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State of Maryland Medical Assistance Manual Revised April 2014

Resources for institutionalized persons are evaluated in accordance with Section 800. For the purpose of assessing resources and determining resource eligibility, countable resources are those resources which are not subject to exclusion, e.g. bank accounts, non-home real property, cash, etc. Excludable resources are those resources which are not counted in determining resource eligibility. Such exclusions include the home, certain burial funds, personal effects, etc. Refer to COMAR 10.09.24.08 for countable and excludable resources. For an institutionalized person who is not married, only the resources of the institutionalized person are considered. If an institutionalized person is married and shares the same room with his/her spouse in the LTCF, their combined resources will be considered available to each other for the first six (6) months of institutionalization (beginning with the earliest month that either spouse is considered institutionalized) and the MA-2 standard for two persons will be applied. Beginning with the seventh (7th) month of institutionalization, if a husband and wife live together in the long term care facility, the resources of each will be considered separately even if they share the same room. For a person who was institutionalized prior to 9/30/89 and has a spouse living in the community, only the resources of the institutionalized person will be considered. For the persons listed above, countable resources of the institutionalized person are compared to Schedule MA-2. If countable resources are greater than the MA-2 standard, the person is not eligible. If resources are equal to or less than the standard, the person may be eligible and the person’s income must be evaluated. (f) Spousal Impoverishment Financial eligibility for these institutionalized persons is determined according to regulations for preventing Spousal Impoverishment found in COMAR 10.09.24.10-1. Spousal impoverishment provisions apply when an applicant for MA-LTC is married to a person who is living in the community—that is, not in a medical institution or a nursing facility. For an institutionalized person with a community spouse, there is a 3-step process for determining resource eligibility. 1. An assessment of the couple’s countable resources as of the beginning of the first continuous period of institutionalization; 2. An eligibility determination based on attributing a specific portion of the resources to the institutionalized spouse and a specific portion to the community spouse; and 3. A post-eligibility period during which the resources attributed to the community spouse during the eligibility determination are actually placed in the name of that spouse. A resource assessment is an evaluation of the couple’s total combined resources as they existed at the beginning of the first continuous period of institutionalization. This assessment may be made prior to application for Medical Assistance at the request of either spouse or a representative. Upon admission, a nursing home is required to advise the client and family that a resource assessment is available upon request. The client and family should further be informed that the assessment is a necessary part of the Medical Assistance eligibility determination process. Should