How do I protect my Aunt’s house?

Hi Kelly - I'm not clear on your statement that "Medicaid is only good for 2 yrs." There are different care situations where Medicaid comes into play, but the lady I care for has been in a nursing home for well over 5 years and Medicaid has been covering that for the majority of that time. She will be on Medicaid for the rest of her life. As far as I understand it, the only thing that would stop her Medicaid would be if she earned/inherited/won a significant amount of money or other assets (which is beyond unlikely to happen for this particular lady). Some people are on Medicaid for decades. Have you talked to an elder law attorney? What type of care are you anticipating will be needed for your aunt?

Medicaid lasts as long as you have no money. I know a woman who's been on it at least 25 years.

Who is her POA? If she doesn’t have one, she may still be able to appoint one if she can convince a lawyer that she understands what she is agreeing to on a good day. What in the POA’s education or experience qualifies them to be a landlord?

Renting out a house is a lot of work and requires periodic injections of cash, which will be unavailable from someone on Medicaid. The depreciation expense deduction is less likely to be useful to someone on LTC Medicaid.

Read the articles on Medicaid on the site that hosts this forum. Then get the Nolo Press book on long term care (and maybe landlording) from the library. Then you can have a base from which to ask questions when you meet with the elder law attorney.

https://www.agingcare.com/topics/104/medicaid

Who wants to inherit and live in this house and how much work are they willing to commit to?

You need more information. Fear comes from not knowing the facts.
Try to slow things down and do not panic.

If a move is imminent, start packing boxes, label them carefully.

You came to the right place on this forum.
Enter into the search icon (the magnifying glass icon above in the navigation bar):
"Can Medicaid seize the home?"

here is an expert article:
"Can Medicaid Take a Senior’s House to Pay Their Nursing Home Bill?"
K. Gabriel Heiser:  Medicaid Secrets   |   Updated April 21, 2022

I would reach out to an Aging and Adult Services or an Area Agency for the Aging for a reference to a pro bono attorney in your area. They can offer advice as there are ways to protect real estate in some states. An attorney will know what options are available to you.
They can also assist with document preparation if that is needed.

Depending on what state your Aunt resides in, qualifying for Medicaid usually means she has to qualify financially AND medically. In many states Medicaid only covers LTC, not IL, AL, or MC. And a doctor decides whether or not she needs LTC.

Medicaid does not seize houses. They put a lien on the house that needs to be satisfied when it is sold or changes owners.

Since Medicaid is a program run by each individual state, you should consult with a certified elder law attorney and a Medicaid Planner for her state for the MOST accurate information that will help you in your situation. This is a global forum with anonymous, non-attorney participants -- there are no consequences for people here giving you bad information that you act upon. Pay for accurate information or you'll pay a price for following bad advice.

FYI renting out a house usually requires that it is completely up to code and has additional insurance. Being a landlord means paying for or doing repairs in a timely manner, continuuing to pay for upkeep, property taxes, etc. If your Aunt goes into AL -- which can be at least $2K minimum per month -- the house may cost her (and you) to keep it. If she's making income from a house rental she won't qualify for Medicaid financially, even if she qualifies medically.

If I were in your shoes I'd pay to get accurate and smart guidance from the professionals. It will be a worthwhile investment.

Medicaid (which is for poor people and funded partially by the federal governement and the individual state). There is a "5-year Look Back period' for Medicaid assets (depends on state). Basically, prior to five years when she goes on Medicaid, the house must be transferred out of her name and to someone else as a gift. If you don't do this, you will lose the house because Medicaid will be responsible for her care and they use whatever assets to fund that care. (fyi: However, Medicaid is not just good for 2 years it is for lifetime in most states (check your state), that is why they take over the assets.)
Good Luck.
MOBrien

Do everything you can to keep the government from getting the house. The whole industry is so corrupt and greedy the government doesn't deserve to get reimbursed for any of it.

Auntie in MI & your in TX, right? You all absolutely want to & supposedly can afford to have home continue to stay in family, right? If so, here’s my not an attorney suggestion….. MI like TX is 1 of 6 states that allow Lady Bird Deed aka a Qualified Interest / Beneficiary Deed. MI estate law attorney will need to draw this up & Auntie needs to be competent enough to sign off on. Has to - HAS TO - be done b4 she ever files for LTC Medicaid or a community based Medicaid program. “Lady Bird” allows for property to stay in Aunties name but transfer outside of probate to named beneficiary. So outside of estate recovery.
BUT
Before you do this, realize elder who goes onto LTC Medicaid who keeps their home - whether it’s purely owned by them, or on future to hopefully happen Lady Bird Deed, or Testamentary or other Trust, or titled in a Life Estate - the family / heirs will need to from their own wallet pay for & do whatever is needed on the property still in Aunts name for Aunties lifetime and probably 2 years post death and deal with the required attempt for State to do a recovery of costs paid via MERP. So once Aunt on LTC Medicaid, all property taxes, insurance, utilities, maintenance etc will be on you & Sister as auntie is required to have almost all her mo income plus rental income go as NH copay. Could be 3 year$ could be 13 year$$$$$. Long Covid is an unknown and Aunties young at 66.

If u have to save up to pay for gas to drive to MI, imo, u don’t have $ to afford her home for years.

If Aunt has a mortgage, personally I do NOT see keeping it as an option. Mortgage atop all usual property costs plus being out of state makes it too much $ & too unwieldy. If this is the case, imo, have her make you or Sis as POA so y’all can oversee selling it at FMV & hopefully while she is still in spenddown mode so that not filing LTC Medicaid application till years from now. All $ has to go for her care, no gifting!

Keeping a house in the family sounds great & can be done but imo You need to do clear eyed evaluation on her financials especially as to past 3 years property costs & what type of spend down she has to do. That means you & Sis get up to MI and go thru Aunties checkbook, bank records, bills, retirement info, etc to find out exactly what’s what. If it’s $10k a year thats way different than $35k yr. If house needs a new roof ($20k) & plumbing ($8K) to ever rent it, do you & Sis have the $ to do this plus regular costs and be there as needed to oversee repairs done? And costs never ever realistically affect your own living situation?
Not to sound all “EmpressIgloo”, but to me, having a family member keep their home while on LTC Medicaid is like having 2nd or 3rd home w/their costs & responsibilities BUT you do not yet actually own it so run risk that things may not over time go as planned. Most folks cannot afford a 2nd home & don’t like risk, so think about this. I’ve been on this forum a long time & what seems to happen is all fine for 6-8 mos, then prop tax bill comes & something bad $$$ happens at house & fam do not have time or $ or interest to deal w it.

If rented, this can get complicated. Prop insurance will need to change as no longer homeowner occupied. Prop taxes likely change too as homestead exemption revoked so increase & significantly. It has to be maintained to keep renters. City may tax on rental.

Rent is income so has IRS filing. Rental will need to have property ok for whatever regulations Aunties city requires on rentals (like no STR). You live in TX and unless your Sister lives nearby Auntie’s place, realistically need property management Co to oversee rental, payments, deal with all maintenance.

Should this all happen & rental income plus Aunties SS income not be enough to pay for her NH and Auntie has spent down all her other assets to 2k, only then Auntie can file for LTC Medicaid.

As Geaton posted, Auntie does need to be “at need” both financially and medically for LTC Medicaid.

"Depending on what state your Aunt resides in,"

"I’M still trying just to save enough gas money to drive from Texas to Michigan to see my aunt! "

Renting the house is a bad idea due to all reasons mentioned. I’ve been a landlord off and on since age 26. You cannot imagine the crises that evolve, and you may not have steady tenants either. A place can be not rented for months at a time and the water and electricity bills still have to be paid, insurance isn’t cheap, and many tenants don’t take care of the house or actually destroy it before leaving. Sell the house and invest in a sure thing, like laddered CDs so the interest can help pay for care. That way you’re using her money to make more money, and you can use the principal as needed. Some CDs are paying 3% or more now. Check this on bank rate.com. Do not invest in risky ventures like stocks where the money can be wiped out due to a squirrelly stock market. As for long Covid, I know other survivors who aren’t doing well and their doctors say that research is ongoing to find out how to treat it. Sorry this happened to your aunt, but it’s appropriate to note that she isn’t the only one and that we all need to continue protective measures against this horrible disease.

First, Medicaid does not seize a house. Its an exempt asset. The problem is that if Aunt goes into a NH, her Social Security and any pension are used to offset her care. Someone else has to pay to keep the house going. Even though Aunt still owns the house Medicaid has a lot to say about who lives in it. Renting it means Aunt has income that will take her over her monthly income allowed. At time of the person's death, the house becomes an asset that a lien (to recover for her care) will be placed on the house which will need to be sold to satisfy the lien. A lien is not placed till the person dies. If a house is sold while a person is in a NH with Medicaid paying for their care, Medicaid stops, the proceeds from the house needs to be spent down, then Medicaid reinstated.

Each State tends to be a little different in monthly income and assets allowed. In my State the assets allowed are 2k. The monthly income (SS and pension if one) cannot go over about $2300. I am just giving you the basics here so u have an idea. What you may want to do is look up Medicaid in her State and see if there is a booklet you can download explaining what her State allows. Then you can always call a Medicaid caseworker to explain things that you do not understand.

Assisted living is private pay. In some States, if you pay for at least 2 years in an AL you can apply for Medicaid. But, the AL has to except Medicaid. If Aunt is in the early stage, she may not qualify for Medicaid so an AL would be the choice. Her house can be sold (at Market Value) and the proceeds used to offset the cost of the AL. If ur State has the 2 yr private pay then apply for Medicaid and she has enough money for the house, she will be OK.

I would not rent. If she has Dementia, she will never be able to return to her house. It gets worse. Renting is a headache. Like said the Township has to OK it. A Certificate of Occupancy is needed each time a new tenant moves in. Painting and carpeting need to be done every so many years. Then there's the tenant...will they trash the place? You live too far away to keep an eye on it.

Earlybananas, you are right, Medicaid is only good for 1 or 2 years but, you just have to requalify when it is expiring. There are 2 different Medicaid programs, community and long term care. They each have different criteria and contractual lengths.

Imagine if it was for life and people got back on their feet, earning 200k annually and getting taxpayer funded Medicaid? Yeah, not good.

I remember the panic you are feeling all to well. First, breathe! Second, Breathe! Thirdly, get on the phone to agencies local to your Aunt. Area on Aging, county counsel on aging, those searches should direct you to whom to call. They will have lists of the local resources and contact information they will email to you.

Do NOT go rushing half way across the country without some information to help you when you get there.

The hardest thing I learned was that people can be dangerous to themselves and others (passively) and you can not do a thing about it, unless the person has been declared incompetent by a court of law. So you can't force her to do anything. Are you able to speak with her doctor and find out if he would testify that she isn't competent? That's the 1st step, a court requires 2 doctors to say someone is not competent, because taking away someone's autonomy is a BIG deal and not an easy prove.

If you are prepared to be her live in caregiver, in a state you don't live in for 5 years, you can probably save the house, if you can get her to do a deed transfer based on MI law. If not, that ship has sailed.

Medicaid won't take her house but, they will require that she pays all of her monthly income as her share of costs minus about 60 bucks for personal needs, like depends, hair cuts, etc. So she will have no money to pay towards the house. Are you and your family prepared to pay for everything? Because renting it out could cause her to NOT qualify for Medicaid and ALL of the rent money would have to go towards her care, leaving you to pay for everything house anyway.

Sometimes we have to let go of houses to ensure our loved ones get the best care possible.

If you can get her into care, sell the house to pay for the best facility that accepts Medicaid and self pay until she qualifies to receive public assistance.

I would find out where you actually stand based on Michigan laws, then see if you can be proactive or just wait for the crisis that takes all of Aunties choices away.

Best of luck! Remember, Breathe!

See an elder law.attorney!

My friend put her moms house up for rent to pay for moms board and care. It worked only because she and her brother lived nearby and were wealthy enough to subsidize property management.

Their mom died after only 3 years at 95. That was about as long as this was sustainable.

Your aunt is three decades younger. Unless both of you want to assume the hands on yourself for her for life, there is no “family home” for you two to inherit.

If the income does not meet or exceed the cost of her care, then you are chasing rainbows and wasting time. I think what you are saying is that the sale of the house will only cover 2 years of coverage before Medicaid. Stop being greedy if you expect to inherit.

Here 's an option. If you want the family house, then buy it at market value so that she can have good and enriching AL care until she applies for Medicaid.

Your Google search is completely wrong. If all she has is the house and she needs full time care, she can stay there and receive in home care of a few hours a week but you will have to provide the rest. Or she goes in a SNF, someone who lives in the house pays all taxes and upkeep until she passes. After that there will be a lein on the house which will be satisfied upon the sale balanced to the cost of her care. Which means someone will still have to purchase the house.

KellyBananas, I understand the house as a deep emotional tie. Problem is emotion will not pay Aunties property taxes, emotion will not tell & make Auntie take 2 pills at 8 AM

That her home is in Michigan & that MIchigan allows for Lady Bird Deeds is a rare gift that I think the 3 of you should explore with a MI elder law atty and take into account all Aunties financials to see just how long possible it will be till she runs out of her own $ to pay for private pay care whether in her home or in a facility. And plan that either you or Sis can and will move up to MI FT to caregiver for her either to do in home care once she has run out of $ or do it now to have her $ paid for caregivers s..t..r…e..t..c…h out longer.

At a minimum, one of you Sisters need to be there living with her FT at the beginning of this journey. Long Covid is such an unknown, she could be fine in her home with you or Sissy as a companion / caregiver. And be fine for years. We have a friend with long Covid, his executive functioning is gone so he has had to retire but still ok to drive and shop but not able to deal with numbers. Your Aunt could be ok in her home with you around; she’s just 66, it’s so young (most of us answering you on this site are over 66 btw!) Someone needs to go with her to her MD visits and make sure she’s doing her meds and therapy on schedule.

You cannot put any of this on autopilot. & neither can you think that renting the house and dealing with renters - even if it’s fully renovated and looks cute - can be put on autopilot. Please heed the advice posted on others experience in renting….. it’s accurate!

if you & Sissy & Auntie want to keep the place, then all 3 of you need to commit to do whatever to make it happen and be able to use the rare advantage MI Lady Bird deed allows for. You do not yourself have $, but you have your own person to be there and do, which is priceless. Best of luck in all the decision making in the future.

Are either of you POA or guardian of your Aunt? If not, that is step one. She can get on medicaid without the sale of her one primary home, but do know that the rental of said home is unlikely to be enough to give her care in facility and that the income may be too high if she has it to apply for medicaid. I would start out with the emergency guardianship, then see an elder law attorney about how to act as her financial fiduciary, how to keep records. I would not jump to renting the home, but instead jump to apply for medicaid and get Aunt placed. Then make decisions later about the home. Best out to you. So sorry for these circumstances.

I have rentals in several states that my husband owned. It is very expensive and time consuming to handle rentals. I am in the process of liquidating the properties.
You will not make enough money from renting to pay for care. Sell the house and use the proceeds to pay for care. When the money runs out apply for Medicaid.

Your “immediate concern” is losing Aunts house? How about what is best for aunt here?

Going into a home with money widens quality options. The quality options that accept Medicaid generally prefer clients with a history of private pay as opposed to the few that generally accept everyone.

Bananas, stop it about how “family” home with so many happy childhood memories and that’s why the house matters. There are two of you, you and sissy, who want this house to sell, because what else will you do? Move in together? Lol.