More and more senior citizens are becoming concerned about nursing home costs.  No one really wants to go to a nursing home.  Nearly every elderly person would prefer to stay at home.  However, no matter how much children love their parents, caring for an elderly parent at home can be so stressful that a stay in a nursing home often becomes necessary.  A Kaiser Family Foundation Survey in 2003 found that if you are 65 years of age or older, there is a 45% chance that you will spend some time in a nursing home.  The average nursing home stay is 2.4 years.

Medicaid is the most common way of paying for nursing home costs.  When you apply for Medicaid for nursing home costs, they will count your assets to see if you qualify.  They do not count the value of your home.  However, there is a trap here.  Even though the Medicaid rules say that your home is an “exempt” asset which is not counted when you apply for Medicaid, once you are on Medicaid, they may be able to put a lien on your home.  A lien is like a mortgage.  It will guarantee that the government will be paid back money that they pay for your nursing home costs.

For example, suppose you have to spend the last 3 years of your life in a nursing home.  Suppose you have very little in assets besides your home.  Medicaid pays your nursing home bills, but puts a Medicaid lien on your home.  At a cost of $9,000 per month, your nursing home stay could cost $324,000!  After you pass away, you owe to the government the entire amount they paid for you.  The government will approach your children who are hoping to inherit the home.  They will give your children a chance to go to a bank to borrow the money to pay off the amounts Medicaid paid for your nursing home costs.  If your children want to keep the home, they are forced to buy it.  If they cannot afford to do that, the government could sell the home, and keep the proceeds from the sale, up to the amount that is owed to them.  If there is any money left over after all expenses, your children get to keep the extra.

Because of the great danger of losing the home to nursing home costs, it becomes important to understand how you can protect your home from Medicaid liens.  The first thing to remember is that a Revocable Living Trust will not protect your home from nursing home costs!  This is one of the most common misunderstandings.  Many people have a “living trust” and think they are safe.  A living trust (also called Revocable Living Trust) will protect your assets from probate, but it will not protect from nursing home costs.

The government will not place a lien on your home as long as your spouse is living in the home.  The danger is that the spouse who is living in the home could die first, or also end up in a nursing home.  Then the home is no longer protected from Medicaid liens.  This kind of problem can be prevented by advance planning.  In my opinion, the best method for protecting the home from nursing home costs is for the parents to give the home to the children, but to keep a “life estate.”  A “life estate” means that the parents can live in the home for the rest of their lives.  Yet, they have given the home to the children.  (For those of you who do not have children, I apologize for always talking about children.  This technique will work just as well with a niece or nephew or anyone else you choose to inherit your home.)  In next month’s column, I will explain in more detail how this life estate method works.