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Asset Assessments

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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  1. Asset Assessments Judie Hughes DHS Health Care Training

  2. Topics • Purpose and Benefits • Definitions • Forms • Submissions • Process • Division of Assets

  3. Purpose • Avoid spousal impoverishment • Determine counted assets for the spouse requesting MA-LTC

  4. Benefits • Protects assets for spouse not requesting MA-LTC • Reduces amount of counted assets for the spouse requesting MA-LTC

  5. Process Overview • Identify and verify marital assets • Determine protected and counted asset totals for both spouses • Divide assets

  6. Community Spouse • Legal spouse of a LTC spouse • Not residing in LTCF or receiving services through a waiver

  7. LTC Spouse • Legal spouse of a community spouse • Meets continuous LTC/EW period

  8. Continuous LTC/EW Period • 30-consecutive days through: • Residence in LTCF • Receipt of services covered by EW or AC after an LTCC

  9. LTC Facility • Medical hospital • Nursing facility • ICF/MR • MA-covered be in RTC

  10. Name that Spouse Example 1 LTC Spouse: Community Spouse: Betty Barney

  11. Name that Spouse Example 2 LTC Spouse: Community Spouse: Neither Neither

  12. Name that Spouse Example 3 LTC Spouse: Community Spouse: Mindy Mork

  13. Name that Spouse Example 4 LTC Spouse: Community Spouse: Neither Neither

  14. Name that Spouse Example 5 LTC Spouse: Community Spouse: Raymond Debra

  15. Name that Spouse Example 6 LTC Spouse: Community Spouse: Neither Neither

  16. Community Spouse Asset Allowance (CSAA) • Calculated share of assets attributable to the community spouse. • Used to determine LTC spouse total counted assets.

  17. Forms • DHS-2908 • DHS-3340 • DHS-3340A • DHS-1503 • DHS-5181

  18. Submissions • Required when an LTC spouse requests MA-LTC • Optional at time of first continuous LTC/EW

  19. Review • Protects marital assets • Reduces counted assets • Continuous LTC/EW period • Required at application • Optional for an estimate

  20. Processing Step 1 Determine the asset assessment effective date.

  21. 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

  22. 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

  23. 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

  24. 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

  25. 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

  26. Effective Date Example 6 • Hugo entered LTCF January 19. • Dottie LTCF July 1 – August 15. • Hugo requests MA-LTC September 10. None

  27. Case Scenario LTC Spouse? Community Spouse? Required? Ida Effective Date? Ida Hardy No August 15, 1999

  28. Processing Step 2 Request completion of the DHS-3340.

  29. Case Scenario Hardy and Ida submitted a completed DHS-3440 on November 15, 1999.

  30. Processing Step 3 Evaluate marital assets following asset assessment rules.

  31. Processing Step 4 Determine the total counted marital assets.

  32. Case Scenario Total marital assets = $349,400 Total excluded assets = $166,500 Total counted assets = $182,900

  33. Processing Step 5 Determine the community spouse asset allowance. a. Divide total countable assets by 2. b. Determine minimum and maximum asset allowance figures.

  34. 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

  35. 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

  36. Processing Step 6 Enter the asset assessment results into MAXIS ASET. TE02.13.57

  37. Processing Step 7 Complete and send the DHS-3340A. Send additional notice with instructions if processing at MA-LTC approval

  38. Processing Step 8 At MA-LTC determine counted assets attributable to the LTC spouse.

  39. 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.

  40. 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

  41. Processing Step 8 • Evaluate current marital assets using MA eligibility rules. • Total counted marital assets.

  42. 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

  43. Case Scenario Counted assets = $91,800 CSAA = $91,450 Ida’s counted assets = $350

  44. Processing Step 9 Set DAIL/WRIT for 60 days prior to the first annual renewal month.

  45. Don’t forget… Case note!

  46. Verification • At initial submission • At time of request for MA-LTC • At the first annual renewal

  47. Division of Assets • Divide so each asset is in one spouse’s name • No transfer penalty • Verify legal transfer made

  48. 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.

  49. Wrap - Up • Purpose and Benefits • Definitions • Forms • Submissions • Process • Division of Assets

  50. Other Asset Assessment Info HCPM 19.45 HCPM 19.45.05 HCPM 19.45.10

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