Concerned about keeping my home that is on my Mom's land and what to do for mom. Any advice?

As a very 1st step in the maze that is Medicaid, I’d suggest that you find out exactly what type of placement your State (GA?) will pay for within their LTC Medicaid program. LTC = Long term care program so applicant is living in a facility FT and clearly shows to be “at need” medically for the LTC Medicaid program. Fretting abt the mobile home, her land, etc., which are all part of her financially “at need” part of LTC Medicaid, is to me, secondary to determining where your moms “at need” medically is.

Fwiw Most states do NOT divert or “waive” dedicated SNF Medicaid $ to go over to have AL aka assisted living in their LTC Medicaid program. AL by & large is private pay, or if they or their spouse was military and can get VA “aid & attendance” $ then the VA $ + private pay. States that do AL LTC Medicaid program tend to do it on a very limited basis AND the # of facilities that participate are smallish and have a waiting list from existing private pay residents. AL can easily fill their rooms with private pay so no reason to bother with dealing with Medicaid and it’s compliance/ reporting stuff.

if your state does NOT do LTC Medicaid AL, then you’ll need to see if mom could be “at need” medically for care in a SNF or a MC (again for MC it’s if your state diverts LTC Medicaid $ from SNF/ NH to MC).

How that gets done is via a “needs assessment” and tend to be done by a duo of a RN & SW in person plus a review of moms meds & health chart. Your Area on Aging (u r in one as they are regional planning body’s in every state) should have a listing of resources for getting assessments done. If you have a PACE center, they do assessments. Yiur moms MD writing script for “SNF needed” in & of itself is not enough. My experience is that if mom is seeing her internist every 6 mos or once a year, she will not have a fat enough health chart to show her to be medically “at need”. You are going to have to get her health chart built up to clearly show her needing skilled nursing care.

That she was recently hospitalized does beef up her chart but as she returned home to erstwhile live independently, shows she recovered. (( yeah I know she’s not truly independent as she moved in with you and you & your daughter basically are FT caregivers, but that’s sort of stuff is NOT in her chart; it shows discharged & returned home on her own)). If she’s really ok for AL and flat not needing skilled nursing care, Medicaid is not going to pay for her to be on LTC Medicaid in a NH.

Her land, your mobile home, her mobile home, her $ in the bank, etc is to me all stuff you can deal with for the financial aspect of LTC Medicaid. Mom can continue to own a home, the land her home is on, a car as exempt assets for LTC Medicaid for her lifetime…. It gets sticky but it’s do-able. But the medical stuff is to me way more important to get done and clearly with documentation her chart; her financially “at need” does not matter if she’s is not also medically “at need” as well.

On the Medicaid allows for the elder on LTC Medicaid to continue to own their home, the land it’s on, & 1 car as an exempt asset, by & large all States programs allow for this. Some may require that property have current homestead exemption.

The exempt asset is for their lifetime. After death it becomes a nonexempt asset of their estate. Assets of the estate are subject to a required attempt of recovery or recoup of costs Medicaid paid for the elder. It done via MERP or MERS. Both care paid from LTC Medicaid and from any Medicaid community based programs if applied for after age 55….like if they get inhome health that Medicaid paid for… are in MERP recovery system.

But MERP is way down the road as it’s an after death process.

What is to me, way WAY more importante to be aware of is that LTC Medicaid - aka care in a facility - requires the elder to do a copay of basically almost all of their monthly income to the facility. All they get to keep is a smallish personal needs allowance (PNA) which averages $50 or $60 a mo. PNA kinda is just enough to cover their mo beauty or barber shop costs and some clothing or toiletries replacement. They will NOT have $ anymore to ever pay any property costs….. so no $ to pay taxes, utilities, homeowner insurance, etc. Someone in the family will need to pay all these on a property they do not and may not own when all is said & done AND it could be for years. If there is a mortgage (horrors!!) this could be quite a tidy sum. But if no mortgage and upkeep etc are modest, it could be totally affordable for family. Taxes need to be made a priority to pay as all places do annual tax sales.

So if you go this route, pls pls make sure your wallet and sense of humor on mom keeping her home & you pay all works for you. Remember you do not own it, so doing anything to substantially increase its value is probably not to your advantage. Repair to gas line is yes; but new landscaping & a pool is a kinda hard no. Comprende?

Depending on how your state manages its program, state may want anyone living on the property to be paying rent. Now if you have been a caregiver for the elder or are co-owner of the property or you yourself are disabled then that rental requirement can get waived. Someone on this site did this for a disabled nephew who lived at her moms house. For us, we kept house vacant, shut down utilities & tightened up security, so didn’t deal with it being “occupied”. Your situation is different as your own mobile home on property, so may be you pay land rental? Your situation way different that what JoAnn or I ever dealt with, plus you have been there forever…. I bet caseworker just ignores it if raw land value is low & hard to determine rental footprint.

There are all sorts of exemptions & exclusions to MERP. The one you hear abt most is caregiver exemption: it’s to me basically compensation for the adult heir to inherit elders property IF a Full Time caregiver for elder for at least 2 years prior to elder entering a NH & onto LTC Medicaid. It seems somewhat sticky to do as you have to have documentation from elders MD or SW as to what exactly you did as a FT caregiver….. if elder lives in a NH for 4 years, you might have to be looking to get documentation from old docs from 6 years ago. And has to be your FT job, so you cannot have it where you work FT, help mom PT and you have your kids helping out often but irregularly. If you are going to want to go this route, it would imo be good to right now find an elder law atty with MERP expertise or has a partner who does probate and has MERP expertise to discuss ahead of time. Sounds like you do not have a 5 yr window to transfer property (Sept 2027!), so speaking with an atty really worthwhile to come up with options that work for how GA runs its programs. Good luck!

This is a different take on the legality of your mobile home. How ‘mobile’ is it? If it really is mobile (or can be made mobile), it can be moved off this land to somewhere else. Then it won’t figure in Medicaid at all. If it is ‘fixed’ to the land, then normally in most places it becomes part of the land. You can’t sell a house without the land it stands on, and you can’t sell the land without the house that stands on it – if the house is a ‘fixture’.

The next question is whether your mother is legally competent – does she know what she is doing? If she is OK, you have a window of opportunity to sort out this mess. Look for any ‘evidence’ you can find about that old understanding that you were ‘too naive’ to pursue. I’m not going to suggest how you sort this out, but it is likely to need legal advice in your own State. It may also affect Medicaid look-back, but this is all much too complicated for this site.

Anita, Medicaid typically allows individuals to retain one home and one vehicle. Assuming your mobile is affixed to one contiguous lot, it may be that they treat this as part of the estate.

Anita, in thinking about your ‘mobile home’, I omitted to give you the heads up on site resources that I often try to do. It will help you to learn some of the basics of care options quickly and easily ‘in the comfort of your own home’ (mobile or otherwise). Click on Care Topics at the top of the screen, then use the alphabetic list: A for Assisted Living, NH for Nursing Home, M for Medicaid and Medicare, H for Hospice, anything else that helps. You will find expert articles, then lots of old threads from people who have been through this themselves. You can also use the ‘magnifying glass’ symbol to search other threads that refer to the topic in passing.

I’m sure that at the moment you are concentrating more on your mother, but it takes a bit of time to learn enough about the care system so that you can think about her options, financial and care-wise. Good luck in what is for many people a difficult learning curve, Margaret

Welcome to the forum Anita!

I have to say you are among the minority here who's mother WANTS to move into Assisted Living and you are against it!! Most of the people posting here are dying to have their loved one move into AL and the loved one is fighting them tooth and nail over it!

Your mother should be paying for her own in-home care if she needs it, and not relying on your daughter to do it for free. Your daughter could be working and earning a real living during those hours, but instead, she's caring for her grandmother for free. At least your mother should be paying HER for the caregiving, don't you think? I'm sure she gets Social Security or some other form of income, no?

How would your mother afford to live in Assisted Living, is my next question? If she has funds to pay for AL, she certainly has funds to pay your daughter or another health care provider.

If she has no funds, then is she wanting to live in a Skilled Nursing Facility with Medicaid footing the bill? Is that the reality of the situation, and not Assisted Living?

If so, you should make an appointment with a Certified Elder Care attorney for guidance on the Medicaid requirements/rules in your state. You can Google it too, but in my book, a short visit with an EC attorney is worth its weight in gold b/c you'll get A LOT of very valuable information and resources to help you. Your home is yours and should not be subject to a lien by Medicaid on behalf of your mother's care costs in the future. But again, an EC attorney would be able to answer that question in short order.

Hopefully one of our regulars here, Igloo, will come along and comment; she has excellent knowledge about such matters.

Best of luck to you!

Assisted Living is not covered by Medicaid in most states. Is the mobile home in your name. If she gets Medicaid they will place a lien on her property and if is sold they recoup money from the sale. They are not interested in a mobile home in your name.