper/money trail. I just want to know what type of evidence would be required to Medicaid demonstrating that the care provided really did keep her from assisted living/nursing home. There is no home mortgage and all house expenses, except property taxes, are paid by me.

The guidelines to vary from state to state. Please contact an elder lawyer in your state ASAP. He or she may recommend that you transfer the real estate to you sooner than you think, perhaps even now. In my state, the DPW, who handles Medicaid and estate recovery has made it clear that daily records of everything you do as a caregiver are hard evidence of your caregiver status. So keep a detailed journal.

A valid caregiver contract, and a statement from her doctor that you and the doctor communicate on a regular basis regarding her care is a good start.

For medicaid purposes an irrevocable trust that transfers the house to it , and you as trustee, with the right for her to live & maintain and pay taxes, will protect the house from Mediciad recovery after 5 years. It will also save on taxes if it must be sold during her life, & will avoid probate after passing

I live with my 79 year old mother who has Alzheimer. We live in Louisiana but the rule is basically the same. Our attorney recently did an Act of Donation to gift me the house and said that since I have taken care of her for at least 2 years, the house would be exempt from medicaid should she ever need it. According to what he told me, if the person would not have been able to live alone and would have required a nursing home if you had not cared for them then you should be eligible. I don't have any siblings so it was a pretty easy transfer.

Nolagal,
You are very fortunate to not have siblings who just have sense of entitlement even though they do nothing to provide for the day to day, 24/7/365 care! In my case this has become a nightmare in spite of siblings knowing and even telling others what mom would want!

Wow this is great information. I had no idea that I could be gifted my mom's house--IF it were the case that I had lived there. I live in same neighborhood but in my own house, but I am at my mom' s house every day to check in on her, cook for her, drive her around, etc.
Now I wish I had actually moved in with her, then I could have merited her home (currently I am completely unpaid, because she has nothing but her home).

In Massachusetts we call it Power of Attorney which dies when your mother dies. You need to be also the executrix of your mother's estate. It is true the home does pass to the caregiver. But, the best way to prove it is register to vote in your mother's district and vote. The state also has a Healthcare Proxy. This can be done in your mother's doctor office. But, she has to be able to make these decisions herself. But, where you are her only child a POA and executrix maybe enough. Speak with her doctor about this. Even a mild or mild to moderate person can choose a HCP. This is done with her physician.

Mild to mild moderate demented can choose a HCP