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Your Mother hopefully has a will. If she is the only person on the title and deed of the home, then the home will pass after she dies according to the directions in her will. I am assuming she is not on Medicaid as you don't say anything about medicaid. I am assuming she has a will as you do not say that she has no will. If you have other things to tell us that we need to know before answering this question, do let us know; the more information you give, the more accurate your answers may be.
But in brief, if there is no will then your mother's estate (home, furniture, cars, accounts without a designated "pay on death", stocks, et al) will be probated by the court. An executor (hopefully from the family who is capable and willing) will be assigned by the court to divide the estate among your Mom's legal heirs.
If your Mom requires the assistance of medicaid before her death then Medicaid will recover from her estate what costs the taxpayer has paid for her care from her estate. Each state has differing methods and rules. Usually the executor will receive notification of the amount owed by the person who received Medicaid. That amount will come out of the assets of the estate, including the home.
Many ALF don't accept medicaid, so your Mom may be self pay at this point. Some, however do accept it.
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mom1958 Jun 2021
Sorry.. yes..private pay...relative living in home as caretaker for it. Home is paid for...no other assets. Father passed 4 years ago.
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She needs to have a will that states who is to get her after death assets.
if she has a will and the terms need to change or a new Executor is needed, she can get a codicil done to the will. She needs an attorney do do the codicil.

Often codicils get done as the will has heirs who have predeceased them. This really mucks up how to do the distribution. So it’s easier to get a “do-over” done which a codicil is.

dealing with her assets will fall to whomever named Executor in the will. Usually the old POA is named to be the Executor. There is a POA, right? if not, she needs to have someone become her POA ASAP.

If she died with no debt, no mortgage but just with her home, maybe a car, both fully owned then what happens next is very dependent on your states probate laws.
There tends to be 3 things that Executor can do:
1. Take the will, enter it at probate court (PC) & file for a small estate affidavit. It will go into an abbreviated probate process and eventually the house and car get transferred to whomever named in the will.
2. Muniment of title. Muniment isn’t done in all states but if yours does them they are kinda fabulous imo. Muniment can be done if there is no debt (you attest to this & may need to provide some documentation) but they die with house & auto or land fully owned & in their name & a will clearly indicating who is to inherit each. Muniment tends to have a flat fee, maybe $750. You take the title on all real assets that show no secured lending on them over to PC and file for a muniment. You will fill out all the title transfer paperwork. It goes into a holding pattern for maybe 6 weeks. The Muniment filing gets posted on the open boards in front of the courthouse (so this takes care of Notice Served). The judge signs off on the Order and you get mailed the titles. Voila! Done!
Both 1 & 2 you can DIY if your are kinda comfortable in a courthouse and clearly understand how titles read and have all notarized / sealed paperwork on property ownership. Otherwise you get a probate atty.
3. Traditional full probate where will is filed and a Letters Testamentary are issued and then executor is done under either an independent or dependent administration. This you need to have an atty IMO as the forms are specific. Doing it “pro se”, well your going to make errors.

? for you? The caretaker are they going to inherit the house?
If not, you kinda want that to be crystal clear. Like there is a memo of agreement from mom to them that they are the caretaker and will have to move out x # of months after moms death OR if mom should need to sell her home while alive. There have been a couple of posts on this forum lately where a family member is staying at the house and will….not….leave. Gets sticky as they may be obstinate and have to get evicted by sheriffs Dept. Or they become technically a squatter and you have to go thru that process to get them out.
If you have any misgivings on the house sitter, make sure that all utilities stay in your moms name. All, like power, water, cable, internet. It just eliminates them being able to establish that they are tenants or that they somehow have ownership. Plus mom or whomever is her POA or becomes her executor can go and have all shut off if need be to get them to move out. Yeah it seems like overkill but getting an obstinate family member to move out when they don’t want to will not be easy. They can pay their share of the bills to mom if need be.

Right nOw your mom has the $ to private pay for care. But if she lives long enough, she might outlive her $. And the house may need to be sold to pay for care. The caretaker needs to realize that.
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mom1958 Jun 2021
Bills are very few and small which are being paid off as we can just for good measure.
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1958 - well as you asked, what would be the easiest would be for mom to have your son, who is the current caretaker, become the heir to the home as per her will. It stays in her name and she dies still owning it and then he inherits it totally. Tax wise, capital gains wise, title transfer wise, it’s the best & easiest move.

the sticky will be if there are other heirs who would want their % share of the assets (house, whatever $ in her bank accounts after death) upon moms death. Like yiur Sister. If he is your only son, then you I assume are good on your share of moms estate to do whatever for him. That leaves how your sister would feel and if she has her own kids to be concerned with & they should too benefit from the estate. There r no other siblings, right?

To be equitable, this is what I would suggest….. the house remains maintained but no absolutely no major repairs or renovation done to it. Like repair gas leak but no roof replacement. All repairs paid for by mom as it is still her home. Your mom has in her will for you sisters to share 50/50 in all assets. House gets inspected and appraised after death. You want it to be a “conservative” appraisal. That appraisal $ is what your son buys out his Aunts 50% share. Y’all figure out how this needs to happen. If he actually has $ he could pay her outright; or he has a job and is able to get a mortgage for that amount and pays his Aunt; or he does a private sale w a nice deposit and a promissory note to her - whatever route please get a real estate atty to draw up the paperwork as it will be sticky as the note / sale paperwork is only with her as you transfer your share to him at “$1.00 and other valuable consideration”. The RE atty will know how this must, again must, read. There might be gift taxes associated with your transfer to him (probably not but maybe, the atty will know)

Again if mom keeps on paying all property costs, it will make this simpler. Otherwise you get into somebody (usually an in-law) carping that they paid for the plumber and should get that $ back. Or complain that your kid should really have been paying rent, ignoring the fact that he maintains the house and keeps woodland creatures and vagrants away. You & Sis may get along just fine, it will be the married into the family that carp in my experience.

If you can make all this work and mom has enough $ to get beyond the grave, kudos to all of you.
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If the house is left to your son in a Will then there is no problem. If the house is left to the children, you all have the option of selling it to the son. If no will, an Administrator can be assigned by Probate. That person will carry out the same duties of an Executor. The difference, the State gets involved into who inherits. If children, they will inherit and again, u all then have the option to sell it to your son.
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