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My son has lived with his mother-in-law (96) for 12 years. They live in wv.

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Both good answers above. If he is heir to the house it should be fairly straight forward to get the transfer done. However who are the other heirs and how will they feel about this?
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Sadly the laws are pretty complex in this area and the possible variables are endless. The first thing to do would be to talk with someone with experience in the state this is happening in as the Medicaid laws are generally different by state. The other thing would be to make an assessment of the scenario to see where things stand. For example:
1- The MIL's house only comes into play after her other assets have been used up to pay for the NH and she's wanting to be qualified for Medicaid.
2- If he lived with her to postpone her eventual need for a NH for a few years, there is often consideration given there.
3- Does he have any disabilities.
4- Is she qualified for veteran benefits (if either she or her husband were in the military during a time of war)
5- Doe she have a trust and how is her assets held

There are probably 10 other valuable questions an expert would ask you but the point is that many people act-first/research later and it's very costly to do it that way. Lastly the $500-1,000 you (or someone) pays an expert for help is a bargain in comparison to the cost of a bad decision.
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Two things he needs to look into: the caregiver exemption to estate recovery and that he is heir.
He should look to clearly find out just how the caregiver exemption is done for MERP (Medicaid Estate Recovery) for W. V. and do whatever to get this done so that when it needs to be filed, he will be ready. Each state's Medicaid program is run uniquely and so is it's MERP.

Like for TX, they need to have a letter stating what care services were needed and required to keep the elder from going into a facility earlier and the letter has to be from the elder's MD or social worker on their letterhead with state licensing info. This could be simple to get or could be difficult. The exemption with supporting documentation needs to be filed within 90 days of the date in which the heir or the contact person for the elders Medicaid application is notified of MERP.

Also her will needs to have him as the heir to her estate - so he needs to make sure her will states that & that the will is valid. He may need to do probate to get the transfer done; or if your state allows he could do a muniment or small estates affidavit to transfer the property to his name. Really he should contact an attorney to make sure all is ok, valid and set for him to be the heir with minimal issues.
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If she is going into a Nursing Home on Medicaid all her money goes there too. So he can stay in the house, but he has to pay all the taxes utilities and upkeep out of his own pocket. When she dies, of course Medicaid may put a lien on the house. Since he is old himself, he should apply for a hardship exemption that would allow him to stay there, in view of the fact he cared for her all those years.
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