Saturday, September 25, 2010

Can the Nursing Home Take my Mother’s Home

I recently answered a question on AVVO and thought the answer might be of interest to readers of this blog because it addresses a common misunderstanding. Many people think that the nursing home takes your home if you run out of money to pay for your care. But that is not correct.  Read the question and my answer below.   
The AVVO inquirer said:
“My 50 year old sister is the care-taker of my 87 year old mother. They live together in the home which my mother owns. In the event my mother becomes ill and requires a stay at a nursing home can the nursing home "go after" my mother's house for the costs which exceed her insurance, forcing my sister to move?”
My answer was as follows:
A nursing home can't "go after" a person's home or other assets. The way it works is that when a person goes into a nursing home they have to pay for the cost of their care. Most private insurance (except special long term care insurance) have limited or no nursing home benefits. Medicare has very limited nursing home benefits.

So, your mother would need to find some way to pay for the cost of her care. Most people in nursing homes eventually qualify for assistance from the Government Medicaid program to help pay for the care they need. But Medicaid requires that a person only have limited assets before it will pay for care. This means that a nursing home resident has to "spend down" their available income and assets before Medicaid will pay for their nursing home costs.

However, there are a number of assets that are excluded from spend down under Medicaid rules. One of them is a home of modest value. Medicaid will disregard the nursing home resident's primary residence as long as the home owner (or someone acting on their behalf) says that they intend to return home if that ever becomes possible. This means that, in most cases, a nursing home resident can keep their residence and still qualify for Medicaid to pay the nursing home expenses. The nursing home doesn't (and cannot) take the home.

Note that special rules apply if the Medicaid applicant owns a home that is worth more than $500,000.

So, Medicaid would pay for your mother's nursing home care even though she owns the home, as long as the home isn't worth more than $500,000. It is protected during her lifetime. This likely means that your sister could continue to reside in the home during your mother's lifetime. However, there is a program called Medicaid Estate Recovery that could put the home in jeopardy after your mother's death, to the extent she received Medicaid benefits during life.

Your mother and sister may be able to avoid Medicaid Estate recovery in several ways. For example, since your sister has been caring for your mother, she may qualify as a "caregiver child." If she does, your mother could transfer an interest in the home to your sister that would protect the home no matter what happens to your mother.

The rules are complex but a qualified elder law attorney in the state where your mother resides should be able to advise your mother and sister of the options that are available. They can find a list of certified elder law attorneys in their area at
www.nelf.org. The Medicaid rules vary somewhat depending on the state, and your family really should get some expert guidance as soon as possible.

3 comments:

Shawn said...
This comment has been removed by a blog administrator.
ROSE PHILLIPS said...

My mother-in-law signed her home over to my husband (an only child) and we were caring for her in the home. She then had to have her two big toes amputated and the doctor ordered her in short term rehab at a nursing facility. While at the facility she fell and broke a hip, making to where now she needs constant care. My husband passed away in November and now suddenly Medicaid will not pay for her Nursing hme due to her signing over her home to her disabled son (which was done by the family lawyer). The facility evicted her and I was the only one that would go get her (she has other family that refuses to help) This same family has all the power of attorney over my mother-in-law but refuses to use it to help her. Me and my children have had to rearrange our lives to care for her in the home for months and I am going broke and she is getting worse mentally (nasty, forgetful, mean and uncompliant). We hae spoke to one of the sisters about the situation but she doesn't care as long she doesn't have to take cae of her. Any suggestions...I am planning on putting her name back on the Deed as soon as probate is over so that she can get the care that she needs...please help me figure out what to do until then. I have thought about just dropping her off at her brother's house and saying tag you are it. I need help

Jeff Marshall said...

Rose, you need to get an appointment with an elder law attorney in your geographic area to discuss your options. You can find a list of elder law attorneys on the website of the National Academy of Elder Law Attorneys - www.naela.org.

Jeff