Donations to the institution are not third party payments. They do not count as ISM.
Use the following procedures if the issue of a donation is present:
Do not routinely inquire about, or document, the existence of donations to the institution
on behalf of the eligible individual.
If a question material to the ISM determination arises about whether funds provided
to the institution are a charitable donation or a third party payment for food and
shelter, contact the institution and determine the nature of the funds in question.
Accept the institution's allegation without further development and document the file,
using the Report of Contact (DROC) screen in MSSICS or, for non-MSSICS cases, the
paper SSA-5002 (Report of Contact).
EXAMPLE: Donations to a private nonprofit institution
Frank Stone, an eligible individual, lives at the Mount Royal Retirement Home. A religious
organization operates the home and it is tax-exempt under section 501(c) of the Internal
During the interview, Mr. Stone tells the claims representative (CR) that several
of his relatives send money regularly to Mount Royal.
The CR contacts Mount Royal and learns that neither Mr. Stone nor any third party
pays for his food and shelter.
Upon admission, the retirement home informs relatives of the residents that it costs
$500 per month per resident and asks them to contribute whatever they can afford to
the facility. NOTE:The facility does not send bills to the relatives and the facility does not maintain
billing accounts for the individual residents.
The CR determines that the funds provided by Mr. Stone's relatives are donations as
defined in SI 00835.710B.3. Therefore, such payments are not countable as ISM.
Since neither Mr. Stone nor any third party pays for his food and shelter, the CR
must determine whether to count the food and shelter provided by the institution as
ISM or to exclude it under the criteria for the “Church amendment” or under the SMA
exclusion in SI 00830.605.