When a loved one needs nursing home care, the financial questions come fast. Chief among them: “Are we going to lose the house?”

It’s a reasonable fear. Nursing home care costs around $10,000 per month in Ohio, and many families turn to Medicaid to cover those costs. The assumption that often follows—that Medicaid will take everything, including the family home—causes enormous stress. But that assumption is not entirely accurate.

The reality is more nuanced. In many cases, the home can be protected. However, doing so requires a clear understanding of how Medicaid works and what legal strategies are available. Acting on incorrect information—or doing nothing at all—can be just as costly as the nursing home bills themselves.

Contact our team to learn whether Medicaid will take your house and what Ohioans need to know.

The Home Is Often an Exempt Asset for Medicaid Qualification

This surprises many families: the home is generally considered an exempt asset for Medicaid eligibility purposes. That means your loved one may qualify for Medicaid while still owning their home. Medicaid does not automatically require the sale of the house just to qualify for benefits.

The home is typically exempt when:

• The Medicaid applicant intends to return home (even if that outcome is unlikely), or
• A spouse continues to live in the home

So the first concern, that the house needs to be sold to qualify for Medicaid, is usually unfounded. But that’s only part of the picture.

Medicaid Estate Recovery: Where Ohioans Get Blindsided

Qualifying for Medicaid while retaining the home doesn’t mean the home is safe forever. Ohio, like most states, operates a Medicaid Estate Recovery Program (MERP). Under this program, after a Medicaid recipient passes away, the state can seek reimbursement from assets that remain in the estate—and that includes the family home.

Families often don’t see this coming. A parent qualifies for Medicaid, moves into a nursing home, and the house stays intact. Then the parent dies and the state files a claim against the estate. What looked like a protected asset suddenly becomes a liability.

That said, estate recovery is not automatic. There are exceptions, and estate planning strategies exist to prevent or significantly reduce the state’s claim. The key variable is timing. Specifically, how early the family acts, and what steps are taken before and after a Medicaid application is filed.

Strategies That May Protect the Home from Medicaid Estate Recovery

Depending on the circumstances, several legal options may be available to shield the home from Medicaid estate recovery. These include:

• Certain types of deeds, such as a transfer-on-death or life estate deed, which can affect how the property passes after death
• Trust planning, which can remove the home from the estate (if structured and executed early enough)
• Spend-down strategies, which redirect countable assets in ways that comply with Medicaid rules
• Medicaid-compliant financial strategies that restructure assets without triggering penalties

The right approach depends heavily on individual circumstances—the value of the home, who currently lives there, marital status, the applicant’s health status, and how much time has passed.

The 5-Year Lookback Rule: A Critical Constraint

One of the most important—and most misunderstood—aspects of Medicaid planning is the five-year lookback rule. Ohio’s Medicaid program reviews an applicant’s financial records from the five years preceding the application. Any transfers, gifts, or asset sales for less than fair market value during that period can trigger a penalty.

This rule exists to prevent applicants from simply giving away assets to qualify for Medicaid. A common mistake families make is signing the house over to children shortly before or after a parent enters a nursing home. If that transfer happened within the lookback period, it can result in a penalty that delays Medicaid eligibility—sometimes for months or years.

Simply put: you cannot gift or transfer the home at the last minute without serious legal consequences.

The Estate Planning Mistakes That Cost Families the Most

Beyond the lookback rule, several other errors can undermine even well-intentioned planning efforts:

• Adding children to the deed without understanding the tax consequences. This can trigger capital gains tax issues that may not exist if the home passed through inheritance.
• Selling the home too quickly. Depending on timing and circumstances, a premature sale can affect both Medicaid eligibility and estate recovery exposure.
• Assuming Medicaid will take the house regardless and doing nothing. Inaction forfeits options that might otherwise be available.
• Relying on generic advice rather than a situation-specific legal strategy. What works for one family may be actively harmful for another.

What If a Loved One Is Already in a Nursing Home?

A common concern is that planning opportunities disappear once a parent has already entered a nursing home. That’s not always the case. Medicaid crisis planning—legal strategies implemented after a nursing home admission—may still be possible, depending on the specifics.

The window for effective action is narrow. The difference between acting promptly and waiting can be measured in hundreds of thousands of dollars in estate value. Families in this situation should consult with an elder law attorney before making any decisions about the home or other assets.

Every Family Is Different

There is no universal answer to whether the family home can be protected from Medicaid.

The outcome depends on a combination of factors:

• When planning begins
• What assets are involved
• Who is living in the home
• Which strategies are legally available given the applicant’s circumstances

What is consistent across situations is this: early, informed planning produces better outcomes than crisis planning, and crisis planning produces better outcomes than no planning at all.

Take Action Before It’s Too Late: Consult an Elder Law Attorney

If your parent is approaching the point where nursing home care may be needed, now is the time to seek legal guidance. The options available today may not be available tomorrow.

At DuPont Law Group, our elder law attorneys help Ohio families navigate Medicaid planning, estate recovery, and asset protection strategies with clarity and care. Contact us to schedule a consultation and review your options before making any decisions about the family home.