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No. To transfer a home of a deceased, it would be done as per the will by the executor to the heir as however probate (OR small estate affadavit OR muniment of title) is done in your state. But as a part of the probate process, any claims or liens against the estate must be settled or released in order for a transfer to be legally done. Medicaid via MERP can place a claim or a lien on the estate which has the house as an asset of the estate. There could be other claims or liens against the estate as well (funeral cost, property maintenance, etc).

MERP has pretty exacting terms to which it runs and how exemptions & exclusions are handled. As JessieBelle said there are caregiver exemptions. There are all sorts of others as well. Also the program is required to meet a cost efficiency /cost benefit analysis for a claim or lien to be done. It is up to heirs to
do whatever to get exemptions, exclusions done as well as whatever claims they may have against the estate filed & into probate. Probate rules are very much state dependent. Probate does provide for ways to settle claims if the estate is a negative for asset / debt.

Whomever is the executor is the person who would be the point person on all this. Is that you?

If you don't do probate, what seems to happen is that a lien by default is placed on the property. It cannot be legally transferred or sold ever till that lien is lifted. The lien will be for the entire amount & can have interest placed too. If a lien is placed, it's probably really hard to negotiate the amount.

If the property is higher value ( say 400k) and Medicaid costs were 100k, then when the house is sold medicaid gets its 100k and heir gets the rest. Higher value property is pretty simple to settle. Low value property actually is more complex to deal as the cost benefit analysis comes up & this often subjective.
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I forgot to mention that the caregiver has to live in the house as his/her primary resident.
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No. There are some exceptions for Medicaid recovery. These include having a spouse or a dependent, disabled child that lives in the house, having a home business (e.g. farm) where loss of the home would create a hardship, or if an heir was a full-time caregiver for at least two years before someone entered a NH. Their caregiving had to be so that it made it possible for the person to stay out of the NH.

Everyone that has a house and a will typically leaves the house to someone. This would have no bearing for Medicaid recovery. The state would put a lien on the house, so that it would have to be paid by the heir or through sale unless there is a verifiable exception.
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