Mr. and Mrs. Jones have been living in their own home. On 11/19/99 Mr. Jones is admitted to a nursing home. On 3/26/2000 Mrs. Jones contacts the Department and requests an assessment of their resources. The worker completes Form IM-73 and determines what total countable resources were at the time Mr. Jones entered the nursing home. The total resources as of 11/99 are $500,000. The maximum community spouse allowance in 1999 was the amount listed in (469-000-205). Form IM-73 is signed by both Mr. and Mrs. Jones. Each is given a copy and a copy is retained for the Department record.
On 6/5/2000 Mr. Jones returns to the home with his wife. The assessment completed for 11/99 becomes invalid.
On 1/24/2000 Mr. Jones is readmitted to the nursing home. The assessment completed on 111/99 is again valid.
(Rev. August 1, 2001)