State-specific · State Medicaid agencies
Documentation establishing the Community Spouse Resource Allowance (CSRA) and Monthly Maintenance Needs Allowance (MMNA) protecting the non-institutionalized spouse's assets and income.
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Submit to the state Medicaid agency with the LTC Medicaid application
Provide to your Medicaid caseworker
Filing Deadline
Submit with the LTC Medicaid application. The snapshot of community spouse assets is taken as of the date of institutionalization (or the first continuous period of institutionalization).
Processed as part of the LTC Medicaid application (45-90 days). A separate Community Spouse Resource Assessment can be requested at any time after institutionalization.
The state determines the Community Spouse Resource Allowance (CSRA) — the amount of assets the community spouse can retain. The state also determines the Community Spouse Monthly Income Allowance (CSMIA) from the institutionalized spouse's income. Excess resources must be spent down before Medicaid eligibility is established.
MDS 3.0 · CMS
Standardized health status screening and assessment tool required for all residents of Medicare/Medicaid-certified nursing facilities. Used for care planning and Medicare payment calculation. Must be completed within 14 days of admission and periodically thereafter.
State-specific · CMS / State Medicaid agencies
Federally mandated preadmission screening for all individuals entering Medicaid-certified nursing facilities to identify those with mental illness, intellectual disability, or related conditions who may need specialized services.
State-specific · State mental health / developmental disability agencies
Comprehensive evaluation for individuals identified in Level 1 screening. Determines if nursing facility placement is appropriate and what specialized services are needed.
State-specific · State Medicaid agencies
Application for Medicaid coverage of nursing facility care. Includes detailed financial disclosure of income, assets, and transfers. A five-year look-back period for asset transfers applies.
State-specific · State Medicaid agencies
Documentation of all asset transfers in the 60 months (5 years) before Medicaid application. Uncompensated transfers may result in a penalty period of Medicaid ineligibility.
Insurer-specific · Private LTC insurance carriers (partnership states)
Application for a qualified state LTC partnership insurance policy. Allows the policyholder to protect assets equal to benefits received when applying for Medicaid. Available in most states.
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