I don't think you quite understand.  A two owner search may not be sufficient either.  Consider this...

Bob Smith applies for Medicaid, then Quit Claims to Mary Smith, his daughter.  Mary sells the property Jack Jones for full value.  Bob Smith dies and Medicaid then files a lien against Bob Smith's estate.   Jack Jones then sells the property to Bill Williams, again for full value.  You are then asked to do a current owner search.

Are you going to check Bob Smith on your search?  If you do, are you going to check him for liens beyond the point that Mary Smith sold the property?

From what I have read, the lien would be valid because the property was transfered, intra-family for less than full value, during the statutory "look-back" period.  Can the State then enforce the lien against a subsequent bona fide purchaser?  The answer from our underwriter is yes... that is what makes these liens so troubling. 

Best,
Robert A. Franco