That’s a good question and it's a huge problem with the law. It often means that nursing homes don’t get paid in full during the penalty period. Either the resident or the facility may appeal the transfer penalty on one of two grounds. The first is that your mother did not make the gifts for purposes of qualifying for Medicaid. At least in theory, only those transfers made to become eligible for Medicaid are supposed to be penalized. But this is an uphill battle because you would have the burden of proving your mother’s intent in making the gifts. Second, either your mother or the nursing home can seek a hardship waiver. Each state has its own, often very specific, process for this. Again, the chances of success are usually slim, but it may be worth a try.