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Title 8: Medicaid Page 3 Iowa Department of Health and Human Services Employees’ Manual Chapter D: Resources Attribution of Resources Revised September 13, 2024

In specific circumstances, attribution guidelines may be different:  If both spouses entered an institution but one goes home, complete an attribution for the month the spouse who remains institutionalized entered the institution.  If the previously institutionalized spouse goes home and then the community spouse enters a medical institution expecting to stay for 30 days or more, complete a new attribution for the new institutionalized spouse.  If either spouse dies in the month of application or died in the retroactive period, attribute resources for the month of entry to the institution. Use the attributed resources to determine eligibility for months the spouse was living.  If the applicant marries after entering the institution but before Medicaid eligibility is determined, complete an attribution of resources for the community spouse. Complete the attribution for the month of entry.  If a single member or a member who was widowed after the attribution marries after entering the institution and after Medicaid eligibility for institutional care has been established, do not complete an attribution. If the institutionalized spouse later becomes ineligible for Medicaid and reapplies for Medicaid benefits, complete an attribution for the month of entry. Revise attribution results when:  A final appeal establishes a greater amount of protected resources for the community spouse. See If the Applicant Appeals the Attribution Amount.  The member is later able to verify resources that were owned at the date of entry to the institution. See Calculating the Amount to Attribute to the Community Spouse.  The amount of resources used in the original attribution was not correct. If a person who requests an attribution without filing a Medicaid application fails to cooperate in determining attribution, a new determination is not necessary when you receive an IRS report. (However, do complete the attribution and consider the IRS report when the person later applies for Medicaid if you receive verification and can establish what resources existed when the person entered the institution.) Further details on the attribution procedure are organized as follows:  Resources excluded from attributions  Calculating the amount to attribute the community spouse  Processing a Medicaid application after the attribution is completed  Summary examples of attribution situations