My sister has only enough assets to supplement her Social Security in paying for an Assisted Living facility in our area for about 3-4 years. If she applies for Medicaid when her assets are exhausted, is spending down your assets for Assisted Living acceptable under the 5 year look back rules?
Therefore, I would suggest that you not apply after your sister has completely exhausted her assets. At that point, she would be applying for a Medicaid bed. In the better facilities, Medicaid beds go first to current residents that have exhausted their money by paying privately.
As soon as she is medically eligible for a nursing home, apply with as much money available as possible to increase her chances of being placed in a better facility.
Here's a link to investigate quality ratings.
https://www.medicare.gov/nursinghomecompare/search.html
When Mom started running out of money I applied to Medicaid. In NJ you have 90 days to get them the info needed, spend down and find a facility. I started the process in April. Mom moved into LTC May 1st. She paid privately for May and June taking her under the 2k cap. I called the caseworker, confirmed I did what was needed and Medicaid started July 1.