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The income produced is usually equal to the monthly expenses as the renters do not pay utilities and the dwelling requires a lot of upkeep due to the aging structure.

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You kinda have a different situation for Medicaid.....and there isn't going to be a simple DIY solution and you all may need to evaluate keeping the house at all.

Homesteaded property is an exempt asset for Medicaid. Is the house under parents homestead exemption? If not, the house may not even be viewed as an exempt asset for Medicaid. If that happens, they will not qualify for Medicaid.

Some states will give a homestead to their home which the property owner then makes a rental property. The elder does an annual I want to return home letter to cover that legally. So that might cover that requirement. But there are a host of other issues with keeping momma's house. Please keep in mind that if they go into a NH, they will not have any income to pay for the costs to maintain the home (taxes, insurance, yard, etc). Medicaid requries a co-pay of all their income less their personal needs allowance. The allowance runs from $ 35 - 90 a month - depending on the state. Really it's enough for the beauty shop or barber and cable or phone bill at the NH. There won't be any of their SS or retirement income around anymore to pay for house stuff. This will fall to family or renters to pay for the months or years that they are in the NH. If there is a traditional mortgage, this can be alot of $$ each month. Is the rental income enough to cover all this with a emergency fund?

All states are required to have MERP - Medicaid Estate Recovery Program.
The homesteaded property is exempt while they are alive. But once they die, then MERP can place a claim or a lein on the property with the goal of MERP to get all the proceeds from the sale to off-set the costs the state spent on their NH. MERP has all kinds of exemptions. Google your state's program to see if any of those apply. If it looks like there will be, then you have to be keeping detailed records to let MERP know of the exemptions with the documentation needed so all those costs or other exemptions done and removed from MERP's claim. If there are no exemptions, then when you go to sell or transfer the ownership of the property, there will be a MERP claim or lein that will have to be released to sell the property.
You can't get around MERP claim, if it gets to this point either. When they do a Medicaid application there will be an acknowledgement of MERP form or document within the stack of paperwork that is the Medicaid application.

My mom has her empty homesteaded home, is on NH Medicaid. I & another family member pay for all on the home. We keep detailed records. The decision was made to do this based on alot of things: mom wants to return home; no mortgage; house is modest and costs are manageable; mom has great neighbors who look out for the home; I'm a freelancer so if I had to come up with a week there to oversee a new roof due to hail damage I can do that. Now we are in this for the long haul, whether it's 3 years or 13 years. For us, it works and we are most fortunate to be able to do this. But really I think you need to have a meeting with all family with details & costs on the home to make a non-emotional decision
on the home and what will likely happen under Medicaid/MERP. Good luck.
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Oh I forget, in the part about the not homestead property, if the state maintains the house is an non-exempt asset, it has to be sold for them to qualify for Medicaid. The property assessor value will be the amount of the asset for Medicaid. All this info is collected by the county/parish assessors, is public information and the state has all this info in just a few keystrokes.

If you decide to keep the property, it is to your advantage to have the property with as low assessor value as possible for the full run of their life. So a new roof because insurance (which your cousin pays) is paying for it due to hail damage gets done. But cute new landscaping or adding a new master bedroom & bath doesn't get done. Also if your situation is where there are several family member who say they are going to do stuff, well, this can get really sticky as there always, always is 1 or 2 who promise to do whatever and then don't. How are you going to enforce that Sissy pays for property taxes, of Big Bro pays house insurance?
They agree and then 18 months from now.....don't!
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Probably any incoming-producing property will be viewed by Medicaid as income and therefore until they only reside in a non-income producing home will they qualify for Medicaid. What do the people at Medicaid say? They are the only ones who can answer this intelligently.
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