The Spousal Assessment of Assets

Rich Shea — Tue, 16 Mar 2010 13:19:15 +0000

How will you be able to survive if your spouse needs expensive nursing home care? I hear this question a lot from families facing an unexpected nursing home placement. Unfortunately some families that contact me have already spent more of their own funds than they need to before qualifying for Texas Medicaid nursing home benefits. For the families that contact me early enough to protect assets for the healthy spouse or parent the process all begins with something called the “Spousal Assessment.”

The Spousal Assessment for Texas Medicaid is rather straightforward. It is a snapshot of a married couple’s combined countable resources. This snapshot is the starting point for determining the amount of assets the spouse at home will be able to keep while the spouse in the nursing home pursues Medicaid eligibility. The Spousal Protected Resource Amount is later determined from this initial assessment which many people do not even understand is taking place behind the scenes.

When Can You Initiate a Spousal Assessment

The request and assessment may be made any time from the beginning of the continuous period in an institutional setting to the date of application for Medicaid. Ordinarily this is handled by the Woodlands Medicaid Attorney handling the application for the family.

If you do not have a Woodlands Medicaid Attorney representing you then the couple must provide information on their resources and verification as required by HHSC. If the couple does not provide the verification within the time frame requested by HHSC, HHSC does not complete the assessment and takes no further action = no Medicaid benefits.

When is the Assessment Date

The couple’s combined countable resources are assessed as of 12:01 a.m. on the first day of the month in which the first continuous period in an institutional setting began. When determining the first day of the month in an institutional setting for the Spousal Protected Resource Amount, HHSC may count days the person spent in a hospital if the person admits directly from the hospital to an institutional setting. After the continuous period begins, hospital stays and therapeutic home visits are not considered as breaks in the 30-consecutive-day period.

Are You Giving Away Assets You Can Keep?

The Spousal Assessment procedure is a reminder of how important it is to understand the legal rights you have when faced with a nursing home situation. As I mentioned at the beginning, some families do not contact me until it is too late and they have already spent more than they need to. In situations like that, the family voluntarily gave up assets the healthy spouse was entitled to and it can make surviving that much more difficult for the healthy spouse when they are left with less assets than the law allowed them to keep. Don’t make the same mistake. Speak with a Texas Medicaid Attorney today to protect your rights and property.

TexasTitle19.com is your connection to an experienced Houston Medicaid Attorney who can help you find the right nursing home, get the best care, and pay for it all without going broke. We are currently focused on Harris and Montgomery Counties, including the areas of Houston, Conroe, The Woodlands, Spring, Tomball, Humble, and Katy. We also provide consulting services throughout all of Texas.

The Spousal Protected Resource Amount

The Spousal Protected Resource Amount

Rich Shea — Fri, 16 Jan 2009 13:44:11 +0000

This is the first in a series discussing the key terms and principles you will encounter when applying for Texas Medicaid nursing home benefits. We will begin with the SPRA, or Spousal Protected Resource Amount.

The Spousal Protected Resource Amount refers to the value of assets the “community spouse” is allowed to keep while the institutionalized spouse remains eligible for Texas Medicaid nursing home benefits. The “community spouse” refers to the spouse remaining in the home that is not receiving Medicaid benefits.

The starting point to determine the value of the SPRA is one-half of the married couple’s non-exempt assets valued as of the first day of continuous institutionalization. That figure is then either increased to $21,912 or decreased to $109,560 (as of 1/1/09).

It doesn’t end there however. While it may appear that the at-home spouse can only keep a maximum of $109,560 in non-exempt assets while the institutionalized spouse qualifies for Texas Medicaid nursing home benefits, there is another opportunity to increase the SPRA. That opportunity comes in the form of a Fair Hearing.

The Fair Hearing is your chance to protect more of your assets if certain conditions are met. It is important to note that the social worker assigned to your case does not have the authority to increase the SPRA, only the Fair Hearing Officer has the authority if you satisfy your burden of proof.

The SPRA is one of the items you’ll be focusing on if your spouse needs to qualify for Texas Medicaid nursing home benefits and alternative asset protection strategies are not available. Make sure your Texas Medicaid Attorney is prepared to protect your rights if your spouse needs nursing home benefits.

Miller Trust Texas | Houston Medicaid Attorney » spra

The Spousal Assessment of Assets

The Spousal Protected Resource Amount