8140 Treatment of Resources and Income - The general guidelines of 5200 and 6100 are applicable to persons in institutional arrangements. The following additional rules must also be considered.
8141 Initial Resource Test - When a husband or wife enters a medical institution (whether or not the facility is Medicaid approved) on or after September 30, 11,020 for at least 30 consecutive days and the temporary stay policy of 8113 is not applied, the total value of the resources owned by the couple which exceed the community spouse resource allowances as determined in accordance with 8144.1 below shall be considered available to the institutionalized spouse in determining eligibility (including prior eligibility) regardless of which spouse owns the resources and regardless of whether the spouses intend to divide resources under the spousal impoverishment provisions. This provision is also applicable regardless of any previously established prenuptial or postnuptial agreement or court-ordered divisions of martial property. The combined resources of the couple must be considered despite such agreement.
If the value exceeding the community spouse resource allowance is less than or equal to the allowable 1 person resource level described in 5130, the person in the institution is eligible. In the month following the first month of eligibility, only those resources owned by the institutionalized spouse shall be considered for determining continuing eligibility on his or her case. This may result in ineligibility for the following months unless the couple intend to transfer assets under the spousal impoverishment provisions.
If the value exceeding the community spouse resource allowance is more than the allowable 1 person resource level, the person shall not be eligible until such time that the excess falls below the 1 person resource standard. At that point, the person becomes eligible for the month the excess is reduced. For the following months, only the resources owned by the institutionalized spouse shall be considered on his or her case. This may result in ineligibility for those months as indicated above.
The institutionalized spouse shall not be rendered ineligible because of the initial resource test if the agency initiates legal action in court against the community spouse for failure to make those resources in excess of the resources allowable available to the institutionalized spouse. The institutionalized spouse shall also not be rendered ineligible because of this initial resource test if denial of eligibility would result in an undue hardship. This could include instances in which the community spouse is refusing to make resources he or she owns available to the institutionalized spouse and the above-mentioned support proceeding has not been initiated or where the couple has a substantial outstanding debt which must be met through those resources currently available to them. If undue hardship is claimed, it must be referred to the Area EES Program Administrator for decision in consultation with the EES Policy Section.