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It’s amazing how often admissions at a NH will flat just assume that those entering a NH for custodial care will be filing for LTC Medicaid; and automatically pull out that LTC Medicaid application and start to fill it out for a resident under the guise of being helpful. I can totally see this happening.

Personally I know of 2, both are men whose wives needed care beyond what could be done at home, late 80’s, bedfast, multiple chronic diseases who finally got convinced by their kids (nobody lives close, we’re friends with the kids & 1 of the Dads) to put mom in a NH. They both insisted to the kids they were 100% ok on doing what was needed on their own, don’t tell me what to do. Both are oil and gas retirees with $M+ portfolios. So. Louisiana guys from the bayou who started their working lives with Dresser & Freeport and have great retirement & investments. One thought he had to file for Medicaid as he got this packet from the NH and his daughter is like omg dad that’s not you & mom. It apparently was an interesting apology and conversation with the NH.

My point is, it does happen, we can’t necessarily dogg pile on the OP on this. The NHs can be very aggressive in being proactive to their benefit. Like how they push to have them (the NH) made “representative payee” for a residents Social Security income and any other retirement as well. Back eons ago when NH touring, the majority of NH flat out said that their becoming rep payee needed to happen and only when I pressed them on it, did they relent, that no this did not need to happen, that a check for the copay / SOC was fine. Also were vague on personal needs allowance account / PNA at the NH could or could not be opened and the amount in it determined by the POA. So yeah, I can totally see an aggressive NH admissions & billing pushing through a LTC Medicaid application, getting a frail resident to sign whatever placed in front of them, so that the NH can attach their room & board reimbursement to the residents application.

There’s just NH nonsense that happens…. It was like having the PNA of $60 be the exact amount of in-room cable and in-room local phone charge. It was just scammy on the part of the NH that did this. I so remember this and I’m still salty about it.
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Has the house been in your name for longer than your mother was on Medicaid? It's usually a five-year look back period.
Remember that dealing with Medicaid is very different than dealing with a nursing home or assisted living facility. Medicaid is reasonable. They are not as greedy as a nursing home and don't expect every asset a person has to be liquidated at once and given over to them in cash. Nursing homes do this. Medicaid does not. The nursing home is the one who wants everything in cash immediately. You and your mother do not owe them that.
Most nursing homes start a Medicaid application the minute a new resident sets foot in their facility. That's standard procedure.
You have a right to demand a written bill every month from the nursing home then write a check.
You (if you're POA) do not have to give the nursing home any access to your mom's banking information, what her assets are, or her SS number. DO NOT give them her SS number.
They will make threats and harass you about selling the house and handing everything over immediately. You don't have to.
A representative from Medicaid will contact you.
Also, the nursing home will tell you that you have to at least post the house for sale. You don't. That's them bluffing. You don't have to move out either.
Just bide your time and do nothing. Pay your mother's bill every month and when her cash runs out that's when the negotiating starts.
Talk to an estate lawyer. You may be able to keep the house in trust because you live there. Then you may be able to have lifetime use before anyone gets any proceeds from it.
Talk to an estate lawyer. In the meantime, bide your time and don't let the nursing home talk you into anything.
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If this is a serious ?, & you did not, DID NOT, do the LTC Medicaid application for your mom, & you are not on any signature on her Medicaid paperwork, here’s what you might consider:
- have a Realtor lined up to sell this property. Look for a Realtor with a super low DOM (days on market) history in the neighborhood where the house is. It would not necessarily be a Realtor that you would be friends with, but one that “sells”.
- Let the Realtor know that you are insisting that a Real Estate attorney must be used to do the Act of Sale and all closing documents is to happen. Again must happen.
- have the place as market ready as it ever will be. If you do NOT plan on doing any work on the house, other than keeping it clean, dejunked and cutting the yard, it is what it is, so stick to this as your plan.
- IMPORTANT: have property appraised. Hire a licensed appraiser to do this. Not the “report” that Realtors give you for free. A tailored to the property report done by the appraiser and it will have their signature, state ID/# and will state property value. Prop value part can be mucho importante for other reasons, more below. Cost $500-1K
If structural issues, that needs separate engineering report imo.
Also if ya want to be real OCD on this, you get the property inspected first and also done by a licensed residential inspector. This document you give to the appraiser to use if they wish to (they will).
Then… with that Appraisal document in your hands….
- get a title company to pull a title search & ASAP
You want a deep dive type of search. Looking for any State / County / City filings, Quiet actions, any type of other more subterranean liens. A total review of the chain of filings at the courthouse on the PPIN. It’s more than the usual title report for a mortgage.
- once you get the Title report back, if there is nothing from the State, & in all likelihood if your mom is still alive there won’t be, this enables you to get sellers Title Insurance for the house sale and it will be for the full amount of the Appraisal value based the current report plus whatever bump the Title company might can will do. Ask for the “bump”, it will cost, but you want it, if they will do it.
- it goes on the market & that Realtor has it sold ASAP as you are a “very motivated seller”.
- the Act of Sale documents etc. are done by a Real Estate attorney. Most States do not require an attorney to do real estate transactions. That doesn’t matter for you, you absolutely want a R E attorney doing this. It will cost more but it’s a CYA. Make sure the Realtors get reminded on this periodically.
Then….
you go about your life. The house is sold. As it’s in your name, the $ is yours. When the annual renewal for your moms LTC Medicaid comes around, and it ends up on your lap, you get that attorney who moved house into your name to send the State Medicaid renewal section, a letter that the renewal is not your responsibility as you never filed the initial LTC Medicaid application for your mom and as such have no responsibility on this…. that it needs to go to whomever did this initially.

& should the State give you sass come the Act of Sale or even later, that’s when sellers Title Insurance comes in. That title insurance pays off issues Title Co. should have found but didn’t. Also should State say property was worth more than it sold for, thats when the Appraisal comes in handy. Say tax assessor is 350K but appraisal 298K and sold by a Realtor on a MLS listing for 290K. It’s valid & within 10%. If ya find its way under assessor value, take photos the week of Act of Sale to show just how old & unrenovated the place actually was. FWIW there’s a redditsub on this, it’s not just my wheelhouse.
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BurntCaregiver Jul 2023
@igloo

Never make taking assets and property easier for the nursing home to get.

Talking with an estate lawyer is always a good idea. The OP should just bide for a while and not rush into selling and handing a mountain of cash over to the nursing home when they may not have to.
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Then most likely medicaid will want their cut. Trying to protect assets after getting on Medicaid is a big no no. Still ask a lawyer.
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This a lawyer question, but if you put the house in your name after she got on Medicaid. Then yeah they are going to come for that money.
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If you had it changed over to you after Mom started Medicaid, thats considered fraud. Did you list the house on her application as half owner? If so, yes Medicaid can recover after Moms death. In most states 5 years before application for Medicaid no big transactions like this can be done.
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To clarify, you and your Mom put the house title in your name only after she went on Medicaid?
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chris13 Jul 2023
Yes. The nursing home submitted the Medicaid application. I hired a lawyer who put the house in my name. I was unaware when she was put on Medicaid. They did not inform of this.
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