Hi, my mom currently lives in Texas and has a home health provider that is paid for through Medicaid. I live in Maryland with my husband who is in the military and being stationed back in Texas. Mom is having more and more trouble remembering to take her meds and do daily living stuff in the evenings after the provider leaves for the day. We have been considering converting her garage into an efficiency apartment and living there so I can be close by and help if needed. My question is will this affect my mother's eligibility for Medicaid if we are now living in her property in her garage? Would we need to list our income on the state paperwork?
There is the question of who pays for the conversion work (see below); but even if that's solvable you'll then have the question of what difference her then having a rentable facility on her property might make to her hypothetical income. What's the market rate for an efficiency apartment in her area? If you and DH are living there rent-free, she's "gifting" you the rent; if you pay her a nominal rent, you'll increase her income.
I should tread very carefully before you spend your money on an asset that might make her ineligible for Medicaid! - but maybe the bean counters in the government have already thought of this one and worked it all out. I'd ask.
If it's not going to work, would there be somewhere else you could live for the duration of this new posting?
Also check with your mother's insurance company to see if they'll ensure that kind of living addition.
Are there accommodations on the base for you and your husband, and would that be close enough to your mother?
Have you checked the VA's caregiver benefits recently? They've expanded and there might be some caregiver arrangements available since your husband's on active duty.
Anyway, to my knowledge, garages don't have conversations, although the little inhabitants that might dwell there might. My apologies; I should have written "conversions".
In reality, it's a huge job and likely the garage does not have 'footings' (esp in Texas where most homes don't have basements!) so the whole thing would need to be torn down to basically build a whole new structure.
Plus, tho my experience with Texas' building codes (daughter lived in Houston for 3 years and we NEVER figured out some of the codes!!)...they seemed mighty lax in some areas and really weird in others.
It's NOT a weekend project, you will have to get permits and check zoning and you may wind up with a really tiny space. I have a friend who's son is adding a little 'MIL apartment' in his spacious backyard. Well, it's 800sf and my friend said she had no idea 800sf was SO SMALL. And she's moving in with her DH who is in a powerchair 24/7.
You'll have to do all this zoning research and calculate the cost of building this. I think it's very kind of you to want to care for mom and it's really important you and DH have private space.
If you DO end up doing this, I would encourage you to make this a 2 story building. And with 2 bedrooms. My poor friend--one small bedroom, her DH weighs 400 lbs and they can only get a double bed in the ONE bedroom.
There needs to be space in your togetherness :)
As it’s moms home, it’s all her gain whether she pays a penny towards the build or not. And having an assessory unit will increase it’s sale value. Although that sound all fabulous, if Medicaid is involved, it may not be to the OP advantage financially to spend their $ on building an outbuilding that it would likely be difficult to be easily reimbursement for if the property were to sell as it’s totally own by her mom. Medicaid ime tends to look at whatever family does or pays for their elder as done out of a sense of familial responsibility and done for free without expectation of renumeration or reinbursement. Mom would need to do something definitely ahead of the daughter ever spending any $. Just what, I’m not sure as the mom is already on Medicaid. My first go-to would be doing a Lady Bird Deed, as TC allows for that, but the presence of Medicaid might pose an encumbrance on the property so a Lady Bird cannot be done. It’s a big sticky that needs an experienced elder law atty who understands or has a partner in real estate law & probate to give expertise on.
As Her mom is already on community based Medicaid, that property is already on the radar for the required attempt to do a recovery by MERP as she got Medicaid services after age 55.
Garage conversion would require approval from the County/City. The concrete floor would need to be taken out and re-poured as one would need water/sewer for an apartment, thus connecting to the pipes in the main house.
Heating ducts would need to be installed. Garages are cold on 4 sides, the 3 outside walls and the concrete floor. Some garages have low ceilings, thus the possibility of needing to raise the ceiling height to code. Windows if none exist. Changing the garage door to a regular wall, putting in a window and maybe an exit door.
Might be easier to convert garage to a family room [use as a bedroom], thus no need to install plumbing. Could you use the bathroom(s) in your Mom house? Converting to a family room sells better than an apartment. Zoning may not allow a "rental unit" when it comes time to sell the house. Oh my, so much to think about !!
As for Medicaid, this would be complex. Especially if Mom paid for conversion. If you pay, there is no guarantee that you would get your money back if Medicaid wants reimbursement for your Mom's care. Medicaid does not include your income.
I would not even bring up any construction plans or ideas, this would cause to much confusion. At the end of the day, it doesn't matter where in the house you live, quite frankly, it's none of their business.
No person can help you here because there are so many factors that would determine the answers. Please speak directly with the source to ensure that you are not endangering moms assistance.
Yes, you will not be able to recoup the money you put into the garage. Medicaid probably will not allow it. But as said, you need to talk with Moms caseworker to see how this would effect her Medicaid.
Have you (and your husband) thought through what the commitment really is going to be when caregiving for someone in decline? You say you want to "be close by and help if needed"... you'll be basically living with her, not just "close by". You won't have much privacy, especially if her cognitive decline causes her to no longer recognize boundaries and social signals, as is so common with dementia. "If needed"... not if, but rather "when". It is not a "maybe" or a "sometime" thing. It will be a big commitment that you and husband must both fully understand and want, for an unknown length of time. I'm not judging your plan, just encouraging you to not create an "expectation" or romanticized idea of how "things will go". If you read some of the posts under Burnout topic you'll see that a lot of the time it doesn't go at all like caregivers thought it would. Start by making sure you know facts about Medicaid. Make sure your mom has you as her durable PoA. If she won't do this, then legally managing her care will become significantly more challenging, maybe even not feasible. I wish you much wisdom as you begin to think about how best to help your mom,
I suggest you contact the Medicaid office within the Texas Health and Human Services Dept. to discuss your mom's needs and your garage conversion idea. Most state medicaid offices are eager to recognize the value that adult, live-in children can provide their aging parents and thus their rules are often designed to help facilitate and not discourage such arrangements. Kudos to you and your husband for wanting to do this. Best wishes.
So on the garage reno to an apt, it’s that you’re planning that you & hubs are fronting all the costs on this, right? You not mom.
If that’s the case, I’m way WAY more concerned as to if you have an expectation that mom can reimburse you all costs for building AND / OR if you are thinking that if mom should eventually need to go into a NH that mom can sell it when she’s still alive and y’all get reimbursed for all building costs when it gets sold OR y’all will move into house if she should die or she moves into a NH. That mom can benefit from your presence is obvious but from a financial viewpoint it might not make sense for anyone.
Here’s the rub, house is all owner by her. So anything done to enhance its value benefits her solely. This is not about having a plumber do a gas leak repair or overall property values increase which is out of your control; by actually building a new accessory structure that needs plans, permits and inspections & increases her assets value. It’s real $$$ by you and upfront which benefits her. It’s all her property..... it’s her asset.
If she wants to pay you $ each month to reimburse you for building costs OR if she sells it and gives you $, Medicaid tends to look these as “gifting” which is not allowed. Right now she’s on community based Medicaid so the state isn’t going into minute detail on her assets; it’s more about her being low income and medically “at need” for state to provide a CG to her. But should her care needs get to the point that for her own health & safety she needs 25/7 oversight so she applies for LTC Medicaid, LTC Medicaid will go into detail on all her banking and financials so any $ from her to you appears to be gifting and red flags her application.
Also if new structure increases her overall property value, it could take her over limit set by the state for exempt asset maximum value for Medicaid.
You would need to clearly find out exactly what can be possibly done that enables you pay for & to do a build that is ok for Medicaid in the long view. Imo it’s NOT a ? to ask her caseworker, this is all abt legal agreements and property laws; it’s not something a caseworker can appropriately answer on. It’s attorneys needed & before you start spending $. TX is one of the handful of states that do Lady Bird Deeds and have Testamentary Trust precedence, but my understanding is these have to be done before Medicaid is ever applied for. Your mom is already on Medicaid; info is established as to her assets & income. Doing one of these now after she’s on Medicaid, significantly changes the after death disposition of an asset of hers. That’s going to likely be an issue for Medicaid. It something to clearly discuss with an elder law atty that understands both if it would affect a future LTC Medicaid eligibility & just what TX MERP will do regarding the home. Atty probably will want some of this reviewed by real estate atty or probate guy if you’re planning on keeping home. Not a DIY.
if you are determined to be at moms, I’d suggest that either...
- you clear out 2 or 3 rooms totally & reconfigure for you & hubs as an interim solution. Have a goal of 2 years to tough this out (so u get possible CG exemption for MERP and u become FT CG for her) . Your gonna be beyond peeved, if mom breaks a hip in Oct right about when the apt is done and now she needs to go into a NH & onto Medicaid and LTc Medicaid requires her to copay all her mo income to the NH. So you & hubs are out all kinds of $$$ on the garage apt plus now having to pay all her regular property costs as the required copay has left mom w no $ to pay a penny on her home.
OR
- mom pays totally from her wallet to build apt and you & hubs pay her Fair market rent. Rent if too high can take her income over the max allowed by Medicaid. So rent can be a sticky to do.
once Medicaid involved it flat gets complex. Really find CELA level of atty in TX & start there