PM 07-02-22
- Determine the Community Spouse Resource Allowance (CSRA) using the nonexempt resources shown on Determination of Resource Allowance (HFS 3190). To exclude a nonexempt resource, it must be transferred to the community spouse or to another person for the sole benefit of the community spouse.
- Send the HFS 3190 with the notice of decision. The HFS 3190 informs each spouse:
- of the amount of nonexempt resources the LTC spouse may transfer to the community spouse;
- the LTC spouse may transfer personal effects, household goods, and one motor vehicle in addition to the CSRA; and
- the LTC spouse is allowed one year from the month of application to make the transfer; verify whether or not the transfer was completed no later than the first scheduled redetermination after that year.
Enter Code 715 in Item 91 of form 552 showing the amount of resources the person intends to transfer as the CSRA. If zero, enter 0.00.- Enter Code 716 in Item 91 of form 552 showing the actual amount of resources transferred as the CSRA. If zero, enter 0.00.
Example 1: Mr. G resides in a long term care facility. Mrs. G lives in their home in the community. Mr. G's resources are a $35,000 certificate of deposit. Mrs. G's resources are a $10,000 savings account.
Becasue Mrs. G's resources are below the community spouse resource allowance of $109,560, Mr. G can transfer his resources to her to bring her up to the CSRA. In this case, Mr. G can transfer all of his resources to Mrs. G without affecting eligibility. All of the couple's resources ($35,000 + $10,000 = $45,000) are attributed to Mrs. G, so there are no available resources to affect Mr. G's eligibility. Mr. G must actually transfer the resource to Mrs. G.
Example 2: Using the same situation as above, Mr. G has a $91,000 Certificate of Deposit. Mrs. G has a $20,000 certificate. Subtracting Mrs. G's $20,000 from the $109,560 resource allowance leaves $89,560. Mr. G can transfer $89,560 of his $91,000 certificate to Mrs. G, without affecting his eligibility. Mr. G states that he intends to transfer this amount. This leaves Mr. G $1,440 in nonexempt resources, which is less than the $2,000 resource disregard. The FCRC approves Mr. G's case with no countable resources.
Appeal of Community Spouse Resource Allowance (CSRA)
Example 1: Mr. A resides in a nursing home and has monthly income of $700. Mrs. A lives in the community and has monthly income of $1000. Mr. A's resources total $135,000 in certificates of deposit. Mrs. A's resources consist of a $10,000 savings account.
The FCRC correctly determines that Mr. A may transfer up to $99,560 ($109,560 - $10,000 = $99,560) to Mrs. A as the CSRA.
An appeal is filed for an increase in the CSRA. The appellant claims the amount determined is not enough to raise her gross income to the maximum amount permitted as the Community Spouse Maintenance Needs Allowance (CSMNA) ($2,739 - $1,000 = $1,739).
At the appeal hearing, the appellant provides a quote from an insurance company. It shows that the purchase of a $128,000 single premium life annuity would provide fixed monthly payments of $1,739.
The appeal decision directs the FCRC to increase the maximum amount permitted as the CSRA from $109,560 to $128,000. The FCRC is also directed to count the fixed monthly annuity payment amount of $1,739 as available to the community spouse, whether or not the annuity is purchased.
The FCRC determines that Mr. A may transfer up to $118,000 ($128,000 - $10,000) to Mrs. A as the increased CSRA. Mr. A has excess resources of $15,000 ($135,000 - $118,000 = $17,000 - $2,000 disregard = $15,000).
Treat the $1,739 monthly annuity payments as available to the community spouse, whether or not the annuity is purchased, the month following the month the resources are transferred.
Recalculate the amount permitted as the CSMNA the month following the month the resources are transferred. With the annuity payments treated as available, the community spouse has monthly income of $2,739 ($1,000 + $1,739). This is the maximum amount permitted as the CSMNA. Therefore, do not permit a deduction for the CSMNA.
Example 2: In the above example, Mr. A's resources total $135,000 in certificates of deposit. Mrs. A has a $10,000 savings account.
At the appeal hearing, the appellant provides a quote indicating that the purchase of a $160,000 annuity would provide monthly payments of $1,739 ($2,739 - $1,000 = $1,739). Since this amount is greater than the amount of resources owned by the client ($135,000) and community spouse ($10,000), the appellant must provide a quote of the monthly annuity payments based on the purchase of a single premium life annuity using available assets.
The appellant provides a quote from an insurance company. It shows that the purchase of a $145,000 single premium life annuity would provide monthly payments of $980.
The appeal decision directs the FCRC to increase the maximum amount permitted as the CSRA from $109,560 to $145,000. The FCRC is also directed to count the monthly annuity payment amount of $980 as available to the community spouse whether or not the annuity is purchased.
Since the client's resources ($135,000) are less than the amount permitted as the increased CSRA ($145,000), the FCRC determines that Mr. A may transfer up to the entire amount of $135,000 to Mrs. A.
Treat the $980 monthly annuity payments as available to the community spouse, whether or not the annuity is purchased, the month following the month the resources are transferred.
Recalculate the amount permitted as the CSMNA the month following the month the resources are transferred. With the annuity payments treated as available, the community spouse has monthly income of $1,980 ($1,000 + $980 = $1,980). Therefore, Mr. A may divert up to $759 ($2,739 - $1,980 = $759) monthly as the CSMNA.
Example 3: Mrs. B resides in a nursing facility and has monthly income of $900. Mr. B lives in the community and has monthly income of $1,600. Mrs. B's resources consist of $120,000 in a savings account. Mr. B's resources consist of a $10,000 money market account.
The FCRC correctly determines that Mrs. B may transfer up to $99,560 ($109,560 - $10,000 = $99,560) to Mr. B as the CSRA.
An appeal is filed for an increase in the CSRA. The appellant claims the amount determined is not enough to raise the community spouse's gross income to the maximum amount permitted as the CSMNA ($2,739 - $1,600 = $1,139).
At the appeal hearing, the appellant provides a quote from an insurance company. It shows that the purchase of a $95,000 single premium life annuity would provide fixed monthly payments of $1,139.
The appeal decision does not allow an increase in the maximum amount permitted as the CSRA. The resource allowance standard of $109,560 is greater than the amount needed ($95,000) to raise the community spouse's gross income to the amount permitted as the CSMNA. Therefore, an increase in the CSRA is not permitted. The FCRC determination that Mrs. B may transfer up to $99,560 to Mr. B as the CSRA is upheld.
Do not consider any monthly annuity payments as available to the community spouse unless actually purchased.
