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One issue for real property (homes, land, cars) is that all details are recorded by your local assessor &/or courthouse and this data is dovetailed into the state system. It is a simple set of keystrokes for the Medicaid caseworker to find out when, to whom & to the penny what property sold for and what the tax assessor value was for the property at the time. I imagine it is done automatically for all applicants as family just leaves stuff off the application either intentionally or not. If you do below FMV, you better have documentation from a licensed & registered real estate appraiser as to why it would be of lower value.
Otherwise mom will face a transfer penalty by Medicaid. Transfer penalties are pretty sticky to deal with when it comes to homes & land, (i dealt with one on a car and those are somewhat easier paperwork to deal with) you'll likely need an attorney to work it out for you. So pay for good legal now or pay later.
Please keep in mind that transfer penalties vary by state due to being based on your states Medicaid NH reimbursement r&b rate. It is day based. So like for TX, a 50K transfer penalty = 345 days that she will be ineligible for Medicaid to pay for her NH stay. 345 days is a really long long time for family to either private pay for her stay OR move the elder back into their home as they do not have the $ to private pay. Now whomever got the below FMV home, can re-transfer the property back to the elder but you have to have family that will do this. The house is now theirs and if they flat will not do this or private pay for care, then the rest of the family has to deal with the mom / NH problem. Not pretty.
I think most assessors send out the tax bill in Oct or Nov that is due in January. Be on the lookout for it so you have defined $ figure to work with.
There is something else to consider -- I don't know your SIL, so don't know if it is relevant. If your mother sells her the house without a life estate clause included, your SIL could sell the house. Most kids wouldn't do this, but a few would. Having it in writing that your MIL could stay there until she died or went to live elsewhere will protect her.
I think the best bet is to consult an attorney who specializes in Elder Law for the best way to comply with the rules and achieve as much of the family's goals as possible.