Parents did spend down 3 yrs ago when going to an assisted living facility to become Medicaid eligible. Will Medicaid pay for nursing home?

I agree, confusing. If in an AL its self pay and you need enough in the bank to cover that cost of at least 60k or more a year. Unless, between SS and pensions your parents met the cost of 5k or more a month.

My Mom was in an AL. I was getting down to maybe 4 months she could stay there. Other than the money put aside for the AL she brought in 1700 a month in SS and a small pension. I spoke with Medicaid and it was agreed that her last 20k be used to pay for 2 months of LTC. May 1 she moved into the LTC, July 1 she went on Medicaid. I had 90 days to get all paperwork together they needed, get her spent down and into LTC.

Spend down means (in my state) they have no more than 2k to a persons name. All assets need to be liqidated. This includes insurance policies with cash in value. There r a few exceptions. The person gets a house and a car but then the person isn't allowed to upkeep them. All SS and pensions go to their care, Medicaid picking up the balance.

So the confusion is, how could they have spent down and afforded an AL that is private pay unless someone else paid for it?

If she already spent down and was self pay in AL, then yes.

I'm a little confused by your info..."they" did a spend-down so did "they" qualify for Medicaid? Who qualified? Both of them? Now only your mom needs to transition into LTC but if they were both already on Medicaid, she wouldn't have anything to spend down. What am I missing?