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524 (07/2026) Chapter 2:Eligibility • Section 10: Long-Term Care (LTC) services made good-faith efforts to reach them to gather information, and all attempts have failed.
Examples of good-faith efforts include attempting to contact the spouse through all possible means – friends, family, last known phone/address, employer, social media, Google, etc.
Efforts to reach the spouse should be documented in case notes and attempted prior to contacting policy. • The spouse can be reached but refuses to cooperate or provide information. • The individual is incapacitated and unable to attempt contact, and there is no one to do so on their behalf. Some things to consider when omitting the spouse from the case: • Workers will leave the marital status as married and make detailed case notes so that the Estate Administration Unit (EAU) will know there is a spouse when the time comes. • There will be no Community Spouse Resource Allowance (CSRA) calculation or 90-day transfer window, meaning applicant’s countable resources in excess of $2,000 limit must be converted or otherwise spent down prior to approval. • There will be no Community Spouse Income Allowance (CSIA) deduction to reduce liability. • There will be no automatic primary residence exclusion of the home in which the spouse resides. Be sure to verify whether the home is jointly owned • APD Policy approval is required Community spouse resource allowance (CSRA) This applies to: • An institutionalized spouse who has applied for benefits because the spouse is in or will be in a continuous period of care. • An individual in a nonstandard living arrangement who becomes legally married following the initial approval for service benefits • MAGI-based long-term care recipients who might require OSIPM based long-term care at some point. Continuous period of care means the individual will reside in a nursing facility, home and community-based care setting, or an acute care hospital for at least 30 days or until death. There must be sufficient evidence to show there is a reasonable expectation the individual will remain in care for at least 30 consecutive days. An interruption in care that lasts less than 30 days is not considered a break in the 30 consecutive days of care. A new period of care begins if care is interrupted for 30 days or more. When determining the continuous period of care, home and community-base care settings are Title XIX services needed to keep an individual out of a nursing facility or intermediate care facility for people with intellectual disabilities. These services include: • In-home services, except for state plan personal care services • Residential care facility services • Assisted living facility services • Specialized living facility services • Adult day care services