Elder Law Attorney Tennessee
Long-term care, taken into
long-term view.
Long-term care is the quiet expense that undoes more estates than the IRS. We plan for it before the family has to.
By Knight Lancaster, JD, CPA · Last reviewed May 2026
The plan that spares the family a panicked decision.
If you started looking after a parent's diagnosis, a friend's family selling the house to pay for memory or nursing-home care, an aunt who applied for TennCare and found out the lookback had not run, you are already doing the protective work. Long-term care is the quiet expense that undoes more estates than the IRS. The plan you make today, while signing is still simple, is what spares your family from a decision they would otherwise make in a hospital corridor — selling your home to pay healthcare costs after you pass away.
Most plans do not honor your work to have your home fully paid for. Medicaid's five-year lookback is the single largest threat to a middle-class Tennessee estate, and plans assembled in a hurry, after the diagnosis, almost always force the family to pick between paying off your medical debt personally or selling your home to pay for it.
Done early, with care, the same outcome is quiet: irrevocable trusts where they fit, gifting strategies where they make sense, and a clear written plan that lets the family ask for help without losing the home.
We coordinate the legal architecture with the tax basis and the eventual estate plan in one continuous reading. The point is not to qualify for Medicaid. The point is to spare the family a panicked decision when the call from the hospital comes, and to keep what you have built inside the family while TennCare pays for the care.
What we draft.
Medicaid planning
Before the look-back closes.
Five-year strategies, asset re-titling, and the quiet groundwork that lets a family qualify for TennCare without sacrificing the home.
Asset protection trust
Irrevocable, where it fits.
Medicaid asset protection trusts drafted to TennCare standards, with the tax basis and beneficiary work coordinated alongside.
Incapacity planning
Powers prepared in advance.
Durable powers of attorney and healthcare directives, signed while signing is still simple, so a court conservatorship is not the plan.
Pre-planning, or planning at the crisis.
| Pre-planning, five years out | Crisis planning, after the diagnosis | |
|---|---|---|
| Lookback | Outside the 60-month window | Disqualifying transfers create a penalty period |
| Home recovery | MAPT shelters the home from TennCare estate recovery | Estate recovery routine; the home is the most common target |
| Step-up in basis | Preserved with grantor-trust drafting | Often lost, capital gains exposure to heirs |
| Family options | Trust funding, gifting, careful titling, Medicaid-compliant annuities | Spousal transfers, halving strategies |
| Cost per dollar saved | Lower | Higher |
"The point is not to qualify for Medicaid. The point is to spare the family a panicked decision in a hospital corridor."
The conversation worth bringing to your spouse.
What to say at the kitchen island
"If something happened to my mom tomorrow, would we know whether to apply for TennCare?"
What an elder law plan quietly answers
Pre-planning answers the eligibility question before the diagnosis arrives — whether she qualifies today, what the lookback window means for her assets, and what the next step is, in writing.
What to say at the kitchen island
"I do not want my parents to lose the house to estate recovery."
What an elder law plan quietly answers
A Medicaid Asset Protection Trust, funded outside the five-year lookback, removes the home from recovery and preserves the step-up in basis.
What to say at the kitchen island
"If we wait until the diagnosis, will it be too late?"
What an elder law plan quietly answers
Crisis planning still works, with less room to maneuver. Pre-planning works better. The earliest call is the cheapest.
Every Medicaid planning choice has a money side. The way a MAPT is funded changes whether the home gets a step-up in basis at death. The timing of a gift changes whether the family triggers the lookback. The kind of trust you choose changes the income tax bill on every distribution. As a CPA, Knight sees the money side and the legal side at the same time, so the plan he writes is the one that holds before the hospital does, the one the family can lean on when the call comes at three in the morning instead of standing in a corridor wondering what to sign. The work is meant to feel quiet, on the day it has to. Tennessee bar admitted, dually licensed as a Certified Public Accountant, recognized in Best Lawyers in America.
Elder law, answered.
When a Tennessee resident applies for TennCare CHOICES long-term care, the agency reviews the prior sixty months of asset transfers. Disqualifying transfers create a penalty period during which the applicant pays privately. Pre-planning that respects the window is the central work.
Estate Planning, the umbrella
Estate planning at Lancaster Law spans three silos.
Reviewed by Knight Lancaster, JD, CPA, MBA
Knight Lancaster is the founder of Lancaster Law, P.C. and The Lancaster CPA Firm, P.C. He is one of a small number of attorneys in Tennessee who is also a licensed CPA, giving him a dual perspective on estate planning and the tax consequences that drive it. Knight has been recognized in Best Lawyers in America, Ones to Watch (Corporate Law), in 2023 and 2024, and serves on the Board of Directors of the American Academy of Attorney-CPAs. He earned his JD and MBA from Belmont University (he was the first graduate of Belmont's joint JD/MBA program) and a BS in Accounting from the University of Tennessee.
Read Knight's full bio|Book My Planning Call
This article is for educational purposes only and is not legal advice. Reading it does not create an attorney-client relationship. For advice specific to your situation, contact Lancaster Law directly.
Tennessee Bar
Practicing since 2019
Triple credential
JD · CPA · MBA
Peer-reviewed
Best Lawyers, Ones to Watch, 2023 + 2024
National board
American Academy of Attorney-CPAs, Director
Elder law across Tennessee.
Nashville
1316 Adams St
Nashville, TN 37208
By appointment · 615.649.4660
Franklin
725 Cool Springs Blvd, Suite 600
Franklin, TN 37067
By appointment · 615.649.4660
Knoxville
800 S Gay Street, Suite 700
Knoxville, TN 37929
By appointment · 865.448.7246
Chattanooga
200 W MLK Blvd, Suite 1000
Chattanooga, TN 37402
By appointment · 423.799.2865
Jackson
118 N Liberty Street
Jackson, TN 38301
By appointment · 731.318.4980
Clarksville
1860 Wilma Rudolph Blvd
Clarksville, TN 37040
By appointment · 931.575.6115
Memphis
1661 International Drive
Memphis, TN 38120
By appointment · 901.350.4730
Plan for long care in Tennessee.