One of the most common fears families have when a loved one needs long-term care is this:
“Will the nursing home take our house?”
It is an understandable concern. For many people, the home is their single largest asset and carries deep emotional value. The good news is that, in most situations, a nursing home does not simply take ownership of your house. However, Medicaid rules can apply to home ownership, and planning ahead can make a significant difference.
Below is a general overview of how the law works in Pennsylvania and what you and your family should know when facing this difficult situation.
The Short Answer: Not Usually – But It Depends
A nursing home itself does not take your house as payment for care. The issue usually arises when a person needs financial assistance through Medicaid to pay for long-term care.
Whether your home is protected depends on factors such as:
- Whether a spouse still lives in the home
- Whether another qualifying family member lives there
- The value of the home
- Whether planning has been done in advance
Every situation is different, which is why understanding the details early can help families make better decisions.
When Your Home Is Protected Under Medicaid
To be eligible for Medicaid in Pennsylvania, you cannot have more than $8,000 (or $2,400 for higher income individuals) in countable assets. In 2026, a home worth less than $752,000 is considered an exempt asset for Medicaid eligibility. This means it will not count against you when determining whether you qualify for benefits.
Common situations where the home may be protected include:
- A spouse is still living in the home
If one spouse enters a nursing home, the healthy spouse can remain in the house and take over ownership. - A dependent or disabled family member lives in the home
Certain relatives may qualify to remain in the home without affecting eligibility. - The nursing home resident intends to return home
If there is a reasonable expectation of returning home, the property may remain exempt.
What Is Medicaid Estate Recovery?
Even though a home is typically exempt from Medicaid consideration during a person’s lifetime, it may still be affected later through Medicaid estate recovery.
Estate recovery is where Medicaid seeks reimbursement from the estate of the Medicaid recipient for money expended on their behalf after they pass away.
Recovery may be delayed or stopped when:
- Certain hardship or caregiver child exceptions may apply
- Non-probate planning strategies may reduce or avoid recovery
- Transfers more than 5 years before qualifying for Medicaid
When a Home Might Be at Risk
A home may be more vulnerable when planning has not been done in advance.
For example:
- A single individual enters a nursing home and needs Medicaid
- No spouse or qualifying family member can afford to live in or maintain the home
- The property becomes part of the estate after death
Even in these situations, there may still be options available.
When to Talk to an Elder Law Attorney
You should speak with an elder law attorney if you are concerned about the costs of long-term care and how that might affect your home. These decisions can have lasting financial consequences, and reliable guidance can help families feel more confident during a challenging time.