Can My Grandmother Spend Down for Medicaid By Paying Off My Mother's House, Her Primary Residence?

Unfortunately, the answer is probably no. Your grandmother can pay any debt as part of her spend down, but without an agreement that your grandmother had to pay rent to stay with your mother, she does not owe anything. That’s the general rule. You should consult with a North Carolina elder law attorney to make sure that this rule applies there or that there is no other remedy available. To find an attorney near you, go here: https://www.elderlawanswers.com/north-carolina-elder-law-attorneys.