Asset Assessments

Judie Hughes

DHS Health Care Training

Topics

Purpose and BenefitsDefinitionsFormsSubmissionsProcessDivision of Assets

Purpose

Avoid spousal impoverishmentDetermine counted assets for the

spouse requesting MA-LTC

Benefits

Protects assets for spouse not requesting MA-LTC

Reduces amount of counted assets for the spouse requesting MA-LTC

Process Overview

1. Identify and verify marital assets

2. Determine protected and counted asset totals for both spouses

3. Divide assets

Community Spouse

Legal spouse of a LTC spouse

Not residing in LTCF or receiving services through a waiver

LTC Spouse

Legal spouse of a community spouse

Meets continuous LTC/EW period

Continuous LTC/EW Period

30-consecutive days through:

Residence in LTCF Receipt of services covered by EW

or AC after an LTCC

LTC Facility

Medical hospital Nursing facility ICF/MR MA-covered be in RTC

Name that Spouse Example 1

LTC Spouse:

Community Spouse:

Betty

Barney

Name that Spouse Example 2

LTC Spouse:

Community Spouse:

Neither

Neither

Name that Spouse Example 3

LTC Spouse:

Community Spouse:

Mindy

Mork

Name that Spouse Example 4

LTC Spouse:

Community Spouse:

Neither

Neither

Name that Spouse Example 5

LTC Spouse:

Community Spouse:

Raymond

Debra

Name that Spouse Example 6

LTC Spouse:

Community Spouse:

Neither

Neither

Community Spouse Asset Allowance (CSAA)

Calculated share of assets attributable to the community spouse.

Used to determine LTC spouse total counted assets.

Forms

DHS-2908 DHS-3340 DHS-3340A DHS-1503 DHS-5181

Submissions

Required when an LTC spouse requests MA-LTC

Optional at time of first continuous LTC/EW

Review

Protects marital assets Reduces counted assets Continuous LTC/EW period Required at application Optional for an estimate

Processing Step 1

Determine the asset assessment effective date.

Effective Date Example 1

Rick entered LTCF September 3. Continues to reside in LTCF. Requests MA-LTC October 5. Luann in home – no services.

September 3

Effective Date Example 2

Mike entered hospital June 3. Transferred to current LTCF July 2. Requests MA-LTC October 2. Holly in home – no services.

June 3

Effective Date Example 3

Bob services in home July 1. Insurance paid – screened June 29. Requests MA-LTC September 16. LTCC September 15 Jackie in home – no services.

September 15

Effective Date Example 4

Jim entered hospital June 3. LTCC June 25 AC services June 28 after discharge Jim requests MA-LTC August 20 Nancy in home – no services.

June 3

Effective Date Example 5

Patrick entered LTCF April 3. Discharged April 30. Enters current LTCF July 15 Requests MA-LTC August 20 Jan in home – no services.

July 15

Effective Date Example 6

Hugo entered LTCF January 19. Dottie LTCF July 1 – August 15. Hugo requests MA-LTC

September 10.

None

Case Scenario

LTC Spouse?

Community Spouse?

Required?

Ida Effective Date?

Ida

Hardy

NoAugust 15, 1999

Processing Step 2

Request completion of the

DHS-3340.

Case Scenario

Hardy and Ida submitted a completed DHS-3440 on

November 15, 1999.

Processing Step 3

Evaluate marital assets following asset assessment rules.

Processing Step 4

Determine the total counted

marital assets.

Case Scenario

Total marital assets = $349,400

Total excluded assets = $166,500

Total counted assets = $182,900

Processing Step 5

Determine the community spouse asset allowance.

a. Divide total countable assets by 2.

b. Determine minimum and maximum asset allowance figures.

Processing Step 5

c. If half of total countable assets are: ≤ minimum – CSAA is minimum ≥ maximum – CSAA is maximum In between – CSAA is actual amount

Case Scenario

What is Hardy’s CSAA?a. Half of total countable assets

$182,900 ÷ 2 = $91,450b. $23,744(min) and $81,960(max)c. CSAA = $81,960

Processing Step 6

Enter the asset assessment results into MAXIS ASET.

TE02.13.57

Processing Step 7

Complete and send the DHS-3340A.

Send additional notice with instructions if processing at

MA-LTC approval

Processing Step 8

At MA-LTC determine counted assets attributable

to the LTC spouse.

Processing Step 8

a. Determining the current CSAA.

Compare half of total counted assets owned on the effective date to the current minimum and maximum asset allowance.

Case Scenario

What is Hardy’s updated CSAA? Half of total countable assets

$182,900 ÷ 2 = $91,450 $29,389(min) and $104,400(max) Actual CSAA = $91,450

Processing Step 8

b. Evaluate current marital assets using MA eligibility rules.

c. Total counted marital assets.

Processing Step 8

d. Calculate LTC spouse counted assets. If counted assets:

≤ CSAA =$0 counted assets for LTC spouse

> CSSA - Total counted assets - CSSA = LTC spouse counted assets

Case Scenario

Counted assets = $91,800

CSAA = $91,450

Ida’s counted assets = $350

Processing Step 9

Set DAIL/WRIT for 60 days prior to the first annual renewal month.

Don’t forget…

Case note!

Verification

At initial submission At time of request for MA-LTC At the first annual renewal

Division of Assets

Divide so each asset is in one spouse’s name

No transfer penalty Verify legal transfer made

Case Scenario

Assets reduced. Ida approved for MA-LTC. Notice sent 60-days before

renewal. Renewal submitted

Verify Ida-owned assets Verify legal transfer of other assets.

Wrap - Up

Purpose and BenefitsDefinitionsFormsSubmissionsProcessDivision of Assets

Other Asset Assessment Info

HCPM 19.45

HCPM 19.45.05

HCPM 19.45.10

Thanks!