Emily Anderson

Emily Anderson

Emily Anderson.

Using Emily’s case documentation, answer each of the following questions to help you determine the appropriate income calculation.

1. Is Emily residing in an LTCF or requesting services through a waiver?

She resides in an LTCF.

2. When was Emily admitted to the LTCF?

Based on the information found in the “Admission Information” section of the Physician Certification Form (DHS-1503) from Abbott Northwestern/Sister Kenny, Emily was admitted to the hospital on the second of last month (LM/02/YY) and began receiving skilled nursing facility services on the twelfth of last month (LM/12/YY) there. She entered Bethany Covenant Home on the fifteenth of last month (LM/15/YY). She is expected to remain in the LTCF for over 180 days.

3. When will MA-LTC begin for Emily?

The Application for LTC Services (DHS-3531) was submitted today. On the application she requested one month of retroactive coverage. Determine eligibility for MA-LTC beginning on the twelfth of last month (LM/12/YY) as she began receiving skilled nursing facility services on that date and she is requesting MA-LTC coverage for last month.

4. Does Emily have a community spouse?

Based on the DHS-3531, Emily is widowed and does not have a community spouse.

5. Will Emily use an LTC income calculation?

Yes, Emily will use an LTC income calculation, because she resides in an LTCF. All LTCF residents use an LTC income calculation.

6. What income calculation will you use for this month?

Begin using the LTC income calculation this month (the month after LTC services begin) because Emily is residing in an LTCF and does not have a community spouse.

7. What income calculation will you use for last month?

Use an MA Method B community income calculation for last month because Emily has an age 65 or over basis of eligibility and the LTC income calculation will not begin until the month after she enters an LTCF because she does not have a community spouse.

To Do: Update your version of Emily’s DHS-5590 (MA-LTC Case Checklist) with the income calculation begin and end dates for the types of income calculations she will be using.

Page 2

Types of Income Calculations - Caseload Activity

«Back | Next»

Skip to content subnavigation Questions? | Policy Manual | Training Information

Skip to content subnavigation
Questions? | Policy Manual | Training Information