Do I need an appointment to talk about Medicaid recovery or is there a pdf file to read and download to understand?

At what point in the Medicaid maze are you in?.... like are you dpoa for a parent who wants to keep their homestead although they are entering a LTC facility and applying for Medicaid and you want to figure out what is likely to be issues/concerns, OR has your elder died and you have gotten a NOI (notice of intent) type of letter from the state or its MERP / Estate Recovery outside contractor stating that $ is owed to the state?

My mother is 91 . Living at her own home. I provide with private pay 24 hour care. I am doing this to try to keep her at home and out of a nursing home. She is now on Medicare. But I am afraid we will run out of money. And will need to place her in a nursing home. Yes I am trying to protect her home. My father and mother built home themselves. Not a lot of value. But want to keep it in the family. She put it it a living trust 4 years ago. I am afraid when her funds are gone the nursing home will want her home. Please any help would be appreciated.

NH does NOT want her house. NH are not in the old lady homestead biz. What NH wants is to be paid for her stay at the facility whether it’s via private pay, LTC insurance or Medicaid.

Ok so property is in a living trust. Usually folks do a living trust as a way to avoid future probate. It’s done for estate planning (Probate & tax avoidance) which is not necessarily Medicaid planning.

Whether or not the existing LT can work for Medicaid in my not an attorney experience is dependent what kind of LT and when it was done. For LTs there are basically 2 types: revocable and irrevocable.
If it’s revocable and your mom applies for Medicaid whether today or next year, it doesn’t matter as she can revoke the trust at anytime and Medicaid will expect her to do so and therefore it makes the property an asset in her name. And which will not not be able to pass outside of probate which is important for Medicaid Estate Recovery system (MERP). Her home - once back in her name - for Medicaid will be considered an exempt asset. Although that sounds super fabulous, the rub will be IF mom goes into a facility — due to Medicaid required copay or SOC (share of cost) — basically all her monthly income will need to be paid to the NH. So all expenses on the property that is in her name will fall to DPOA / you/family/ heirs to pay from day 1 of NH Medicaid till beyond her death as her executor will have to deal with property for both MERP (Estate Recovery) and probably probate as well.

If it’s a irrevocable Trust, for most states, then in order for the property to be outside of Medicaid it will need to be a full 5 years that irrevocable trust has legally existed. The founder of the trust (mom) will need to have trust done so that they really truly relinquish all rights. Medicaid although a federal & state program is administered uniquely by each state and each states property laws vary so just how LT are handled will vary by state. You should clearly check with the atty that did the LT originally to see how the LT as written will runs for your states Medicaid eligibility. Really of all this seems beyond complex to you, then have the atty Shepherd your mom’s future Medicaid application. Realize whatever the case, again, the same issues with property costs exists as the SOC must be paid by mom to the NH.

If mom didn’t title other assets within the trust (like stocks) at the same time the living trust so there was created an income stream to pay all property costs, then every penny on the house - not in your name - will fall to you as DPOA to deal with.

So ? to you.....  what kind of trust?, 
If it’s revocable, then imho to keep house makes sense only IF you / heirs likely have exemptions or exclusions to MERP and can deal with MERP, Probate, & property costs. 
If it’s irrevocable, can you continue the current in her home situation till it is definitely beyond the 5 yr look back period and not apply for Medicaid till over 5 yr mark?
Does trust have other assets to pay property costs?, and 
If not, will DPOA, the LT trustees/ beneficiaries pay all property costs without fail? And pay all property costs for an undetermined period of time? 

For an elder to keep thier home can be done but will not be simple no matter what path.
As a first step I’d suggest you get out the trust paperwork, draw up a list of things you don’t understand and schedule an appointment with the law firm that did it. And before the atty appointment, go throw them mom’s bills on the house for the past 2 years to see just how big of a expenditure property will be. If it’s going to be vacant, price out vacant dwelling policies... they are specialty underwriting and not cheap. Good luck!

When/if the time comes, you will probably need a lawyer because of the trust. One who knows Medicaid.

If Mom didn't have a trust, this is how it works. Medicaid will allow Mom to keep the house. But...none of her money can go for upkeep, taxes or utilities. Her SS and any pension will be turned over to the nursing home and the balance paid by Medicaid. A small amt ($50 in NJ) from her SS will go into a Personal Needs Fund that the Home handles. This is for any personal needs she may have. Getting her hair done, clothes, etc. Since her money can't be used the house, someone else will have to maintain it. If you sell, it must be sold at Market Value. The proceeds will go to her care and there is no guarantee that you will get the money you paid into it. There's lots more to this. You maybe able to rent but it would be at the amt Medicaid deems appropriate. Profit goes towards Moms care. If you still have the house upon her death, a lean will be put on it and satisfied at time of sale. If you choose to keep the house, u may have to pay the lean. This is a question for Medicaid.

The house is exempt asset for medicaid consideration. To avoid medicaid recovery, in many states, as long as you avoid probate you avoid medicaid recovery. The trust should enable that. Now every state is different so it's best to see an attorney in your state.