One in 10 Americans over age 65 years and almost half of those over age 85 years have Alzheimer’s disease or a related type of dementia.  Alzheimer’s disease (AD), the most common form of dementia, involves a gradual breakdown of nerve cells in the brain. Affected persons lose the ability to interpret information and send messages to their bodies to behave in certain ways. Over time they experience mental, emotional, behavioral and physical changes, necessitating increasing amounts of….


Probate is the legal process of transferring ownership of property from the decedent to his or her heirs either by accepting the validity of their last will and testament or by following the Kentucky laws of intestacy.  For a will to be valid, it must be “self-proven” or proven as valid in court by at least one of the witnesses.  A valid will can also be holographic: written entirely in the handwriting of the decedent, signed, and dated.



Gardens are great, but they require a lot of time, labor and money. They also require land space and good soil. Container gardening skirts all these obstacles, offering reduced time, effort and costs, and can be enjoyed in an apartment or other home lacking a yard. Vegetables and herbs can be grown in containers on a balcony, patio or walkway.



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The Wrong Way for Betty to qualify is to spend down all their assets until they have only $2,000 in family assets. While she will certainly qualify, John will be without assets that he could have retained.

The Right Way for Betty to qualify is to get a Resource Assessment as soon as Betty goes to the nursing home. The Medicaid case worker will tally up the countable assets, which, in this case, is only the $60,000 account (in the state of Kentucky, the retirement accounts are exempt assets) and then divide the assets in half. Betty gets $30,000 in her “bucket.” John gets $30,000 in his “bucket.” The home and the car are exempt for the community spouse. John and Betty’s spend-down amount is $28,000; they will need to spend the funds in Betty’s “bucket” until her assets are only $2,000. These monies can be spent on either of them.  John could buy a new car, pay down the mortgage, remodel the home, buy special things for his wife like a new TV or clothing.  After Betty’s bucket is at $2,000 or less, she can apply for Medicaid and will be eligible.

Tip:  Medicaid requires thorough documentation of all assets, purchases and transfers. Keep all your bank records and purchase receipts and be prepared to trace all transfers of funds.

This is the second Resource Assessment Article we have published within a years’ time. Our office has heard so many stories from families who have gone about things the wrong way, we felt it was worth addressing again.

Interactions with the Medicaid Office can be very overwhelming.  If you would like to know more or need help, contact a qualified elder law attorney.

Medicaid Resource Assessment are an important tool to understand and utilize when one spouse is in need of long term care. A portion of the Medicaid rules is designed to protect the community spouse (spouse at home) from impoverishment and unnecessary dissipation of family assets. Only the institutionalized spouse (spouse in a facility) is required to have assets of $2,000 or less and a pre-paid funeral.

The failure to have a proper Resource Assessment in a timely manner can cost couples thousands and even hundreds of thousands of dollars. The community spouse is entitled to keep a portion of the family assets and the Medicaid office establishes that amount at the time of the Resource Assessment.  During the Resource Assessment, the caseworker will look at the countable assets belonging to the couple and allocate them between the spouses. Depending on the amount of the countable resources, the community spouse can keep half the amount (based on a specific minimum and maximum allowed amount). At that time the caseworker will determine the amount of the spenddown (if one is necessary) in order to qualify for Medicaid.

The spenddown is the amount money the Medicaid office determines, under the Medicaid rules, which the couple must dispose of in a Medicaid approved manner so their assets reach the level that they will qualify for long term care Medicaid.     


The Resource Assessment is a snapshot of the assets owned by a married couple for the Medicaid office. A delay in obtaining the assessment will reduce the amount of assets available to be retained by the community spouse. It is better to obtain the Resource Assessment sooner rather than later (within the first couple of months of institutional placement) when assets are higher rather than lower – you want to walk into the Medicaid office for your Resource Assessment owning more assets than less! The patient usually is not eligible for Medicaid at the time of the assessment which makes the assessment even more important. It may not make sense until you see how it works.

Example: Betty and John, a long- time married couple, were devas- tated when Betty had to be placed in the nearby skilled nursing facility. Betty and John were both well- educated individuals and knew that for Betty to be eligible for Medic- aid, they would have to spend down their resources. John read articles in magazines and the internet about Medicaid. He knew Betty could only have $2,000 in assets. Both of them have retirement accounts, they own their home and one car, and John has $60,000 in a non-retirement investment account.


Mary Ellis Patton is an associate at Bluegrass Elderlaw, PLLC in Lexington, Kentucky. In her practice, Mary uses customized Powers-of- Attorney, Wills, and Trusts to help clients to achieve their financial, legal, and health care goals. Mary is licensed to practice law in both Kentucky and Ohio. She is the author of Chapter 13, Age Discrimination, of the Kentucky Practice Series, Elder Law Volume.

more articles by mary ellis patton


Katie received her J.D. from Northern Kentucky University,  a Legal Masters (LL.M.) in Estate Planning and Elder Law from Western New England University and joined Bluegrass ElderLaw after several years as a sole practitioner.