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Title 8: Medicaid Page 39 Iowa Department of Health and Human Services Employees’ Manual Chapter D: Resources Transfer of Assets Revised September 13, 2024 Transfers That Do Not Cause a Penalty

2. Ms. O has a 32-year-old daughter who has always lived with her, but does not provide care to Ms. O to enable her to stay at home rather than in a medical institution. She wants her daughter to have the home and transfers it after her entry to the skilled nursing facility. The daughter does not receive SSI, Social Security, or Railroad Retirement, but alleges a disability. Disability Determination Services determines that the daughter is disabled. The transfer of the home is not a disqualifying transfer. 3. Mr. E, who lives in a skilled nursing facility, transfers his share of his home to his brother. They inherited the home from their father and had lived there together for 20 years. This transfer does not disqualify Mr. E for payment of nursing facility services, since the brother had an equity interest and they had lived together more than one year before Mr. E’s entry to a nursing facility. Rebuttal of Transfer of Assets Legal reference: 20 CFR 416.1246, IAC 75.23(5)“c”(249A) Assume all applicants or members who transfer assets do so to become eligible for Medicaid unless the applicant or member proves otherwise. The burden of proof is on the applicant or member to prove assets were not transferred to meet eligibility requirements. The applicant or member must:  Explain why the asset was transferred.  Explain the applicant’s or member’s relationship to the person who received the transferred asset.  Establish the fair market value and the equity value of the resource.  Verify an attempt to dispose of the asset for a fair market value.  Explain why less than the fair market value was accepted.  Establish that an agreement, contract, or expectation was created at the time of transfer stating the applicant or member received or will receive compensation for the value of the transfer. Compensation is money, real or personal property, food, shelter, or services received by an owner in exchange for an asset.  Explain how the applicant or member planned for self-support after the asset was transferred.