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[quote=Anonymous]Medicaid spend down rules vary from state to state. No state would kick a community spouse out of the shared home to finance the care of an institutionalized spouse. It is not taken into the spend down equation. However, the state could look to recover some of the cost of care from sale of the house somewhere down the road. You already said you're consulting with an attorney, and that's a good move because the answers depend a lot on the state and the specific circumstances. I guess she's trying to protect assets she considers to be hers while also continuing to be the beneficiary on his transfer on death accounts (anywhere he has designated a beneficiary). If he is a handful and is rejecting home care, I'm not surprised she is looking to put him in a nursing home. That will get expensive quick but less than a nursing home. Home care you could maybe do for $5K per month if she deals with some of it (so less than full time). That has its own set of issues. Two of my elderly widowed neighbors had home care for a time and both had items and cash stolen from their home. One had her credit card misused. I was lucky to have the world's best nurse for my mother, but getting trust worthy caregivers isn't always easy and if you hire them, you need to be around often enough so that they know they're supervised. That's just reality and I've been down that road with my own parents, my in laws, a neighbor who had no family and another relative.

Is your stepmother retired? Does she have a pension to protect? I hear more and more about gray divorces for asset protection reasons. It used to be that women outlived men and often had been raising children, so out of the workforce, or just didn't have the ability to generate the same income as men and there was no incentive for a women to initiate divorce. I'm sure we will hear more about them although with five year lookback, I don't know if your stepmother gained anything in the long run or not.

I had a friend with very severe muscular dystrophy. She was diagnosed in her twenties and wasn't able to work much. Her husband kept her home for decades but finally divorced her so she could spend down and collect medicaid and she went to a nursing home. Very sad situation, but she knew it had to happen because he needed his retirement money to fund his own old age. He worked a trade and made a decent living, but they weren't wealthy by any means. Being sick and needing extensive care is hugely expensive.

Good luck, I know it's stressful so he's lucky you are making sure he has an advocate. [/quote]

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