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I took care of Mom and Dad (severe dementia; died 2012) since 2011, moving in with Mom in 2013, and now she may need to go to a nursing home. I am disabled due to a birth defect of a spinal deformity and cannot physically care for her any longer. Mom put me on the deed to the house in 2012. After all of these years of caregiving, I fear that I will now lose my house and home, which BTW was my childhood home. She gets a monthly SS check and a pension check from my dad's retirement.

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If mom needs to apply for NH Medicaid to pay for her stay, then there will be a requirement for the State (or it's outside contractor) to attempt to recover all $ paid by Medicaid on mom's behalf from whatever assets she has in her estate. This is called MERP - medicaid estate recovery program. For those on Medicaid, they have to be impoverished to qualify so their home and a car would be their estate.
Just how Medicaid is run and how MERP is done is unique for each state as your state laws regarding property, death, probate all make a difference. Some states place a lein on the property upon getting Medicaid; other states have the $ paid as a claim against the estate for probate.

Now MERP has all sorts of exemptions and exclusions - there are those for caregivers, for low - income heirs, for disabled heirs. Your state will have those details on its Medicaid website. It is up to the heirs to apply for and provide documentation requited for exemptions, exclusions, too. Also the states are required to show a cost-benefit analysis to go after a recovery. MERP is still in the first few years of being in effect and seems to not have a defined standard that most states are following. About 1/3 of the states have turned MERP over to contractors who approach it more aggressively and get a % of the recovery.

It sounds like imho that you have exemptions to recovery as you are disabled.
You should find out as clearly as possible about how this exemption runs for your state's program. Although this sounds just fabulous, what seems to often be the case is that the caregiver cannot afford the house. Realize that once mom goes into the NH on Medicaid, she will be required to do a copay or her SOC (share of cost) of all her monthly income less a small personal needs allowance (this varies by state from $ 35 - 105). This often comes as a surprise to families. If you have needed and been relying on mom's income to make ends meet; to be able to afford all the costs of the house, well mom's $$ will not be there anymore. So although you can get the house (so no Medicaid MERP done), you cannot afford it.
Really take pen to paper and go over the costs on the house and your income to see if this will work over time. Good luck.

Recovery is only on whatever % ownership mom has too. So if you all are 50 - 50 then only her half of the house is subject to recovery.
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What has happened with the savings is that you have been "co-mingling" funds. @ issues: 1 Medicaid considers that it's all mom unless you can document that it's not & 2. SSA really does not like it either and can ask that you become a representative payee for mom's SS if they find out there's commingling. Personally i think being rep payee is kinda a whole extra layer of pain in the butt of paperwork to deal with that most don't need. So what to do, I'd asap go and get a new bank account that is yours & yours alone that your income goes into. I;d leave mom's as it is and you're probably already signature, she gets her stuff direct deposited into it (another pain to change). And from here on out everything house gets paid 50/50 from each account.

You are probably going to have to look back through the past to reconstruct and document that not all the money in the account is mom's. How to do this, I don;t know, I didn't have to deal with this for my mom. Hopefully someone else on this site can give you suggestions. 3 years isn't that much to reconstruct.

You know before time goes on, really you should plan on taking mom to see an elder law attorney to make sure all her legal is good. There could be the possibility to have mom do a "caregiver contract" to pay you. But if you are disabled, it may not be easily done either for expected capabilities or could effect you ability to yourself get low-income benefits. A good elder law guy should be familiar with how this could work or doesn't work.

I would put off moving her into a NH and applying for Medicaid till after you see legal too, Even if you need to ask friends or family to help out or pay for short term extra set of hands to help. Good luck, get organized and stay cool.
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In some states Medicaid will allow the home to be transferred to an adult child caregiver if that caregiver has provided medically necessary care for a period of two years prior to entering the nursing home. Find an attorney well versed in Medicaid Planning who will be able to help you.
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If you are unfamiliar with how Medicare & Medicaid works and how property plays into all this, Heiser's book is really priceless to provide a basis for understanding all this.

One big issues is that the states are all over the map in how MERP is done as each state administers its Medicaid program uniquely so therefore MERP is done state specific. How your state law does probate or handles intestate deaths also makes a difference e.g. claim vs. lien on property.

For example for the caregiver exemption for TX MERP (which is done by an outside contractor), the person asking for the exemption has to respond to the initial "intent to file a claim" within a set period of time that there are exemptions or exclusions being asked for. If you don't, then too bad. So if the point person on file for TXDADS is Brother Bill and he ignores it, but you were the caregiver so don't respond as you did not know about the intent letter till after the 90 day required response, then your kinda out of luck.

Also for the caregiver exemption for TX you have to provide a letter from the deceased elders doctor or social worker on their letterhead with their state licensing info as to just what you did and why it was needed to be provided. Now whether or not this could be easy to get who knows!! I've found that MD's really shy away from signing off on letters that have "LEGAL" issues (like ones needs stating incompetency) as their area of expertise is medical and not legal. Same could hold true for SW. I can totally see a doc declining to do a letter as the elder is not a current patient so no current files. Also if there is a time lag between when caregiving was done and when they finally die, the MD or social worker may not be able to provide the details required to get the exemption. With the switch to electronic medical records happening, I'd bet old files are getting jettisoned. From the time my mom moved out of her home and died at the NH was 8 years. I highly doubt her old doc would do a letter for things from almost a decade ago.

You really need to find out how a caregiver exemption is done and plan for it.
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MaryM, Texas also has Lady Bird deeds that has something to do with transferring the house. Maybe somebody here knows something about that, I certainly do not or how it may play in.
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MaryM, I do hope.you can find a competent lawyer familiar with your state's Medicaid and estate planning laws. I know it seems so expensive, but if you research a bit on your own (your state may have an estate planning section on the government website) and also research your prospective lawyer, at least you have done all you can to minimize the lawyer's billed hours. Please talk with a lawyer before applying for Medicaid -- there may be things you can do, before applying, that can't be done adtwrwards. Read Gabriel Heiser's book, it was in my public library. Good luck.
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Dear Gladimhere and Mallory,

Thanks for information. I will buy the book.....marymember
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Suggestion. If you want to get some basic information from an elder law attorney, but you don't know where to start, contact the Alzheimer's Association. Alz.org. Alzheimer's does not have to be your issue and you don't have to tell them that. Join a caregivers support group (a good idea anyway). The reason I recommend this is that it will give you access to their free seminars. One they do regularly is medicaid planning. It is run by an elder law attorney, and it's very good. Bring all your questions because afterward there will be a Q&A session. This will allow you to get immediate and accurate answers and it will also allow you to vet the attorney for future use. After the session, you will know whether or not you need a paid consult. Good luck!
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I'd like to add that at the seminar I attended the attorney offered free consults to our group. Free is good.
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There is a 5 year look back period... Also if you have kept your mother out of a nursing home for two years by living with her they consider the house your legal address. Do you have the house in a life estate? Contact someone to help you with the application and they can advise you what to do legally with her assets such as a spend down... Pre paid funeral 1500.00 burial account and 2000.00 limit in a bank account also in Mass. Allowed to spend 72.80 on her personal needs. Good luck !!! It is a stressfull process but hiring someone to help me with the application gave me a huge sence of relief.
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