Page 5

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

January 5, 2026 Division of TennCare 5 b. Refusal of CSRMA A community spouse who receives Families First (FF), Supplemental Nutrition Assistance Program (SNAP) benefits, Supplemental Security Income (SSI), TennCare Medicaid, Veterans Affairs (VA) pension, Qualified Medicare Beneficiary (QMB) benefits, or other needs-based assistance may accept or decline all, some or none of the CSRMA if the allocation would cause the loss of or decrease in those program benefits. If the community spouse accepts only a portion of the CSRMA, the remainder amount is counted as part of the institutionalized spouse’s resources.

c. CSRMA Examples Example 1: The combined resources of Mr. and Mrs. Smith total $27,000. The total divided by 2 equals $13,500. Mr. Smith’s, the community spouse’s, share of the total resources is the required minimum ($26,076 for 2021). This leaves $924 available to the institutionalized spouse. Mrs. Smith is resource-eligible for Institutional Medicaid.

If the resources determined available to the institutionalized spouse exceed the $2,000 resource limit, the institutionalized individual is not eligible until resources are within allowable limits. See the ABD Countable and Excluded Resources policy.

Example 2: The combined resources of Mr. and Mrs. Revco total $54,000. The total divided by 2 equals $27,000. Since one-half of the total is above the required minimum for 2021, Mrs. Revco’s share equals $27,000. This leaves $27,000 available to the institutionalized spouse. Mr. Revco must decrease his share of the resources to $2,000 in order to be resource-eligible. When total resources do not exceed $29,000 ($27,000 + $2,000), Mr. Revco will be resource eligible.

6. Resource Transfer as a Result of Assessment a. CSRMA “Grace Period” Sometimes a legal transfer of resources must occur to effectuate the results of a resource assessment (e.g., separating commingled funds, removing a spouse’s name from a resource, establishing separate bank accounts). Following a resource assessment and initial approval of eligibility, resources must be transferred within 12 months of the approval. Both spouses must agree to the transfer in order to use the institutionalized spouse’s share in determining her eligibility. The transfer may require conveyance of resources from the institutionalized individual to the community spouse, or vice versa.

b. Transfer Refusal When the community spouse refuses to transfer resources to the institutionalized individual, the institutionalized spouse may still be eligible if the Eligibility Appeals Unit finds that undue hardship circumstances exist.