Bob, thanks for the response.  I've asked his guardian if he lived in the house for two of the last five years.  I'm not sure how long he's been disabled and unable to live on his own.  WI says they paid over $345,000 in medical expenses and the proceeds of the house sale is $23,000.  But I would consider the taxability of the home sale as a separate issue.  The $23,000 proceeds were paid to the state as required.  I've researched deductible medical expenses, and can't find any reference to the issue of medicaid loan repayment as a deductible medical expense addressed.  Taxpayer is single, still living, just unable to live on his own and is currently in adult care.  The first TY I prepared his return is 2018, so it is possible the home sale would not be taxable.