The Community Spouse Resource Allowance (CSRA) applies to all LTC customers with a community spouse, including those who live in NHs or SLFs and those applying for or receiving DoA HCBS waiver services.
The CSRA is the portion of total non-exempt resources owned by the LTC spouse, the community spouse, or jointly by both, which may be transferred to the community spouse. The CSRA must be directly available to the community spouse or to another person for the sole benefit of the community spouse. The CSRA, up to $109,560, is not considered available to pay for the care of the LTC spouse. After subtracting the CSRA from the total non-exempt resources of the LTC spouse and the community spouse, the remainder is available to pay for care of the LTC spouse.
The LTC spouse is not required to transfer his or her resources up to the CSRA to the community spouse but is allowed one year from the month of application to do so if he or she chooses. No later than the first redetermination following that year, verify whether or not the transfer was completed. If the LTC spouse has not transferred the resources to the community spouse, the resources are considered available to the LTC spouse.
In addition to the CSRA amount, a client is allowed to transfer, for the sole benefit of his or her spouse: personal effects, household goods, and one motor vehicle, regardless of their dollar value.
If the community spouse fails to disclose information about his or her assets, do not allow a CSRA and consider all assets available to pay for the LTC customer's care.
If the community spouse begins receiving DoA HCBS waiver services or becomes a resident of an NH or SLF, do not allow the CSRA. If the CSRA has already been determined, discontinue the transfer.
Notify each spouse of the amount of nonexempt resources available to the community spouse and the amount remaining to pay for care of the LTC spouse.
The CSRA is an amount not to exceed $109,560 except as specified below.
The amount allowed as the CSRA may exceed the resource allowance standard of $109,560 only in the following situations:
- a court order establishes a different resource allowance; or
- an appeal decision determines that the transfer of income-producing resources in excess of the standard CSRA is needed to raise the community spouse's income to the maximum amount permitted as the Community Spouse Maintenance Needs Allowance (CSMNA) (see PM 15-04-04-a).
Appeal of Community Spouse Resource Allowance (CSRA)
The appeal decision bases the amount of an allowable increase in the CSRA on the cost of a single premium life annuity with fixed monthly payments. These payments are equal to the amount needed to raise the community spouse's income to the maximum amount permitted as the Community Spouse Maintenance Needs Allowance (CSMNA). See PM 15-04-04-a. Diversion of income from the client as the CSMNA is not considered in the appeal decision.
The appellant must provide a quote of the cost to buy the single premium life annuity. The quote must be from a company that offers annuities. If resources are less than the amount needed to buy the annuity, the appellant must provide a quote of the monthly annuity payments using available resources.
The appeal decision informs the FCRC of the amount to permit as the CSRA and of the amount of the fixed monthly annuity payments to treat as available to the community spouse, whether or not the annuity is purchased.
The actual purchase of the annuity is not required. Count the monthly amount the annuity would pay as available to the community spouse, starting with the month following the month the resources are transferred. The monthly amount the annuity would pay is fixed and does not change.