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Louisiana Medicaid Eligibility Manual Eligibility Determinations

Reissued March 18, 2025 Replacing March 5, 2024 Page 4 of I-1660 Revised/added text indicated by underscore Deleted text indicated by “”

● At the time a Medicaid application is made ** for each New Admission to an institutionalized setting.

Note: If an application for Medicaid is not made at the time of admission to the institution and the assessment is not completed at the time of admission, the assessment at the time of the Medicaid application shall be based on resources at the beginning of the most recent continuous period of institutionalization.

When an assessment is done prior to application, compare the countable resources at application to the resources of the institutionalized spouse as determined in the resource assessment. Refer to I-1664, Resources Assessment. Evaluate any significant difference as a transfer of resources for less than Fair Market Value (FMV). Refer to I-1670, Transfer of Resources for Less than FMV.

Note: When a couple requests an assessment and no application, an application form is not required. Verify ownership interest and current value of resources. If necessary documentation and/or verification is not provided timely, notify the couple in writing that the assessment cannot be completed.

The couple who is not applying has no right to appeal a resource assessment decision. As a part of Patient Rights, nursing homes are required to advise all new admissions of their right to request an assessment of couple resources. Although it is not required that either spouse apply for assistance, they shall be encouraged to apply to protect the date of application and to provide appeal rights. Advise the couple that they will also be required to meet all other applicable eligibility factors.

I-1664 RESOURCE ASSESSMENT PROCEDURES

Complete a resource assessment for the couple as of the first day of the month of the most recent new admission to the LTC/HCBS/ACH facility as follows:

Determine the separate assets of the community spouse, separate assets of the institutionalized spouse and shared assets of the couple.