COMMUNITY SPOUSE BECOMES INSTITUTIONALIZED
MANUAL REVISION #3: 1030.035.15.03, 1030.035.36
Once an institutionalized spouse is determined Medicaid eligible the
subsequent institutionalization of the community spouse has no effect on
the original institutionalized spouse’s eligibility, unless the community
spouse applies for Medicaid. This policy is based on a Missouri Court of
Maples v. Department of Social Services
When a community spouse enters a Medicaid certified Nursing Facility bed,
do not deactivate the assessment of assets nor count the community spouse’s
resources as available to the institutionalized spouse if:
This revision does not change the definition of a community spouse. Continue to follow the current instructions on assessing assets, establishing the spousal share, permitting transfer of assets to the community spouse, and determining eligibility should the community spouse apply for assistance.
Under the previous policy, staff deactivated the assessment case if the community spouse became institutionalized. Staff then counted all resources to include those owned solely by community spouse and covered by the spousal share. If resources exceeded the $2000 married couple maximum, the institutionalized spouse’s continued vendor eligibility ended.