Law 6842 - Fall 2009
American Health Care Law
Professor Vernellia R. Randall
The University of Dayton School of Law


Mary's Farm
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Unit 01 Organization                                                          x
Unit 02: Access                                                           x
Unit 03: Quality                                                          x
Unit 04: Reform                                                           x
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Mary's Farm

Furrow, et. al., Health Law, pp. 576.

Mary Montgomery is 78 years old and recently widowed. For 50 years she and her husband Bill farmed together on the 320 acre farm they inherited from her parents. The farm was homesteaded by her grandparents in 1882 and has been in the family ever since. For the past 15 years, Mary's oldest son, Owen, has done most of the farming, and she and her husband intended to leave the farm to Owen when they passed away. Making a living on the farm was never easy, but over the years Mary and Bill managed to pay off mortgages they had put on the farm. Mary received $30,000 in life insurance at Bill's death which she has saved. Mary now lives on this sum and on her Social Security. Mary has been bothered by arthritis for several years and her condition has recently worsened. She is finding herself more and more forgetful, and although she jokes about this, she is worried that her mind may be going altogether. Owen's wife, Jane, comes by several times a week to straighten up Mary's house and to make sure that she eats well.

Mary has come to you because she is concerned about her future. Although she has no immediately life-threatening medical problems, she knows that her health is deteriorating and that sooner or later she will have to go into a nursing home. She recently went down to Park Acres Home (which is run by her church) and talked to the administrator. She was surprised to learn that skilled care in the home costs $2400 a month. She had always assumed that Medicare would cover any nursing home care she might need, and was shocked to discover that it would only cover at most 100 days, and perhaps none at all. The administrator told her that may of the patients in the home were on Medicaid, but that to become eligible for Medicaid she would have to sell the farm and liquidate the sum she would receive, plus her savings, because in her state Medicaid covers only persons with less than $1900 in savings.

Mary wants to know whether there is some way she can pass the farm and her savings on to Owen and Jane and make herself eligible for Medicaid. She knows Owen cannot afford to buy it from her, and is heart-broken at the thought of it being sold out of the family. Moreover, after all of the work Owen and Jane have done on the farm for her, they deserve it.


Unit 02 Access and Cost Control
09: Access and Uninsured                                x
10: Uninsured                                  x
11: Middle Class - State                                 x
12: Middle Class - Federal                                 x
13: Poor - Medicaid                                   x
14: Elderly - Medicare                                 x
15: Cost - Fraud and Abuse                                  x
16: Cost - Stark                                x
17: Rationing                                  x







Related Pages:
Home ] Up ] Medicaid Spend-down ] Synthesis of Research on Spend-down ] [ Mary's Farm ]
Subsequent Pages:
Home ] Up ]
Previous Pages:
Home ] Lesson 09: Access and Cost Control ] Lesson 10: Access and the Unininsured ] Lesson 11: Access - Middle Class - State ] Lesson 12: Access - Middle Class - Federal ] Lesson 13: Access - Poor - Medicaid ] Lesson 14: Eldery -  Medicare ] Lesson 15: Medicare and Medicaid Fraud and Abuse ] Lesson 16: Stark I & II ] Lesson 17: Allocation of Scarce Resources ]
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Professor Vernellia R. Randall
Institute on Race, Health Care and the Law
The University of Dayton School of Law
300 College Park 
Dayton, OH 45469-2772
Email: randall at