Mr. and Mrs. Bird have been living in their own home. On 12/9/2000, Mrs. Bird is admitted to a nursing home. Mr. Bird contacts the Department on 4/5/2001 and requests an assessment of their resources. The worker completes Form IM-73. Total resources owned as of 12/2000 are $10,000. Since $10,000 is less than the minimum amount for 2000, the minimum amount is used. The amount reserved for the community spouse is always at least the minimum. Form IM-73 is signed by Mr. Bird (Mrs. Bird is unable to sign). Two copies are given to Mr. Bird and one is retained for the Department record.
Since the client is already within resource limits, an application for AABD/MA is completed on 4/5/2001. The worker also completes Form IM-74. The community spouse reserved amount is $10,000 and the applicant's share is $0. Resources consist of -
| Community Spouse Allowance | Alternate Care Spouse | |||
|
Savings Account #1 |
$ 8,500 |
|
|
|
|
Checking Account #2 |
$ 1,500 |
|
|
|
|
TOTAL |
$10,000 |
TOTAL $00 |
|
|
(Rev. August 1, 2001)