Both Spouses Residing in LTCF

In situations where both spouses of a married couple reside in an LTCF, allow the spouse who will be returning to the community within the three consecutive calendar months to use the home maintenance allowance. The other spouse may use either of the Veteran’s Improved Pension or Personal Needs Allowance based on which one is applicable.

Example:

Colten requests MA payment of LTC services and is approved eligible for the month of July. His wife is already a permanent resident of the LTCF. There is no one currently living in their home. Colten is expected to be discharged home in September.

Action:

Allow Colten to use the home maintenance allowance for August, the only month he is using an LTC income calculation (he does not have a community spouse), because:

He resides in an LTCF.
He is expected to return home in less than three consecutive calendar months.
He maintains a home in the community.
No one is living in the home.

Note: While Colten is a resident of the LTCF his wife may not allocate any of her income to Colten because he is not a community spouse.

In a situation in which both spouses are admitted to an LTCF on the same day, only one spouse can receive the home maintenance allowance. Determine which spouse will receive the home maintenance allowance based on what is most advantageous to the clients. Consider who has enough income to allow and when each person is anticipated to be discharged.