In fact, there is a policy and a strategy for this type of situation often referred to as "just say no" or "spousal refusal." If a spouse refuses to cooperate with a Medicaid application, the state Medicaid agency is supposed to evaluate the nursing home resident’s application without regard to the estranged spouse’s assets or income. As a prerequisite, the nursing home spouse must sign over to the state his rights of spousal support, meaning, at least in theory, that the state could then sue the estranged spouse for support. But that’s quite unlikely to happen. For more information, click here.