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Asset Assessments. Judie Hughes DHS Health Care Training. Topics. Purpose and Benefits Definitions Forms Submissions Process Division of Assets. Purpose. Avoid spousal impoverishment Determine counted assets for the spouse requesting MA-LTC. Benefits.

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Asset Assessments

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Asset Assessments

Judie Hughes

DHS Health Care Training


Topics

  • Purpose and Benefits

  • Definitions

  • Forms

  • Submissions

  • Process

  • Division of Assets


Purpose

  • Avoid spousal impoverishment

  • Determine 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

  • Identify and verify marital assets

  • Determine protected and counted asset totals for both spouses

  • 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

No

August 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?

  • Half of total countable assets $182,900 ÷ 2 = $91,450

  • $23,744(min) and $81,960(max)

  • 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

  • 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

  • Evaluate current marital assets using MA eligibility rules.

  • Total counted marital assets.


Processing Step 8

  • 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 Benefits

  • Definitions

  • Forms

  • Submissions

  • Process

  • Division of Assets


Other Asset Assessment Info

HCPM 19.45

HCPM 19.45.05

HCPM 19.45.10


Thanks!


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