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Aged, Blind and Disabled Manual Policy Manual Number: 125.015 Section: Institutional Medicaid Chapter: Resource Assessment

January 5, 2026 Division of TennCare 2 A resource assessment can only be completed upon receipt of all relevant documentation of resources and, for HCBS cases, an approved PAE. All of the countable resources owned individually or jointly by both spouses are counted; resources excluded under the ABD Countable and Excluded Resources policy are not counted in the resource assessment. Only one resource assessment must be completed for a married couple.

b. Who is Required to Have a Resource Assessment A resource assessment is required for all individuals applying for Institutional Medicaid who have a legal spouse living in the community, whose whereabouts are known. If an estranged community spouse refuses to cooperate with providing verifications of assets owned by either spouse, the community spouse should be notified of the State’s requirement to determine the applicant’s resource amount and spousal allocation for resources owned by the applicant and the community spouse. Undue hardship may be requested with the Undue Hardship Waiver Form. TennCare staff should contact the Eligibility Policy Unit for further guidance in these cases. If the community spouse lives out of state, the resource assessment is required if the community spouse can be located and the couple is still legally married.

The resource assessment and Community Spouse Resource Maintenance Allowance (CSRMA) may be allowed if a couple is still legally married, but living separately and consider themselves separated, if the whereabouts of the community spouse are known or he can be located.

c. Request Time Frame For residents in a medical institution, the resource assessment may be requested at the time of admission whether or not the resident is applying for TennCare. For individuals seeking HCBS, a resource assessment cannot be requested until an approved PAE is received. A resource assessment can be requested for individuals seeking HCBS, even if a TennCare Medicaid application has not been filed. Generally, it may be to each spouse’s benefit to have the assessment done at the time of admission, even if no concurrent application for TennCare Medicaid is made, since the availability of documentation at this time may result in the protection of a greater amount of assets for the community spouse. Under no circumstances can a resource assessment be completed prior to the first period of continuous confinement.

If the request for the assessment is delayed until the time of application, the assessment will be done retroactively to the first period of continuous confinement, but the results may be limited by the availability of documentation. When a TennCare Medicaid application is made, the results of the assessment are used as part of a formula to determine how much of the total assets may be protected for the community spouse. The remaining resources after allocation to the community spouse are considered available to the institutionalized individual.

If it is discovered at application, or at any time after the assessment is completed, that not all resources were reported or known, the assessment is recalculated. Resources available at the