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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 8 TPAES. Mr. Smith receives $800/month in Social Security benefits and $200/month in pension. Mrs. Smith has no income. Mrs. Smith’s total shelter cost is $500 per month and she receives the Standard Utility Allowance ($311). Her calculated CSIMA is $2,232. Mrs. Smith is allocated all of Mr. Smith’s income (less $70 Personal Needs Allowance (PNA) as the applicant is in a nursing facility), which is $950. Given that the income allocation is less than the CSIMA, there is an income shortfall of $1,282.

The Smiths have $260,000 in combined countable resources. Mrs. Smith receives the maximum resource allocation of $123,600. The remaining $136,400 is available to Mr. Smith. Given that Mr. Smith’s resources exceed the $2,000 resource limit, Mr. Smith is resource-ineligible for TennCare Medicaid.

The Smiths appeal the TennCare Medicaid denial on the basis of Mrs. Smith’s income shortfall as the community spouse. An appeals hearing officer determines that the CSRMA, in relation to the amount of income it generates, is insufficient to raise the community spouse’s available income to the Maintenance Needs Standard, and that additional resources above the CSRMA are needed in order to make up the shortfall. The CSRMA can then be overridden by the appeals hearing officer.

Note: For HCBS cases, the process is the same as in the above example, except the PNA is 300% of the Federal Benefit Rate (FBR). The community spouse of an individual receiving HCBS services may be eligible to receive an additional resource allocation when monthly income does not meet the Maintenance Needs Standard.

8. Transfer of Assets for Less than Fair Market Value (FMV) A transfer of assets for less than FMV is not considered to have occurred when resources are transferred from the institutionalized individual to the community spouse or vice versa in accordance with a completed resource assessment. This also holds true for any spouse-to-spouse transfers that take place after September 30, 1989. There will be no penalty applied for transfers between spouses after that date.

Should the spouse who received the allocation according to the resource assessment then transfer the resource to someone else for less than FMV, the transfer will not be treated as a transfer of assets since the resources of a couple are treated separately after the establishment of Institutional Medicaid eligibility.

Transfer of assets for less than FMV is considered part of the application process whether or not a resource assessment has been requested previously or is requested at application. Transfer of assets is not considered if only a resource assessment is requested (no TennCare Medicaid application filed concurrently). See Transfer of Assets and Penalty Periods policy.