What is the Caregiver Child Exemption in regard to nursing home care

When facing the need for nursing home care, a common fear is the loss of the family home. Where a child has been living in the home with the parent and caring for the parent, the child may qualify for the Caregiver Child Exemption. The exemption allows for the family home to be gifted to the caregiver child without causing a penalty period to be assessed when applying for Medicaid.

Generally, a primary residence is not a countable resource when determining Medicaid eligibility where certain exceptions apply. One of those exceptions is where the Medicaid applicant (the individual requiring skilled nursing care) is married and their spouse is residing in the house. Where there is a spouse residing in the home, the value of the home will not be counted as an available resource for Medicaid. However, if the house is sold or if the spouse moves from the house the protection is lost. Pennsylvania does have other exemptions available to protect the family home. One of those exemptions is the Child

Caregiver Exemption.

To qualify for the exemption, the Medicaid applicant must demonstrate that they meet the requirements of 55 Pa. Code §178.104(e). Those requirements are as follows: (1) the child has resided in the home with the parent for at least two years immediately preceding the admission to the nursing home; and (2) that because the child provided care to the parent, the parent was able to remain at home instead of entering a skilled nursing facility for those two years.

It is important to know that the Pennsylvania Department of Human Services

(“DHS”) reviews each request for the Child Caregiver Exemption on a case-by-case basis. DHS will require that a letter be obtained by the Medicaid applicant’s physician which articulates the parent’s current diagnosis and limitations, memorializes the doctor’s awareness that the caregiver child was providing care for a period of at least two years, and that without the care provided by the child, the parent would have required care in a skilled nursing facility two years prior. Verification of the child’s residence in the parent’s home is also required. Typical proof is tax records showing the family home as the child’s address, utility bills, etc.

If you believe that the Caregiver Child Exemption is applicable to your personal situation, it is very important to consult with an Elder Law Attorney that can properly explain the exemption and assist you with applying for Medicaid and claiming the exemption. It is also important that you understand the various tax implications with the transfer of the home. nature, consult your attorney for advice to fit your particular situation.

Rebecca A. Hobbs, Esquire is licensed to practice in the Commonwealth of Pennsylvania and is certified as an Elder Law Attorney by the National Elder Law Foundation as authorized by the Pennsylvania Supreme Court. She is a principal of the law firm of O’Donnell, Weiss & Mattei, P.C., 41 High Street, Pottstown, and 347 Bridge Street, Phoenixville,610-323-2800, www. owmlaw.com. You can reach Ms. Hobbs at rhobbs@owmlaw.com