My mother is now in a LTC nursing home. She's applied for Medicaid to cover expenses while she's there, however her & my father own a house. My father is worried that Medicaid will want for them to sell it. So he wants to sign it over to one of us children so that Medicaid won't take the estate. What does he have to do?
You dad needs to see an elder law attorney ASAP. There is a process to follow that he will not become impoverished. He is permitted to keep the home, and a car and up to 120K in cash. Anything over that will have to pay for mom's care. See an elder law attorney that specializes in Medicaid planning. NOW!
Medicaid does not require the selling of a house while either spouse is alive. The state will recover some of their costs when neither spouse lives in the house and it is sold.
Mother has already applied for Medicaid. It is way too late (by 5 years) to sign the house over to children.
An experienced lawyer can help ensure that your parents are positioned as well as they can be for the care costs that lie ahead. A mistake can be extremely costly -- it is far better to spend some money for a legal consultation than to risk a lot of money trying to do it yourselves.
Predatory people often read death notices and they often drive through neighborhoods and look for signs of people who appear to be in trouble. This is how the predator moves in, gaining the person's trust and eventually access to assets, including bank accounts and even life insurance policy's among other things. Predatory people buddy up with a sour agenda (unknown to the potential victim). They usually go after people who have money, and my family was just one of those families who had money. This is why serious asset protection should be planned when you're young and still able to make those decisions. Predatory people usually don't target those who have little or nothing, it's usually the people with something. This is why it would probably be a very smart move to put your home into a trust or find some other alternative way to protect it against potential predators. You really don't want anyone taking advantage of you in your golden years, especially if you ever happen to become mentally incapacitated to the point you can't even think for yourself.
Suggestions on wealth advisors, etc is just a waste of time & energy for everybody.
LMS - your dad under Medicaid rules is considered the "community spouse" and as such they do no themselves need to be " at need" for your mom to be qualified for medicaid. Only mom need to be "at need" & medically needy and financially impoverished. To me, the CS / NH situation really needs eider law atty. to work with them. One problem is that if the Medicaid application has already been done, your parents financial situation may be fixed as most Medicaid programs do CS/NH applications review of assets & income based on a " snapshot" day which is usually the date of the medicaid application. If your parents have under the CS limit (about 119k) and dads own personal monthly income is sufficient to cover his day to day expenses, then this is not quite an issue. But if they have over 119K in assets, & dad needs some of moms retirement monthly income to make ends meet (like there is horror-of-horrors a mortgage!) & they still have a lot of debt or dada has his own meducal expenses needed to be paid each month, it's quite a different situation and they need good elder law atty to get dads situation to get perhaps get any assets over the 119k spent down on things needed for dads living situation and his getting CSRA / MMNA maximum. Community spouse resource allowance /monthly maintenance needs allowance - I think of these as sorta like alimony for the nonNH spouse. If dad is still relatively healthy and could likely out live mom by years or decades this is especially important. If dad is right behind mom in entering a NH not quite so important.
CSRA is set by each state so it varies. Like for TX is right under $ 2,900 a mo. So in theory if moms monthly income is $ 3,200 a mo so her required copay or SOC ( share of cost) to the NH would be $ 3,140 a mo. But if dad got the maximum CSRA of $ 2,900 then moms copay to the NH would only be $ 240.00. The whole CSRA equation is really critical for may/december marriages but it's available to all CS. It's stuff like this that makes a good elder care atty priceless.
So what to do......my suggestion is for you to get a tight & realistic financial & health picture on dads situation: review last 2 years on house costs in detail; are the majors needing replacement at the house (roof, AC/heat) and what would be those costs; what is the plan for funeral & burial and are they prepaid and if not is there $ to do this; what is the house worth and would it be a challenge to sell; have a reality check on dads health and ability.
All this gives you a better picture of the situation both for you & your siblings to discuss with dad and with the atty. Be realistic, which can be hard.....but the scenario for a 78 yr old health dad with a smallish,1story easy to get around in house that is paid off is quite different than for an 88 yr old with copd, diabetes and a huge 2story house with a mortgage and needs a new roof.
By & large Medicaid cannot require them to sell the house. Their home and a car are considered exempt assets during their lifetime. But Medicaid is required to do an attempt to recover all costs paid by Medicaid on the assets of the Medicaid recipient upon death or ineligibility, this is done via MERP or MERS. MERP is done as a claim or lien on the property however it works within your states laws on property, probate, etc. MERP has many many exclusions and exemptions which family, dad or heirs can file for & it falls to family to file for and provide all documentation for. Many states have surviving spouse as a total exemption for MERP. MERP has to go by probate rules if probate is done, which can be an advantage to your dad or heirs. Your elder law atty will know just what's what for your state regulations, law and administrative code.
Also most NH Medicaid applicants are widows or widowers, so much of the info on the web, told by others, etc. is based on the rules for solo applicants. Often the admissions for a NH don't understand the nuances of CS/NH Medicaid eligibility as well. For widow widowers it's pretty simple with the key items being 2k in non exempt assets and within the limits of monthly income. But for CS it's lots more complex and add in if the still at home spouse has their own issues or aging there can be lots of misinformation. That why legal can really help.
But both NH and state have to be paid or attempt a recovery made to cover the costs of care paid. But the method to attempt to recover differ.
For a NH, there usually is something in the admissions paperwork to have a family member sign off to be financially responsible. This is why it is very important that family either have the elder themselves sign all documents or the DPOA sign every item every time as "Jane Smith Jones in her limited capacity as DPOA for Anne Smith" to provide for a distancing from being personally responsible for the costs of their elders NH. Over & over again folks are on this site who sign off in a stressed rush to get their parents in a facility and find that they actually could be totally responsible for their parents costs of care if something goes amiss and don't get a copy of the contract and admissions documents. If you live in filial responsibility state the facility can attempt to recover the costs from any family member via a lawsuit. If the elder refuses to pay or refuses to do their required by Medicaid co-pay the NH can and likely will place the account up for collection. If they use an aggressive collection outfit, it will be the letters, followed by lawsuit, required court appearance and judgment issued against the elder which means they can get a lein on the elders house (unless they live in the handful of states that do not allow this on homestead).
For state Medicaid programs, they do this both by doing an annual renewal with updated financial documentation to prove that they are still within "at-need" status and eligible for Medicaid when they are alive. And then by doing the required attempt of recovery of costs of care via MERP after they die from the assets of their estate which will mean their home or their life insurance if they had their estate as the beneficiary. Dealing with MERP successfully can be done. BUT family will need to totally do whatever for exemptions or exclusions or other filing and documentation required within the timeframe for MERP inquiry or within probate to have the MERP claim or lein released or negotiated or not attempted. Or they do a Lady Bird deed in those states that allow.
Keeping elder on NH Medicaid old home can be done but family will have to be able to pay all costs on the empty home from day 1 of NH Medicaid to their death and then beyond through the probate, Lady Bird deed transfer or MERP recovery process. Family will have to pay all house costs and be able to do this for a unknown period of time and be willing to risk that it may not work out. But if you have the wallet to do so and don't mind risk, and you have a reason to keep the house even if just sentimentality then have the elder keep the empty home. For a lower value property, the costs to maintain for years could exceed the value of the property so no recovery as no cost-benefit so gets released. For a high value property close to the 500K/750K limits, it can be sold with heirs and MERP likely all getting proceeds from the sale. For those in the middle, it's really important that meticulous records are kept on the costs on the property as it's going to be a deduction from MERP &/or a claim against the estate in probate. Some rent the home to offset costs as well.
Whatever the case, keeping house is going to require work, funding, meticulous record keeping and risk on the part of family. It's not a nightmare but requires a long term commitment (could be 6 mos or 6 years), being a risk-taker and bit of a pitt-bully personality for sibling or in-law in charge and kum-ba-ya by all the rest of the family. For most families, neither the math nor family dynamics work so the home gets sold with the proceeds used to private pay for care till spent down and then apply for Medicaid.
But it can be done. There are folks on this site who have done it.
If that's not enough, I saw a staff member handle an Alzheimer's patient very roughly and jerk her around. Yes, there is abuse going on in some of these institutions. If they can threatened and harassed people on the outside, just imagine what most likely goes on secretly inside behind closed doors. The patient's family was nowhere around, and it was me who saw the abuse against the patient. After I reported it to the head department of nursing, the nursing home staff with whom I had a problem of hateful remarks must've been the one to drop up some kind of lies to the guardian of my foster dad because my visitation to him was severed after that. It was just because I reported and abuse incident that I clearly saw against another patient other than the one I was visiting. In other words, I was punished for reporting abuse, and chances are the Guardian will most likely never let me see my foster dad again just because I did the right thing.