IM-143 December 5, 2022; IM-130 December 21, 2021; IM-168 December 11, 2020; IM-163 November 26, 2019; IM-68 December 10, 2018; IM-161 December 21, 2017; IM-01 January 4, 2017; IM-05 January 15, 2015; IM-115 December 13, 2013; IM-112 December 28, 2012; IM-102 December 3, 2008; IM-116 December 7, 2007; IM-112 December 14, 2006; IM-145 December 1, 2005; IM-127 December 2, 2004
The following briefly describes the four steps to determine resource eligibility for an institutionalized spouse based on a division of assets.
- Assessment: At the beginning of the first continuous period of institutionalization beginning on or after September 30, 1989 or receipt of HCB Waiver Services on January 1, 1993 or after, the community spouse, the institutionalized spouse, or a representative acting on behalf of either member of the couple, may request an assessment of the couple’s assets. Determine the equity value of the non-exempt assets for the month in which the first continuous period of institutionalization begins. Assessments evaluate non-exempt assets in the month in which the first continuous period of institutionalization begins regardless of when a request for assessment is made.
Complete only one (1) assessment per case. If the institutionalized spouse leaves the nursing facility and subsequently returns, use the assessment completed for the beginning of the first continuous period of institutionalization that began on or after September 30, 1989 to determine vendor eligibility.
- Spousal Share: Compute the spousal share that is one-half of the couple’s non-exempt assets but not less than the minimum and not more than the maximum spousal share amounts as shown on MHABD Appendix J.
- The minimum and maximum spousal share amounts are increased each January in accordance with the increase in the Consumer Price Index.
- Disregard of Spousal Share: When making an initial vendor eligibility determination for an institutionalized spouse during a continuous period of institutionalization, determine the equity value of the non-exempt assets owned by the couple. Disregard the amount of the spousal share in determining resource eligibility for the institutionalized spouse provided the institutionalized spouse intends to transfer assets to the community spouse if necessary for continued eligibility. The resource maximum for the institutionalized spouse is the maximum for a single person.
NOTE: Division of Assets affects only vendor or HCB cases. A Division of Assets does not affect eligibility determinations for Supplemental Nursing Care (SNC), MHABD Spenddown, MHABD Non Spenddown, or TWHA. SNC and non vendor programs do not allow for a disregard of spousal share in determining eligibility even though an individual residing in a non MO HealthNet certified bed in an Intermediate Care Facility or a Skilled Nursing Facility may qualify for a Division of Assets.
- Transfer of Assets: Once vendor eligibility is established, the institutionalized spouse must transfer to the community spouse sufficient assets so the assets in the name of the institutionalized spouse are less than the resource maximum for a single person.
After vendor eligibility is established, assets in the name of the community spouse are not considered available to the institutionalized spouse (1030.035.15 Assessment of Assets).