Page 9

F-115.2.7 Separate Treatment of Resources After Eligibility is Established During the "continuous period" of institutionalization and after the customer has been determined eligible, no resources of the community spouse are available to the customer, unless actually made available to the customer. If the community spouse in an ongoing case passed away, the only assets available to the institutionalized spouse are items received by a will after an order of the probate court, or anything held in joint tenancy. F-115.2.8 Undue Hardship An undue hardship determination may be requested at any time when applying spousal impoverishment rules, transfer of asset provisions, or when applying the home equity interest provision. If undue hardship is claimed as a result of a denial of eligibility for excess resources under spousal impoverishment rules, the applicant may be determined eligible, despite having excess resources, if all of the following conditions exist: 1. The institutionalized spouse is otherwise eligible for Medicaid without applying spousal impoverishment rules; and 2. The community spouse is the sole owner of liquid resources or non–liquid joint resources valued in excess of the federal maximum; and 3. The community spouse has refused to make the resources available to the institutionalized spouse; and 4. The institutional spouse has insufficient funds to cover the cost of institutionalized care; and 5. Without Medicaid, the institutionalized spouse would go without life sustaining medical care as determined by an individual licensed to practice medicine in the State of Nevada. NOTE: Undue hardship requests must address each point above. Send undue hardship requests to the Chief of Eligibility and Payments for evaluation and decision. F-115.2.9 Additional Resources Following Initial Eligibility If the institutionalized spouse acquires a new countable resource following the initial eligibility determination, his/her resource eligibility must be re–evaluated. Determine how much of the spousal protected resources (Line II "e") was used to transfer resources in the community spouse's name only. If there is a balance remaining, more resources countable to the institutionalized spouse can be protected for the community spouse so the institutionalized spouse remains resource eligible. Determine if the spousal protected resources have an unused balance in an amount equal to or more than the new resource. If not, and the excess of resources is over the resource limit, terminate Medicaid coverage allowing for adverse notice. If the balance of the spousal protected resources is enough to cover the new resource, apply the transfer to community spouse provisions as outlined in this section. F-115.2.7 LONG TERM CARE SERVICES Division of Social Services Medical Assistance Manual 08 Aug MTL 08/25 Separate Treatment of Resources After Eligibility is Established