Resource level required for spouse to live in community must be determined using reasonable method.

Topic: Public Health, Decided by Judge Miller 
Docket Number: ***** , Decision Date: 2016-08-18 
Attachment: Click here to download the decision. 

A nursing home resident and his spouse, who resided in the community, were denied Nursing Home Medicaid because their combined resources exceeded program limits.  Federal law allowed for redetermination of the resource limit where it was necessary to allow the community spouse to generate sufficient income.  However, federal authority only instructed the state to use reasonable methods in recalculating the resource limit.  Accordingly, the Court remanded the case to the Division of Family and Children Services with directions to apply a reasonable method for redetermining the resource limit.  The Court noted that this reasonable method could account for reinvestment of the resident’s and community spouse’s assets into investment vehicles that yielded greater income.


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