(Revised 8/1/05 ML #2981)
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Amended IM 5242
Amended Attachment IM 5242
IM 5242
(N.D.A.C. Section 75-02-02.1-24(2))
At the beginning of the first continuous period of institutionalization, or receipt of HCBS, an institutionalized spouse, a HCBS spouse, or a community spouse may request an assessment of their assets.
The asset assessment establishes the spousal share, the community spouse asset allowance, and the amount of assets that must be spent down before Medicaid eligibility can begin.
If an asset assessment is not completed at the time of the first continuous period of stay by the institutionalized or HCBS spouse, the couple may later provide verification of the assets they had at that time. Only consider those countable assets that the couple can verify as owning at that time to establish the community spouse asset allowance.
Distribution of the asset assessment form requires that one copy be sent to each spouse, one copy be sent to the Economic Assistance division, and one copy is retained at the county. Economic Assistance can be contacted for a copy of the asset assessment if the institutionalized, or HCBS, spouse applies in the future and the county in which the application is filed does not have a copy.
The assessment of assets is completed using Form SFN 200, "Asset Assessment" (05-100-65). The asset assessment must include all of the couple's assets owned jointly or individually.
Part II of SFN 200, "Asset Assessment," must be completed within thirty days of receipt of the completed Part 1. The file must include documentation of all assets.
