How to Keep the Family Home When a Parent Needs a Nursing Home in Florida (2026)

By Margot Cooke, Florida Senior Living Advisor (25+ years, started as a medical social worker) · About Genesis 22 · Last updated 2026-07-26

A son in Daytona Beach called me terrified that the nursing home was going to take his mom’s house. He had read scary articles online and convinced himself the family was about to lose the only thing his dad had left them. I sat with him on the phone for an hour. I explained that nursing homes do not take houses, that Florida‘s homestead exemption is one of the strongest in the country, and that with the right Florida elder law attorney we could put a Lady Bird deed in place that would keep the home in the family even after Medicaid covered mom’s care for years.

Two months later mom was on the SMMC LTC Medicaid waiver in a community she loved, the Lady Bird deed was on file in Volusia County, and the son could finally sleep. Here is how the pieces fit together.

First: nursing homes do not take houses. Medicaid estate recovery does (sometimes)

Let me clear up the language. A nursing home does not “take” the family home. The nursing home bills for services rendered. If the family cannot pay, the nursing home pursues collection through standard creditor processes (which Florida’s homestead exemption protects against in most cases).

The risk people usually mean is Florida Medicaid estate recovery. Federal law requires every state Medicaid program (including Florida’s) to seek reimbursement from the estates of deceased Medicaid recipients aged 55 and older for the cost of care provided. Florida limits estate recovery to assets that pass through probate, which is the key. Assets that pass outside of probate (with a beneficiary designation, in a trust, via a Lady Bird deed, by joint tenancy with right of survivorship) are typically beyond the reach of estate recovery.

So the planning question is not “how do I keep the nursing home from taking the house” (it cannot). The planning question is “how do I keep the home outside of probate so Medicaid estate recovery cannot reach it.”

The Florida tools that keep the home in the family

Florida homestead exemption (during the senior’s lifetime). The primary residence is non-countable for Florida Medicaid eligibility (with an equity cap around $752,000 in 2026 and an intent-to-return presumption). A Florida senior can own a home worth $400,000 and still qualify for the SMMC LTC waiver or institutional Medicaid for nursing home care.

Lady Bird deed (after the senior’s death). An Enhanced Life Estate Deed that lets the senior keep full ownership and control of the home during life and passes the home automatically to named beneficiaries at death, outside of probate. Because Florida estate recovery only reaches probate assets, the Lady Bird deed effectively shields the home. Florida is one of only about 5 states that recognize this deed.

Community Spouse Resource Allowance. When one spouse needs nursing home care and the other does not, the at-home spouse keeps the home (along with up to $162,660 in other assets in 2026, one vehicle, and household goods). The home cannot be touched while the community spouse lives in it.

Joint tenancy with right of survivorship or “transfer on death” beneficiary deeds. Other Florida tools that pass the home outside of probate. A Florida elder law attorney will pick the right one based on family situation.

What does NOT work in Florida (and often backfires)

Adding a child to the deed. Common, well-intentioned, often disastrous. Florida treats the transfer of an interest in the home to a non-spouse as a gift, triggering the 5-year Medicaid look-back. The child also takes on tax exposure and creditor risk. Use a Lady Bird deed instead.

Quitclaim deed to a child or trust without elder law advice. Almost always the wrong move. The 5-year look-back catches it, and the homestead protections may be lost.

Cashing out the home and gifting the proceeds. Triggers the 5-year look-back penalty (a $300,000 gift creates roughly a 28-month penalty period during which Medicaid will not pay for care).

Waiting to do anything. If care is needed sooner than 5 years from now, the look-back constrains many options. The earlier you set up the Lady Bird deed and other structures, the more the family keeps.

The Florida-specific exceptions to estate recovery

Florida Medicaid estate recovery cannot pursue a claim if any of the following apply at the time of the senior’s death:

The surviving spouse is alive. Recovery is delayed until the surviving spouse dies, and even then is limited to assets that passed through probate.

A child of the deceased is under 21, blind, or permanently and totally disabled. Recovery against the home is barred entirely.

A sibling has equity in the home and lived there for at least one year before the senior’s nursing home admission. Recovery against the home is barred.

An adult child caregiver lived in the home for at least two years before the senior’s nursing home admission and provided care that delayed institutionalization. Recovery against the home is barred (this is the “caretaker child exception”).

A Florida elder law attorney can document these exceptions during planning to make estate recovery effectively unavailable.

• Talk to a Florida elder law attorney 5+ years before nursing home care is anticipated. Plan early.
• Use a Lady Bird deed (Enhanced Life Estate Deed) for the family home. Florida-specific tool. Set up while your parent has capacity.
• Do NOT add a child to the deed. Use a Lady Bird deed instead.
• Document the homestead exemption and intent-to-return at the time of any Medicaid application.
• If the at-home spouse is alive, the home stays. Recovery is delayed and limited.
• Use the caretaker-child exception if an adult child has lived with and cared for the senior for at least 2 years before nursing home admission.
• Read Florida Medicaid estate recovery rules at the Florida Agency for Health Care Administration website (ahca.myflorida.com).

Frequently asked questions

For more guidance on Florida senior living decisions, browse the Genesis 22 blog or our advisor services.