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West Virginia Income Maintenance Manual Chapter 24

West Virginia Income Maintenance Manual Page 62 Chapter 24 Long Term Care

3. Services expected of the caregiver, if any, during any period the individual may reside in an assisted living, skilled nursing, or other type of medical or nursing care facility on a temporary basis between stays at home. ➢ Requirements Regarding the Provision of Services The following describes the requirements regarding the provision of services: • Services paid from transferred resources must be rendered after the written agreement was executed between the individual and the caregiver; • A PCC may be in place at the time of the individual’s stay in a nursing facility or a similar placement; however, it is assumed, unless proven otherwise, that personal care services during this time are provided by staff rather than the caregiver named in the PCC; and, • At the time of the receipt of the services, the services must have been recommended in writing and signed by the individual’s physician as necessary to prevent the transfer of the individual to residential care or nursing facility care. Such services may not include the mere providing of companionship. ➢ Requirements Regarding the Transfer The following describes the requirements regarding the transfer: • The transfer to the relative or friend acting as caregiver must have taken place at the time the personal care services were rendered; • The transfer cannot be for services projected to occur in the future, but must be paid for at the time rendered; and, • FMV must be received by the caregiver in the form of payment for personal care services provided to him. The Worker must determine if reasonable payment for personal care services occurred. If the amount transferred to pay for personal care services is above FMV, the amount transferred in excess of FMV is subject to a transfer penalty. Allowable PCC Example: Mr. Daisy applies for Medicaid. He transferred $5,000 to his granddaughter to pay for personal care services provided to him for the last five months. The Worker reviews the PCC and contacts a community agency representative who indicates the payments made were similar to the rate paid by agencies at the same time period in the same locale. Since the payment was reasonable and the PCC meets all the criteria required in Section 24.8.2.F, the