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Effective: August 1, 2007 |
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19.45ar2 - Asset Assessments (Archive) |
Archived: February 1, 2008 |
An asset assessment, completed for MA only, is a snapshot, or summary, of all non-excluded assets owned by a married couple on a specific date, which is based on the first continuous care period.
Determining the Asset Assessment Effective Date.
When Is an Asset Assessment Required?
The following definitions will be used throughout this section of the manual. These definitions can also be found in the glossary.
Long-Term Care Facility (LTCF) :
A place such as a nursing facility, intermediate care facility for persons with mental retardation or related conditions (ICF/MR), medical hospital, or an MA-covered bed in the Regional Treatment Center (RTC).
A person who resides in a medical or nursing facility or who receives EW services and is expected to remain in the facility or receive EW services for at least 30 consecutive days and who is married to a community spouse.
A person who does not reside in a medical institution, LTCF, or receive Elderly Waiver (EW) services whose spouse does reside in a medical institution, LTCF, or receives EW services and meets the definition of a LTC Spouse. A community spouse may or may not receive MA.
Long-Term Care Consultation (LTCC):
A screening program that prevents inappropriate nursing home or boarding care placement. LTCC was formerly known as the Pre-Admission Screening Program (PAS).
A continuous care period is a 30 consecutive day period of time in which a person is expected to stay in a medical or LTC facility or receive home and community-based services that are included in EW. Begin counting the 30 consecutive days from:
l The date of entry in a medical or LTC facility.
l The date home and community-based services begin.
The federal Medicaid program calls this the Continuous Period of Institutionalization.
The asset assessment is determination of assets owned by a married couple on the first day of a spouse’s first continuous LTC/EW period.
The goal of the asset assessment is to estimate the amount of assets each spouse can retain when the LTC spouse applies for MA, which may be days or years after the first continuous LTC/EW period.
Couples are strongly encouraged to complete the Asset Assessment Form (DHS-3340) as close as possible to the first day of the first continuous LTC/EW period, so that documenting assets they own will be at its easiest.
Asset assessment policy is applied to married people when one spouse either:
l Begins a continuous LTC/EW period, in any state, anticipated to last 30 consecutive dates or more, on or after October 1, 1989.
l Meets both of the following conditions:
n Was screened by the LTCC team on or after July 1, 1991.
n Was receiving, or is anticipated to begin receiving, home and community-based services within 90 days of the LTCC screening and the services will continue for at least 30 consecutive days.
Determining the Asset Assessment Effective Date
The effective date of the asset assessment, which is the date the ”r;snapshot” of non-excluded assets is taken, is the first day of the earliest continuous LTC/EW period for either spouse in one of the following situations:
l Admission to a medical hospital.
l Admission to a nursing facility.
l Receipt of home and community-based services that would be covered by the EW or AC program, or the LTCC date, whichever is later. Receipt of home and community-based services means that the person meets all of the following:
n Requires a nursing home level of care.
n Is at risk of nursing home placement.
n Is receiving specific services that would be paid for by EW or AC if the person was otherwise eligible for EW or AC. The services must be provided by a licensed person who is qualified to provide those services.
Note: If the services have not begun prior to the LTCC date, they must begin within the period of time covered by the LTCC.
The continuous LTC/EW period is calculated by counting the date of entry and the date of discharge to determine whether a stay has lasted at least 30 consecutive days.
The asset assessment effective date does not change from the first continuous LTC/EW period.
Example:
Josie, age 50, and Vinnie, age 45, are married. Josie enters a LTCF on June 10 for rehabilitation after knee surgery. She is discharged home on July 1. Josie then enters the same LTCF on September 1 for rehabilitation from surgery on the other knee. She is discharged home on October 15. Josie, who thinks she is having an unlucky year, enters a different LTCF on December 26 after falling and breaking her hip. She is discharged home on January 28. Josie does not plan to apply for MA any time soon because her private health insurance is covering her medical expenses.
Action:
The asset assessment date is September 1, which is the first day of her first 30 consecutive days of LTC/EW services. Josie can choose to complete the asset assessment prior to her MA application, or can wait until she applies for MA.
Although a new continuous LTC/EW period begins after a client re-enters an institution after having been discharged for at least 30 consecutive days, the date of the asset assessment is the first day of the first continuous LTC/EW period.
When Is an Asset Assessment Required?
Require an asset assessment for married couples at the time of application for MA if an effective date can be determined and an assessment was not previously completed in any state, or if a previously completed assessment is not available.
The same asset assessment will be used at every application.
Provide the Asset Assessments for Medical Assistance form (DHS-3340) for the client to complete if one has not been completed prior to MA application.
The asset assessment can be completed prior to MA application, if requested by the LTC spouse or the community spouse and an effective date can be anticipated.
l If an asset assessment is completed and a continuous LTC/EW period is not met, the assessment cannot be used. A new assessment will need to be completed when the continuous LTC/EW period is met.
Example:
Norman is admitted to a medical hospital on June 2. On July 7 he enters an LTCF directly from the hospital for convalescent care. He is discharged home on October 10. He does not apply for MA for any part of this period. On November 2 he is readmitted to the LTCF. His wife remains in the community. They apply for MA for Norman on September 15 of the next year.
Action:
The effective date of the asset assessment is June 2. The asset assessment will be based on all assets owned on that date. Norman and his wife must complete the asset assessment with the MA application in order to have eligibility determined.