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REV. MAY 3, 2018 NEBRASKA DEPARTMENT OF MEDICAID ELIGIBILITY MANUAL LETTER #43-2018 HEALTH AND HUMAN SERVICES 477-000-032

Example 3: Mr. Smith entered a nursing home on 12/1/2015, and applied for Medicaid on 6/25/18. On 2/25/17 he transferred a $20,000 CD to his son. On 12/10/17 he transferred a $10,000 CD to his grandchild. Since Mr. Smith is in a nursing home and has transferred resources for less than fair market value during the 60-month period before the date of his Medicaid application, he is subject to a period of ineligibility from the date of his application. Current actual monthly cost to a private pay patient is $5,000.

$20,000 amount of transfer on 2/25/17 $20,000 countable disposal ÷ $5,000 private pay cost = 4 months of ineligibility

$10,000 amount of transfer on 12/10/17. $10,000 ÷ $5,000 private pay cost = 2 months of ineligibility Total months of ineligibility are 6 beginning with 6/18 the month of Medicaid application.

Example 4: Mr. Smith lives at home and gave his son $12,000 on 3/25/18. Mr. Smith applied and was approved for Medicaid in 09/18. Deprivation regulations do not apply to current eligibility because he is not in a nursing home or receiving any type of nursing services.

On 10/2/18 Mr. Smith enters a nursing home and the monthly private pay rate is $4,800. A transfer of assets for less than fair market value has occurred within the 60-month look back period from the date of nursing home entry. Mr. Smith is ineligible for nursing home payment for a period of 2.5 months. Deprivation does not apply until Mr. Smith was residing in a specified living arrangement.

$12,000 amount of transfer on 3/25/18 $12,000 ÷ $4,800 private pay cost = 2.5 months of ineligibility from the month of entry to the nursing home.

Mr. Smith must be given ten-day notice that he is ineligible for 2.5 months effective 11/18 due to deprivation of resources.

Example 5: Mr. Smith applies for Medicaid on 8/10/18 and has lived in the nursing home for several years. There were 4 transfers of cash made as follows:

In 3/17 he transferred $4,000 to his daughter In 4/17 he transferred $3,500 to his daughter In 5/17 he transferred $3,000 to his son In 6/17 he transferred another $3,500 to his son

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Official source

REV. MAY 3, 2018 NEBRASKA DEPARTMENT OF MEDICAID ELIGIBILITY MANUAL LETTER #43-2018 HEALTH AND HUMAN SERVICES 477-000-032

$20,000 amount of transfer on 2/25/17 $20,000 countable disposal ÷ $5,000 private pay cost = 4 months of ineligibility

$10,000 amount of transfer on 12/10/17. $10,000 ÷ $5,000 private pay cost = 2 months of ineligibility Total months of ineligibility are 6 beginning with 6/18 the month of Medicaid application.

$12,000 amount of transfer on 3/25/18 $12,000 ÷ $4,800 private pay cost = 2.5 months of ineligibility from the month of entry to the nursing home.

Mr. Smith must be given ten-day notice that he is ineligible for 2.5 months effective 11/18 due to deprivation of resources.

Example 5: Mr. Smith applies for Medicaid on 8/10/18 and has lived in the nursing home for several years. There were 4 transfers of cash made as follows:

In 3/17 he transferred $4,000 to his daughter In 4/17 he transferred $3,500 to his daughter In 5/17 he transferred $3,000 to his son In 6/17 he transferred another $3,500 to his son