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In your follow up, you mentioned that son has taken care of mom for several years. Medicaid has a caregiver exception that protects the rights of adult children who live in the home and provide two years or more of home care for a parent who would otherwise have needed care in a facility. This exception takes effect upon the elder's admission to a facility.

You also mentioned that an ownership interest was transferred many years ago, well beyond Medicaid's 5 year look back period for disqualifying transfers.

So there may be many ways for your elder to qualify for Medicaid home care benefits now, and for Medicaid to cover costs in a facility if needed in the future.

Talking with an elder law attorney in your state now can open up all the options for your family.
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Thank you for your response and all your information. I truly appreciate it.
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So I’m guessing that you & hubs have realized that caregiving for her in her home has gotten to the point where she is needing a higher level of care and that on her own she doesn’t have enough funds to private pay for very long. And then add in that you have spent a tidy sum to cover her living costs. You trying to figure out how everything can equitably be figured out if Medicaid is applied for, that’s it, right?

Please keep in mind that each state runs its Medicaid programs uniquely. So what someone did in TX for their mom will be different than for a parent in CA. But for all states they will have to be “at need” BOTH medically & financially for the Medicaid program she’s applying for. Before you get too deep into finances, remember that for LTC NH, she must show that she needs skilled nursing care. That may not be easy to be determined if she’s living at home and does not have the fat medical chart that an elder hospitalized then discharged to NH rehab will have. Most states do not cover AL or if they do it’s via a waiver program which may not be easily accessed as either there’s a long waiting list to get a spot which living at home or the AL all seem to require a year or 2 of private pay before Medicaid. Financial are what most think about regarding Medicaid but she has to clearly show “at need” medically.

IMHO you will eventually need to have mom work with an elder law atty if hubs will be seeking the caregiver exemption to MERP / Estate Recovery to acquire mom’s 50% ownership of the house. He would need to be a full time caregiver usually 2 years prior to her entering a NH AND the care kept her from entering a NH & onto Medicaid earlier. So a MD or SW letter attesting to this will likely be needed. Just how much detail is something to discuss with the atty. To me, it’s better to try to get exemption in tandem with her Medicaid application as doing it possibly several years later could be difficult. The atty shepherds both items.

If caregiver exemption cannot work and you should want to buy her 50%, it needs to be FMV. FMV usually tax assessor annual value. But if assessor figure is whack, get it appraised. Not a figure from a Realtor, but a licensed, registered appraiser that places their seal on it. It’s a legal document that can be used for FMV. Some have posted that they used Realtor figure. But if the house has decades of delayed maintenance, the appraisal will give a more accurate figure. 

Medicaid tends to view whatever we do or spend on our parents as done out of a sense of familial duty without expectation of reimbursement. You’d need some type of memo of understanding or promissory note done in advance to even start to try to get around this.
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Wow, thank you for your answers. Tax Bill is "and", son and I have paid for all expenses since 2004. No mortgage on home. Hubs did have another job all these years. He has been in the home and taking care of her since then.
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How the property is registered at the courthouse will be the biggest determining factor as to what can happen.
So how does the tax assessor bill read? His name only? Her name? Both name with an AND or an OR between the names?
If there is a homestead exemption on it, how does it read?

For all those years of caregiving, did/do you & hubs live with your mil?
Or do you & hubs have your own home?
Did hubs have another job during this period of time? 

Property has costs, how have these been paid? 50/50? All by mil? You & hubs?
If MIL goes into a facility, her monthly income is a required copay by Medicaid, so can you easily afford all property costs from now till beyond her death if need be? 
Is there a mortgage (!horrors!) on the property?

I’m guessing that your thinking that mil is at the point of needing to go into a NH. I would suggest that you do NOT apply for Medicaid until you get a firm idea of the property situation cause anything filed or any paperwork drawn up must be done before Medicaid application is ever submitted.
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Are they on as coowners. Or did she hand the house over to him entirely. If he is the only owner than you have no problem. Look back is five years. Now if coowners, not sure how that will work.
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Oh yeah, duh.....if mom goes on medicaid, will medicaid take the home? (son has cared for mom for 14 years.
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Jackie, what is your question?
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