Protect my mom's house from Medicaid

[Jason Schaefer]

I recently discovered that my 74yo mom's house is still in her name. When my dad passed years ago my uncle had handled the trust and all the finances. I assumed he had moved the house to the trust but was recently informed while visiting him that wasn't the case. I feel dumb for not having noticed this sooner.

Fortunately my mom is healthy. However she is 74 with two replacement hips and works full-time (she has no hobbies so cleans offices at a local clinic). So, I do worry about something happening and her landing in a nursing home. Thanks to working and having low expenses, she has money saved and will be able to pay for some of her care. But considering the high cost of nursing home care, at some point the house asset would be needed to pay the bill.

My understanding is that Medicaid has a five year lookback rule, so even if she were to gift or sell me the house today, there would still be risk of losing the house if something happened in the next five years. Same if we move the house into an irrevocable trust. I'm wondering if anyone knows of any clever ways around this or other options?

Perhaps we're best putting the house in an irrevocable trust and crossing our fingers that we won't have any need to apply for Medicaid in the next five years. But, I'd prefer a strategy that didn't rely on hope!