Can a Nursing Home Take Your House in Massachusetts?

If one of your relatives has gone into a nursing home, you’re likely feeling a lot of relief. While many people dread going into a nursing home, most facilities nowadays provide our loved ones with not just the care they need, but more enrichment than they had at home. You no longer have to worry about what will happen to them when you’re not looking, and they get all the benefits of a purpose-built facility, around-the-clock care, and someone ensuring their days are joyful.

The Financial Strain of a Nursing Home

But once that relief has passed, there’s a new worry: how they (and thus you) are going to pay for it. Few people have a pension large enough to cover the cost and often families are left scrambling to seek Medicaid (known as MassHealth in Massachusetts) or sell assets to pay for their care. Like all other forms of medical care in the US, nursing homes walk a fine line between offering us essential services and care in times of need, and being cripplingly expensive.

If you’re behind on nursing home bills and are concerned about what action a nursing home may take to get their dues, or are looking forward to the future and trying to plan for your family, keep reading. We’ll explain what measures you can take to protect the family home.

How much does a nursing home cost in Massachusetts?

The cost of long-term care services in Massachusetts has risen significantly in recent years, surpassing national averages by approximately 20-30%. According to the Massachusetts Division of Insurance’s latest data, here’s a comprehensive overview of these costs:

Assisted Living:

• Massachusetts Average: $5,640 per month ($67,680 annually)
• Boston Area: $6,442 per month ($77,304 annually)
• Western Mass: $5,125 per month ($61,500 annually)
• Cape Cod Region: $5,890 per month ($70,680 annually)

Nursing Home Care:

• Semi-Private Room: $12,623 per month ($151,476 annually)
• Private Room: $13,535 per month ($162,420 annually)
• Boston Metro Area: $14,890 per month ($178,680 annually)
• Memory Care Units: Additional $1,500-2,000 monthly

Home Health Care:

• Home Health Aide: $30-32 per hour
• Licensed Practical Nurse: $55-65 per hour
• Registered Nurse: $75-95 per hour

These figures highlight that Massachusetts ranks among the top 10 most expensive states for long-term care. Such costs can rapidly deplete personal resources, making it crucial to establish a financial plan to protect assets and ensure access to necessary care. MassHealth (Medicaid) eligibility becomes an important consideration for many families, with current asset limits at $2,000 for individuals and specific provisions for married couples.

Can Medicaid (MassHealth) pay for my loved one’s nursing home care?

Yes, but only if your loved one fits their criteria. The good news is that you can use some of the methods we outline below to ensure your loved one does meet their criteria.

To be eligible for MassHealth, your loved one must be:

• A Massachusetts resident
• A legal US resident
• In a financial situation that would be characterized as low income (though there is no income limit for individuals with disabilities, who may be able to pay a one-time deductible to qualify) – this is $18,075 a year for a 1-person household
• Has no more than $2,000 in assets ($4,000 for a couple)

How can I avoid selling assets to pay for nursing home care?

There are a few ways to avoid selling assets to pay for nursing home care – note that they require the person going into the nursing home to still be in their right mind at the time of making these decisions. Here are your options:

1. Gift
2. Irrevocable Trust
3. Life Estate

Giftingis what it sounds like – simply giving your assets to your family members. There are still often tax implications when you do this (such as gift and capital gains taxes), but it will ensure a nursing home cannot claim your assets.

An Irrevocable Trustworks similarly; your assets (including your home) can be put into a trust and you can name a trustee (typically a partner or adult child) who will then have ownership over everything in the trust. While you are no longer the owner of the assets in the trust, you can continue to use your property until you are unable to do so and it cannot be claimed by any of your creditors (such as a nursing home).

A Life Estateis another good option if you want to “hide” your property value from applying toward your MassHealth eligibility. A life estate is where you essentially give ownership to another person while ensuring you can be the tenant for the rest of your life.

MassHealth 5-Year Look Back Policy

If you’re considering creating an irrevocable trust or life estate, you need to know about the MassHealth 5-Year Look Back Policy. This policy is best to know about more than 5 years before nursing home care is needed since after that 5-year term your assets will still be considered when they look at your eligibility.

When you apply for MassHealth the government will look at your past five years of financial history to determine whether you are eligible for benefits. If your property is in an irrevocable trust and sold after five years, the proceeds will not affect your eligibility. However, any assets transferred within the last five years will have an impact. With a life estate, the proceeds from the sale of the property will affect your eligibility at any time during your lifetime.

If you are not sure how to proceed, it’s best to consult an elder law attorney for individual advice.

Can a nursing home take your house in Massachusetts?

No, a nursing home cannot directly take your home or place a lien on your property under Massachusetts General Laws Chapter 118E, Section 31 (M.G.L. c. 118E, § 31). However, they can pursue the estate or the resident’s children legally to try and recoup their losses through the Massachusetts Filial Responsibility Law (M.G.L. c. 273, § 20). Additionally, under MassHealth regulations (130 CMR 520.007), while your home is protected as a non-countable asset during your lifetime, it may be subject to estate recovery after death if you received MassHealth benefits.

Can MassHealth take a home?

MassHealth (Medicaid) will not be able to force the sale of a home (and will never force a remaining spouse out of the home), but they can place a lien on a property, meaning they would have a claim on the proceeds if/when the property is sold.

This lien can be thought of as a loan building up over time – instead of paying for your nursing home fees upfront each month, MassHealth pays it for you but adds it to your lien so they can recoup all or some of their money when the property is sold.

For this reason, it’s usually best to sell or transfer ownership of a home before nursing home care is required.

How to Avoid Your House Being Used to Pay for Your Nursing Home Care

If you have time to plan ahead (meaning you or your loved one does not need to go into care imminently, and will likely not need to within the next five years), you should consider protecting your assets now through the methods we discussed above. Even if you don’t have that much time, it is worth speaking to an estate and/or elder law attorney to find out what you can do to protect your assets.

Unfortunately, in some cases, you may be forced to use your own assets to pay for your care, which usually means your assets must be liquidated.

If you are the caretaker of someone going into care, do not pay for their care personally – use their assets until it’s no longer possible to do so, at which point they will be eligible for MassHealth.

What to Do If They’re Already in Care

If your loved one has already gone into care and you need to find cash quickly to start paying for their nursing home fees, selling their home is often the most straightforward option.

If you can, look at a few nursing homes to find one you feel offers the best conditions for the cost. Often, our loved one goes into the most expensive care available at short notice, since they have plenty of space and may be close by, but moving your loved one to another facility may mean they can afford their care for years to come.

If you need to sell their home fast, we’re here to help. We buy homes in as-is condition for cash throughout Massachusetts, closing in as little as 2 weeks. To find out more about the process or to get a cash offer, click here.