Assets as caregiver payments?

I don't understand why there needs any care giving if the family member is on medicaid. I'm assuming it's long term medicaid otherwise it wouldn't be a question. Since long term care on medicaid, community medicaid, et al is the only time that assets come into play. New expanded medicaid used as health insurance considers only income. You could have a billion dollars under your mattress and still get expanded medicaid. If it's institutionalized medicaid shouldn't all their care giving needs be met?

Assets have a value. Owner of an asset can get leading against an asset; asset is used as collateral; it’s secured lending. Like get a HELOC or Reverse Mortgage on a house. Owner could use $ lent from HELOC or RM to pay for in home care, or get a new roof. Is this what you are thinking? If so, pls realize the loan has to be repaid or the lender will acquire it. Heloc maybe start repayment 6 mos after lending starts; RM on death or after they move out of the home. Either are secured lending, gotta be repaid even if they die.
Also Medicaid can look at any $ they get paid as income too. Might increase the income above the max allowed by Medicaid.

OR
is it you’d like for them to sign off an asset to you now and you debit your future time / fees against the asset? Personally I don’t see that ever being ok for Medicaid. It’s gifting of an asset no matter how you dress it.