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State of Maryland Medical Assistance Manual Revised April 2014

the assessment be requested prior to application, it will be done by the Office of Eligibility Services (OES). A fee will be assessed for this service. When a person applies for Medical Assistance, the CM must ask the applicant or representative if an assessment has been done. If it has, the LDSS must request a copy of the assessment from the OES by name and social security number of the applicant. Request a copy even if the A/R has a copy of his /her assessment notification. The assessment may be appealed at the time of the notification of the eligibility determination. If an assessment was not made prior to application for Medical Assistance, the CM must make the assessment. There can be no charge for this, as it is part of the eligibility determination. Resources must always be assessed as they existed at the beginning of the first continuous period of institutionalization, regardless of when the assessment is actually made or by whom. To assess a couple’s resources: 1. Determine when the first continuous period of institutionalization began. To decide this, the following questions will need to be answered: • When was the person first admitted to the LTCF? • Was the person admitted from the community or as a transfer from another LTCF? If a transfer, when was the admission to the first LTCF? • If the person was admitted from an acute care hospital, was he/she in LTC immediately preceding the hospitalization? If so, when was the person admitted to that facility? For an applicant who has been recently institutionalized, this information should be readily available from the documents obtained during the eligibility determination process. For a person who has paid privately for some time, a more thorough inquiry must be made to accurately determine the month the first continuous period of institutionalization began. 2. Determine the couple’s total combined countable resources as they existed in the month that the first continuous period of institutionalization began. • The same rules used to determine resource eligibility are applicable in the assessment. • All non-excludable resources owned by either or both spouses are included in the assessment. 3. Once the value of the couple’s total combined countable resources has been determined, divide this figure by two. The result, one half of the total, is the Spousal Share. This share remains unchanged throughout the continuous period of institutionalization, even though the amount of total resources may change. Once the spousal share has been established, either by the Office of Eligibility Services or the CM, the appropriate amount to attribute to each spouse must be decided upon. (At this point, the amount attributed to either spouse is unrelated to actual ownership of the resources. For example, jointly held resources may be entirely attributed to one spouse, or resources held in the husband’s name only may be attributed to the wife.) The purpose of attributing resources is to