December 1973 Eligibility Requirements Manual – Table of Contents

1040.020.40.10 Periods of ineligibility when both spouses are institutionalized

IM-42, June 23, 1994

Whenever a penalty period is assessed to either member of a couple, the period applies to whichever one of the couple becomes institutionalized.  If only one member of the couple is institutionalized, the period is calculated and applied in the same manner as though the institutionalized person were single. However, if at any time during the penalty period both members of the couple should become institutionalized, the remaining penalty period must be proportioned between them.  Divide the remaining penalty period by two.  If the remaining penalty period before dividing is an even number of months, the spouses will have an equal number of months in their respective penalty periods.  If the remaining penalty period before dividing is an odd number of months, arbituarily assign the extra month to one or the other spouses.

If a penalty period applies while both spouses are institutionalized but one spouse then leaves the facility or dies, the remaining penalty period must be applied in its entirety to the remaining institutionalized spouse.

If neither spouse is institutionalized, the penalty period runs in the same manner as though applied to a single institutionalized person.

Example:  Emile and Carlotta Guitterez are married.  Carlotta transfers property to her niece in June 1994, incurring a penalty period of 38 months, ending in July 1997.  Emile becomes institutionalized in October 1994.  Because of Carlotta’s transfer, Emile is ineligible for vendor benefits.  The notice to Emile should include the months for which he is ineligible, a statement that any transfers made by either spouse, may affect applications by either spouse, and that this or other penalty periods may change if Carlotta should require nursing care or HCB services.  The legal citation remains 208.010 RSMo.

In November 1995, in the 18th month of the penalty period, Carlotta also becomes institutionalized and applies for benefits.  20 months of the penalty period remain.  It is divided equally between them.  Emile and Carlotta each remain ineligible for vendor benefits for 10 more months, through September 1996.  The notice to Carlotta should include the months for which both she and Emile are ineligible, citing 208.010 RSMo.

Example:  Sam and Irma Goldberg gave away property in April 1994, enough to incur a period of ineligibility of 42 months.  In June, they both enter a nursing facility.  Two months of the penalty period had passed prior to their entry into the nursing facility, leaving 40 months (since neither was institutionalized for those two months).  Each is ineligible for vendor benefits for 20 months.

Eight months later, Sam dies.  Between the two spouses 16 more months of the penalty period have been used. Irma remains ineligible for 24 more months.