If my mother has to go into an assisted living facility, can she sells her mineral rights before?

GA, of course they run with the land. You are correct, I hadn't thought about it. Underlying water rights are a big deal in the dry, arid west. They always remain with the property unless they were severed years ago. Law will permit severing water rights, but with that development rights are relinquished.

Last phrase should be she "doesn't have standing..."

May I confirm something? You write that she owns mineral rights. It's been awhile since I worked on commercial real estate issues involving properties with mineral rights, but as I recall, they ran with the land. There was an underlying grant of mineral rights to, say, an oil or gas producing company. These companies held rights, but were not fee holders. The fee holder (owner) received revenue from the oil production, but the fee holder did NOT own the mineral rights.

If your mother in fact owns the land but not the underlying rights, but does receive revenue from them, she doesn't has standing to sell them.

Just sharing this so you can put the entire issue in perspective.

Suzie Rich, Your mother has enough income and assets to perhaps consult an elder attorney with what seems a complicated financial picture.

She can sell the rights at fair market value. Then read Jessie's post. I will add that if sold for less than market value, Grandma will be penalized by Medicaid for an amount equal to what it should have sold for, or in this case could make grandma completely ineligible for Medicaid if income it provides is in excess of the limits.

If she needs to go on Medicaid, then the money she receives from the sale would have to be spent before she could qualify. Is the well a good source of income? Does the amount she receives put her over the amount needed to qualify for Medicaid? I am trying to fit the picture into what Medicaid would require. These questions are relevant. If it is income producing, Medicaid would consider the income along with her other monthly income in calculating eligibility and need. They would likely also put a lien on the well. If it is not a source of income, it may need to be sold at fair market value.

Medicare does not seek recovery or consider assets. It is something all citizens over 65 are entitled to. Medicaid is different. It requires that there be minimal assets and will seek recovery on property to help reimburse taxpayer contribution to patient care.