A lot of older people will start transferring their financial assets to their children and grandchildren before they even need this kind of intensive care. If the transfer process is completed and then more than five years goes by without the senior needing to check into a nursing home, the family is 'home free.' But if the worst happens and they have to check into a nursing home before the five years is up, the government has the right to look back into their finances and demand that they spend down a certain amount of their assets before Medicaid kicks in to pick up most of the nursing home bill.