If my Dad is about to enter a nursing home can I keep and live in his home if I pay a reasonable amount of rent?

Thelma, if you have been your father's full-time caregiver for 4 years, your help allowed him to avoid a nursing home during that time, and you are the sole heir of the house, you may be able to keep the house. This varies from state to state. There are many factors that may hamper you keeping the house. For example, if you worked outside the home, the state may decide that your help was not mandatory.

Some states in certain instances may let you keep the house outright. Other states, from what I understand, may grant a life estate, where you can use the house as long as you remain in it, but it reverts to the state if you move.

Thelma - in general for Medicaid, their homestead is an exempt asset for the rest of their life. But upon death, the home goes from an exempt asset to an non-exempt asset. When they go onto Medicaid, all the rules and compliance items they sign off on acknowledging. One of the things that is a part of Medicaid is MERP - Medicaid Estate Recovery Program. It is MERP that can place a claim or a lien on the home after their death in which the $ from the sale of the home will reimburse the state for some of the costs paid for her care by Medicaid. All states have to have a MERP in place. Some states do MERP by state workers, but many states have outsourced this to contractors who get a % of the recovery.

MERP has all sorts of exemptions, exclusions, hardships, etc which family can file for. It is up to you to do this and to provide whatever documentation is necessary. There is a caregiver exemption, in which if your provided care for 1 -3 years (depends on state) that kept them from going into the NH, then you can file the caregiver exemption. So MERP does not do a claim or a lien. There are all sorts of other exemptions too and in some states you can do certain types of deeds or life estates which will be outside of probate so outside of MERP. Each state manages Medicaid uniquely so you need to google your state's program. It can be overwhelming to figure out and really working with an elder law attorney can be the best way to deal with all this.

Renting the house, well, that's probably is a cluster to deal with. Rent of any type is income, and all their income has to be paid to the NH. Plus there are tax filing stuff on rental property and it could totally change her homestead exemption. Probably no advantage to paying rent unless the rent is huge, like 5K or so, and can be enough to totally private pay for her care. I doubt that is the type of rent you were thinking.

But it's good that you have the income to pay rent. Realize that once he goes into a NH and onto Medicaid, all of his monthly income (SS, retirement or any other income) has to be his co-pay or her "SOC" (share of cost in Medicaid speak) to the NH. He can continue to keep home as an exempt asset for Medicaid but will have no income to pay for anything on the home. If you are living at the home, and want to stay there, you will need to pay for everything on it. Taxes, insurance, utitilies, yard work, repairs, etc. And you will pretty well need to pay all this from now till whenever dad passes away. Try to go though the past couple of years to see what the costs on the house runs and then look hard to see if it is manageable for you to pay for all the next few years. If your state does the caregiver exemption like most do, you cannot file for it until the elder dies and then you submit the exemption after death upon the state's sending you the MERP "intent to file" (a recovery claim or lien) letter. In order for all this to work, you just have to have the disposable income to pay for whatever on the house for the unknown period of time that dad is still with us and then file the exemptions and the documentation for the exemption.

For a lot of families, paying for things for their parents home just isn't feasible in the long run. So they end up placing the house on the market within the first year @ the NH and then all the $ from the sale has to be used for a spend-down at the NH. If you can't afford the costs on the home, you probably are better off selling the house from the get-go and doing a spend-down of the $ before ever applying for Medicaid so that you can get things that dad will need - like dental work, a funeral / burial policy - rather than just paying it all for his NH stay. Good luck.

I forgot to mention that what you wrote about reimbursements for maintenance is important. Keep good records on all the money spent on the house. If the house is taken in recovery, then that money is reimbursable. You will have to pay for all the expenses if your father is in the NH on Medicaid. There is no money allowed for property on the outside.

thelmal1979, you need to consult an attorney who specializes in Elder Law and is very familiar with Medicaid rules. There will be a fee, but it will be very worthwhile to be assured of doing things correctly right from the beginning. The lawyer will also be able to advise you whether paying rent is advisable. Your father would just have to turn it over to the nursing home.

Yes--I have been his owner caretaker for over 4 years---I have not worked since 2-19-10, No one else has helped me care for him---do you know of attorney in Indianapolis or area who could help me---or could you help me with legal work? thank you---yes--I will definitely keep all receipts --it need some major work--thank you.

Thelma, there is a website AVVO where you can ask attorneys in your area questions, receive answers, and all at no charge. The politically correct term to use is Medicaid planning. I permits a caregiver child to keep the house if the care provided kept parent out of a nursing home, but does not apply to memory care, if I understand correctly. That is a policy that, IMHO, should be changed. Caring for one with dementia in many ways would be just as difficult as one that has physical illnesses.

If Dad is competent he can set up the Medicaid planning for you. And even under Medicaid recovery, many times they will allow the child caregiver to remain in the home.