Medicaid Lien Can Attach to a Nursing Home Resident's House Before Death

Ohio can record a TEFRA lien against a Medicaid nursing-home resident's home while the person is still alive, without forcing an immediate sale. Being exempt from Medicaid eligibility rules does not shield the property from a lien, and certain relatives such as a spouse or a minor or disabled child can prevent the lien from being filed. Families may only discover the claim during a title search years later when trying to sell the home.

Ohio uses a TEFRA lien, authorized by a 1982 federal statute, against homes of Medicaid nursing-home residents who are permanently institutionalized. The claim does not require an immediate sale; it preserves the state’s right to recover from equity when title later changes. Other states may wait until after death through estate recovery.

Medicaid’s eligibility exemption for a primary home is separate from lien exposure. Before recording a lifetime lien, Ohio must find the resident cannot reasonably return home, provide notice, and allow challenge. A spouse, minor child, or blind or disabled child living there can block the lien; if the resident returns home, it must be removed.