I understand the "what" of spousal impoverishment for Medicaid. Spouse can keep half of countable assets, up to about $124,000 in Nebraska. But WHEN is this calculated? Say Mom and Dad have $200,000 in countable assets when Dad enters assisted living. They can private pay for a while, but if he is there more than a couple years, they'll have nothing. I know, check with elder care attorney. Do you know how many of those there are in rural Nebraska? None.