Mr. and Mrs. Edwards have been living in their own home. On 10/15/2000 Mr. Edwards enters a nursing home. On 1/20/2001 Mrs. Edwards contacts the Department to request an assessment of their resources. The IM worker completes Form IM-73 and determines what total countable resources were at the time Mr. Edwards entered the nursing home. The total of all resources owned as of 1/20/2001 is $60,000. Each of the Edwards is entitled to $30,000 in resources. The minimum and maximum amounts to be used are at 469-000-205.
Mrs. Edwards provides the IM worker with verification that total resources owned in 10/2000 were $65,000. The spousal reserved amount is $32,500. On Form IM-73 the Edwards resources as of 10/2000 consisted of -
|
Certificate of Deposit #1 |
$25,000 |
|
Certificate of Deposit #2 |
$25,000 |
|
Stocks ABC Company 100 shares worth $100 per share |
$10,000 |
|
Bond E |
$ 5,000 |
|
TOTAL |
$65,000 |
Form IM-73 is completed and signed by both Mr. and Mrs. Edwards, a copy is given to each, and a copy is retained for the Department's record. $32,500 is reserved for the community spouse (Mrs. Edwards).
On 5/1/2001 Mrs. Edwards requests an application for AABD/MA for Mr. Edwards, who is still residing in the nursing home. The worker completes Form IM-74. Resources owned at the time of application are $36,500, which include the $32,500 community spouse allowance plus $4,000 for the alternate care spouse.
On Form IM-74 the Edwards' resources as of 5/1/2001 consist of -
| Community Spouse Allowance | Alternate Care Spouse | ||
|
Certificate #4 |
$10,000 |
Savings #5 |
$4,000 |
|
Bond E |
$ 5,000 |
|
|
|
Stocks ABC Company 100 shares worth $100 per share |
$10,000 |
|
|
|
Savings Account #5 |
$ 7,500 |
|
|
|
TOTAL |
$32,500 |
|
|
Mr. Edwards meets all other eligibility requirements. The AABD/MA application for Mr. Edwards is approved with a medical effective date of 5/1/2001; Mr. Edwards’ nursing home care is paid for 4/1/2001 as are all other medical bills. Notice is sent advising him of the date of eligibility and also notifying him that he has 90 days from the date of the notice to complete the transfers of ownership so that only $4,000 in resources remain in his name.
On 6/28/2001, Mrs. Edwards provides the worker with verification that Mr. Edwards’ name has been removed from the CD, bond, stocks, and savings account #5. They put his $4,000 into a new account, savings account #6.
(Rev. August 1, 2001)