How much can a Kentucky nursing home resident keep and still get Medicaid?
A single Kentucky applicant's countable resources must be no more than $2,000 ($4,000 for a two-person household) under 907 KAR 20:025, and once on Medicaid a nursing home resident keeps a personal needs allowance of $60 a month from income, with the rest going toward the cost of care.
The personal needs allowance rose from $40 to $60 on July 1, 2024 under House Bill 6 of the 2024 Regular Session, according to the Department for Medicaid Services' provider letter of August 7, 2024. Income after the allowance and any allowed deductions is the resident's “patient liability,” paid to the facility; Medicaid pays the rest of the facility's Medicaid rate.
What protects the spouse who stays at home?
Kentucky's spousal impoverishment rules (907 KAR 20:035) let the community spouse keep the greater of the spousal share, half the couple's countable resources up to a federal maximum indexed every January, or the state spousal resource standard, plus a monthly income allowance up to the federal maintenance standard.
Resources protected for the community spouse must actually be transferred to that spouse within six months of the initial eligibility decision. Because the federal maximums change every year, confirm the current dollar figures with DCBS or an elder law attorney before moving any money; we do not publish an estimate.
Does Kentucky look back at gifts before approving nursing home Medicaid?
Yes. Like every state, Kentucky reviews asset transfers for less than fair market value during the federal look-back period before the application, and an improper transfer can cause a penalty period during which Medicaid will not pay for nursing facility care.
Transfers between spouses are treated differently, and some transfers are exempt. This is the single area where families most often hurt themselves by acting before getting advice. Talk to an elder law attorney before gifting money, adding a child to a deed or paying a relative for care without a written agreement.
Which Louisville-area nursing homes accept Medicaid?
Most Louisville-area nursing homes are certified for both Medicare and Medicaid; CMS lists the certification type for each, and our nursing home roster shows every OIG-licensed facility with its CMS rating, but always confirm a specific facility has a Medicaid bed available for long-term stays.
OIG's long-term-care roster distinguishes nursing facility (NF) beds, which participate in Medicaid, from state-licensed nursing home (NH) beds; a handful of Louisville facilities hold NH beds only, and CMS does not rate those. Kentucky expanded Medicaid under the ACA on January 1, 2014, but expansion eligibility is separate from the aged, blind and disabled pathway that pays for long-term care.
At a glance
| Kentucky nursing home Medicaid is | Kentucky nursing home Medicaid is not | |
|---|---|---|
| Resources | Capped at $2,000 for one person | Available to anyone with savings above that |
| Income | Applied to care, minus a $60 PNA | Kept by the resident |
| Spouse | Protected by 907 KAR 20:035 allowances | Required to spend down to $2,000 too |
| Expansion | Separate from ACA expansion eligibility | Automatic for expansion enrollees |
Sources include KRS Chapter 194A, 902 KAR 20:480, Kentucky CHFS and DMS pages, CareScout and VA rate tables as cited above; see our editorial standards.
