Transfer of an Asset
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Transfer of an Asset


Revised March 3, 2014


Long-term care


Purpose:

WAC 182-513-1363Evaluating the transfer of an asset for clients found eligible for long-term care (LTC) services on or after 5/1/2006
WAC 182-513-1364Evaluating the transfer of an asset made on or after April 1, 2003 for long-term care (LTC) services
WAC 182-513-1365Evaluating the transfer of an asset made on or after March 1, 1997 for long-term care (LTC) services
WAC 182-513-1366Evaluating the transfer of an asset made before March 1, 1997, for long-term care (LTC) services

WAC 182-513-1363

WAC 182-513-1363

Effective January 1, 2013

WAC 182-513-1363 Evaluating the transfer of an asset for clients found eligible for long-term care (LTC) services on or after 5/1/2006

Emergency WAC effective 1-1-2014

This section describes how the department evaluates asset transfers made on or after May 1, 2006 and their effect on LTC services. This applies to transfers by the client, spouse, a guardian or through an attorney in fact. Clients subject to asset transfer penalty periods are not eligible for LTC services. LTC services for the purpose of this rule include nursing facility services, services offered in any medical institution equivalent to nursing facility services, and home and community-based services furnished under a waiver program. Program of all-inclusive care of the elderly (PACE) and hospice services are not subject to transfer of asset rules. The department must consider whether a transfer made within a specified time before the month of application, or while the client is receiving LTC services, requires a penalty period.

  • Refer to WAC 182-513-1364 for rules used to evaluate asset transfers made on or after April 1, 2003 and before May 1, 2006.

  • Refer to WAC 182-513-1365 for rules used to evaluate asset transfer made prior to April 1, 2003.

  1. When evaluating the effect of the transfer of asset made on or after May 1, 2006 on the client's eligibility for LTC services the department counts sixty months before the month of application to establish what is referred to as the "look-back" period.

  2. The department does not apply a penalty period to transfers meeting the following conditions:

    1. The total of all gifts or donations transferred do not exceed the average daily private nursing facility  rate in any month;

    2. The transfer is an excluded resource described in WAC 182-513-1350 with the exception of the client's home, unless the transfer of the home meets the conditions described in (d) of this subsection;

    3. The asset is transferred for less than fair market value (FMV), if the client can provide evidence to the department of one of the following:

      1. An intent to transfer the asset at FMV or other adequate compensation. To establish such an intent, the department must be provided with written evidence of attempts to dispose of the asset for fair market value as well as evidence to support the value (if any) of the disposed asset.

      2. The transfer is not made to qualify for LTC services, continue to qualify, or avoid Estate Recovery. Convincing evidence must be presented regarding the specific purpose of the transfer.

      3. All assets transferred for less than fair market value have been returned to the client.

      4. The denial of eligibility would result in an undue hardship as described in WAC 182-513-1367.

    4. The transfer of ownership of the client's home, if it is transferred to the client's:

      1. Spouse; or

      2. Child, who:

        1. Meets the disability criteria described in WAC 182-512-0050 (1) (b) or (c); or

        2. Is less than twenty-one years old; or

        3. Lived in the home for at least two years immediately before the client's current period of institutional status, and provided verified care that enabled the individual to remain in the home. A physician's statement of needed care is required; or

      3. Brother or sister, who has:

        1. Equity in the home; and

        2. Lived in the home for at least one year immediately before the client's current period of institutional status.

    5. The asset is transferred to the client's spouse or to the client's child, if the child meets the disability criteria described in WAC 182-512-0050 (1) (b) or (c);

    6. The transfer meets the conditions described in subsection (3), and the asset is transferred:

      1. To another person for the sole benefit of the spouse;

      2. From the client's spouse to another person for the sole benefit of the spouse;

      3. To trust established for the sole benefit of the individual's child who meets the disability criteria described in WAC 182-512-0050 (1) (b) or (c);

      4. To a trust established for the sole benefit of a person who is sixty-four years old or younger and meets the disability criteria described in WAC 182-512-0050 (1)(b) or (c); or

  3. The department considers the transfer of an asset or the establishment of a trust to be for the sole benefit of a person described in subsection (2)(f), of this section if the transfer or trust:

    1. Is established by a legal document that makes the transfer irrevocable;

    2. Provides that no individual or entity except the spouse, blind or disabled child, or disabled individual can benefit from the assets transferred in any way, whether at the time of the transfer or at any time during the life of the primary beneficiary; and

    3. Provides for spending all assets involved for the sole benefit of the individual on a basis that is actuarially sound based on the life expectancy of that individual or the term or the trust, whichever is less; and

    4. The requirements in subsection (2)(c) of this section do not apply to trusts described in WAC 388-561-0100 (6)(a) and (b) and (7)(a) and (b).

  4. The department does not establish a period of ineligibility for the transfer of an asset to a family member prior to the current period of long-term care service if:

    1. The transfer is in exchange for care services the family member provided the client;

    2. The client has a documented need for the care services provided by the family member;

    3. The care services provided by the family member are allowed under the medicaid state plan or the department's waivered services;

    4. The care services provided by the family member do not duplicate those that another party is being paid to provide;

    5. The FMV of the asset transferred is comparable to the FMV of the care services provided;

    6. The time for which care services are claimed is reasonable based on the kind of services provided; and

    7. Compensation has been paid as the care services were performed or with no more time delay than one month between the provision of the service and payment.

  5. The department considers the transfer of an asset in exchange for care services given by a family member that does not meet the criteria as described under subsection (4) of this section as the transfer of an asset without adequate consideration.

  6. If a client or the client's spouse transfers an asset within the look-back period without receiving adequate compensation, the result is a penalty period in which the client is not eligible for LTC services.

  7. If a client or the client's spouse transfers an asset on or after May 1, 2006, the department must establish a penalty period by adding together the total uncompensated value of all transfers made on or after May 1, 2006. The penalty period:

    1. For a LTC services applicant, begins on the date the client would be otherwise eligible for LTC services based on an approved application for LTC services or the first day after any previous penalty period has ended; or

    2. For a LTC services recipient, begins the first of the month following ten-day advance notice of the penalty period, but no later than the first day of the month that follows three full calendar months from the date of the report or discovery of the transfer; or the first day after any previous penalty period has ended; and

    3. Ends on the last day of the number of whole days found by dividing the total uncompensated value of the assets by the statewide average daily private cost for nursing facilities  at the time of application or the date of transfer, whichever is later.

  8. If an asset is sold, transferred, or exchanged, the portion of the proceeds:

    1. That is used within the same month to acquire an excluded resource described in WAC 182-513-1350 does not affect the client's eligibility;

    2. That remain after an acquisition described in (a) of this section becomes an available resource as of the first day of the following month.

  9. If the transfer of an asset to the client's spouse includes the right to receive a stream of income not generated by a transferred resource, the department must apply rules described in WAC 182-513-1330 (5) through (7).

  10. If the transfer of an asset for which adequate compensation is not received is made to a person other than the client's spouse and includes the right to receive a stream of income not generated by a transferred resource, the length of the penalty period is determined and applied in the following way:

    1. The total amount of income that reflects a time frame based on the actuarial life expectancy of the client who transfers the income is added together;

    2. The amount described in (a) of this subsection is divided by the statewide average daily private cost for nursing facilities at the time of application; and

    3. A penalty period equal to the number of whole days found by following subsections (7)(a), (b), and (c) of this section.

  11. A penalty period for the transfer of an asset that is applied to one spouse is not applied to the other spouse, unless both spouses are receiving LTC services. When both spouses are receiving LTC services;

    1. We divide the penalty between the two spouses.

    2. If one spouse is no longer subject to a penalty (e.g. the spouse is no longer receiving institutional services or is deceased) any remaining penalty that applies to both spouses must be served by the remaining spouse.

  12. If a client or the client's spouse disagrees with the determination or application of a penalty period, that person may request a hearing as described in chapter 182-526 WAC.

  13. Additional statutes which apply to transfer of asset penalties, real property transfer for inadequate consideration, disposal of realty penalties, and transfers to qualify for assistance can be found at:

    1. RCW 74.08.331 Unlawful practices -- Obtaining assistance -- Disposal of realty;

    2. RCW 74.08.338 Real property transfers for inadequate consideration;

    3. RCW 74.08.335 Transfers of property to qualify for assistance; and

    4. RCW 74.39A.160 Transfer of assets--Penalties.

This is a reprint of the official rule as published by the Office of the Code Reviser. If there are previous versions of this rule, they can be found using the Legislative Search page.

WAC 182-513-1364

WAC 182-513-1364

Effective January 1, 2013

WAC 182-513-1364 Evaluating the transfer of an asset made on or after April 1, 2003 for long-term care (LTC) services

Emergency WAC effective 1-1-2014

This section describes how the department evaluates the transfer of an asset made on or after April 1, 2003, by a client who is applying or approved for LTC services. The department must consider whether a transfer made within a specified time before the month of application requires a penalty period in which the client is not eligible for these services. Refer to WAC 182-513-1365 for rules used to evaluate the transfer of an asset made before April 1, 2003. Refer to WAC 182-513-1363 for rules used to evaluate the transfer of an asset made on or after May 1, 2006.

  1. The department does not apply a penalty period to the following transfers by the client, if they meet the conditions described:

    1. Gifts or donations totaling one thousand dollars or less in any month;

    2. The transfer of an excluded resource described in WAC 182-513-1350 with the exception of the client's home, unless the transfer of the client's home meets the conditions described in (d) of this subsection;

    3. The transfer of an asset for less than fair market value (FMV), if the client can provide evidence to the department of one of the following:

      1. An intent to transfer the asset at FMV or other adequate compensation;

      2. The transfer is not made to qualify for LTC services;

      3. The client is given back ownership of the asset;

      4. The denial of eligibility would result in an undue hardship.

    4. The transfer of ownership of the client's home, if it is transferred to the client's:

      1. Spouse; or

      2. Child, who:

        1. Meets the disability criteria described in WAC 182-512-0050 (1)(b) or (c); or

        2. Is less than twenty-one years old; or

        3. Lived in the home for at least two years immediately before the client's current period of institutional status, and provided care that enabled the client to remain in the home; or

      3. Brother or sister, who has:

        1. Equity in the home; and

        2. Lived in the home for at least one year immediately before the client's current period of institutional status.

    5. The transfer of an asset, if the transfer meets the conditions described in subsection (4) of this section, and the asset is transferred:

      1. To another person for the sole benefit of the spouse;

      2. From the client's spouse to another person for the sole benefit of the spouse;

      3. To trust established for the sole benefit of the client's child who meets the disability criteria described in WAC 182-512-0050 (1)(b) or (c);

      4. To a trust established for the sole benefit of a person who is sixty-four years old or younger and meets the disability criteria described in WAC 182-512-0050 (1)(b) or (c); or

    6. The asset is transferred to the client's spouse or to the client's child, if the child meets the disability criteria described in WAC 182-512-0050 (1)(b) or (c).

  2. The department does not establish a period of ineligibility for the transfer of an asset to a family member prior to the current period of institutional status, if:

    1. The transfer is in exchange for care services the family member provided the client;

    2. The client has a documented need for the care services provided by the family member;

    3. The care services provided by the family member are allowed under the Medicaid state plan or the department's HCB waiver services;

    4. The care services provided by the family member do not duplicate those that another party is being paid to provide;

    5. The FMV of the asset transferred is comparable to the FMV of the care services provided;

    6. The time for which care services are claimed is reasonable based on the kind of services provided; and

    7. Compensation has been paid as the care services were performed or with no more time delay than one month between the provision of the service and payment.

  3. The department considers the transfer of an asset in exchange for care services given by a family member that does not meet the criteria as described under subsection (2) of this section as the transfer of an asset without adequate consideration.

  4. The department considers the transfer of an asset or the establishment of a trust to be for the sole benefit of a person described in subsection (1)(e) of this section, if the transfer or trust:

    1. Is established by a legal document that makes the transfer irrevocable;

    2. Provides that no individual or entity except the spouse, blind or disabled child, or disabled individual can benefit from the assets transferred in any way, whether at the time of the transfer or at any time during the life of the primary beneficiary; and

    3. Provides for spending all assets involved for the sole benefit of the individual on a basis that is actuarially sound based on the life expectancy of that individual or the term or the trust, whichever is less; and

    4. The requirements in (c) of this subsection do not apply to trusts described in WAC 182-516-0100 (5)(a) and (b).

  5. If a client or the client's spouse transfers an asset within the look-back period described in WAC 182-513-1365 without receiving adequate compensation, the result is a penalty period in which the client is not eligible for LTC services. If a client or the client's spouse transfers an asset on or after April 1, 2003, the department must establish a penalty period as follows:

    1. If a single or multiple transfers are made within a single month, then the penalty period:

      1. Begins on the first day of the month in which the transfer is made; and

      2. Ends on the last day of the number of whole days found by dividing the total uncompensated value of the assets by the statewide average daily private cost for nursing facilities at the time of application.

    2. If multiple transfers are made during multiple months, then the transfers are treated as separate events and multiple penalty periods are established that:

      1. Begin on the latter of:

        1. The first day of the month in which the transfer is made; or

        2. The first day after any previous penalty period has ended and end on the last day of the whole number of days as described in (a)(ii) of this subsection.

  6. If an asset is sold, transferred, or exchanged, the portion of the proceeds:

    1. That is used within the same month to acquire an excluded resource described in WAC 182-513-1350 does not affect the client's eligibility;

    2. That remain after an acquisition described in subsection (6)(a) becomes an available resource as of the first day of the following month.

  7. If the transfer of an asset to the client's spouse includes the right to receive a stream of income not generated by a transferred resource, the department must apply rules described in WAC 182-513-1330 (5) through (7).

  8. If the transfer of an asset for which adequate compensation is not received is made to a person other than the client's spouse and includes the right to receive a stream of income not generated by a transferred resource, the length of the penalty period is determined and applied in the following way:

    1. The total amount of income that reflects a time frame based on the actuarial life expectancy of the client who transfers the income is added together;

    2. The amount described in (a) of this subsection is divided by the statewide average daily private cost for nursing facilities at the time of application; and

    3. A penalty period equal to the number of whole days found by following subsections (5)(a) and (b) and (a) and (b) of this subsection is applied that begins on the latter of:

      1. The first day of the month in which the client transfers the income; or

      2. The first day of the month after any previous penalty period has ended.

  9. A penalty period for the transfer of an asset that is applied to one spouse is not applied to the other spouse, unless:

    1. Both spouses are receiving LTC services; and

    2. A division of the penalty period between the spouses is requested.

  10. If a client or the client's spouse disagrees with the determination or application of a penalty period, that person may request a hearing as described in chapter 182-526 WAC.

This is a reprint of the official rule as published by the Office of the Code Reviser. If there are previous versions of this rule, they can be found using the Legislative Search page.

WAC 182-513-1365

WAC 182-513-1365

Effective January 1, 2013

WAC 182-513-1365 Evaluating the transfer of an asset made on or after March 1, 1997 for long-term care (LTC) services

Emergency WAC effective 1-1-2014

This section describes how the department evaluates a transfer of assets made on or after March 1, 1997, by a client who is applying or approved for LTC services. The department must consider whether a transfer made within a specified time before the month of application requires a penalty period in which the client is not eligible for these services.Refer to WAC 182-513-1364 for rules used to evaluate the transfer of an asset made on or after March 31, 2003.  Refer to WAC 182-513-1363 for rules used to evaluate a transfer of an asset made on or after May 1, 2006.   

  1. The department disregards the following transfers by the client, if they meet the conditions described:

    1. Gifts or donations totaling one thousand dollars or less in any month;

    2. The transfer of an excluded resource described in WAC 182-513-1350  with the exception of the client’s home, unless the transfer meets the conditions described in (d) of this subsection;

    3. The transfer of an asset for less than fair market value (FMV), if the client can provide evidence to the department that satisfies one of the following:

      1. An intent to transfer the asset at FMV or other adequate compensation;

      2. The transfer is not made to qualify for LTC services;

      3. The client is given back ownership of the asset;

      4. The denial of eligibility would result in an undue hardship.

    4. The transfer of ownership of the client's home, if it is transferred to the client's:

      1. Spouse; or

      2. Child, who:

        1. Meets the disability criteria described in WAC 182-512-0050 (1) (b) or (c); or

        2. Is less than twenty-one years old; or

      3. A son or daughter, who:

        1. Lived in the home for at least two years immediately before the client's current period of institutional status; and

        2. Provided care that enabled the client to remain in the home; or

      4. A brother or sister, who has:

        1. Equity in the home, and

        2. Lived in the home for at least one year immediately before the client's current period of institutional status.

    5. The transfer of an asset other than the home, if the transfer meets the conditions described in subsection (4) of this section, and the asset is transferred:

      1. To the client’s spouse or to another person for the sole benefit of the spouse;

      2. From the client’s spouse to another person for the sole benefit of the spouse;

      3. To the client’s child who meets the disability criteria described in WAC 182-512-0050 (1) (b) or (c) or to a trust established for the sole benefit of this child; or

      4. To a trust established for the sole benefit of a person who is sixty-four years old or younger and meets the disability criteria described in WAC 182-512-0050 (1) (b) or (c).

    6. The transfer of an asset to a member of the client's family in exchange for care the family member provided the client before the current period of institutional status, if a written agreement that describes the terms of the exchange:

      1. Was established at the time the care began;

      2. Defines a reasonable FMV for the care provided that reflects a time frame based on the actuarial life expectancy of the client who transfers the asset; and

      3. States that the transferred asset is considered payment for the care provided.

  2. When the fair market value of the care described in subsection (1) (f) of this section is less than the value of the transferred asset, the department considers the difference the transfer of an asset without adequate consideration.

  3. The department considers the transfer of an asset in exchange for care given by a family member without a written agreement as described under subsection (1) (f) of this section as a transfer of an asset without adequate consideration.

  4. The transfer of an asset or the establishment of a trust is considered to be for the sole benefit of a person described in subsection (1) (e) of this section, if the transfer or trust:

    1. Is established by a legal document that makes the transfer irrevocable; and  

    2. Provides for spending all funds involved for the benefit of the person for whom the transfer is made within a time frame based on the actuarial life expectancy of that person.

  5. When evaluating the effect of the transfer of an asset on a client's eligibility for LTC services received on or after October 1, 1993, the department counts the number of months before the month of application to establish what is referred to as the "look-back" period. The following number of months apply as described:

    1. Thirty-six months, if all or part of the assets were transferred on or after August 11, 1993; and

    2. Sixty months, if all or part of the assets were transferred into a trust as described in  WAC 182-516-0100.

  6. If a client or the client’s spouse transfers an asset within the look-back period without receiving adequate compensation, the result is a penalty period in which the client is not eligible for LTC services. If a client or the client’s spouse transfers an asset on or after March 1, 1997, the department must establish a penalty period as follows:

    1. If a single or multiple transfers are made within a single month, then the penalty period:

      1. Begins on the first day of the month in which the transfer is made; and

      2. Ends on the last day of the number of whole months found by dividing the total uncompensated value of the assets by the statewide average monthly private cost for nursing facilities at the time of application.

    2. If multiple transfers are made during multiple months, then the transfers are treated as separate events and multiple penalty periods are established that:

      1. Begin on the latter of:

        1. The first day of the month in which the transfer is made; or

        2. The first day after any previous penalty period has ended; and

      2. End on the last day of the whole number of months as described in  (a) (ii) of this subsection.

  7. If an asset is sold, transferred, or exchanged, the portion of the proceeds:

    1. That is used within the same month to acquire an excluded resource described in WAC 182-513-1350  does not affect the client’s eligibility;

    2. That remains after an acquisition described in  (a) of this subsection becomes an available resource as of the first day of the following month.

  8. If the transfer of an asset to the client’s spouse includes the right to receive a stream of income not generated by a transferred resource, the department must apply rules described in WAC 182-513-1330 (5) through (7).

  9. If the transfer of an asset for which adequate compensation is not received is made to a person other than the client’s spouse and includes the right to receive a stream not generated by a transferred resource, the length of the penalty period is determined and applied in the following way:

    1. The total amount of income that reflects a time frame based on the actuarial life expectancy of the client who transfers the income is added together;

    2. The amount described in (a) of this subsection is divided by the statewide average monthly private cost for nursing facilities at the time of application; and

    3. A penalty period equal to the number of whole months found by following  (a) and (b) of this subsection is applied that begins on the latter of:

      1. The first day of the month in which the client transfers the income; or

      2. The first day of the month after any previous penalty period has ended.

  10. A penalty period for the transfer of an asset that is applied to one spouse is not applied to the other spouse, unless:

    1. Both spouses are receiving LTC services; and

    2. A division of the penalty period between the spouses is requested.

  11. If a client or the client’s spouse disagrees with the determination or application of a penalty period, that person may request a hearing as described in chapter 182-526 WAC.

This is a reprint of the official rule as published by the Office of the Code Reviser. If there are previous versions of this rule, they can be found using the Legislative Search page.

WAC 182-513-1366

WAC 182-513-1366

Effective January 1, 2013

WAC 182-513-1366 Evaluating the transfer of an asset made before March 1, 1997, for long-term care (LTC) services

Emergency WAC effective 1-1-2014

This section describes how the department evaluates the transfer of an asset made before March 1, 1997, by a client who is applying or approved for LTC services. The department must consider whether a transfer made within a specified time before the month of application requires a penalty period in which the client is not eligible for these services. Refer to WAC 182-513-1365  for rules used to evaluate the transfer of an asset on or after March 1, 1997.   

  1. When evaluating the transfer of an asset made before March 1, 1997, the department must apply rules described in WAC 182-513-1365 (1) through (4) and (7) through (11) in addition the rules described in this section.

  2. When evaluating the effect of the transfer of an asset on a client’s eligibility for LTC services received before October 1, 1993, the department counts the number of months before the month of application to establish what is referred to as the "look-back" period. The following number of months apply as described:

    1. Thirty months, if the asset was transferred before August 11, 1993; or

    2. Thirty-six months, if the asset was transferred on or after August 11, 1993.

  3. If a client or the client’s spouse transferred an asset without receiving adequate compensation before August 11, 1993, the department must establish a penalty period that:

    1. Runs concurrently for transfers made in more than one month in the look-back period; and

    2. Begins on the first day of the month in which the asset is transferred and ends on the last day of the month which is the lesser of:

      1. Thirty months after the month of transfer; or

      2. The number of whole months found by dividing the total uncompensated value of the assets by the statewide average monthly private cost for nursing facilities at the time of application.

  4. If a client or the client’s spouse transferred an asset without receiving adequate compensation on or after August 11, 1993 and before March 1, 1997, the department must establish a penalty period as follows:

    1. If the transfer is made during the look-back period, then the penalty period:

      1. Begins on the first day of the month in which the transfer is made; and

      2. Ends on the last day of the number of whole months described in (b) (ii) of this subsection.

    2. If the transfer is made while the client is receiving LTC services or during a period of ineligibility, then the penalty period:

      1. Begins on the latter of the first day of the month:

        1. In which the transfer is made; or

        2. After a previous penalty period has ended; and

      2. Ends on the last day of the number of whole months described in (b) (ii) of this subsection.

This is a reprint of the official rule as published by the Office of the Code Reviser. If there are previous versions of this rule, they can be found using the Legislative Search page.

CLARIFYING INFORMATION

  1. What is a transfer?

    1. A transferred occurs anytime ownership of an asset is given from one person to another. When a client sells a resource, then that sale is also a transfer.

    2. Penalties arise when the client (or spouse) does not receive adequate compensation and the specific transfer must have a penalty applied.

  2. When to apply transfer rules:

    1. Transfer rules apply to eligibility for:

      1. All institutional services in all medical facilities with the exception of Hospice care centers;

      2. Hospital stays of thirty days or more;

      3. Waiver services with the exception of services provided under PACE;and

      4. SSI recipients receiving any of the services listed above.

    2. Transfer rules apply to income and resources transferred by:

      1. The client or the client’s spouse;

      2. A person with legal authority to act for the client; or

      3. A person acting at the direction or request of the client.

    3. Transfer rules do not apply to eligibility for non-institutional medical programs. The department determines eligibility for non-institutional medical for a client who becomes ineligible for LTC services due to the transfer of an asset. This is true for all clients, including SSI recipients.

    4. Transfer rules do not apply to clients requesting Medicaid Personal Care (MPC) services only. This is because the client will receive non-institutional medical with their MPC services.

  3. Transfers made by Power of Attorney:

    1. Many representatives have been given Power of Attorney (POA) by the client. However, not all POAs have legal authority to transfer a client’s assets. In order for a POA to legally transfer a client’s assets, the POA document must specifically state the representative has the authority to make transfers on behalf of the client.

    2. If the POA document does not contain language that gives the representative specific authority to transfer assets, then the case must be referred to Adult Protective Services (APS) due to financial exploitation.

  4. Transfers and SSI-recipients requesting or receiving LTC:Transfer rules apply to SSI recipients requesting or receiving LTC services.

  5. Other countable assets:In addition to assets owned by the client or the client’s spouse, countable assets include those to which they are entitled, but do not receive due to waiving their rights of ownership to assets in the following ways:

    1. Waiving pension income;

    2. Waiving the right to receive an inheritance;

    3. Not accepting or accessing injury settlements;

    4. Diverting tort or other court payments; or

    5. Refusing to take legal action to obtain court ordered payments.

  6. Transferring  a stream of income to the spouse:

    1. When a client transfers a resource to his or her spouse, the income that is generated by that transferred resource becomes the separate income of the spouse - it is no longer the client’s income.


EXAMPLE

If the client transfers ownership of a rental property to his or her spouse, then any income received from the rental property is now the spouse’s income.


  1. If the client transfers a stream of income to his or her spouse, but there is no resource generating that income, then the income is still considered the client’s, even if it was transferred to the spouse or into a trust for the spouse.

EXAMPLE

A client receives a pension of $500 and is able to change the payment so that the spouse receives the income. All $500 is still considered the client’s income even though is paid to the spouse.


  1. Evaluate court orders that transfer a stream of income to a spouse on a case-by-case basis. You may need to obtain a legal opinion.
  1. Transferring a stream of income to someone other than the spouse:If the client transfers a resource to someone other than his or her spouse, and the resource includes a stream of income not generated by the resource, a transfer penalty is applied.  See Worker Responsibilities 3 for information about how to calculate the value of the transferred income.  NOTE:  If the stream of income is derived from a Life Estate, use the Life Estate tables to determine the value of the transfer

  2. Transfers and Necessary Supplemental Accommodation (NSA):

    Follow Necessary Supplemental Accommodation (NSA) procedures described in NSA when appropriate.

  3. Civil fine to recipient of transfer (RCW 74.39A.160 ):

    1. Under certain conditions, when a Long Term Care (LTC) applicant or recipient transfers an asset for less than fair market value, RCW 74.39A.160 allows the department to impose a civil fine upon the person who receives that transferred asset.

    2. The fine can be imposed under the following conditions:

      1. The LTC applicant or recipient transferred the assets in order to qualify for LTC assistance and the person receiving the asset knew, or should have known, the transfer occurred to qualify for LTC assistance.

      2. The specific transfer would have caused a period of ineligibility

      3. The services were provided and the period of ineligibility was waived because it would cause the LTC applicant or recipient undue hardship.

    3. In order to impose a civil fine, the department initiates a judicial proceeding. The judicial proceeding will determine whether or not a fine is imposed and the amount of the fine. The fine can be up to 150% of the funds the department expends on care for the LTC client during the period of ineligibility due to the specific transfer. In addition, the fine can include the department’s court costs and legal fees.

    4. Refer the case to the AG for possible court action.

  4. Referrals to Adult Protective Services:

    When evaluating the transfer of an asset in which it appears the client has been exploited, consider making a referral to Adult Protective Services.

  5. Lifetime care contracts:

    1. Some transfers are made in consideration of care provided to a client by a family member. Sometimes family members have entered into some sort of contract with the client for this compensation. Frequently these contracts are called Lifetime Care Contracts. Most often, these contracts have been used to “pre-pay” families for future care. However, not all transfers in exchange for care will have been made through a Lifetime Care Contract.

    2. Effective April 1, 2003, WAC 388-513-1364 limits when transfers in exchange for care services can be made to family members. The transfer must meet all the conditions in 388-513-1364 (2) or a penalty period may be imposed.

    3. When evaluating transfers in exchange for care services provided by a family member, the client must have a documented need for the service. The following list contains some acceptable means of verifying the need:

      1. Doctor’s statement

      2. A statement from some other medical care provider

      3. A comprehensive assessment completed by DSHS or AAA staff; however, this must have been completed at the time the care contract was completed

      4. Any other credible means of verifying the need for services.

  6. Transfers to a disabled child:

    1. Do not impose a penalty period for transfers a client makes to his or her blind or disabled child who meets SSA disability criteria. Even if the child is age 65 or over, the child must still meet the SSA disability criteria.

    2. If the client or representative cannot verify that an SSA disability determination exists and they claim the child is disabled, an approved disability determination (NGMA) from DDDS may be needed to establish that a disability exists.


All assets transferred for less than fair market value have been returned to the client

WAC 388-513-1363 (2) (c) (iii) states:

The department does not apply a penalty period for transfers meeting the following conditions:

All assets transferred for less than fair market value have been returned to the client. 

Once a penalty period has been established by the department, a client must transfer ALL assets back in order for the department to do an adjustment.

At the time of application, we use the total uncompensated value to determine the penalty (the amount not returned to the client).  Because this happened prior to the application and the transfer penalty being established, we would not count ALL transferred assets to establish a penalty, we would count the net transferred assets (or uncompensated transfers). 


EXAMPLE

#1.

Mr. H enters a nursing home in 9/15/07.  On 10/1/07 Mr. H transfers $50,000 to his son.  On 10/30/07 son gets legal advice from attorney to transfer what is left back to Mr. H.   On 11/1/07 son gives back $40,000.  Mr. H. uses $20,000 to pay off his current bills, He spends $6000 on a burial plan and has enough left to pay privately until January 08.  On February 1 he is at $2,000 resources and applies for Medicaid.  The uncompensated transfer is $10,000.  ( Original $50,000 – the $40,000 returned to the client to pay off his own bills = $10,000). 

The transfer penalty period is 48 days ($10,000 divided by $206  private NF rate). 

 

Determine Medicaid eligibility under the S series for this client during the transfer penalty period. 

 

Because funds were transferred back to the client prior to an application or penalty established, we do not base the period of ineligibility on the $50,000.


EXAMPLE

#2.

Mr. P. enters a nursing home on 9/15.  On 10/1/07 he transfers $50,000 to his son.  On 11/1/07 Mr. P has $2,000 in his bank account and applies for Medicaid.

 

The penalty is established based on the $50,000 transfer, divided by 206 =  242 days period of ineligibility. 

Denial letter for LTC services with period of ineligibility is sent on 11/12/07.

 

Determine eligibility for Medicaid under S series. 

 

On 12/1/07, Mr. P. wants his period of ineligibility adjusted because the son decided to give $12,000 back. 

In this scenario, we will not adjust the penalty in this example because the penalty period was already established.  In order for the penalty not to apply, ALL the assets must be transferred back to Mr. P.

Mr. P has a right to file for an undue hardship.

 


EXAMPLE

#3.

Same as scenario  #2, but Mr. P.’s son starts reading the RCWs indicated in WAC 388-513-1363 (13)  He decides he better transfer the $50,000 back to Mr. P.   RCW 74.39A.160 indicates the department could charge the son with a civil fine.  The fine can be imposed of 150% of the amount the department expends for the care of the applicant. 

 The department will take back the transfer penalty period of  242 days since all of the assets have been transferred back to the client.  Mr. P will pay privately with his $50,000 and re applies when he is close to the $2,000 resource limit. 

 


WORKER RESPONSIBILITIES

  1. Questions to ask yourself when evaluating a transfer:

    In order to determine if a penalty period is applied when considering Long-Term Care, we must evaluate the transfer and first determine if the transfer will cause a penalty period. Some questions to ask yourself as you evaluate transfers:

    1. What asset was transferred?

    2. Was the asset one in which a penalty period is required?

    3. What was the value of the transferred asset?

    4. When was it transferred?

    5. Did the transfer occur within the “look back” period?

    6. Why was it transferred?

    7. Did more than one transfer occur?

  2. Transfers and SSI-recipients requesting or receiving LTC:

    Transfer rules apply to SSI recipients requesting or receiving LTC services. If the transfer causes a penalty period for the SSI-Recipient:

    1. Continue Title XIX non-institutional Medicaid.

    2. Set an alert for ten days to allow time for a fair hearing (FH) request.

    3. If a FH is requested, take no action until you have a decision from the Administrative Law Judge (ALJ). If the ALJ decides the period of ineligibility is appropriate or if no hearing is requested, send a memo to the office of Social Security with the following information:

      1. The client's name and SSN; and

      2. A statement that the client is ineligible for institutional care due to a transfer of resources and the month and year the client will again be eligible for institutional care.

  3. Transferring a stream of income to someone other than the spouse:

    If the client transfers a resource to someone other than his or her spouse, and the resource includes a stream of income not generated by the resource, a transfer penalty is applied. To calculate the value of the transferred asset:

    1. Use Appendix 5 - Individual Life Expectancy Annuity Table

    2. The table is divided by gender and age. Determine your client’s life expectancy based on their age as at the time of the transfer. Round up to the nearest whole year.

    3. Based on their life expectancy, determine how much income the client would have received if the transfer had not occurred, starting with the date of the transfer through the end of his or her life expectancy.

    4. If the stream of income is derived from a Life Estate, determine the value of the Life Estate using Appendix 2 -Determining the value of a life estate.   


EXAMPLE

A client is male and is applying for LTC assistance. When he was 94, he transferred a stream of income ($3000 annually) to his son. Based on the annuity tables, the client’s life expectancy at the time of transfer was 3.04 years. Round up to the nearest whole year, or 4 years. The client would have received $12,000 during the remainder of his life expectancy ($3000 X 4). Therefore, on the date the transferred occurred, the client transferred $12,000 to his son. We must consider a penalty period based on the $12,000. A period of ineligibility would begin the effective date of the transfer.



  1. Establishing periods of ineligibility:

    1. Once established, a period of ineligibility runs continuously whether or not the client has a break of thirty consecutive days in the current period of institutional status.

    2. Do not impose a penalty period for the transfer of an asset if the asset is returned to the client or to the client’s spouse or if the transfer occurred before the look back period.

    3. Refer to the definition of "undue hardship" in WAC 182-513-1301  as appropriate.

    4. For applications, allow the client the opportunity to withdraw the application. If the client does so, do not establish a period of ineligibility.

  2. Non-institutional medical:

    1. For applications, determine eligibility for non-institutional medical when denying LTC services for the transfer of an asset.

    2. For active cases that require a period of ineligibility because of the transfer of an asset, continue the client’s non-institutional medical until the following steps have been taken:

      1. Send a D01C notice to close the assistance unit (AU) for LTC services, and inform the client that non-institutional medical will continue until eligibility is re-determined. Include an eligibility review form .

      2. Set an alert for ten days for the return of the review. If the client does not respond or provide the necessary information, close the AU according to the advance and adequate notice rules.

      3. Of the client returns the eligibility review form with the necessary information, determine eligibility for other programs as appropriate.


NOTE: If the case record contains all of the information needed to re-determine eligibility for other medical programs, do not require the client to complete an eligibility review.

  1. Penalty periods and married couples:

    1. For a married client with a non-applying spouse, assign the penalty to the LTC Medicaid spouse (the one receiving LTC services).


EXAMPLE

A married person, John, applies for LTC. A resource was transferred during the look-back period causing a penalty period of 120 days. Only one spouse is requesting LTC services. Apply the entire 120-day penalty period to the applying spouse.


  1. If the non-applying spouse applies for LTC and there is a penalty period remaining, evenly divide the remaining penalty between both spouses.

EXAMPLE

Same example as above but now the spouse, Martha, is requesting LTC services. Martha applies July 1, 2003. John still has 60 days remaining on his penalty period; therefore, his penalty period will end on August 29, 2003. Divide the remaining 60 days currently assigned to John in half. Apply 30 days to Martha, her penalty will run from 7/1/03 - 7/30/03. Reduce John’s penalty to 30 days so his remaining penalty will run from 7/1/03 - 7/30/03.


If both spouses apply for LTC, evenly divide the penalty period between both spouses.

When both spouses are institutionalized and both have a penalty period assigned, if one spouse is no longer institutionalized, then apply any remaining penalty to spouse who remains institutionalized.


EXAMPLE

John and Martha each have 30 days remaining on their penalty period and Martha dies. Apply the 30 days from Martha and extend John’s period of ineligibility.


If the community spouse dies, determine whether the institutionalized spouse will inherit any resources. If it appears the institutionalized spouse will do so, determine when the inheritance should take place and tickle for proper action at that time.If the community spouse applies for LTC services or non-institutional medical, consider resources previously transferred from the institutionalized spouse to the community spouse as the separate resources of the community spouse.


How to Calculate Ineligibility Periods


NOTE:

Some of the scenarios in the transfers made or after 5/1/2006 section include multiple transfers, some occurring prior to 5/1/2006.  This will give field staff an idea of how to apply the penalty periods during the 5 year look back (that was effective 5/1/2006) when there are multiple transfers in a case determination. 




Transfers made on or after 5/1/2006

  • Effective with transfers on or after 5/1/06, the $1000 excluded transfer amount in a single month has been reduced to the average daily private nursing home rate in effect at the time of application (for applicants) or in effect at the time of transfer (recipients).  As of 10/1/05, that amount is $190.

 

  • The lookback period has been lengthened to 60 months for all transfers made on or after 5/1/06.

 

  • Transfers made prior to the effective date of the new WAC follow the old rules and old lookback period.  Refer to WAC 182-513-1364.

 

  • For transfers made on or after 5/1/06, add the total value together of all transfers for all months and calculate one penalty period based on that total. 

 

  • Clients must be otherwise financially and functionally eligible for LTC before imposing the penalty.  If clients are not otherwise financially and functionally eligible for LTC, deny the request for services but DO NOT impose the penalty at this time.  The penalty will be imposed when/if they reapply at a later date and the transfers are within that application's lookback period. 

     

 

For Applications:

 

If the transfers were made on or after 5/1/06 - WAC 388-513-1363:

  • 60 month lookback period for all transfers.
  • Add together the total uncompensated value of all transfers made during the lookback period (after 5/1/06).
  • Do not include values of transfers that were made prior to 5/1/06.
  • Divide the total uncompensated value of assets transferred on or after 5/1/06 by the average daily private nursing facility rate in place at the time of application.
  • Start the penalty on the date the client is otherwise eligible for and would have started receiving LTC services had it not been for the penalty, unless there is already a penalty that overlaps that date.  Clients must be otherwise income, resource, and functionally eligible as of this date. 
  • If an overlapping penalty exists, start the new penalty on the first day after the existing penalty ends.
  • If clients are not income, resource, or functionally eligible, do not impose the penalty.  Deny the application based on the eligibility factor(s) they do not meet.  Advise clients that the transfers could possibly affect eligibility at future applications, depending upon when the transfers were made and when they reapply. 

 

 


EXAMPLE



Scenario #1:

 

Nursing home resident applies on 5/1/06.  The client reports he transferred his home valued at $250,000 in January 2003.  It was not transferred into a trust.  

 

Use the WAC based on the date the transfer occurred.  This transfer occurred prior to 5/1/06 so you will use the old rules found in WAC 182-513-1364.  The lookback period for this transfer is 36 months.  This transfer is outside of the lookback period.  Do not impose a penalty.

 


EXAMPLE



Scenario #2:

 

            Same client as above but the home was transferred in October 2003. 

 

Use the WAC based on the date the transfer occurred.  This transfer occurred prior to 5/1/06 so you will use the old rules found in WAC 182-513-1364.  The lookback period for this transfer is 36 months.  This transfer is within the lookback period. 

 

Divide the home’s value at the time of transfer by the average daily private nursing home rate in effect on 5/1/06 (time of application).  The amount is $190.  $250,000 ÷ 190 = 1,315 days. 

 

The penalty starts on October 1, 2003 and ends May 7, 2007. 

 

Determine if the client is eligible for non-institutional medical.

 


EXAMPLE



Scenario #3:

 

Now move forward into the future.  Client applies for COPES services on October 1, 2009.  He is financially and functionally eligible as of 10/25/09.  He transferred his home on May 1, 2006 to his friend.  The home was valued at $250,000.  It was not transferred into a trust.

 

Use the WAC based on the date the transfer occurred.  This transfer occurred on 5/1/06, the date the new transfer rules went into effect.  Use the rules in WAC 182-513-1363.  The lookback period for this transfer is 60 months.  This transfer is within the lookback period.

 

Divide the home’s value at the time of transfer by the average daily private nursing home rate in effect as of the application (10/1/09).   Since we do not have that amount, let’s assume that hypothetically it is $220 per day.  

$250,000 ÷ 220 = 1136 days.

 

The penalty starts on October 25, 2009, the date the client was otherwise eligible for LTC services, and ends on December 3, 2012. Determine if the client is eligible for non-institutional medical while in the penalty period. 

 


EXAMPLE

Scenario #4:

 

Nursing home client applies 7/1/06.  The client reports there were asset transfers prior to application but none of them were made into a trust.  He is functionally and financially eligible for LTC as of 7/1/06.  He transferred $30,000 on December 1, 2002; $30,000 on August 1, 2003; $30,000 on May 1, 2006; and $30,000 on June 1, 2006.

 

 


NOTE:

Transfer #1:  $30,000 from December 1, 2002

  • Use WAC 388-513-1364 to determine the penalty.

      

  • Use the 36-month lookback period.  This is outside the lookback period so there is no affect on eligibility.  Do not impose a penalty on this transfer.

 


NOTE: 

Transfer #2:  $30,000 from August 1, 2003.

  • Use WAC 182-513-1364 to determine the penalty.
  • Use the 36-month lookback period.  This is within the lookback period so a penalty must be established. 
  • Calculate the daily penalty by dividing $30,000 by the average daily private nursing home rate in effect at the time of application ($190).  157.89 days; round down to 157 days. 
  • Penalty begins 8/1/03 and runs for 157 days until January 4, 2004.  This penalty does not have an affect on the current application.

 


NOTE: 

Transfers #3 & #4:      $30,000 from May 1, 2006

  $30,000 from June 1, 2006

 

  • Use WAC 182-513-1363 to determine the penalty
  • Use the 60-month lookback period.  These are within the lookback period so there is a possibility of a penalty.
  • Add together the transfers made after the change in rule (during the lookback period).  Divide the total by the average daily private nursing home rate in effect at the time of application ($190).  315.78 days, or 315 days.
  • Penalty begins the date the client would otherwise start LTC services if not for the penalty and run for 315 days. 
  • The penalty is from 7/1/06 through 5/11/07.
  • Determine if the client is eligible for non-institutional medical.

 

 


EXAMPLE

Scenario #5

 

Client is applying for MNRW on January 5, 2007.  He is financially and functionally eligible as of January 20, 2007.  In reviewing his monthly bank statements you see that he has been making regular monthly withdrawals of $200 beginning in May 2006 through December 2006.  When asked, he states he gives his daughter $200 per month just to help her out and he was worried he would be over resources when he needed help to pay a provider.

 

Always presume a client gifted assets in order to qualify unless the client can show you it was for some other reason.  In this case, he admits that part of the reason for the gift was so he would qualify.

 

Determine when the gifts were made.  In this scenario, they were all made after 5/1/06.  The lookback period is 60 months.  These gifts are within the lookback period.

 

Add together the values of all gifts made after the change in rules.   You will apply one penalty period to the total.

 

May 2006                    $200

June 2006                    $200

July 2006                     $200

August 2006                 $200

September 2006           $200

October 2006  $200

November 2006           $200

December 2006           $200

TOTAL XFER $1,600

 

$1600 ÷ 190 = 8 days. 

 

The penalty begins the date he would otherwise be eligible for services, or January 20, 2007 and ends January 27, 2007. 

 

There is no need to determine eligibility for non-institutional medical in this scenario.  If LTC services are opened on 1/27/07, he will be able to receive Medicaid (the MAID) beginning 1/1/07. 

 


EXAMPLE

Scenario #6

 

  1.   He is otherwise eligible effective 12/1/07.  He had a stroke in November, 2007. 

 

You learn he paid Wossamotta U $30,000 in August, 2006 to help pay his 18 year old grandson’s college tuition, books, and fees.  It has always been his dream this grandson would go to college and he promised the boy he would help with the costs.  At the time he transferred the cash, he did not know he would need LTC

services within the next 60 months.  The client is able to produce his cancelled check made payable to Wossamotta U for $30,000 (Go Bullwinkle!).

 

The evidence supports his statement that he did not transfer the $30,000 to qualify for Medicaid.  Do not impose a penalty. 


For LTC Recipients

  • LTC are required to report changes in income and resources by the 10th of the month following the change.  Transferring assets are examples of such changes. 

 

  • When a recipient timely reports an asset was transferred, the penalty begins the first of the month following the 10-day advance notice period.

 

 


EXAMPLE

Client transfers $50,000 on July 1, 2006.  He reports it to the FSS on August 10, 2006.  He has reported the transfer timely.  The penalty begins September 1, 2006.


If a recipient made multiple unreported transfers, calculate a penalty period based on the total of the uncompensated values of all transfers added together.


EXAMPLE

On the September 2006 eligibility review the FSS learns the client has been transferring $5,000 per month of the home equity in the following months:

 

$5,000             May 2006

$5,000             June 2006

$5,000             July 2006

$5,000             August 2006

 

The client transferred a total of $20,000 home equity.  Use this amount to establish one penalty period.

 

 


  • If a recipient fails to report a transfer and we learn about it later, determine the effective date of the penalty per reporting requirements in WAC 388-418-0007.  For multiple unreported penalties, the effective date will be based on the earliest transfer.

 

  • Client has until the 10th of the month following the transfer to report it
  • We allow 10 days advance and adequate notice

 


EXAMPLE

While completing an eligibility review on June 5, 2007 we learn a recipient transferred their home valued at $300,000 to their adult child (who is not disabled and has not lived in the home) on December 25, 2006. 

 

Following reporting requirements, the recipient should have reported the transfer by January 1, 2007.  If it had been reported timely, we could have terminated LTC benefits effective February 1, 2007, allowing for 10-days advance notice.

 

Since the effective date should have 2/1/07 had it been reported timely, the penalty begins 2/1/07.  The client has an overpayment for February 2007, March 2007, April 2007, May 2007, and June 2007. 

 


EXAMPLE

An Active nursing home client makes the following transfers:

 

$5000 value of home 7/1/06    

$5000 value of home 8/1/06

$5000 value of home 9/1/06

$5000 value of home 10/1/06

 

  • Client fails to report the transfers and worker learns of them while completing the eligibility review on 3/23/07. 

 

  • Add the uncompensated value of the transfers together.  Total amount transferred $20,000

 

  • Divide total by the average daily private nursing home rate in place at the time of the most recent transfer.  Current standard is $190. 

 

  • Result is the number of days in the penalty period.   105.26 or 105 days

 

  • Determine when the penalty should have started if the client had reported the first transfer timely:

 

  • The first transfer was made 7/1/06.  Client should have reported it by 8/10/06.  Allowing for 10-days advance notice, the penalty for the first transfer should have started 9/1/06. 
  • The new rules allow us to establish one penalty for the total that was transferred.  Since the total transferred was $20,000 causing a 105-day penalty, the penalty for these transfers begins 9/1/06 and ends 12/14/06

 


How to Calculate Ineligibility Periods

For transfers made on or after April 1, 2003

  1. When one or more transfers occur during one month only:

    1. Total the uncompensated value of all transfers that occurred during that month.

    2. If the total is $1000 or less, do not impose a penalty period.

    3. If the total is greater than $1000, then:

      1. Divide the total by the statewide average daily private rate in effect at the time of application or request for services, or if the client is a LTC recipient, the rate in effect at the time of the transfer. Currently, this amount is $163;

      2. Round down to the nearest whole day; and

      3. Begin the penalty on:

        1. The first day of the month in which the transfers occurred, or

        2. The day following the last penalty period, if there was a period that overlaps the first day of the month; and

        3. A period of ineligibility cannot begin prior to the month in which the transfer occurred.


EXAMPLE

A client transfers $4000 on 4/30/03. There are no existing penalty periods.

  1. Divide $4000 by $163. Result is 24.53 days.

  2. Round down to nearest whole day, or 24 days.

  3. The period of ineligibility cannot start prior to 4/03, so it starts on the first day of the month in which the transfer occurred (or 4/1/03) and will run for 24 days: 4/1/03 - 4/24/03 = 24 days

  4. Client is ineligible from 4/1/03 - 4/24/03 and potentially eligible 4/25/03.


EXAMPLE

Client transferred $22,000 on 5/31/03. There is an existing penalty that ends 7/31/03.

  1. Divide $22,000 by $163. Result is 134.96 days.

  2. Round down to nearest whole day, or 134 days.

  3. The period of ineligibility cannot start prior to 5/1/03. However, there is an existing penalty period and it overlaps the first day of May (the month of transfer) and ends 7/31/03. Therefore, the penalty period for this transfer starts the day after the existing penalty ends, or 8/1/03 and will run for 134 days: 8/1/03 - 12/12/03 = 134 days

  4. Client is ineligible from 8/1/03 - 12/12/03 and potentially eligible 12/13/03.


EXAMPLE

A client transfers $1000 on 4/1/03, $1500 on 4/15/03, and $500 on 4/30/03. There are no existing penalty periods.

  1. Add together all transfers made during the month. The total of all transfers made in 4/03 is $3000. This is more than $1000, so a penalty period will be applied for 4/03 transfers.

  2. Divide $3000 by $163. Result is 18.40 days.

  3. Round down to nearest whole day, or 18 days.

  4. The period of ineligibility for the transfers made in 4/03 cannot start prior to 4/1//03, it starts on the first day of the month in which the transfers occurred (or 4/1/03) and will run for 18 days.

  5. Client is ineligible from 4/1/03 - 4/18/03 and potentially eligible 4/19/03.


EXAMPLE

A client transfers $4000 on 4/19/03 and $4000 on 5/31/03.

  1. Consider each month separately

  2. For 4/03, the total amount transferred was $4000. Calculate a period of ineligibility for transfers made in 4/03:

    1. Divide $4000 by 163. Result is 24.53 days.

    2. Round down to the nearest whole day, or 24 days.

    3. The period of ineligibility for the transfers made in 4/03 cannot start prior to 4/1//03, so it starts on the first day of the month in which the transfers occurred (or 4/1/03) and will run for 24 days.

    4. Client is ineligible from 4/1/03 - 4/24/03 and potentially eligible 4/25/03.

  3. For 5/03, the total amount transferred was $4000. Calculate a period of ineligibility for transfers made in 5/03:

    1. Divide $4000 by 163. Result is 24.53 days.

    2. Round down to the nearest whole day, or 24 days.

    3. The period of ineligibility for the transfers made in 5/03 cannot start prior to 5/1/03. Although there was a penalty period in April, it ended prior to 5/1/03. Therefore, May’s penalty period starts on the first day of the month in which the transfers occurred (or 5/1/03) and will run for 24 days.

    4. Client is ineligible from 5/1/03 - 5/24/03 and potentially eligible 5/25/03.

  4. Penalty period #1: 4/1/03 - 4/24/03

    1. Client is ineligible from 4/1/03 - 4/24/03

    2. Client is potentially eligible from 4/25/03 - 4/30/03

  5. Penalty period #2: 5/1/03 - 5/24/03

    1. Client is ineligible from 5/1/03 - 5/24/03

    2. Client is potentially eligible beginning 5/25/03 and ongoing.


  1. When multiple transfers occur over multiple months consider each month separately:

    1.  Establish a separate penalty period for each month.

    2. A penalty period is based on the total uncompensated value of all transfers that occurred within the same month.

    3. If the total uncompensated value of all transfers made during any month is $1000 or less, then do not impose a penalty period on the transfers made in that month.

    4. If the total uncompensated value of all transfers made during a month is more than $1000, then:

      1. Total all the transfers made during the month.

      2. Divide the total by the daily statewide average private rate in effect at the time of application or request for services, or if the client is a LTC recipient, then the rate in effect at the time of the transfer. Currently, this amount is $163.

      3. Round down to the nearest whole day.

      4. Begin the penalty on:

        1. The first day of the month in which the transfer occurred, or

        2. The first day after a previous penalty period ends, if the periods overlap, whichever is later.


EXAMPLE

Client applies in May 2003 and has transferred $150,000 on 11/15/00 and $5,000 on 4/3/03.

  1. Consider each month separately.

  2. For the transfer made in 11/00, use the rules from WAC 388-513-1365. $150,000 was transferred in 11/00. Calculate a period of ineligibility for this transfer:

    1. Divide $150,000 by 4938 (current Statewide Private Nursing Facility Rate). Use the rate in use at the time of application. Result is 30.37 months.

    2. Round down to the nearest whole month, or 30 months.

    3. The period of ineligibility for the transfer of $150,000 made on 11/15/00 starts 11/1/00 and runs for 30 months;

    4. Client is ineligible from 11/1/00 - 4/30/03

  3. For the transfer of $5000 made in 4/03, the total amount transferred was $5000. Calculate a period of ineligibility for transfers made in 4/03:

    1. Divide $5000 by 163. Result is 30.67days.

    2. Round down to the nearest whole day, or 30 days.

    3. The period of ineligibility for the transfers made in 4/03 cannot start prior to 4/1/03. There is an existing penalty period that overlaps 4/1/03. Therefore, the penalty period for the April transfer will start on the day after the existing penalty period ends. The existing penalty period ends 4/30/03, so the second penalty begins 5/1/03 and will run for 30 days.

    4. Client is ineligible from 5/1/03 - 5/30/03 and potentially eligible 5/31/03.

  4. There are two penalty periods:

    1. Penalty period #1: 11/1/00 - 4/30/03

    2. Penalty period #2: 5/1/03 - 5/30/03

  5. Client is potentially eligible beginning 5/31/03


 For asset transfers on or after March 1, 1997 through March 31, 2003 use the following steps to calculate a period of ineligibility:
  1. For all assets other than annuities, determine the uncompensated value of the transferred resource. This is done by subtracting the compensation received for an asset from the equity value of the asset.

  2. Divide the uncompensated value by the statewide average monthly cost of private nursing facilities at the time of application, or transfer if the client is a recipient.

  3. Round the result down to the nearest whole month. The result is the number of months of the period of ineligibility.

  4. Notify the client of the period of ineligibility. A period of ineligibility starts on the first day of the month in which the client transferred the asset or after a month in which a prior period of ineligibility ends, whichever is later.

For the transfer of an asset before March 1, 1997, refer to WAC 182-513-1366.


ACES PROCEDURES

Long Term Care, Alternate Care, Waivered Services - Transfer of Resources

Resource transfer

TRAN screen

 

Modification Date: March 3, 2014