By Michael Shemtoub, trial attorney, Beverly Law. Updated November 2026.
Worried about care in a nursing home?
Leave your name and phone. We call back today, in English or Spanish. The consultation is free and confidential.
Free consultation · English y Español · No fees or costs unless we win
What a nursing home can do about an unpaid bill
A facility that is owed money can sue like any business, and a money judgment can become a lien on real estate. In California the lien is created by recording an abstract of the judgment with the county recorder (CCP 697.310). In Washington a judgment is a lien on the debtor’s real estate that is not exempt by law (RCW 4.56.190). Each state then protects a home from judgment creditors in its own way.
| State | Home protection from creditors | Law |
|---|---|---|
| California | A homestead exemption equal to the greater of $300,000 or the county’s median single-family home price for the prior year, capped at $600,000, with both figures adjusted for inflation each year since 2022 | CCP 704.730 |
| Texas | The homestead is protected from forced sale for all debts except a short list, such as purchase money, property taxes and certain home loans. A nursing home bill is not on that list. | Tex. Const. art. XVI, sec. 50 |
| Washington | A homestead exemption equal to the greater of $125,000 or the county median sale price of a single-family home in the prior year | RCW 6.13.030 |
The California and Washington exemptions protect a dollar amount of equity, so a home worth far more than the exemption can be at risk once a creditor holds a judgment.
Admission papers and family members
Federal rules for nursing homes that take Medicare or Medicaid say the facility must not request or require a third person to personally promise payment as a condition of admission, expedited admission or continued stay. The facility may ask a representative who has legal access to the resident’s income or resources to sign a contract to pay from the resident’s money, and that signature must not create personal financial liability for the representative (42 C.F.R. 483.15(a)(3)).
Medicaid and the home while the resident is living
For Medicaid long-term care, the home is usually an excluded asset while the resident intends to return to it.
- California: the principal residence is exempt, and that includes a home the person formerly lived in when they now live in a nursing facility and intend to return (Welf. & Inst. Code 14006).
- Texas: the HHSC handbook excludes the home based on the person’s written statement of intent to return, and it stays excluded while a spouse or dependent relative lives there. The 2026 home equity limit is $752,000 (HHSC handbook, F-3000).
- Washington: the home stays excluded when the client or a representative states the client intends to return (WAC 182-512-0350).
Federal law allows a lien on a living resident’s real property in one narrow case. The state must find that the resident is an inpatient in a nursing facility or similar institution who cannot reasonably be expected to be discharged and return home. No lien is allowed while a spouse, a child under 21, a blind or disabled child, or a sibling with an equity interest who lived there at least a year before admission lawfully lives in the home. The lien ends if the person is discharged and returns home (42 U.S.C. 1396p(a)). Washington’s statute also calls for notice and an opportunity for a hearing before that lien, and DSHS says a lien is released if the person goes home (RCW 43.20B.080; DSHS 22-619).
Free case review
Tell us what happened. We will tell you plainly whether there is a case and what to do next. You owe no fees or costs unless we win.
Estate recovery after death
Federal law requires states to seek repayment from the estates of people who were 55 or older when Medicaid paid for nursing facility services, home and community-based services and related hospital and drug costs. Recovery can happen only after the death of a surviving spouse and only when there is no surviving child under 21 or blind or disabled child. States must waive recovery when it would cause undue hardship (42 U.S.C. 1396p(b)).
| State | How far recovery reaches | Main limits |
|---|---|---|
| California (Medi-Cal) | For deaths on or after January 1, 2017, only assets in the probate estate (Welf. & Inst. Code 14009.5) | No claim under the age-55 rule when there is a surviving spouse or registered domestic partner, a child under 21, or a blind or disabled child. The state must waive its claim, subject to federal approval, on a homestead of modest value, meaning a home worth 50 percent or less of the county’s average home price. Hardship requests go to DHCS within 60 days of the claim letter (DHCS). |
| Texas (MERP) | Long-term care services received after age 55, for people who began services after March 1, 2005 (HHSC guide) | No claim when there is a surviving spouse, a child under 21, a blind or disabled child, or an unmarried adult child who lived full time in the home for at least a year before the death. No claim when the estate is $15,000 or less or Medicaid costs are $5,000 or less. A hardship can apply when the homestead is worth under $150,000 and the heirs meet an income limit. |
| Washington (DSHS) | The estate plus nonprobate assets as defined in RCW 11.02.005 (RCW 43.20B.080) | DSHS does not begin recovery during the life of a surviving spouse, or while a surviving child is under 21, blind or disabled. No lien is filed on the home while a spouse, domestic partner, or minor, blind or disabled child lives there (DSHS 22-619). |
The Texas guide adds that the state never asks for more than it paid. Texas cases are handled by the firm’s Texas-licensed attorneys, Joyce Ondich and John Efstathiou.
What this means for your case
If a nursing home sues you or your parent over a bill, get advice before the deadline to respond. If the facility asked you to co-sign, keep the papers. Questions about transferring a house belong with a lawyer who handles Medicaid planning. If the resident was hurt by neglect, the injury claim is a separate matter, and Medicare or Medicaid may have to be repaid from any recovery. Our $50,000 settlement page shows how those repayments work, and whether Medicare pays for nursing home care covers who pays for the stay. For timing, see how long a nursing home lawsuit takes, and for abuse claims visit our nursing home abuse section.
Common questions
Can a nursing home put a lien on my mother's house without going to court?
Generally, a private facility needs a money judgment first. The pre-death Medicaid lien is a separate, limited state power.
Did I become responsible for the bill by signing the admission papers?
Federal rules bar Medicare and Medicaid facilities from requiring a third person to personally promise payment. Signing as a representative to pay from the resident’s own money creates no personal liability under that rule.
Will Medi-Cal take the house after my father dies?
For deaths since January 1, 2017, California recovers only from the probate estate, and not when a spouse, registered domestic partner, child under 21 or blind or disabled child survives.
Does Texas MERP apply to every Medicaid recipient?
No. It covers long-term care received after age 55, with exemptions for surviving family and small estates.
Can Washington recover from assets outside probate?
Yes. RCW 43.20B.080 reaches nonprobate assets as well as the estate, subject to the deferrals for a spouse and certain children. Beverly Law offers a free case review in English or Spanish at (310) 552-6959. You owe no fees or costs unless we win. Find more answers in our injury law FAQs.
Ask a question
Not ready to call? Write your question and someone on our team will answer. No cost, no commitment.
Injury lawyer — Beverly Law
Hurt because of someone else in California, Texas and Washington? Talk to an injury attorney. Free, confidential, English or Spanish. You owe no fees or costs unless we win.
Related pages
Sources
- Cal. Code Civ. Proc. 697.310 (leginfo.legislature.ca.gov)
- Cal. Code Civ. Proc. 704.730 (leginfo.legislature.ca.gov)
- Texas Constitution art. XVI, sec. 50 (statutes.capitol.texas.gov)
- RCW 4.56.190 (app.leg.wa.gov)
- RCW 6.13.030 (app.leg.wa.gov)
- 42 C.F.R. 483.15 (admission policy) (ecfr.gov)
- 42 U.S.C. 1396p (law.cornell.edu)
- Cal. Welfare and Institutions Code 14006 (leginfo.legislature.ca.gov)
- Cal. Welfare and Institutions Code 14009.5 (leginfo.legislature.ca.gov)
- DHCS, Estate Recovery Program (dhcs.ca.gov)
- Texas HHSC, Medicaid for the Elderly and People with Disabilities Handbook, F-3000 Home (fhb.hhs.texas.gov)
- Texas HHSC, Your Guide to the Medicaid Estate Recovery Program (hhs.texas.gov)
- WAC 182-512-0350 (app.leg.wa.gov)
- RCW 43.20B.080 (app.leg.wa.gov)
- Washington DSHS, Apple Health (Medicaid) and Long-Term Services and Supports for Adults (DSHS 22-619) (dshs.wa.gov)
Important: This page is general information, not legal or medical advice, and reading it does not create an attorney-client relationship. Every case is different; talk to a lawyer about yours. Texas cases are handled by the firm’s Texas-licensed attorneys, Joyce Ondich and John Efstathiou. Last reviewed: November 7, 2026.