What happens if the house has a cosigner and the owner needs to go to a long term care facility?

Medicaid doesn't put a lean on the house till death. I think this is a question for a Medicaid lawyer who can read the mortgage agreement. Be aware, once on Medicaid there will be no money for mortgage payments, utilities, house insurance and taxes so the cosigner will probably be responsible. Also, if a person is in a facility paying privately before Medicaid can take over, this is considered part of the spend down. So as I said earlier, no money can be spent on the house by the person in the facility.

This depends on the title. If the house is held jointly by the co-signer...then if it says mr. Smith AND joe johnson.....then expect Medicaid to be considering half that house to be his.   If it is held... OR...then Medicaid will consider it to be all his...and they will put a lien on it.  The mortgage holder will likely "call" the loan at that point.  Banks do not like having any lien ahead of the first mortgage.

If he is not on the title, then there could be an issue if there is ever any mortgage problem... otherwise not.