The market appears to be back to bubble territory in the Bay Area. I just saw small some Habitat for Humanity townhomes on a small lots located next to a busy freeway interchange being offered at over $400K. And you had to be willing to put in 250 - 500 of hours of work yourself, be moderate income ($67k for a family of 4) and fill out an application in order to even be considered to possibly be chosen to receive this bargain basement price.
If you have a moderate income in the Bay Area, I think it just makes more sense to rent or at least not buy a house at over 6 times your household income at the likely top of a housing bubble but what do I know.
I believe this Habitat for Humanity townhouse was a sign from the housing Gods and the Case-Shiller index that it is time to pack up and sell before the latest tech bubble bursts and takes home prices along with it.
In regards to LTC and Medicaid, I am not going to keep a big house at our ages for LTC we may never need, or just need a likely average of two years, in which case we would just pay out of pocket. From what I have read:
How Can I Safely Transfer My Assets to Get Medicaid to Pay for Long-Term Care? | Nolo.com
I do not think a home purchase or a number of other exempt asset transfers to a healthy spouse (like buying a business) have a look back period, so the big house or other exempt asset transfers are always an option down the line should one of us need an outside the bell curve, unusually long term nursing home stay. We save more money by downsizing now than buying or keeping a big house we don't want or need in our fifties for LTC expenses that may or may not occur 20+ years from now, especially when there are many loopholes and spousal asset transfers not subject to a look back period, and the look back period for non-spousal gifts in California is still only 30 months.