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We children are caring for her at home but now understand that Medicaid offers more help than Medicare, but one of us still lives in the home with her. We, of course, don't want to lose the home after her passing. She is 93 and my father passed away in 2004. Her only issue at this time is mobility and we want to keep her at home, which is what she wants. Any suggestions? What is the time frame we're looking at? Can the home be sold to one of us for a small amount to get into one of our names? Any information will be appreciated. Please and thank you......DScott

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Mahoney, Medicaid is an at needs program for people who really, truly qualify financially, w/o shifting or hiding assets. It's not like selecting a Medicare supplement plan, or any other health plan just b/c one plan offers more than another.

Someone legitimately has to be at need for the assistance, and be income qualified w/o hiding assets (even though attorneys show clients how to do this).

While you may be contemplating a move that you feel would benefit your mother, it's close to being a fraudulent transaction b/c you would be attempting to deliberately hide an asset from Medicaid, and you're clearly expressing a desire to do so.

If you want to keep her at home, start investigating means to retrofit the house, plan for the family to provide care, or investigate private duty care (a basically uncontrolled privately funded in home help industry) .

Do some research to learn about what other steps you can take at home, for her mental and physical health, well being, social interaction, etc.

But don't even think of cheaply selling the house to get it out of the Medicaid realm.

Medicaid funds are limited and should be designated for people who REALLY are in need of assistance.

Besides, it's
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Medicaid is not for those who have assets. The government should not bear the cost of her care if she has assets.
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I live in Ohio and I can personally attest to the fact that Medicaid is going to smell something rotten in Denmark if Mahoney and their family attempts to put one over on them. We’ve tried twice to apply, everything on the up and up, and have been denied. When Mom was approved, I was her POA and she and I couldn’t sneeze without them saying “bless you” from the bushes. I would think everything over twice and three times before attempting anything like that.
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Your mother lives in her own home and receives care from a resident child, yes?

Your mother has Medicare coverage for her health needs. On what basis would you make an application for Medicaid, then?

Medicaid is, as GA has already explained, a relief program for people who do not have health insurance (your mother has) and do not have the money or assets to pay for care (your mother has).

Your mother can make a caregiver's agreement with the resident child and pay that child for his/her support. Would that help, at all? What sources of income does your mother have?
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Mahoney, at least you asked the question. Many don't and then create one heck of a mess to straighten out just when parent needs help.
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If mom were to sell the home at a discounted rate to a child she would be subject to Medicaid penalty for difference between fair market value and discounted sale price. Same thing if she were to gift the house to the children.

However, if a child provided medically necessary care, as determined by the doctor, house may be able to be transferred to caregiver child when mom enters a nursing home. No assisted living does not count. And it depends on Ohio's administration of Medicaid.
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mahoney323, when it comes to elder care and what to do next, everything becomes so complex. I didn't know squat about what to do, what can be done, and what cannot be done. I used the help of an "Elder Law Attorney" to guide me through this crazy maze.

It is not uncommon for an elder to what a grown child's name on the deed. It isn't until after the fact that the family realized this wasn't a good choice. Complex issues with "gift tax" for the elder, and "capital gains tax" if the grown child later sells the house as the bases used for the formula goes all the way back to when one's parent had bought the house. If the house is inherited, the formula goes to the value of the house when the parent had passed.

Oh, if only we could see into the future to see what life would be like for that elder we could better plan. They could still be very active in their 90's, or be bedridden in their 60's.
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I honestly wasn't trying to put one over on Medicaid. I have no inkling as to how all this works and was searching for information. Obviously, I need to do A LOT of research to know better how to help her. Thank you all for your help. DScott
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Keeping a parents home can be done. The issues - in my experience- are whether or not it’s feasible. And feasibility interdependent on your states property & probate laws & Medicaid administration (especially for exemptions & exclusions to Estate Recovery such as the caregiver exemption as it sounds like a heir is living in her home as caregiver); status on the house; financial & risk aversion/ability of you & your siblings; and DPOA & future Executor ability to track & document every cent. Nothing will be simple.

The only way for it to be simple is one buys mom’s house at FMV.

Each state administers its Medicaid program uniquely within overall federal guidelines. By & large Medicaid allows for elder with a homestead if under Medicaid market value limit (most states at 550k) to continue to own home and have it considered an exempt asset. Now they will need to file some sort of “intent to return” document with Medicaid and acknowledge that MERP (Estate Recovery) exists. Also All states have a caregiver exemption to MERP, but how it can be done will depend on your state (some only allow it to go forward after death not in tandem with elders Medicaid application). A few states allow for legal that bypass probate - Lady Bird Deed - so no MERP. Not simple and why you hear you need an elder law attorney.

But you can can do a bit of determination in advance of meeting with mom’s attorney. Hurdles initially seems to be threefold .....
1. once they apply for LTC Medicaid -as mom is now a resident in a NH- all their monthly income (SS, pension) is required by Medicaid to be paid to the NH as a copay or SOC (share of cost). Mom will have realistically zero $. Remember in order for her to apply for LTC Medicaid she needs to be at-need both medically and financially which means impoverished and have spent down her non-exempt assets to be no more than 2k. Often the SOC comes as a complete surprise. Mom will have no $ for house in her name.
2. So all property costs fall to family to pay from day 1 of NH to beyond her death. Taxes, insurance, utilities, maintenance, etc. And pay on a property that they do not own (unless 1 can get the caregiver exemption done fully to transfer title before mom dies) and may not ever own dependent on what happens after death. If there’s a traditional mortgage (horrors!) this could be quite a sum each month. Look at all property costs and add it up. If need be could each sibling be able to pay all property costs individually?
3. When mom dies, house becomes non-exempt asset of her estate. And subject to any liens or claims against the estate including whatever path MERP (Medicaid Estate Recovery) takes in your state. Someone will eventually need to deal with MERP but whomever is currently DPOA will have to keep rigorous documentation on property costs now and then future Executor after death. Will DPOA do this? Would Executor likely do this?

What seems to happen is that there are multiple siblings - all heirs as per mom’s will. Initially family is all kum-ba-ya in sharing concern for mom & mom’s house. They don’t mind paying for things as they know they will inherit their share. But eventually that’s over. And it’s really over when mom goes onto Medicaid as Medicaid can place a lien onto the property or file a claim against the estate in probate. If Bro & his wife won’t pay a penny on taxes on a house they’re likely to get no benefit from, what then? Sissy’s $ priority is her kids tuition, so no $ from her, what then? If 1 family member lives in the home, everybody else feels House is their problem & their wallet. If preNH caregiving is being shared among several, then there is no full time caregiver to get the caregiver exemption, so to possibly get house, probate will need to be opened with claims against the estate filed by family. Probate has costs to do. 

If there is a single caregiver exemption likely, they need to be able to afford the house on their own. Mom may need to do a codicil to her will to have the solo caregiver child as her only heir. It’s something to clearly ask her attorney as to how your stat s Medicaid deals with exemptions. 

Really to keep a home, family needs to be all in with time, $ & pitbullie determination to do whatever needed for however long required. You know your family best if that’s at all feasible. Good luck.
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In NY if you lived at home w her as her caregiver then there is penalty exemption . She can transfer deed to you w Life` estate for her. Go to estate lawyer
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