Uncle is right of surviorship on Mom's deed. How can he sell me his interest without Medicare involvement?

By applying & accepting Medicaid, your mom agreed or acknowledged that any assets she has upon death are subject to a claim or lien by Medicaid through MERP - Medicaid Estate Recovery Program. If mom does anything with her assets now (& before she dies) she can face a transfer penalty from Medicaid - which means Medicaid will not pay for her care till it the penalty is worked out.

i would suggest that you carefully do a cost / benefit on the house. Are there any debts on the house - if she has been in a NH for 4 years, who has been paying the taxes, utilities, insurance, yard stuff, maintenance? If the house is empty, then whomever has paid those costs can file an exclusion or exemption to MERP for all those costs too. If the taxes haven't been paid, that is a real problem - you need to see just what the situation is on all that as most places have a 3 year tax lien situation so you don't want to do stuff and then find out that the property has been redeemed through a tax sale. If the tax assessor has the value of the property @ 80 K what is the breakdown on the 80K - the assessor statement will show the value of the land and the house (the "improvements"). If it will take 60K to get habitable, you probably will have to self-pay for all the repairs as it probably cannot make it though an appraisal for you to get a loan for repairs from a bank. It may be that it is the land value is the only worth. 60K is a good bit of $ towards a new house in good neighborhood so think carefully if the house & land is really worth the time & investment even before you have to deal with MERP.

Dogabone, maybe you should dig up your aunt's garden and start tearing out some walls. I'll bet she hid all that money she keeps taking out of the bank. I know a man who was left a little house from his neighbor. When he started remodeling, he found half a million in stocks and bonds hidden in the walls that the old man forgot about.

Sounds like you need to talk to a attorney about this.There's answers you just need to talk to the correct person as a attorney that knows the in's and outs.You can buy the house from them at a % rate.
I was told that if a sibling,child can show proof that he or she lived in the house for more then a yr.Medicaid won't attempt to collect on it.
The one thing that I noticed is,
Now days people wait to long of time to move,transfer assets before attempting to apply for Medicaid.When people reach their retirement days.They think to late about what if.What if I become ill or need healthcare.Medicare don't pay for long term in home healthcare.Medicare only pays for short term healthcare.If a person would ever need long term healthcare that would require that person to spend their retirement savings for that healthcare cost.After all funds are drained then & only then Medicaid the free ride kicks in.
My advice to people is,
If you see your retirement days coming around the corner?Don't keep all your retirement savings in banks.Dig a hole and plant it in the ground.I don't work all my life just to pay for healthcare cost.I work so I can enjoy my retirement.I would say to buy Gold but,Gold prices seem to be sinking now days.

Did you check the liens? If there is a Medicaid lien and any back taxes, walk away and don't look back. You might pay him 40K and end up with a notice of seizure when mom dies. Don't do it.

So what are our options. He has no interest in the home. She has been for 4 years and the house is a mess. I am willing to take it over however it appraised at 80 k needing 60 k to occupy.

You mean Medicaid? He can't and he is the only one who can keep his half.