Provider Notice issued 12/13/12

Increase in Prevention of Spousal Impoverishment Standards

This is to inform you that standards for the prevention of spousal impoverishment effective January 1, 2013 will remain the same as those put in place July 1, 2012. Effective January 1, 2012 these amounts were increased but later decreased, effective July 1, 2012 as a result of the SMART Act, to the amounts in place in calendar years 2009, 2010, and 2011.

The term "spousal impoverishment" includes the standards for the Community Spouse Resource Allowance (CSRA) and the Community Spouse Maintenance Needs Allowance (CSMNA). The prevention of spousal impoverishment standards should be included in the oral and written information that must be provided to residents and potential residents about how to apply for and use Medicaid benefits. Facilities are required by federal regulations (42 CFR 483.10) and state statute (210 ILCS 45/2-211) to give an explanation of resident rights at the time of admission and at least annually thereafter.

The CSRA standard will remain $109,560. This is the maximum amount of resources a resident may transfer to a community spouse or to another for the sole benefit of a community spouse. The actual amount a resident may transfer is determined by deducting non-exempt resources of the community spouse from the standard of $109,560.

The CSMNA standard will remain $2,739. This is the maximum amount of monthly income a resident may give to a community spouse. The actual amount a resident may give is determined by deducting any gross income of the community spouse from the standard of $2,739.

Facilities may print brochure, HFS 3191, Nursing Home Services and Information for Couples, which gives additional information relating to the prevention of spousal impoverishment.

If you have any questions concerning this notice, contact the Bureau of Long Term Care at 217-524-7245.

Theresa A. Eagleson, Administrator

Division of Medical Programs