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Aged, Blind and Disabled Manual Policy Manual Number: 125.010 Section: Institutional Medicaid Chapter: Transfer of Assets and Penalty Periods

January 5, 2026 Division of TennCare 13

Institutional Medicaid category (not LTSS payments), if otherwise eligible. HCBS applicants are not eligible for Institutional Medicaid, including demonstration equivalent categories such as 217- Like and the At-Risk Demonstration categories, during a penalty period. Institutional Medicaid eligibility for HCBS applicants is conditioned upon the actual receipt of HCBS services, which cannot commence until the applicant is able to enroll in the CHOICES program.

b. Calculating the Penalty Period for Assets Transferred on or after 02/08/2006

The penalty period for NF and HCBS applicants is calculated in the same manner. To determine the penalty period, divide the uncompensated value of the asset(s) transferred by the average daily private pay rate for nursing facility care at the time of application for TennCare Medicaid or the date of transfer, whichever is later.

Note: In order to comply with the requirement that partial month penalties are assessed, TennCare Medicaid will use the average daily rate of nursing facility care to calculate the penalty period. Average Cost of Nursing Facility Care Date Daily Rate Monthly Rate 06/01/2011 – 11/30/2012 $152.23 $4,567.00 12/01/2012 – 02/28/2015 $153.02 $4,591.00 03/01/2015 – 12/31/2020 $182.42 $5,472.00 01/01/2021 – 12/31/2021 $219.36 $6,580.80 01/01/2022 – 12/31/2022 $228.41 $6,852.30 01/01/2023 – 12/31/2023 $236.34 $7,090.20 01/01/2024 – 12/31/2024 $274.00 $8,220.00 01/01/2025- 12/31/2025 $286.00 $8,580.00 01/01/2026 $295.87 $8,846.10

The penalty period will determine the number of days in which the individual is ineligible for nursing facility services. Eligibility cannot begin until the full number of days has passed.

See Section 1.k.i. Determining Compensation.

Example: Mr. Haywood transferred an asset in January 2015 with an uncompensated value of $10,000. He applied for TennCare Medicaid on February 1, 2015. He is eligible for TennCare Medicaid, but for the transfer of asset for less than FMV. The individual has been in the nursing facility since February 1, 2015. The uncompensated value is divided by the average daily cost of nursing facility care to determine the penalty period: $10,000/153.02 = 65.3 days. Round down to the nearest whole number to determine the penalty period of 65 days.

The penalty period will begin on February 1, 2015, and will run for 65 days.