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• A spouse • A child of the institutionalized person or their spouse, regardless of the child’s age, if the child is blind or permanently and totally disabled 17.2.6.10 Certain Payments to Relatives for Services Provided Payments (or transfer of ownership of something of value) by an institutionalized person to a relative for services provided to the institutionalized person is an allowed divestment and doesn’t result in a penalty period if either: • The amount is less than 10 percent of the maximum Community Spouse asset share (CSAS) and meets both of the following: ◦ The services directly benefited the institutionalized person. ◦ The payment did not exceed reasonable compensation for the services provided. • The amount is greater than 10 percent of the maximum Community Spouse asset share and meets all of the following: ◦ The services directly benefited the institutionalized person. ◦ The payment did not exceed reasonable compensation for the services provided. ◦ The institutionalized person and the relative providing the service have a written, notarized agreement that meets all of the following: ◾ Specifies the service being provided to the institutionalized person ◾ Specifies the amount to be paid to the relative providing the services ◾ Was notarized at the time the relative began to provide the services Example 9 Kerry requests enrollment in Family Care on January 10. She paid her son $3,500 to remodel her bathroom the previous month. Her son installed new tile and fixtures, which directly benefited Kerry. Kerry provides verification from a local contractor who estimates he would have charged $4,000 for the same job. This amount is less than the maximum Community Spouse asset share at the time, so Kerry doesn’t need a notarized agreement. Since the bathroom remodel directly benefited Kerry and she did not pay more than reasonable compensation for the service, the payment to her son is an allowed divestment and doesn’t result in a penalty period.

Example 10 Rosemary enters a nursing home and applies for Medicaid on November 1. When asked if she has transferred any assets in the past 60 months, Rosemary indicates that she paid her daughter $30,000 in exchange for her daughter providing personal care for her over the past two years. Rosemary provides an estimate from a home care provider that a similar amount of care from one of their employees would have cost $32,000 for two years. This payment is above 10 percent of Rosemary’s Community Spouse asset share, so Rosemary must provide a notarized agreement. Rosemary provides the IM agency with an agreement that is dated and notarized at the time her daughter began providing care. Rosemary provided the required notarized agreement and did not pay more than reasonable compensation for the service her daughter provided. The payment to her daughter is an allowed divestment and doesn’t result in a penalty period. 17.2.6.11 Payments to Relatives While the Institutionalized Person Did Not Receive Room and Board A payment for room and board made to relatives by an institutionalized person after they were institutionalized is an allowed divestment and doesn’t result in a penalty period if the payment is only for the month immediately preceding the month that they entered the institution, the payment was for