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). For more information regarding these facility types, refer to the Minnesota Health Care Provider Manual Intermediate Care Facilities (ICF/DD) and Swing Bed Hospital Services.

An MA enrollee who is absent from a LTCF on a leave day is still considered to be residing in a LTCF.
Housing Support and Housing with Services Establishments are not LTCFs

Household Composition and Family Size

Financial eligibility rules vary depending on MA basis of eligibility when a person who resides in a LTCF and meets the LTC eligibility factors, requests Medical Assistance for Long-Term Care Services (MA-LTC). The varying rules for household composition and family size, contribution to the person’s cost of care, type of income calculation used, and the program asset limit that applies are in the chart below.

	Household composition and Family Size	May need to contribute to cost of care	Income Calculation used	Asset limit
MA for People Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD)	Household of 1 (no deeming)	Yes	LTC income calculation (to determine LTC spenddown)	Yes, MA-ABD asset limit. If married then also subject to an asset evaluation.
MA for Employed Persons with Disabilities (MA-EPD)	Household of 1 (no deeming)	No	ABD income methodology (to determine premium amount)	None
MA for Families with Children and Adults (MA-FCA) no medical spenddown	FCA household composition determines family size if temporary stay. Household of 1 (no deeming) if their stay in the LTCF is permanent.	No	None. No contribution toward cost of care	None
MA-Families and Children with a Medical Spenddown	Household of 1 (no deeming)	Yes	LTC income calculation (to determine LTC spenddown)	Yes, MA-Families and Children with a Medical Spenddown asset limit. If married then also subject to an asset evaluation.

Legal Citations

Code of Federal Regulations, title 42, section 435.726

Code of Federal Regulations, title 42, section 435.733

Code of Federal Regulations, title 42, section 435.735

Code of Federal Regulations, title 42, section 435.832

Minnesota Statues, section 256B.057