PA 1572 is the resource assessment form that a married Medical Assistance applicant should complete when he or she moves into a skilled nursing facility. If a skilled nursing facility resident applies for long term care Medicaid benefits in Pennsylvania, completion of PA 1572 is a requirement.
This resource assessment form will determine how much of a married couple’s total resources can be protected and how much must be spent down before the institutionalized spouse (the spouse in the nursing home) can qualify for Medicaid.
What is PA 1572
PA 1572 is the form given to any married person when they are admitted to a skilled nursing facility. This resource assessment form is not an application for Medicaid. However, the form is arguably more significant than the PA 600 L, which is the application for long term care benefits in Pennsylvania.
The PA 1572 is part of the Admissions Notice Packet (MA 401) that is provided to every person when they are admitted to a long term care facility. This form can be completed by the individual admitted to the facility, a family member, friend, or representative.
The resource assessment requires that the applicant and the spouse report their resources. The spouses must report their resources based on one of the following dates: 1) the date one spouse is admitted to a LTC facility and is applying for Medicaid; 2) the date one spouse is admitted to LTC for a continuous period of at least 30 days; or 3) the date the spouse is assessed functionally eligible for HCBS.
PA 1572 is a critical part of the Medicaid application process and arguably more significant than the actual application because the form determines the spousal share of the community spouse (the spouse not admitted to the nursing home).
What is the spousal share?
The spousal share is the dollar value of resources protected for the community spouse. The spousal share is also referred to as the community spouse resource allowance, or CSRA.
The maximum amount the community spouse can keep is currently $119,220. The minimum CSRA is $23,844.
When an application for long term care benefits is submitted, the County Assistance Office will use the CSRA determined by the resource assessment form as the dollar amount protected for the community spouse.
The spousal share is determined by the total countable resources that the applicant and spouse own and have access too. The spousal share, or community spouse resource allowance, is determined as follows:
1) Determine the total countable resources of the married couple as of the “snapshot” date. The snapshot date is the date the institutionalized spouse is admitted to the nursing home. The worker determining the spousal share will not examine if resources are owned by one spouse or another. The total combined resources are considered.
2) The total countable resources will then be compared to the minimum and maximum community spouse resource allowance.
If the total resources are less than $23,844, then the community spouse can keep all of the resources. If total resources are $47,688, then the community spouse may keep the minimum.
In order for the spousal share to be $119,220, the total countable resources must be double that number. In other words, for the CSRA to be $119,220, the countable resources must be at least $238,440.
If 50 percent of the total countable resources exceed the minimum but are less than the maximum, the spousal share will be half of the countable resources. For example, if the total countable resources are $100,000, the community spouse resource allowance will be $50,000.
We recommend speaking with an attorney before completing the PA 1572 and particularly if the total countable resources total more than $50,000.
What else should I know about PA 1572?
PA 1572 should be completed immediately. The sooner the resource assessment is completed, the better. It will likely be easier to gather the necessary documentation and obtain an accurate accounting of resources at the snapshot date then many months or even years later. Additionally, establishing the protected amount and the spend-down amount will help the attorney to better plan for eventual eligibility and asset preservation.
Do not spend down resources to qualify for Medicaid before the spouse is admitted to the nursing home. Wait until admission and the PA 1572 is provided before beginning a spend-down. Any resources used before admission to the skilled nursing facility will not be part of the spousal share. This is a serious mistake that must be avoided.
Do not let anyone, including someone from the nursing home, tell you that community spouse IRA or the primary residence is used to determine the CSRA. This is incorrect. If you are unclear about the Medicaid rules and what the spouse not in a nursing home is entitled to keep, contact an attorney before spending down resources.
After the spousal share is determined using the PA 1572, the community spouse can request an increase.
If the community spouse resource allowance is above the minimum amount as determined by PA 1572, a spend-down of resources is necessary for Medicaid eligibility.
However, proven Medicaid planning solutions exist that can save families tens of thousands of dollars. Before undertaking an expensive and unnecessary spend-down by private paying for care, please contact VA Legal Team. We offer a free consultation.