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<My grandparents are 81 years old, and my grandmother has Alzeimers and diabetes. Despite his careful planning, my grandfather never anticipated a long term illness that will require a nursing facility (at $6-8K per month). He knows that at that rate his assets will be depleted very quickly before Medicaid will inevitably take over.>


I think you got some good advice from Phil. Unfortunately, it does not look like there was very much careful planning in this situation, which is not unusual. At the very least, your grandfather should have 250k to cover 3 years of NH expenses before he could even think of gifting anything to his children. More importantly, his plan should not forget about his own financial needs for his normal living expenses. There are a good many complexities in these cases. In addition to legal advice, he could benefit from talking to a good tax pro.

BTW, I apologize if this sounds wrong, but I hope your grandfather is the one initiating all of this. He could be very vulnerable in his condition and anxious daughters attempting to save "their" inheritance could easily cloud his judgement. If he has decided to make some changes now, they should be done very carefully. Changing titles on any property could have some serious tax consequences later.

If the diabetes that your grandmother has is being properly treated and she is otherwise strong physically, she can survive for many more years. Trying to care for an alzheimer patient at home often causes much more harm to the caregiver, both pysically and emotionally. Make sure that your grandfather is not carrying too heavy of a load during these difficult times. Good luck.


BRG
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