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So the patient own a home that is not yet paid off? I would assume that motivate payments would be a legitimate use of funds, but I'm hoping some more expert has a good answer for you.
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Is the medicaid application for an individual to go into a NH? So they will be moving into a NH & moving out of their home? If that's the situation, to have them keep their now empty home with an outstanding mortgage probably isn't at all realistic to do IMHO. Reason is that for NH Medicaid residents, they have to do a copay or their SOC ( share of cost ) of ALL their monthly income to the NH less a small personal needs allowance ( this varies by state from $35-90). There won't be any of their $ to make mortgage payment, so family will need to pay mortgage and all other costs on the property (taxes, utilities, insurance, etc) for the rest of the now in a NH elders lifetime.

Now if there is a spouse that will be living in the home, they should be able to get CSRA - community spouse resource allowance - from the NH spouses income & their income that enables them to cover the mortgage.

Also if they keep the home & are on Medicaid, it will be subject to MERP after they pass. MERP has all sorts of exemptions & exclusions but family will need to have pretty detailed documentation on all costs to file. I'd suggest that family should look into all this carefully. If the at home spouse survives the NH medicaid spouse, that is an exclusion to MERP.
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