A nursing home can't simply take your house, as nursing facilities aren't in the business of seizing real estate. What can happen is that the cost of your care, if paid for by Medicaid, can eventually create a claim against your estate after you pass away, and your home is often the biggest asset in that estate. So, while the nursing home itself isn't coming after your property, the way you pay for care can put your house at risk down the road.
Our knowledgeable attorney at The Law Office of Whitney L. Thompson, PLLC guides Houston and Bay City, Texas, families through Medicaid planning, asset protection strategies, and the legal process of handling a home when a loved one needs long-term care. Contact us today to get dedicated legal guidance when protecting what's yours.
How Nursing Home Costs Actually Get Paid
Most people don't pay for long-term nursing home care entirely out of pocket. Between the cost of skilled nursing care in Texas, which runs well into the thousands of dollars per month, and the speed at which savings can run out, money is gone quickly. That's where Medicaid usually comes in.
Medicaid planning is a joint federal and state program that helps cover long-term care costs once someone's income and assets fall below certain limits. It's the primary way most Texans pay for extended nursing home stays. But Medicaid isn't a gift with no strings attached.
Federal law requires every state, including Texas, to try to recover the money it spent on your care after you pass away. That's done through the Medicaid Estate Recovery Program, or MERP. So, the real risk to your home doesn't come from the nursing home. It comes from MERP, once care has been paid for, and the recipient has passed away.
What Is the Medicaid Estate Recovery Program (MERP)?
Texas has had MERP in place since March 2005. Once a Medicaid recipient who was 55 or older when they received long-term care services passes away, the Texas Health and Human Services Commission (HHSC) may file a claim against the person's estate to recover what Medicaid paid.
This applies to nursing home care, certain home- and community-based waiver services, related hospital care, and prescription drug costs associated with that long-term care. It does not apply to Medicaid received before age 55, and it doesn't apply to most routine medical care unrelated to long-term services.
For most families, "the estate" primarily refers to whatever passes through probate, and for many of our clients, that's the family home.
When MERP Can and Can't Touch the House
Here's where it gets more encouraging. Texas law builds several important protections, and MERP is far from automatic.
A living spouse changes everything: If the Medicaid recipient is survived by a spouse, HHSC cannot pursue estate recovery for as long as that spouse is alive. This is one of the most important protections available, and it's automatic; no special filing is required at the time of death.
Minor or disabled children offer protection too: If the person who died has a surviving child under 21, or a child of any age who is blind or permanently disabled, the state generally will not pursue recovery.
Small estates are often exempt: If the value of the estate is below a certain threshold (currently set at $10,000), Texas typically won't pursue a claim, since the cost of collection outweighs the benefit.
Undue hardship waivers exist: If recovering from the estate would cause real hardship, for example, if the home is a family farm that's been worked for generations, or if an heir would become homeless, families can request a hardship waiver. These requests must be filed within a specific window after HHSC sends its notice of intent, so timing matters.
Caregiver children can sometimes keep the home outright: Under federal law, if an adult child lived in the parent's home for at least two years before the parent entered a nursing facility, and that child's care actually helped delay the nursing home admission, the parent can transfer the home to that child without triggering a Medicaid penalty. Once that transfer happens, the home is no longer part of the parent's estate at all.
Debts and upkeep costs come off the top: Even when a claim is filed, valid estate debts like funeral expenses, legal costs, and any mortgage balance get paid first. Money spent maintaining the home while the owner was in a nursing facility can also be deducted from the MERP claim, as long as there are receipts to back it up.
What About While Someone Is Still Alive?
Medicaid cannot take or force the sale of your home while you're still living, even if you're in a nursing facility long-term. Unlike some states, Texas MERP does not place liens on a Medicaid recipient's property, either before or after death. Recovery occurs only after death and only through a claim filed against the probate estate.
Why Planning Ahead Is Necessary
The protections built into Texas law are real, but relying on them after the fact is a lot riskier than planning in advance. A lawyer can help families put strategies in place well before a nursing home stay becomes necessary, including:
Structuring how a home and other assets are titled
Exploring options like life estates, irrevocable trusts, or caregiver child transfers
Reviewing eligibility timing for Medicaid to avoid unnecessary penalties
Preparing hardship waiver documentation in advance when a claim looks likely
The earlier this planning happens, the more options are on the table. Medicaid has strict look-back rules for asset transfers, so waiting until a crisis hits often narrows the choices considerably.
Let's Talk About Protecting Your Home
Every family's situation is different, whether it's an aging parent who may need care soon, a spouse currently receiving Medicaid benefits, or an estate already facing a MERP notice. Whatever stage you're at, we'd welcome the chance to talk it through with you. A conversation now, before care becomes urgent, can make all the difference in the options available to your family later.
From our offices in Houston and Bay City, Texas, we serve clients across Brazoria, Fort Bend, Harris, Matagorda, Montgomery, and Wharton counties. Our lawyer at The Law Office of Whitney L. Thompson, PLLC, has the knowledge and resources to guide you throughout the process. Contact us now to schedule a consultation.
