PM 15-04-04-a
Refer to Record a Diversion wizard for instructions on entering the spousal maintenance needs allowance income diversion.
NH/SLF cases
- Verify income of the community spouse (see PM 08-02-00).
- Enter the community spouse and institutionalized spouse's income in IES. Review the IES wizards Complete Income Questions and Record a Diversion for further instructions.
- To figure the amount of the Community Spouse Maintenance Needs Allowance (CSMNA), subtract the spouse's gross income from the maintenance needs standard. The difference is the amount of the deduction.
- Allow the maximum amount of the deduction as figured in the IES calculation unless notified by either spouse of a different amount.
- The amount of diversion is calculated and displayed on the EDG summary under the group care credit (GCC) tab.
- Send the 360C notice of decision.
NOTE: The HFS 2500 form only needs to be sent if the 360C doesn't display the correct group care credit calculation.
Example: Mr. A resides in a long term care facility (NH or SLF) and receives RSDI of $3,500 per month and a pension of $1,250 per month. Total monthly income is $4,750. Mrs. A resides in the community and receives RSDI of $630 per month.
For this case, the CSMNA is $3223.50 ($3853.50 - $630). Therefore, $3,223.50 is deducted as the CSMNA. The amount of $3,223.50 is not available to apply to the cost of long term care if it is given to the community spouse. $1526.50 (total income minus CSMNA amount) is available to apply to the cost of long term care.
Medical cases applying for or receiving services through the DoA HCBS waiver
Example 1: Mrs. B lives in the community and receives DoA HCBS waiver services. Monthly non-SSI income is $800 per month. Mr. B lives in the community and does not receive DoA HCBS waiver services. Total monthly income is $900 per month.
For this case, the Community Spouse Maintenance Needs Allowance (CSMNA) is equal to the maintenance needs standard of $3,853.50 less gross monthly income of the community spouse ( $3,853.50 - $900 = $2,953.50). Since this amount is greater than the client's total non-SSI income, enter the amount diverted on Form 2382A. The actual amount of diversion is $800, which is equal to the DoA spouse's income.
