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 1.Identify and verify marital assets 2.Determine protected and counted asset totals for both spouses 3.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

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

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

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

15. Name that Spouse Example 6 LTC Spouse: Community Spouse: 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? a.Half of total countable assets $182,900 ÷ 2 = $91,450 b.$23,744(min) and $81,960(max) c.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 a.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 b.Evaluate current marital assets using MA eligibility rules. c.Total counted marital assets.

42. Processing Step 8 d.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

51. Thanks!