When applying for long-term care Medicaid, there will be an analysis to determine if the applicant is eligible. Is the applicant medically and financially eligible? For the financial piece of the analysis, there are strict rules regarding how many assets an applicant can have and still qualify for long-term care Medicaid benefits, such as nursing home care or care provided in the community under a Medicaid waiver. But as of what date should the state conduct this financial analysis of assets? This date is called the “snap-shot” date.
How does the applicant know when the snap-shot date is? Federal law (42 US 1396r-5 (c)) dictates that the snap-shot date is the first day that the applicant was institutionalized for 30 consecutive days. “Institutionalized” could mean either a hospital stay, nursing home stay, or combination of both. But the stay must have been 30 days consecutively, with no interruption.
Some states interpret the federal rule differently. Some states say that the snap-shot date is the first day of the month in which the 30 days of institutionalization began. Other states use the actual date of the first day of the 30 days of institutionalization.
There was a recent New Jersey case that analyzed what the snap-shot date would be in a particular situation. In S.W. v. Cumberland County Board of Social Services, the New Jersey Dept. of Human Services determined that the snap-shot date to determine eligibility for Medicaid was the time at which the Petitioner was determined eligible for the level of care provided in a nursing home.
Under New Jersey law, a snapshot of a couple’s total combined resources at the beginning of the continuous period of institutionalization is used to determine the amount of resources that the couple is amount to retain. The community spouse is permitted to keep the lesser of one half of the couple’s total resources or the maximum amount set forth by New Jersey law, which is known as the Community Spouse Resource Allowance (CSRA).
According to the instant case, the determination of when the snapshot occurs depends on the type of service an individual is applying to. Petitioner applied for benefits through the Managed Long Term Services and Supports (MLTSS) waiver program, which means that the snapshot does not hinge upon physical admission to a Title XIX facility. The MLTSS waiver program supports eligible individuals to remain living in the community, whether at home or in an assisted living facility, rather than in a nursing facility. To qualify for a MLTSS waiver program, an individual must in need of nursing home level of care, which is determined by a pre-admission screening (PAS).
In this instance, the petitioner’s PAS was completed on February 20, 2019. The Petitioner was certified as eligible for “nursing facility level of care.” The Dept. of Human Services therefore issued a final agency decision determining that the Petitioner’s snapshot date occurred in February 2019.
Knowing how one’s local jurisdiction calculates the snap-shot date can be critical in elder law planning. Helping a client plan hinges upon what their financial analysis is and so one needs to know when to look at those finances. The plan can be drastically different if one snap-shot date is used versus another. To make matters even more intricate, states differ on how they determine when the snap-shot date is. And even still, as evidence in this New Jersey case, the snap-shot date may be different depending upon what type of Medicaid services the applicant is applying for.
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