PM 07-02-22: Community Spouse Resource Allowance

WAG 07-02-22

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. New textUse this amount for applications received on or after 07/01/12. This amount also applies at the first redetermination after 07/01/12 when determining if the CSRA was transferred as the customer or his/her representative indicated at intake. 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, Revised textif he or she chooses, is allowed to do so until the first redetermination after one year following the month of application. 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. New textDo not review the community spouse's resources at redetermination except of verify transfer up to to the CSRA. Verification of the CSRA transfer at first redetermination involves verifying the change in ownership of only the resources reported at intake unless there is evidence that one or both spouses failed to accurately report resources at intake. Resources acquired, transferred, etc. by the community spouse after initial determination are not subject to review.

New textNote: If the community spouse acquires a resource (such as an inheritance) after initial eligibility is determined, it does not affect the CSRA which was previously established and the new resource is not available to the LTC spouse. If the LTC spouse receives a resource after eligibility is determined, it cannot be transferred to the community spouse even if the transfer would bring resources of the community spouse up to the maximum CSRA amount. If, after eligibility is determined, a resource is received by the couple (not legally owned by one or the other alone), half of the resource belongs to the community spouse and the other half is available to the LTC spouse.

In addition to the CSRA amount, a customer 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 Revised textresources or transferred resources, the customer is ineligible. New textBoth the applicant and spouse must cooperate by providing information about resources owned by either or both spouses.

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 New textbut the ownership of the resources has not been changed, 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.