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If the community spouse dies prior to an eligibility decision, spousal impoverishment rules do not apply. Treat the case as a non-spousal case and apply patient liability rules accordingly for all requested months of coverage. If the institutional spouse dies prior to an eligibility decision, spousal impoverishment rules do apply. Treat the case as a spousal case from the date of application through the date of death of the institutional spouse. Obtain verification of the community spouse's gross income and housing costs. • If income verifications are not received by the required date, the case will be completed without allowing a maintenance allowance. • If verification of housing costs and/or utility expense is not received, compute the spousal income allowance without it. • Notify the customer on the Notice of Decision, that patient liability was determined without a maintenance allowance deduction. If verifications are received after the patient liability has been determined, the maintenance allowance deduction will be allowed beginning the month the verification was received. The community spouse monthly income allowance deduction will be discontinued if the agency receives information that the community spouse is not receiving the maintenance allowance. F-120.1 Treatment of Income, Deductions and Expenses The division of income policy DOES NOT APPLY when determining patient liability. Consider all income the payor designates as the institutionalized spouse’s income when determining patient liability, unless otherwise excluded. When determining patient liability for initial and ongoing cases, budget income for the month received and deductions/expenses for the month they are paid and/or incurred. With receipt of unanticipated income, adjust patient liability for the month it is received, not to exceed the actual cost of care for the month. If the payor designates payment to both the institutionalized and community spouse, consider one-half of the income available to each of them. If the payor designated payment in the names of the institutionalized and community spouse, or both, and to another person(s), consider the income available to each person in proportion to the person’s interest. If payment is made with respect to both spouses and no such interest is specified, one-half of the joint interest shall be considered available to each spouse. If the customer has a court order granting a spousal maintenance allowance, a copy of the order must be sent to the Chief of Eligibility and Payments for a decision on whether the Division of Social Services (DSS) can recognize the order. The response from the Chief takes precedence. F-120 LONG TERM CARE SERVICES Division of Social Services Medical Assistance Manual 08 Aug MTL 08/25 PATIENT LIABILITY