My father does have the start of Dementia but was recently evaluated and they say he can still make his own decisions. He cannot go home, an at home health team cannot care for him he needs 24 hour care. I am under the understanding that medicaid will not pay if he owns a home that no one lives in. I understand it is hard to give up your home, also my home I grew up in, but if he will not sign it over, the nursing home will be forced to make him leave. Just don't know where to turn anymore :(

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In PA when my mom went through this, the co-pay was not income minus personal care allowance, but also minus utilities and some other home expenses. They also allow keeping a vehicle.
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Candy - see an elder law attorney who has a practice in the city where dad's house is. Really please do. Medicaid rules and management is done by the states and how your dad's state law is on Medicaid, and property rights will make a huge difference in what can be done right now and also what the situation will be for Medicaid estate recovery (MERP) after dad dies. It may be best where dad sells the house and goes onto private pay for NH and then can use the rest of the proceeds from the house to buy a preneed funeral and burial policy, get dental work done or other things that he would like or would make his life better but whatever the case, you could determine how the $ gets spent on him or his care or his needs rather than the state.

Most states have Medicaid so that the Medicaid applicant does NOT have to sell their home. The home can remain an exempt asset for Medicaid for their lifetime. They can continue to own the house....they may have to do an annual "I want to return" statement or letter for Medicaid. Some states will not allow the home to exempt if they are viewed with a terminal disease (like a major cancer but not dementia) but most states do not take this approach. They can continue to own it.

The NH doesn't want Dad to sign over his house - they are not in the real estate business and the NH cannot make Dad sell his house either. BUT the NH does need to get paid - whether that is private pay, LTC insurance or by Medicaid. If dad meets the Medicaid qualification for financial and medical, he doesn't have to sell his home.....but.....

Here is where it gets sticky if the elder still has their home......Medicaid requires a co-pay of all their income less dad's state personal care allowance. The PCA allowance is between $ 35 - 90 a month. So say dad gets $ 800 from SS and then $ 1,000 from retirment and his PCA is $ 50 a month. So every month the NH MUST be paid $ 1,750.00 a month from dad's income. Realistically there will be no $ for dad to pay for anything for his house as it has to go to his NH co-pay. Now if someone else is living in the home, then whomever is living in the home is fully expected to pay for all costs on the home. Like taxes, insurance, utilties, etc. They benefit from dad's property ownership but have to pay any costs AND there is no MERP exemption for the $ paid on the house when dad died. If there still is a mortgage, then there is possibly alot of $ each month needed for the house.

But with an empty house, in most states's, the $ spent by family or others on the empty house is a MERP exemption. No one is living in the home so there is no benefit. Understand? Now if the costs of the house are low, and there is no mortgage, and the house would be a difficult house to sell OR would cost significant amount of $ to have it go to marketability and stay on the market, you may be best off by keeping it and just paying for whatever you absolutely need to for dad's lifetime. If you decide to keep the house, you really kinda have to decide to do this for the long haul and till dad dies. Whether it's manana or a decade from now. And You have to keep detailed accounting on what was spent and then after dad dies file for an MERP exemption on those costs according to MERP rules in your state. You also can file your own claim against the estate in probate too if you have an agreement with dad about all this done.

This is going to sound harsh, but if dad is youngish (early 80's) and healthy by & large and just starting with dementia, then he could well live another 5 - 10 years. But if dad is mid90's and later state dementia, then maybe a couple of years. So you need to keep all this in mind and just how much of a sense of humor you can have in dealing with an empty house when evaluating what to do. I will say this, if there are a bunch of you - like there are 4 kids - then everybody is going to be all kum-ba-ya at the beginning and will say they will do whatever to make this work. Then what happens is that Sissy # 1 does not pay the tax bill or insurance and says she did....; BIL # 2 does not maintain the grass and gets all argumentative about the height of the grass; etc. It gets ugly and 1 kid ends up having to deal and pay for all. And when dad dies, they all have their hand out for their share. If this sounds like your situation, think hard about if you have the sense of humor to deal and possibly pay for whatever comes up. Good luck.
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