Medicaid Estate Recovery [wa State, Dshs, Ofr]

TL;dr: WA state Medicaid estate recovery with no assets other than a house that was owned 50/50 with surviving child over 21, was fixed income with no way to pay for own housing. See questions below, but how bad off is this situation?

Brief history of the situation:

• Dad refinanced house in 2001, only name on title.
• I moved in with parents in 2003 trying to look for work in my profession at the time.
• Dad died in 2005, I took over payments of the mortgage as my mother was basically a housewife for the past 25+ years. At this point she only received about $420/month in SSI (dad didn't work a lot of jobs that paid into SS). Technically dad was underwater on the mortgage when I took it over (owed $90K on a home that was valued at less than $80K). Mom was 58 at this point.
• Apparently mom was qualified for Medicaid sometime in the early 2010's. Mom was 63+ at this point.
• Refinanced the house from a 30 year ARM to 15 year fixed in 2017, put home in 50/50 my name, mom's name (something even the mortgage company said I didn't have to do; I still have the email from them saying they didn't care who's name it was in, as long as it was hers or mine). The mortgage was in both of our names. Mom was 70.
• Mom started getting home care assistance 2-3x a week for 2-4 hours per visit starting in 2019 (made me happy as I was working full time, and I dreaded leaving her home alone as she was a fall risk). Unclear if this was Medicaid or just a WA state program.
• Mom was diagnosed with stage 3C ovarian cancer in May 2024, had a protracted effort to try and treat it, but died shortly before treatment was set to begin in November 2024. Mom was 77.
• Medicare initially paid for her stay in a skilled nursing facility (SNF) starting July 9, through September 5, 2024. Medicaid apparently took over after UHC Medicare Advantage denied her additional time and paid from September 6, until she was discharged to a hospital on November 13, 2024. Some back of the napkin math with the SNF billing rep came out to about $11-13K that Medicaid likely paid.
• Mom had no life insurance, and at the time of her death her SSI was $~750/month (still not enough to pay the mortgage).
• Mortgage is down to < $50K with about 7-8 years left, value of home is estimated at around $240K.
• I provided increasing levels of caregiving for her, starting around 2015. I did her laundry, yard work, shopping for groceries, cooking/meals, doing dishes, picking up prescriptions, etc. She was fairly self sufficient around the home, using the restroom and taking showers on her own (we had assistive devices (shower chairs, etc) to help).

My understanding is DSHS, through their Office of Financial Recovery (OFR), will collect what was "correctly paid" now that she has passed. They can use her "interest" in the house (her half, so up to $120K in value) to repay what Medicaid paid out. Apparently I could have used a "caregiver exemption" prior to her death to transfer the house, but that option disappeared when she died according to one attorney I contacted (which seems strange to me; the goal was to bring her home after a successful treatment, and from what I was told if I had used the caregiver exemption and successfully got the home in my name, she wouldn't be allowed to come back).

My goals are to avoid paying anything to the state (especially considering I basically kept mom from being homeless for nearly 20 years, I think this isn't unreasonable), and get the house in my name.

Anybody have any legal advice for dealing with Washington state DSHS / OFR and avoiding losing a large chunk of my "investment" in the home? And some specific questions:

• If I open probate, will DSHS/OFR expect/demand immediate payment of the Medicaid debt?
• Can OFR be negotiated with to erase or wipe out the debt?
• If they refuse to negotiate/forgive the debt, can they force a sale to settle the debt (and how does this interact with probate; if I just leave things how they are can I delay this)?
  • Do they offer repayment plans or anything to avoid selling the house?
• I know some DSHS decisions can be appealed to an ALJ/court, are OFR decisions/determinations able to be appealed? If so, are there good ways to appeal these to get a reduction/elimination of the debt?
• My understanding is they collect long-term care (LTC), do they collect anything else they may have paid for (such as the home care assistants she got 2-3x a week for a few hours a day)? I get the impression Apple Health paid her copays for prescriptions and office visits.

I can provide additional details if it helps. I will add that she got a letter shortly after she died from DSHS stating that they used a "housing allowance" to cover her time at the SNF for September, October and November (it showed she would owe $0 for those months). Prior to that, DSHS was saying she would pay about $613/month for her "share" of the SNF stay that UHC Medicare Advantage didn't cover for those same months.