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State of Maryland Medical Assistance Manual Revised April 2014

property owners under lien procedures. When the lien process is applicable to the LTC person, refer to Section 15 for specific procedures concerning the use of this form for the Medical Review process. Month of Admission For a lone person over 21 who is admitted to an LTCF on any day other than the first day of the month, the residential maintenance allowance is given to enable the person to meet financial obligations associated with living in the community, such as rent and utilities. Month of Discharge For a lone person over 21 who is discharged from an LTCF to the community, the Residential Maintenance Allowance is given to enable the person to meet expenses related to resuming community residence, such as rent and utilities. While the allowance in the months of admission and discharge is unrelated to the first circumstance described above, there is still a regulatory limit of 6 months for the residential maintenance allowance. Therefore, when a person receives this allowance in the month of admission, then presents medical documentation to support the intent to return home within 6 months, this allowance can be given for 5 additional months, for a total of 6 months. If the person receives this allowance for the maximum of 6 months, and does not return at the end of that time, the allowance cannot be given again in the month of discharge. 3. Spousal Allowance This is a deduction from the income of the institutionalized person to enable the spouse to be maintained in the community. This applies only to a legal spouse, including a spouse from whom the institutionalized person was separated prior to institutionalization. Under the Spousal Impoverishment provision, the Spousal Allowance is based on an amount related to the Federal Poverty Level for two persons. This amount is intended to meet the basic maintenance and shelter needs of the community spouse, enabling the person to maintain the living arrangement the couple had prior to the institutionalization of one spouse. If a person’s shelter costs exceed 30% of that amount, the community spouse may qualify for an excess shelter allowance in addition to the basic maintenance and shelter. The sum of the basic maintenance and shelter and the amount for “excess shelter” may not exceed the amount in Schedule MA-8. There is no limit to the amount of resources a community spouse can retain and still be eligible for this allowance. The following standards, found in Schedule MA-8, are to be used in calculating the community spousal income. 1. Basic Maintenance and Shelter (BMS); 2. Excess Shelter Standards (ESS); 3. Maximum Allowable Maintenance and Shelter Costs (MAMSC); and 4. Utility Standards (US).