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resources is conducted to determine the amount allocated to the non-LTSS or “community” spouse. For the purposes of this Part, the point of continuous LTSS (formerly referred to as the point of continuous institutionalization (POCI)) is: 1. Health institution – The first (1st) day of the month in which the LTSS applicant or beneficiary began to receive or is determined to have a need for services in a health institution that is expected to last for thirty (30) consecutive days or longer going forward. 2. Home and community-based services – The first (1st) day of the month that the State or its contractual agent determines, based on an assessment as defined in Part 5 of this Subchapter, that a person who has submitted a completed application for Medicaid LTSS requires or is receiving at least monthly one (1) or more of the Medicaid LTSS covered services identified in Part 10-1 of this Chapter. C. The CSRA assessment is optional for LTSS recipients in health institutions before applying for Medicaid and mandatory for all couples at the time of application without regard to the type of Medicaid LTSS they are seeking – that is, in a health institution or home and community-based setting (HCBS). 1. Optional, preliminary CSRA for LTSS in health institutions – At the beginning of a continuous period of LTSS in a health institution, either spouse, or a representative acting on behalf of either spouse, may request a preliminary CSRA assessment. The optional CSRA assessment serves only as a snapshot of the couple’s joint resources at the point in time in which it is completed. A CSRA is performed again, at the time of application, in most instances. a. Purpose. The optional assessment calculates the total value of the couple’s combined countable resources, owned either jointly or separately, as of the date on which continuous LTSS in the health institution began. The purpose of this assessment is to provide the couple with the information necessary for their financial planning in anticipation of Medicaid eligibility. b. Requirements. An application for Medicaid is not required in conjunction with the optional assessment. Accordingly, information for this CSRA is not verified. The State bases the assessment on information provided through attestations and any documents that may be submitted in conjunction with the request for the CSRA. A letter is sent to the person requesting the CSRA assessment by the State indicating the outcome. c. Limits. Due to federal requirements, the optional CSRA is not available for persons receiving long-term care in a HCBS setting until they have applied for Medicaid LTSS. The CSRA for a