If my dad gets POA over my mom, who has dementia, can he sign for her to remove her off the house so she can get on Medicaid and be placed?

If you have a large amount of assets, make sure you find a professional that has dealt with larger estates. While each state is different, and many will not agree as the one that handled my LO's estate told me, Medicaid has many legal loopholes that can save families at the expense of tax payers.

They will be worth the cost if your estate is on the larger side.

Terese, I’m going to guess that your Dad has told you that government is going to come and take the house away from him should mom go into a NH & onto Medicaid and that someone told him that if he takes moms name off the house, then government can’t do it. And you are very concerned as it sounds sketchy as hell and Dad tends to do things in a fit of pique.

If this is what’s what, here’s what you need to be aware of Medicaid-wise imo:
- LTC Medicaid program will pay for the room & board costs for your mom in a NH if if she is determined to be “at need” BOTH medically AND financially. It is a two part eligibility system.
- the financials are what you hear abt & have obvious fear factor, but the medical “at need” is just as important. In many ways, trying to prove medically at need without coming into a NH via a post hospitalization rehab placement can be difficult. Rehab stay plus hospital notes have a nice fat file for Medicaid to use to evaluate need easily. If mom is living at home, that degree of detail may not be there. So no “at need” medically. You need to look into this ahead of her ever applying imo.

- for “at need” financially the applicant (mom not dad) need to be impoverished & under whatever your state has as it maximum mo. income and has nonexempt assets under whatever $ amount state has set. Tends to be $2200 individual mo income, 3k in nonexempt assets.
- That home owned jointly is an exempt asset for her lifetime and only after she dies that MERP (estate recovery) enters the situation. Just how MERP runs again differs by state. All kinds of exemptions, exclusions to MERP. Dad as long as it’s his homestead will not have to sell it. He could die still owing it and then it’s on his heirs (you!) to deal with the place.

- BUT if dad does something to remove her ownership now and then mom applies for LTC Medicaid b4 2027, Medicaid will assess a gifting transfer penalty. So if house value is 400k, then her 50% is 200K & if your state pays $185 day Medicaid room&board, that’s 1,081 days of ineligiblity that someone will have to private pay for her to ever stay in the NH. 1,081 DAYS! Dad changing ownership will surface & this info in states database.
- Parents have to submit 5 yrs of financials in some way. Any big $ moves will surface & will be red flags waving at the caseworker. You don’t want to go there….

- Mom will be required to do a copay of almost all her monthly income (like her SS) to the NH. All she gets to keep is a smallish personal needs allowance ($60 avg).
BUT
Dad becomes a community spouse (going to stay living in the community) & he can ask for a resource allowance from moms mo income if he can show cause. It’s called CSRA or MMNA & again it varies by state. If dad needs $800 a mo of moms $1200 SS $ then he can get it as his CSRA. But it has to be filed for & shown cause. An attorney imo is best on all this.

- for Community Spouse / NH spouse situations, the rules on income & assets are complicated. Dad is NOT expected to impoverish himself; a CS usually gets to retain up to 128k in assets. & his mo income should not be a factor for moms eligibility.

Personally if this was my parents I would find a CELA level of elder law attorney and make an appointment for Dad & whomever is their POA to go and discuss what their finances look like & exactly how your state runs it’s LTC Medicaid program and what is likely for MERP (estate recovery) and dealing with the house; y’all come up with a plan that’s legit and workable. AND do this as far ahead as possible to mom ever needing to go into a facility. If things need to move…… like dad sets up his own savings account with his own assets….. that kinda imo needs to happen b4 ever filing for Medicaid. Just makes the process way more defined. Good luck and let us know how it goes.

Given that there seems to be a basic lack of information I would suggest your Dad and you go together with your Mom to do the POA (if your Mom is competent to do this). You need a well written document and someone who will serve as second (might be you). You need to learn what powers a POA gives. You need a well written POA that give you the powers you need. Does your Father and Mom already have a will or trust drawn up? If not, this needs doing as well. And if they do, there may already be a "springing DPOA" in those papers. Check them.
Know going in that you NEVER get POA OVER a person. A person who is MENTALLY COMPETENT GIVES you POA, confers it upon you to act as he or she WISHES you to act. Only guardianship gives any powers OVER someone and that means that person is diagnosed usually by two MDs to be incompetent in their own care. Take these letter with to the attorney.
As to medicare and the home. Again, this is attorney question. The attorney will need to know how the deed is held. The home will not be taken from your father if he is on the deed. You need to understand under exactly what circumstances in your own state the sale of the home can be recovered. There is really now way to protect the sale of home after the passing of your parents from medicaid clawback if the goal now, when your Mom is close to needing care, to protect assets.
For all these reasons and most of all because these legal things cannot be done WRONG you need the help of a licensed professional, in this case an elder law attorney with knowledge also of Trust and Estate. There is document work and the attorney will have questions. You Dad should bring basic list of assets in his and your Mom's name.
Sorry about the cost, but doing this wrong can be catastrophic.

Depending on how severe the Dementia is, your Dad may not be able to get it. Mom has to be competent to assign anyone to be her POA. She needs to understand what she is signing. And if he is able to get it, the answer is No he cannot take her off the deed and expect Medicaid to pay for her care.

When there is a spouse, Medicaid considers them a Community Spouse. Any assets they have together needs to be split. Mom split going to her care. When almost gone, about 3 months before it runs out, Dad will then start the Medicaid application. He will be able to remain in the home and have a car. His bills will be looked at and that will determine whether he needs Moms SS and any pension she has to live on. Otherwise, he money goes towards her care. At time of Moms death, a lien will be placed on Moms half of the house. This lien will need to be satisfied at time of Dads passing or if house is sold.

I am just giving the basics here. Dad should see an elder lawyer. If he does not do things the correct way, Medicaid has penalties. This means paying out of pocket for Moms care, physically caring for her himself, or hiring someone until the penalty is met.

Medicaid is for the poor. Those that have nothing but maybe a small pension and SS check.

I don't know if you're aware of this or not, but Medicaid does a 5-year 'look back' period on an applicant's finances.
If her name is removed from assets like real estate and bank accounts now, the family will have to wait five years to put her into a care facility or to have get Medicaid-paid homecare help that will not have to be paid back after she dies.
Because your parents are legally married, your father would be entitled to retain half of the value of their shared assets. Your mother's half would go towards her care if she's placed in a facility or if you're expecting her homecare services to be paid by the state.
For example: If their house is valued at $100,000 Medicaid can only take value up to $50,000 which would be your mother's share of it. Medicaid would allow your father to remain in the house until he dies. If your mother has social security of her own, or whatever amount she collects from your father's will also get put towards her care in a facility. They will not take your father's though.
The only way to get your mother on Medicaid to put her in a facility or on state-paid homecare is to take assets out of her name and wait five years. If their assets are large enough to create an Irrevocable Trust, you could try that but it's a big headache.
Medicaid had to get strict like this because for too many years families were having grandma and grandpa transferring assets out of their names in the car on the drive to the nursing home.

Regarding the PoA, it would be wise to have someone younger than your mom and dad to be her PoA. You don't say how old she currently is, but if she's in her late 60's or 70's her PoA could conceivably become incapacitate or pass away before she does. I'm 63 and my husband is almost 65. I have my adult son as my PoA, not my husband (because they have a healthy relationship and I can trust them to work together). My very healthy 62-year old cousin just died unexpectedly sitting on his couch in his house, without having been ill prior. My other cousin is 68 and has rapidly advancing ALZ. Just a thought for your mom and yourself when you create your own PoA.

Don't do that, it would be considered fraud on the Medicaid application. That will end up with someone being required to personally care for grandma.

See an elder law attorney in her state that is specifically trained in Medicaid qualification to learn what can be legally done in her state.

Was this dad's idea of yours? Remember, that dad is not a POA "over her". It is his responsibility to act in her best interest which includes preserving her assets to buy her the best care possible. Conducting her business in a way that benefits him, or anyone else, would be a breach of fiduciary duty. Google it.

You simply cannot hide or transfer in an effort to qualify for Medicaid. If he were to transfer the house to someone else, it must be sold at fair market value. If it isn't then Medicaid will charge grandma a penalty equal to the difference, meaning a period of time that grandma loses Medicaid eligibility, someone else must volunteer to care for her and then reapply once her assets are spent down.

Example: grandma's house is worth 200K, nursing home cost is 10K a month, someone else would have to volunteer to care for grandma for 20 months.

My strong guess is that for Medicaid it would class it as a gift of Mother's half share to Dad, subject to gift rules.

I agree that you need to consult an attorney to do this correctly, or it might all blow up on them.

As POA, your dad shouldn't be mixing his interests with hers anyway; it isn't ethical. I assume he's a joint owner of the property, so for him to essentially sign the house over completely to himself would be a big no-no.

Agree with what others have said. Check with a good eldercare lawyer. Internet and "friends" advice often are worth what you paid for them, no matter how well meaning, unfortunately, and many things change state to state.

I agree with getting legal advice. But it's much too late to try to hide assets and there's really no hiding a house. IIRC, he can stay in the house and at some point, when the house is sold, her half will be used to go towards her care.

Depending on her level of dementia and whether she is still competent, she may or may not be able to legally sign to give POA to anyone. If she's still competent, get it done ASAP. And dad's too.

He should see a certified elder law attorney to apply for Medicaid.

He could cause her to be denied if he starts hiding assets.

An attorney will be able to explain what he is allowed to keep, the house and 1 vehicle and enough money to not be destitute, among other things.

Please don't change any titles or move money, they will find out and it won't be good.

You all need to see an eldercare lawyer or medicaid planner in your state.