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ALL of it, ALL the way through 2009 or farther in some states.
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Medicaid is state run under an overall federal guideline. So just how your application & supporting documents are reviewed will vary by state. There seems to be no set standard.

For my Mom in TX, it was a 3 year & 6 mos review of all financials. Yes, 42 months of bank statements. Between those and insurance policies and property documents, my moms supporting was over 100 pages. In addition a letter was required from her bank as to the disposition of all CD, T bills etc closed or not renewed and where the proceeds went as well. . For us, the $ went into her main drawing account so the trail of $ was obvious. But had a CD of $5,678 been cashed out, there would have been a transfer penalty inquiry on the $. For my MIL, also in TX, there were ? on checks under $100 for transfer penalty - she wrote checks to her state paid aides to go & buy liquor for her when she was living in sub. housing. It needed to be established that the $ was not gifting.

I think they are looking for a pattern of spending that fits their income and assets. In order to financially qualify for Medicaid basically it's 2K in income & 2K in assets. Now for their Medicaid application, they have to provide their awards letters & banking details, so someone who gets $1,000 a mo income with 50K in savings 3 years ago & lives with family should have a pretty good nest egg that will need to be spent down & used for private pay for care before Medicaid will pay. If they don't, $$ has been probably transferred or gifted. They will have to show just where 48K in savings and the 36K in income just vanished to. If you get a transfer inquiry, you have a very tight timeframe to do this otherwise app will be declined. Medicaid will send you the decline letter & also the NH gets the letter. NH will expect family to sign off on a private pay contract in order for mom to stay there too.

But say its the same finances for an applicant who has a home & paid for home health care or other verifiable health expenses, it can make sense that they are now impoverished at 2K as $ has been spent on the home & care over the past 3 years to get to the point of being impoverished.

I would imagine that the states have a basic algorithm program that they enter in the awards data combined with living situation & it tells them just how much $ the applicant should have. You can't hide gifting or transferring, it will come up.
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