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Title 8: Medicaid Page 45 Iowa Department of Health and Human Services Employees’ Manual Chapter D: Resources Transfer of Assets Revised September 13, 2024 Penalties for Transferring Assets 3. Multiply the full number of months from step 2 by the average monthly statewide cost of nursing facility services to determine the amount of the transfer that would be used to cover the full months. 4. Subtract (result of step 3) from the total assets transferred (amount in step 1) to determine the balance or partial month amount. 5. Divide the partial month amount (result from step 4) by the daily average statewide cost of nursing facility services to come up with the number of additional days for the partial month penalty. 6. Start the penalty on:  The date the applicant or member would otherwise be eligible for Medicaid payment of long-term care services, or  The level of care effective date for Medicaid HCBS waiver applicants, or  The level of care effective date for PACE enrollees, or  The first day of the month assets were transferred, whichever is later.

1. Mr. Z transfers $95,000 to his best friend on February 11, 2006. He enters a nursing facility on March 3, 2006, and applies for Medicaid nursing facility payment on June 9, 2006. The worker determines that the transfer was made in order to qualify for Medicaid. Since the transfer took place after February 8, 2006, the partial month of ineligibility is not rounded down. The penalty period is figured as follows: a. Divide the total transferred by the statewide monthly cost of nursing facility services ($95,000 ÷ $3,697.55 = 25.69). b. Figure the amount used in the full 25 months of penalty (25 months × $3,697.55 = $92,438.75). c. Subtract this from the total transferred to come up with the partial month balance ($95,000 − $92,438.75 = $2,561.25). d. Take the partial month balance and divide by the statewide daily average cost of nursing facility services ($2,561.25 ÷ $121.63 = 21 days). The penalty period is 25 months and 21 days.