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My brother and I feel both our parents need to be in a nursing home. I know they'll have to spend down to qualify for Medicare/Medicaid. I was thinking they could transfer the house to me or my brother (or both), and we could rent the house. Would Medicare/Medicaid still count it as an asset of my parents?

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I'm familiar with Iowa Medicaid, there is a five year look back on all transfers of assets at the time of Medicaid application. If this is true for Medicaid in every state, you needed to do the transfer of assets five years before your parents needed nursing home care.
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Sure, you can transfer the house to you or another - but your parents won't qualify for medicaid for several years, depending upon your state. Medicaid gives money to those with little or no assets. Your parents don't qualify as of now.

Most of us have to sell our parent's house to afford assisted living.
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MediCARE & MediAID are very different. Medicare is a age based entitlement which just about everybody gets & pays into via FICA (or taken from their SS if they are drawing that) and in general does hospitalization, providers fees and med's, and it's federal. Medicare is about short term medical situations. Medicaid is a joint fed & state based program that is needs-based....in general about 2K in monthly income and 2 K in non-exempt assets and also they must demonstrate the need for skilled nursing care - so just because they are old, or have dementia, etc in & of itself may not qualify them for skilled care. You have to spend down or be at poverty level to qualify. Medicaid is managed by the states and vary in the requirements state by state under a general federal guidelines.

CMS is the umbrella for both Medicare and Medicaid - their site is pretty good for finding out details on how the programs do and don't work. You really want to understand how they are different and how to qualify and how they can overlap.

Really there is alot to think about when they have a home. The house is right now a totally exempt asset for Medicaid & can remain exempt for their lifetime in most states BUT there will be estate recovery possibility by MERP. But if they sell, gift or transfer ownership for 5 years prior to their application, then the house in no-longer exempt and the proceeds from the sale is income that has to be spent-down. If they gift or transfer it to you, then they will get a "transfer penalty" for the value of the home based on the annual assessor report.

Transfer penalty is a hot mess to deal with too....and will show up eventually, as all property ownership from the local assessor is dovetailed to the state system. The transfer is based on your state daily reinbursement rate to the NH by Medicaid. For example in TX, it's about $ 145.00 a day (TX is low too). So say the house is 100K value and and they gift it to you and your brother. That would be a transfer penalty of 690 days in which your parents will be ineligible for Medicaid payment to the NH. Each state has it's own formula in how it's determined too. If you are the point person for your folks @ the NH, the NH will fully expect you to pay the penalty.Often the other siblings who benefitted from the transfer, will just disappear and you are left to deal with the private pay needed. A mess.

If you rent it, then it becomes "income producing" property and the rent has to be paid to the NH in addition to their SS and retirement. Realize that all their income less whatever your state has as their "personal needs allowance" ($ 35 - 90 a mo) MUST be paid to the NH as their co-pay. Realisticaly they won't have any money to pay for the insurance, taxes, yard, repairs, etc on the house for the months & months or years they might be in the NH.

It's alot of things to think about and you don't want to make a decision that could be very costly a couple of years from now. That's why an elder care attorney is so worthwhile to meet with. If you have over 5 years, then you can plan it out. But otherwise it's as Perseverance said. Good luck.
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Federal mandates for Medicaid state that if an adult child has lived with the parent for at least 2 years and has provided care that kept the parent out of the NH for those two years can legally posses the home.

BUT nevertheless....get professional legal counsel before you do any 'kitchen table estate planning' as they call it.

Don't do ANYTHING until you find out what you should and should not do...from an eldercare lawyer!
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Yeah, the thing about the SS income makes it hard to just put someone in the NH for longer than skilled pays for but less than the rest of their lifetimes. Because if you can't pay the bills, there is no home to come home to. And by the time one finds a job, if they are that lucky, it is time to quit to take care of the returning family member.

I'm lucky in that the house is paid for (twice actually). And I've had no full time job for ten years! I needed 'disposable' jobs and then I began a home business but even that was put on hold for the last couple of years due to broken hips and care increasing pretty much to total in that time.

It is good for me to know that I could still get medicaid help if I needed it to make mom's life better or safer or whatever. We've discussed the fact that one day it might prove impossible to keep her home and stay together. And that's okay because I will only do that if there is nothing else left to do or try, We are still a long ways from that point although in everyone else's eyes I should have put her in the NH several years ago. That's okay. This is my life and her life...not theirs. They can deal with it as they see fit just as I intend to.

I do feel, tho, from recent experiences, that they will do everything they can to corner you into NH placement. But they don't know me like mom and I know me. I have amended my promise with her consent and so it has eased my stress a lot.

Knowing I will have a place to live when it is all over is also a relief since I spent the years I could have worked toward that taking care of her without any income hardly at all. And knowing that even if I have no other choice but NH, I won't lose the one thing she was able to give me out of love makes my choice more clear and just strengthens my resolve. I just want her to live out her last days in her own home no matter if I get the house or not. Proving to me, thankfully, that it is really and truly all about her in my own heart!
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There are legal clinics that accept "sliding scale" for legal advice. Legal Aid also does lawyer referral - expect to pay about $30 for the first law visit. Otherwise, you may be able to get a law professor at your local university (usually they are lawyers), to give you off-the-record "non" advice which might be the cost of lunch or dinner. When in doubt do it under the heading of "research for an article" - - then actually WRITE THE ARTICLE or LETTER TO AN EDITOR so you are truthful in calling it this. (I'm a writer, and blogger. I do this when I research for information that I need and suspect that others do, too. ) If you are wondering "where" to submit your article or information, consider maybe sending it to this website and forum.
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Yes I was given same info as Babylon...but 5 ys in home care and that is just with reference to the title/MERP. they are still going to give all of the "current/future" monthly ssi income to the nursing home! In my case there is a mortage involved and I have no money left in savings to pay it. But half the battle is secure, they cant take it from us...if I can clean up this mess in time and maybe get some kind of income to make the mortage payment but my credit and work history are shot so I doubt I can assume the loan! so I am still kinda screwed!! maybe they will be gentle and look at cg for 9 plus years as work history, but I doubt a bank would!!
I haven't had good luck with finding an eldercare atty in my area and ones I have consulted haven't impressed me much so I kinda in limbo on spending money we don't have on mediocre at best, advice at $400hr or whatever it is! sorry I rant...meant to just include the ssi monthly income issue with that loophole
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well put Babylon I could not agree with you more 8 ys 10 months of hard labor for me and counting. all I want is to know I have a place to live when it is all over. But the truth is I deserve that security for what I am doing, and I don't have it ....it is scary if I don't change the situation before It is too late!!!
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When did they start needing fulltime care? It has to be documented by a doctor that they can not live alone nor do 3 or more things themselves in order for it to be considered real "care-taking" of them. The reason my Mothers Attorney didnt do Trusts is because then the family doesnt step up to the plate and help take care of them themselves. He said that "the family knows the money is safe and then they put the parent into a nursing home, a State Funded Nursing home that takes medicaid, and do you really want them there?" You could move them in with you, sell their home and use the money for their care by you, or someone else, in your home. You could get a reverse mortgage on their home and hire a nurse for them too. Other than that, there is a 5 year lookback on all assets, including other assets as well they might have.
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What kind of attorney was your Mom going to (re: reverseroles)
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