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Louisville Senior Advisor

The money is running out

Spend-down, Kentucky Medicaid, State Supplementation, and why waiting makes it worse.

Quick answer

Because Kentucky Medicaid has no waiver that pays for assisted living, a resident who runs out of money must usually move: to a personal care home where State Supplementation applies, home with HCB waiver or PACE services, or to a nursing facility that accepts Medicaid once the resident qualifies.

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What happens in Kentucky when a parent's money for assisted living runs out?

Because Kentucky Medicaid has no waiver that pays for assisted living, a resident who runs out of money must usually move: to a personal care home where State Supplementation applies, home with HCB waiver or PACE services, or to a nursing facility that accepts Medicaid once the resident qualifies.

This is the single most important question to ask before moving into assisted living in Louisville: what happens here if private funds run out? Most communities will say the resident must leave; Kentucky requires a written move-out notice and help finding a new home, but not a Medicaid option.

How do I work out how long my parent's money will last?

Add up liquid assets and monthly income, subtract the full monthly cost including care-level charges, and project forward with an annual increase; Kentucky's assisted living median rose 8% from 2024 to 2025, and nursing home medians rose more than 10%.

Run it with a realistic increase, not last year's rate. If the runway is under two or three years, start Medicaid and benefits planning now.

Which benefits should Louisville families check before money runs out?

Check VA Aid and Attendance for veterans and surviving spouses (up to $29,093 a year for a single veteran in 2026), long-term care insurance, Kentucky State Supplementation for personal care or family care home residents with SSI-level income, and Medicaid eligibility for nursing facility care, the HCB waiver or PACE.

Kentucky's Medicaid resource limit for one person is $2,000, and the nursing-home personal needs allowance is $60 a month. The spouse at home is protected by separate allowances under 907 KAR 20:035.

Should we talk to an elder law attorney?

Yes, before moving or giving away any money: Medicaid's look-back on transfers can create a penalty period, and an attorney can structure spousal transfers, care agreements with family members and the timing of an application lawfully.

KIPDA's ADRC at (502) 266-5571 can help with the benefits side at no cost.

Can a Louisville assisted living community keep a resident who runs out of money?

Some can and do for long-time residents, but none is required to, because no Kentucky Medicaid program pays assisted living; ask each community in writing what its policy is before move-in.

If the answer is that the resident must leave, ask whether the same operator runs a personal care home or nursing facility nearby, and how much notice it gives. Kentucky requires a written move-out notice and help finding a new place.

At a glance

Planning early meansWaiting means
ChoicePicking a Medicaid-certified nursing facility or PCH in advanceTaking whatever bed is open
BenefitsVA and State Supplementation claims filed on timeMonths of unpaid bills while claims process
Waiting listsA place on the HCB list by application dateStarting at the back of the list
AssetsLawful spousal protections usedLook-back penalties from rushed gifts

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.

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