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She has had medicade for 20 years as she was disabled.

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No recovery for SSI. If she's been on Medicaid for ages she may have run up enough in relevant medical bills over the years whether or not she's gone to a nursing home now. At her passing the lien would be filed. Whether or not there any loopholes, you'll have to find out.
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Neither NH or a State Medicaid program is going to take over ownership or dealing with your moms 38K value home.

The Medicaid that your mom has been on past 20 years more than likely has been Medicaid as health insurance. She has been low or lower income so has been eligible for Medicaid health insurance coverage. If over 65, should also be also on Medicare as well for health insurance. If so, she would be a “dual” and abt 60/70% of elderly that are in NH in the US are duals AND ALSO on LTC Medicaid (a separate application than Medicaid as health insurance ) as well. Add to this that most who enter a NH, do it as post hospitalization (MediCARE benefit) discharge as a rehabilitation patient (Medicare benefit) to a NH that has a rehab unit. Then after days in rehab, it’s determined they cannot return home so go from a rehab patient on Medicare to a custodial care resident at the NH……. At this point what the NH will want is something to determine how your mom will pay for her continued stay: if your mom will be filing for LTC Medicaid program (Medicaid program that will pay for custodial care in a facility); or that mom herself has the financial resources to private pay for her stay in the NH; Or that she has family who will sign off financial responsibility to pay for her care.

NH does not care about your mom owning a house, or that that house has a utility bill or property taxes, or a mortgage, etc. LTC Medicaid by & large allows for her to continue to own her home as an exempt asset but she will not have any income to be able to pay any property costs on that house still in her name. After her death, Medicaid is required to attempt a recovery of costs paid from any assets of her Estate which would be her home. Her monthly income is required to become a copay or share of cost paid by her to the NH each month. Say your mom gets $1200 Social Security each month and lives in Texas, she would be required to pay NH $1140 ea mo & keep only $60 for her own personal needs allowance to pay for beauty shoppe, clothing, in room phone, etc. type of costs. Mom will have zero $ for the house still in her name.

So the issue will be for you & your siblings is…… what - if anything- do we need to do with moms house??? If you have POA that fully allows for you to sell it, then you can sell it. Personally I’d be concerned that trying to sell a home with a value of 38K may be more trouble than it’s worth… is it liveable? it this land value and house really has no value? Is the place safe to show & walk through? Why oh why is the price so low? Does it have any issues….. by that I mean is your mom current on paying property taxes, does it have homeowners insurance, any fines on the property? I’d suggest that you find out taxes and fines as these have hefty interest and fees. Could take a big chunk out of 38K. Whatever $ you put onto the house cannot be easily reimbursed by your mom from the sale of the house as it looks like gifting so any work needed to put it on the market has to be paid by your mom on her house from her own money before she enters a NH to have this run smoothly for her LTC Medicaid application. Or you spend the $ and are ok if you are not necessarily reimbursed.

Also LTC Medicaid expects any property to be sold at FMV. That’s best done if sold by a Realtor & placed on MLS. So no FSBO nonsense or sold to family member for less than the full amount of the last tax assessor bill.

Please realize you can choose NOT to deal with the property. If it really cannot be sold, or the costs to get it sold you cannot afford to do, then get the utilities pulled and board it up. Families do this all the time. It’s not ideal but sometimes is just the best choice.
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AlvaDeer Jul 10, 2023
This is so good and so complete, as always, Igloo. I always wish you were here each and every day.
My guess with this small "home" is that it may be a mobile home, simply because I cannot imagine anything of this little value. My brother had an exquisite single wide 70s mobile home in a historic trailer park in Palm Springs as his last home. Bought it for 30,000 and sold for 100,000 some three or four years later. Now selling for 150,000. But it was registered as a mobile home in the 70s, DMV registration, and not even as a home. So go figure. It gets so complicated out there. Happily he decided to sell it before going into ALF tho I loved staying in it when I visited. Just a great community. Just wonder how medicaid would recover any assets on that; likely would try to find a way.
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Has she had SSI or Medicaid. They are different in terms of recovery, I do believe. I would pass this question by an attorney. On Medicaid you are allowed to keep a home, but a lien would be placed on said home on your death to recover funds paid by taxpayers for your care; Same for a car. Allowed to keep it in your lifetime. If you were hoping to "inherit" this home, and are living in it, can prove hardship, sometimes there is a way you can keep the home from "clawback" by Medicaid.

Unfortunately I have to advise that an hour of attorney time from an elder law attorney may be the only way you can get your question answered, and I sure wish you luck. Start saving NOW as it can cost 400.00 for you to buy an hour of their time.
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