Will a Patient’s Multi-Family House be Subject to Claim by Medicaid?

 In Long-Term Care Planning

Question:

I am a nurse who works as a case manager on a geriatric psychiatry unit in Everett, Massachusetts. I frequently have patients who need to go into a nursing home for long-term care from the inpatient setting and the families try to save the nursing home from attaching the patient’s home (their one and only asset). Some of the patients own a two- or three-family home where they live in one apartment and the rest of the family lives in the other one or two apartments. Therefore, they want to save the property for their family. They would rather take the patient home than admit them to a nursing home in order to save the house and this becomes an issue for appropriate placement. It is my understanding that a house will not be attached by a Medicaid if the family member can prove they have taken care of the patient for the previous two years. What I don’t know is when the patient passes on or the family member moves out of the property will the state attach the property at that time? Also, is a single family home treated differently than a multi-unit home?

Response:

Many families face this situation and it involves a Catch 22. While being a caregiver for two years can prevent any penalty for a transfer of the home, it does not protect it from estate recovery upon the patient’s death — Medicaid has a right to recover it’s costs from the house. In order to avoid this, the house needs to be transferred to the caretaker child during the patient’s lifetime. In general, Medicaid treats multifamily houses just like single-family houses, but unfortunately they can be inconsistent on this. I would recommend that anyone in this situation consult with the state Medicaid agency or a local elder law attorney to make sure they take any necessary steps to protect the home.

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