Medical Assistance for Long-Term Care Services

2.4.2.4 Long-Term Care Facility Services

A long-term care facility (LTCF) is a place such as a skilled nursing facility, Intermediate Care Facility for the Developmentally Disabled (ICF/DD) or medical hospital in which the individual receives skilled nursing services (swing bed). Housing Support (HS) and Housing with Services Establishments are not LTCFs. For more information regarding these facility types, refer to the Minnesota Health Care Provider Manual.

There are different rules that apply to people requesting Medical Assistance for Long-Term Care Services (MA-LTC) in a LTCF depending on the person’s basis of eligibility:

People with an MA for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) basis of eligibility who have met the LTC eligibility factors are subject to an asset test and may need to contribute to their cost of care in the LTCF. The amount the person needs to contribute to the cost of care in the LTCF is based on an LTC income calculation.
- People with a community spouse are also subject to an asset assessment.
People with an MA for Families with Children and Adults (MA-FCA) basis of eligibility who have met the LTC eligibility factors are eligible for MA-LTC are not subject to an asset test and do not need to contribute to their cost of care in the LTCF.
People who are enrolled in MA-EPD and meet the LTC Eligibility Factors use the MA-ABD income methodology and are subject to MA-EPD asset limits. See EPM 2.3.5.3.1. MA-EPD Assets.

Household Composition and Family Size

Household composition means the people included in a person's household. Household composition determines the family size. Household composition and family size are factors used to determine financial eligibility.

Household composition and family size are determined for each person separately and may be different for each person on an application or in a household.

People living in an LTCF follow these household composition and family size rules:

People eligible for MA with an MA-ABD basis of eligibility have a household composition and family size of one. Only the person's assets and income are counted in the LTC calculation when determining eligibility for MA-LTC.
People with an MA-FCA basis of eligibility continue to use the same household composition and family size when they are in the LTCF, however, they do not need to contribute to the cost of care in the LTCF and are not subject to an asset test.

Legal Citations

Minnesota Statutes, section 256B.057

Minnesota Statutes, section 256B.0575