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Any money or property given within the 5 year look-back is subject to a transfer penalty by Medicaid. The transfer penalty varies by state as it is based on each states Medicaid reimbursement rate. For Texas it's about $ 145.00 a day which is low, while other states have it at over $ 300 a day. So a 10K car is about 70 days of NH private pay in TX, while in another state it could be only 35 days. There is a whole specific formula for it and loco to figure out.

Whatever the case, imho you really should meet with an elder care attorney to go over your parents situation and also update any legal and add on whatever else might be helpful. They will know how Medicaid is being reviewed in your state and what may or may not be an issue. When I did this with my mom it was well over a dozen years ago and way before NH was even a thought. The attorney suggested in addition to the usual DPOA, MPOA, to do a "Guardianship in Case of Incapacity" as his experience was that often the elder will in a fit of pique or moment of hatefulness...do the "I'm changing my POA" routine. It provides for a trump card to pull out to keep that from happening and really I would have not known how important it would be if the attorney had not suggested it. I've been executrix twice and think I'm pretty pro-active but really good legal is important even if you are savvy in dealing with governmental regulations.

For tangible property, like a home or car, ownership and changing of ownership is just keystrokes away from being found out as all that data is in the state's centralized database from the local or county tax assessor. For bank accounts and other financials, it could take longer for Medicaid to find out but most states have a program that ferrets out transfers. Some states are switching from Medicaid review being done by state employees and are using contracts. HMS is a big player in doing contracts and they have extremely sophisticated systems to look at compliance, fraud and oversight. If there is something, they will find it.

The only asset that seems to be under the radar that I've heard of is oil & gas & mineral revenue (this probably because of how ownership get's recorded & revenues paid) or of course, if they hoarded cash and there was no banking ever done. Good luck.
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The lookback for Medicaid is five years, not three.
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