Medical Assistance for Long-Term Care Services

2.4.2.1.1 Asset Assessment (Archive)

An asset assessment is an evaluation of assets owned by a married couple when the long-term care (LTC) spouse requests Medical Assistance for Long-Term Care Services (MA-LTC) in a long-term care facility (LTCF) or through the Elderly Waiver (EW) program and is married to a community spouse. The asset assessment is also used in the Alternative Care (AC) eligibility determination.

The asset assessment documents all assets owned individually or jointly by the couple on the first day of the LTC spouse’s first continuous period of institutionalization. The couple must document and provide proof of these assets. The asset assessment is used to calculate which assets the community spouse can keep. The amount of assets the community spouse is allowed to keep is called the Community Spouse Asset Allowance (CSAA). All of the couple’s assets that do not make up the CSAA must be evaluated when determining if the LTC spouse meets the asset limit. The LTC spouse is either determined to be asset eligible for MA-LTC, or the amount of assets the LTC spouse must reduce in order to achieve asset eligibility for MA-LTC is determined.

A couple may request that the county or tribal agency complete an asset assessment even if they are not applying for MA-LTC when one spouse has or anticipates a continuous period of institutionalization. County and tribal agencies are required to complete the assessment. This will help the couple estimate how many of their assets must be spent before the LTC spouse may be eligible for MA-LTC.

When the Asset Assessment is Required

An asset assessment is required when a person, who is an LTC spouse, requests MA–LTC and all of the following conditions exist:

• the person is married. Separated spouses are still married; marriage only ends with divorce or the death of one spouse;

• the person resides in an LTCF and has lived, or a physician anticipates a person will live, in an LTCF for at least 30 consecutive days; or

• the person is requesting services through the EW or AC programs and has received a long-term care consultation (LTCC) that demonstrated the person requires an institutional level of care and the person has received, or a lead agency case manager anticipates the person will receive, EW or AC services for at least 30 consecutive days.

An asset assessment is not used to determine asset eligibility if an enrollee receiving MA-LTC marries a person who meets the definition of a community spouse after eligibility for MA-LTC is approved.

An asset assessment is not required as long as the person continues to receive MA-LTC. An asset assessment is required if a person has a break in LTC services and the county or tribal agency receives a new request for MA-LTC.

A couple is not required to complete a new asset assessment if the couple completed an asset assessment at another agency or in another state and the LTC spouse had a continuous 30-day period of institutionalization.

Whereabouts of the Community Spouse are Unknown

When an asset assessment is required and the LTC spouse does not know the whereabouts of the community spouse, they must make a reasonable effort to locate the community spouse.  

If reasonable efforts to locate the community spouse do not succeed, eligibility for MA-LTC for the LTC spouse is possible. If the spouse cannot be located, the LTC spouse must complete the asset assessment based on the information they know about the community spouse’s assets.

Asset Assessment Effective Date

The asset assessment requires an evaluation of all assets owned individually or jointly by a married couple on the LTC spouse’s asset assessment effective date. The asset assessment effective date is the first day of the LTC spouse’s first continuous period of institutionalization that has occurred on or after October 1, 1989.

Continuous Period of Institutionalization

A continuous period of institutionalization is a 30-day consecutive period in which:

• A person lives in an LTCF.

• A person has a documented need through an LTCC for services that would be provided by EW or AC.

• The person had a combination of services either provided in an LTCF or paid for by EW or AC.

• A person receives skilled nursing care in a swing bed in a medical hospital.

If the person is discharged from a hospital, the first day of the continuous period begins on the date the person was admitted to the hospital when the person:

• Is discharged directly from a medical hospital to an LTCF

• Received services that were paid for or would qualify for payment by the EW or AC programs immediately upon release from the medical hospital

Anticipated Continuous Period of Institutionalization

If the LTC spouse has not had a continuous period of institutionalization, one can be anticipated if the LTC spouse is likely to remain institutionalized. When the continuous period is anticipated, the determination for MA eligibility is not delayed. If the actual continuous period of institutionalization is less than 30 days, eligibility is not redetermined for months already approved. If the person does not complete the 30 days, the effective date is not valid for future determinations.

Verification of Asset Assessment Effective Date

The asset assessment effective date must be verified. A person should be assisted in obtaining supporting documentation if the asset assessment effective date cannot be verified with sources already available.

Assets Evaluated in an Asset Assessment

Countable assets, regardless of availability, are used to calculate the CSAA. The couple’s assets are evaluated in the asset assessment to identify countable and excluded assets. See MA for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) Excluded Assets and MA-ABD Countable Assets for more information.

• If the couple owns more than one vehicle, the vehicle with the lowest equity value is excluded (regardless of which spouse owns the vehicle).

The “Asset Assessment for Medical Assistance (MA) Payment of Long-Term Care (LTC) Services” (DHS-3340) form is used to document the couple’s assets. The couple must provide proof of the value of their assets on the asset assessment effective date, regardless of whether the asset is excluded or unavailable.

Notification Requirements

The LTC spouse, the LTC spouse’s authorized representative if applicable, and the community spouse must be notified of the results of the asset assessment. Any of these individuals may appeal the asset assessment results.

Legal Citations

Minnesota Statutes, section 256B.059

United States Code, title 42, section 1396r-5

Published:  June 1, 2016

Archived:  December 22, 2016