How do I save the house if Mom has to go to a nursing home? - AgingCare.com

How do I save the house if Mom has to go to a nursing home?

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I have been taking care of Mom for some time now, she had been diagnosed with dementia several years ago. I have heard there is a law or act that may help me. What steps do I need to take to prevent the loss of her house if it becomes too much care for me to give and ask for professional help?

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What you are worried about is the house having a claim or a lien on it due to the MERP (estate recovery) aspect of Medicaid for NH.

gladinhere is spot on in her answer.

Keep in mind that each state administers their Medicaid program under their own rules that are vey much dependent on their state laws as applied to property ownership, probate and death BUT within an overall federal umbrella or guideline. The feds require MERP be set up but the state decide how it runs and what the exemptions are. There is a caregiver exemption for the home probably in all states. This exemption seems to run that if you provided full-time care for the Medicaid applicant which enabled them to stay at home for 2 years, then the house is excluded from MERP. You need to contact someone within DHS of your state to see how the exemption can be done....like if it can be done prior to the admission into the NH and on Medicaid and what documentation is needed to make that work successfully; or if the state program has it that is is done after the applicant dies. Google your state Medicaid & MERP sites.

Please realize that if you have been caregiving and have not been getting paid and therefore have little or no income, and if it has been the case that mom or dad's SS and retirement has been paying for everything, that you are going to face some financial challenges after they go into the NH. Once they go into the NH and onto Medicaid, they are required to do a co-pay to the NH. The co-pay is all their monthly income less whatever your state has as their "personal needs allowance". The PNA varies by state from $ 30 - 90 a month. My mom's PNA is $ 60 a month and really that is enough for beauty salon, magazine or snacks for the NH canteen or clothing replacement. There will NOT be any of your parents money to pay for everything on the house.Someone will have to pay for the house taxes, insurance, utilties, etc. If you live in the house, the state expects you to pay for all as you have the benefit of using/living in the home. If the house is empty and you live at another address, then all the expenses on the empty house can be deducted from the final MERP total against your parents estate after they die, but you have to pay on all for the long haul until they pass away.

If the house is up for sale, then most states allow for a diversion of their co-pay to pay for things on the house while it is on the market. There could be a limit on the amount or the length of time. For my mom's state, it is 6 months and there has to be an active Realtor contract (so no FSBO stuff) and the amount depends on the costs of the home.

If any of this is your situation you need to carefully think about what to do before she applies for Medicaid. If mom has a spend-down to do, you need to think about doing any spend-down to pay or prepay for all you can on the house before she goes into the NH. It gives you some breathing room on the costs of the house.
Good luck and keep a sense of humor in all this if you can.
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See an elder law attorney. I assume you are not on the house. If you care for mom in her home for two years prior to her needing nursing home care, the home can be transferred to you without Medicaid penalty, in most states. Do you have her POA's? Are there siblings?
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