Mom has IRA - Is this subject to paying spend down for Medicaid?

BTW, it doesn't matter who is named beneficiary. That does not come into effect until after the death of a person. The IRA is money that is saved for retirement. Even if it were deemed exempt during a person's lifetime, it is most likely going to be taken during Medicaid recovery later on, as it is part of the person's estate.

I looked up the IRA rules. If an IRA is not in pay-out status, it is considered a non-exempt asset that has to be spent down in order to qualify for Medicaid. If an IRA is in pay-out status, it is an exempt asset, but the distributions are considered as income. If an IRA is in payout status, it is important to plan the distributions so that they aren't so large that one becomes temporarily unqualified for Medicaid.

I personally don't know why the status determines if it is exempt or non-exempt. Even when an IRA is in pay-out status, people can withdraw larger amounts from them. I imagine considering them exempt would be important if there was little SS or other retirement money, and the IRA was your main income.

I believe unless it is in some sort of "special needs trust" it is not protected from Medicaid spend down.

Yes, it is. IRAs differ in how they are handled by Medicaid, depending on if distributions from them are active or not. I do not know the exact rules. The Medicaid workers would let you know how it needed to be handled.