Changing the LTC Needs Allowance

Although a client moving between an LTCF and SIS-EW continues to use an LTC income calculation, the needs allowance must be updated.

• If an MA-LTC client moves from an LTCF to the community and is SIS-EW, change the needs allowance to the SIS-EW maintenance needs allowance for the month after discharge from the LTCF).

Example:

Nicole is an MA-LTC enrollee residing in an LTCF.   The personal needs allowance is currently being deducted on LTC income calculation. On April 8, Nicole is discharged from the facility.  She will continue receiving LTC services through the EW at home.  Her income is below the SIS. 

Action:

Change Nicole’s needs allowance from the personal needs allowance (which you will learn about shortly) to the SIS-EW maintenance needs allowance for the month of May (the month after Nicole is discharged from the LTCF).  

• If an MA-LTC client who is SIS-EW moves into an LTCF, change the needs allowance to the appropriate needs allowance for the month following the month the client moved into the LTCF. 

Example:

Viseth is an MA-LTC enrollee receiving services through the EW.  His income is below the SIS.  On October 30, he enters an LTCF where he is expected to reside permanently.

Action:

Change Viseth’s needs allowance from the SIS-EW maintenance needs allowance to the personal needs allowance for the month of November (the month after Viseth enters the LTCF).  (Though this change is after 10-day notice cutoff for November, as you will learn, the LTC income calculation can be adjusted without regard to 10-day notice.)