“We Thought We’d Lose the House” — What Ohio Families Should Know About Medicaid and the Family Home

It usually starts the same way. A parent falls, or lands in the hospital, or gets a diagnosis that changes everything in just one afternoon. 

Within a week, a daughter is sitting at her kitchen table after midnight with a folder of paperwork she doesn’t understand and one fear she can’t put down. She is already sure the family is going to lose the house.

She isn’t alone in that fear. We hear it at Cleveland Elder Law all the time, and it almost always rests on a misunderstanding. The house has been in the family for decades. The stories she’s heard all end the same way: a parent goes into a nursing home, and the house is gone. With care now costing more each month than the household has ever spent, it feels less like a risk than a foregone conclusion.

It isn’t. Understanding where the fear comes from, and where it falls apart, is often the moment things start to feel manageable again.

The fear: the nursing home will take the house.

This is the version most people carry, and it isn’t how it works. A nursing home does not seize your parent’s home at admission. Nobody hands over a deed at the door. What’s actually at stake comes later, and it’s something you can plan around.

The real issue: paying for care, and what happens after.

Long-term care in Ohio is expensive. According to the 2025 CareScout Cost of Care Survey, a semi-private nursing home room in Ohio runs about $9,186 a month, just under the national median. Few families can absorb that for long, so most turn to Medicaid to help cover it.

This is where the house actually enters the picture. Not while your parents are alive and receiving care, but afterward, through a process called estate recovery. After a Medicaid recipient passes away, the state can seek repayment from the estate for the care it paid for.

So the nursing home never takes the house. The real risk is what the state may recover later, unless the home has been protected ahead of time.

What most people don’t know: the home can usually be protected.

In Ohio, the family home is often far more protectable than people assume. There are established legal strategies, the kind elder law attorneys use every day, that can keep a home in the family instead of losing it to care costs. What matters most is how early a family gets good information, not how much money they have.

We see a version of this story constantly.

A daughter came in already certain the house was gone. Her mom had just been diagnosed with dementia — still living at home, still herself most days — and the daughter assumed she was there to learn how to sign the house over before it disappeared into care costs.

That's not what happened. Because her mom still had time and wasn't yet in a care facility, we sat down with the family and mapped out a full plan before anything else. We went through her existing estate documents and showed the daughter where they no longer fit the reality they were facing because she needed planning built around care, not just around passing things down someday.

From there, we drafted an irrevocable trust designed specifically to hold the family home: one built to protect it from estate recovery and start the five-year Medicaid look-back clock while her mom still had time on her side. We retitled the house into the trust, but her mom's life didn't change.  She was able to stay right where she was, in her own home, living on her own terms. 

Years later, when her mom did need nursing care, we worked with the family to create a customized plan to navigate the Medicaid application process — and the protection held. The house was still in the family. Her daughter never had to sign anything away, because they'd protected it early, before a crisis could make the decision for her.

Earlier is better, because planning ahead keeps more options open. But even in a crisis, even when a parent is already in care, there are usually more choices left than it feels like at that kitchen table. Many families come to us believing they are there to sign the house away, and they leave with options they didn’t know existed.

“We’re going to lose the house” is where a lot of families start. It doesn’t have to be where they end.

Where to start.

If you’re the one sitting up at night with this fear, the most useful first step is a conversation, before decisions get made under pressure that are hard to undo. You don’t need to have everything figured out. You just need to know what’s possible.

Each family’s estate planning needs are unique. Please consult with an elder law attorney to discuss your specific situation and create a plan that works for you.