SUMMARY CHART FOR INSTITUTIONAL INCOME ELIGIBILITY PROCESS
STEP
TANF/SSI Related
DETERMINE
COMPARE TO
IF BELOW
IF ABOVE
1
SSI related
Gross income
Medicaid SIL
Eligible for CN and institutional care. Go to Step 3.
Go to Step 2 ***
TANF related
Countable income *
TANF grant payment standard
Eligible for CN and institutional care. Go to Step 3.
Go to Step 2
2
SSI related and TANF related
Countable income *
Facility's private rate and client's recurring medical expenses
Eligible for institutional care. Go to Step 3 to determine if MN with or without spenddown.
Not eligible for institutional care. Determine MN eligibility as if living in own home.
3
SSI related and TANF related
Available income **
Facility's DSHS contracted rate
Eligible for CN or MN without spenddown
Must spenddown to be eligible for MN
The NF is "locked-in" and must accept the DSHS contracted rate, instead of private rate from the client.
* Determine countable income by subtracting exemptions and disregards from gross income.
** Determine available income by adding income disregarded in Steps 1 and 2 back in to countable income then deducting post-eligibility income allocations and exemptions].
*** If married with community spouse, redetermine income eligibility using "community income" rule.
Modification Date: October 28, 2007
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