My question is are we able to remove Nana's name from the title/deed through the court system because of her advanced Alzhiemers or do we need to wait until she passes away?

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NH (aka skilled nursing facility/SNF or long term care/LTC) is paid for 3 ways: 1) private pay by either the elder or their family; 2) from LTC insurance; or 3) by qualifying for Medicaid.

Medicaid rules determined by each state & are state specific even though it is a federal & state program. Medicaid is needs-based.
You are expected to spend your assets first and foremost before the state will pay. There are things you can do to reduce assets but these need to be done by someone qualified to do this that will pass your state's review. An certified elder law attorney is best to do this.

For NH Medicaid eligibility, an individual must show that:
1) are 65+ (can be younger if qualified disabled),
2) medical condition requires that level of nursing care,
3) monthly income at or below their states max (about 2K),
This is the “income test”– how much $ do you make. TX is $2,094.
4) all countable assets are at or below 2K
This is the “asset test” – how much $ do you own.
5) not gifted away anything of value during 5yr look-back period.

If you do, could be a “transfer penalty” when items are gifted. Penalty different for each state as it’s based on each state’s NH reimbursement rate. For Texas in 2011, it was $ 142.92 a day rate.

Max look-back is 5 yrs. Most states require 3 – 6 mo. of financials with initial Medicaid application. Can require more financials if something pique’s interest.
Financials include all banking, all insurance policies, social security and retirement statements, funeral & burial policies.

ASSETS: All assets are counted, unless the assets fall within the short list of "noncountable" assets:
- personal possessions,
- a vehicle (some states have a limit on the value)
- their principal residence, provided it is in the same state in which the individual is applying for coverage & the house may be kept with no equity limit if the "community spouse" lives there; otherwise the equity limit is 500K (750K in some states). Value must be validated and based from the annual tax assessors bill.
- prepaid funeral (irrevocable, NCV, usually 10K max)
- small amount of life insurance (usually $1,500 & NCV)
All other assets (savings, stocks, whole life, rental property) are counted.Must “spend down” to get to their states max to qualify.

The financials are what most folks focus on. But remember that they also need to medically qualify for skilled care for Medicaid. Good luck.
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Holly, OK as I see it there are 3 very different issues here:

1. Your grandma is, I assume, at the point where you feel she needs a higher level of care than living in her mobile home and the family is thinking it's NH time. &
2. She has an asset - the mobile home - that is owned by 3 different people. &
3. How to deal with grandma's assets.

On the 1st, gran has to qualify both financially and medically in order to get into a NH and have her NH stay paid for by Medicaid. I will do another post with the basic details on Medicaid, but also there are several articles on this site about NH and Medicaid you should read and familiarize yourself with. Realize that just because they are old or have a dementia, that may not meet the medical requirement to get into a NH. She doesn't have to sell the trailer to get accepted by Medicaid - it's about her overall assets and income to qualify financially.

2. A trailer is kinda a different kind of asset in that you usually don't own the land that it sits on (its in a trailer park?) & you really just have the trailer and the overall value of them is low. Do you have any idea of the resale value on it? There should be a tax assessor value on it that you can use for an idea of it's worth.

Why the need to sell it?

We went through hurricane Katrina and had friends who bought a mobile home to have to live out of while they redid their home or while they rebuilt. The resale value is squat. A friend of mine referred to it as a "used cat food can in value".

3.Assets. Family getting or splitting the $ that's gran's from the mobile home sale has problems if gran is going on Medicaid anytime in the next 5 years (2017).

If, say, you do sell the mobile home for 30K and if gran owns 1/3 of the home, then her 10K is her money and has to be spent on her care and her needs. If it goes to family, it becomes a gift and can be subject to a "transfer penalty" under Medicaid rules. So the 10K will have to be private pay by the family in order for the NH to accept her as that 10K which should have been used on her needs and her care was given or gifted to others. The sale will be recorded somewhere and it will surface in the Medicaid application review by the state eventually. It may not come up in the initial review and certification for Medicaid but show up 8 months later when she is already in the NH. This is a awful & panic situation for the family to be in and often the NH will issue a 30 day eviction notice on the resident until someone signs off on a contract for financial responsibility for payment. The NH does this because they have gotten a letter from the state Medicaid program on the disqualification on the resident and the amount so the payment needs to be paid by family. For example, the transfer penalty in Texas (all this varies by state) is about $ 145.00 per day (this is the reimbursement rate the state pays the NH for a resident per day), so 10K is about 70 days of private pay that someone will have to sign off on or put a deposit towards for gran to stay at that NH.
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Thank you for the responses... My mom, an aunt, and my Nana are all on the deed to the mobile home..can my Nana be eligible for medicaid now? Or does her name need to be removed from the deed first? There are 8 brothers and sisters and all have agreed to split the any earnings from the sale of the mobile home. thank you!
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Contact an "Certified" Elder Law Attorney for the correct answer. Let him/her explain about family protective trusts and/or loosing the step up value of Nana's home. Assuming Nana's is in a nursing home, talk to the CELA about medicaid payments vs: assets. Talk about the "risk" about putting assets in your name and like how the house could be considered an asset in instances of divorce or lawsuit within your own family. If you live in the same house as Nana 2 of the last 5 years you might be able to qualify for a the "child-caregiver", but state medicaid rules vary so again consulting an CELA is the best option for you. There are dozens of options I could go on here but your question is too short for a more specific answer.....
I can only say if you are a child caregiver you might be better off doing nothing also. Do the research, then spend the money on an attorney only if you need them. Because I've never meet an attorney that wont take your money. Email me with your specific situation or better yet contact your medicaid office in your particular state and ask about medicaid rules and exemptions available for your situation.
Each person has different curcumstances so you would be wisely advised to seek professional help of an CELA....after of course contacting your medicaid office for some general research information.
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Why the need to change title?

If she had granted a DPOA, then that person has the ability to make financial decision for her. So the DPOA can, in theory, sell her property. There are 2 possibilities here: a true, actual on the market sale or a transfer to a family member. For an actual sale, where it goes on the market, a Realtor will usually require a notarized copy of the DPOA and often can ask for a separate document from the DPOA releasing the real estate company of any problems or culpability that might arise later if the sale is challenged or vacated.The property sells by the Realtor and the $ proceeds are Nana's and used by Nana. For a property transfer to family, it's sticky in that the property has a value and if it is not sold at the assessor or appraised value, then there are tax implications as well as possible fall out from family as to Nana's "gifting" of something of value to one and not another. Plus if she ever needs to go on Medicaid, the transferring of property not at full value will be a problem also as will transferring $ from Nana to other family.

If you wait until she dies, assuming she has a will, whomever is the executor of her estate, will transfer or sell her property as per the will in probate court.

If there is no will, then she dies intestate and that can be a real sticky to deal with as you have to establish heirs and the state gets involved.

All of these issues really need legal expertise and by someone who does elder or estate law and preferably has a practice in the county in which the property is.
Good luck.
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