In Pennsylvania, there may be planning options available to help protect the spouse at home and preserve important assets, including the family home. The answer depends on your timing, how the home is titled, your income, your assets, whether Medicaid may be involved, and whether any planning was done before the need for care.

The most important thing to know is this: do not transfer the house, add names to the deed, gift money, or make major financial changes without speaking with an elder law attorney first. Well-meaning decisions can create serious problems later. 

The Fear Behind the Question

For many families, the home is more than a financial asset. It may be where a couple raised children, spent their retirement, hosted holidays, or planned to live for the rest of their lives.

So when one spouse needs nursing home care, the spouse still living at home may feel overwhelmed. They may be asking:

• Can I keep living in the house?
• Will the nursing home take everything?
• Will Medicaid force us to sell the home?
• Do I have to spend all of our savings first?
• What happens to the house after my spouse passes away?

These are common and understandable questions. Long-term care is expensive, and many families do not realize how quickly nursing home costs can affect savings, income, and estate plans.

The Spouse at Home May Have Protections

When one spouse needs long-term care and the other spouse remains at home, Medicaid rules may treat the situation differently than when a single person applies for benefits.

The spouse who remains at home is often called the community spouse. Pennsylvania’s long-term care Medicaid rules include protections designed to prevent the community spouse from being left with nothing.

This does not mean every asset is automatically protected. It also does not mean the family should wait until the last minute. But it does mean that married couples may have planning options that are not always obvious.

An elder law attorney can help review:

• The home deed
• Bank accounts
• Retirement accounts
• Income sources
• Life insurance
• Existing wills or trusts
• Powers of attorney
• Prior gifts or transfers
• The timing of nursing home admission
• Whether Medicaid planning may be needed

Every detail matters.

Be Careful Before Transferring the House

Families sometimes panic and think the fastest solution is to transfer the house to a child or remove one spouse’s name from the deed.

This can be risky.

Medicaid has rules about asset transfers. In Pennsylvania, transfers made within a certain look-back period may be reviewed when someone applies for Medicaid long-term care benefits. If assets were given away or transferred for less than fair market value, it may cause a penalty period, meaning Medicaid may not pay for care right away.

That can leave families with a nursing home bill and fewer options.

Before making any transfer, families should speak with an elder law attorney who understands Pennsylvania Medicaid rules, estate recovery, tax concerns, and family protection planning.

What About Medicaid Estate Recovery?

Another concern families have is what happens after the spouse receiving care passes away.

Pennsylvania has an Estate Recovery Program. This program allows the Commonwealth to recover certain Medical Assistance payments made for long-term care services after the recipient passes away.

This does not always mean the house will be immediately taken. The outcome depends on ownership, family situation, estate assets, timing, and whether planning was done in advance.

This is one of the reasons it is so important to understand the difference between:

• Medicaid eligibility during life
• Protection for the spouse at home
• Ownership of the home
• What happens after death
• Probate and estate recovery

These pieces are connected, but they are not all the same.

Common Mistakes Families Make

When a spouse needs nursing home care, families are often under stress. They may be trying to make decisions quickly while also dealing with health changes, hospital discharge planning, dementia, family disagreements, or pressure from a facility.

Some common mistakes include:

1. Giving the house to the children too quickly

This can create Medicaid penalties, tax issues, family conflict, or loss of control.

2. Waiting until all the money is gone

Many families assume they cannot call an elder law attorney until they are almost out of money. In reality, earlier planning often creates more options.

3. Assuming the nursing home gives legal advice

A nursing home may explain billing or admissions paperwork, but it does not represent your family’s legal interests.

4. Not updating powers of attorney

If the spouse needing care no longer has legal capacity, planning may become harder. Strong, updated powers of attorney are often critical.

5. Believing there is only one option

Some families think they either private pay until everything is gone or apply for Medicaid with no planning. The right plan may involve several steps.

So, Can You Protect the House?

The honest answer is: possibly, but it depends.

The home may be treated differently than other assets, especially when one spouse continues to live there. There may also be planning strategies available to protect the spouse at home, preserve assets, and avoid unnecessary mistakes.

However, the wrong move can cause serious consequences. That is why this question should be answered based on your family’s actual situation, not general advice from a friend, neighbor, or internet search.

When Should You Call an Elder Law Attorney?

You should consider speaking with an elder law attorney if:

• Your spouse has been diagnosed with dementia
• Your spouse may need nursing home care soon
• Your spouse is already in a nursing home
• You are worried about paying for long-term care
• You are considering transferring the house
• You are being told to spend down assets
• You are unsure whether Medicaid may be needed
• You want to protect the spouse still living at home

The earlier you ask, the more options you may have.

SGY Can Help Families Plan Before and During a Crisis

At Steinbacher, Goodall & Yurchak, we help families understand their options during the second half of life. If your spouse needs nursing home care, you do not have to figure everything out alone.

Our team can help you review your home, assets, income, legal documents, care needs, and next steps. Whether you are planning ahead or already facing a crisis, getting the right guidance can help protect your family from costly mistakes.

If you are worried about protecting your home while your spouse receives nursing home care, contact SGY to schedule a conversation.

Frequently Asked Questions

Will Medicaid automatically take our house if my spouse enters a nursing home?

Not automatically. The answer depends on your situation, including how the home is owned, whether a spouse still lives there, whether Medicaid is involved, and what happens after death.

Should I put my child’s name on the deed?

Do not add a child to the deed without legal advice. This can create Medicaid, tax, creditor, and family ownership issues.

Can I keep living in the house if my spouse goes into a nursing home?

In many cases, the spouse at home may be able to continue living in the home. However, it is important to review your full financial and legal situation.

Is it too late to plan if my spouse is already in a nursing home?

Not always. Crisis planning may still be possible, but timing matters. Speak with an elder law attorney as soon as possible.

What documents should we review?

You should review powers of attorney, wills, trusts, deeds, beneficiary designations, financial accounts, insurance policies, and any prior gifts or transfers.

Schedule an Information Gathering Session Today

Disclaimer: This article is for general informational purposes only and does not constitute legal advice. Every family’s situation is different. You should speak with an attorney about your specific circumstances.