INSTRUCTIONS TO STAFF 317:35-19-20
an individual applies for nursing facility service, the transfer of assets
look-back period starts with the application date. When the individual transferred assets
without receiving fair market value within the last 60-calendar months, the
penalty period starts with the date the individual is determined financially
and medically eligible for long-term care (LTC) services if it were not for the
transfer penalty. This is normally the
medical eligibility date.
(1) The area nurse determines medical
eligibility at the same time as Adult and Family Services (AFS) LTC staff
determines financial eligibility. When
the individual is receiving SoonerCare (Medicaid), AFS staff only need to
determine if the individual transferred assets without receiving fair market
(2) When the area nurse determines that the
individual does not meet nursing facility level of care, the area nurse
notifies the AFS LTC worker of the decision.
The AFS LTC worker denies the Medical Financial tab and the
authorization in Family and Client Services System (FACS). The penalty period start date is not set.
(3) When the individual is not financially
eligible for a reason other than transfer of resources, AFS LTC staff denies
the application and a penalty period is not set. AFS LTC staff notifies the area nurse of the
(4) When AFS LTC staff denies the nursing
facility application because of the asset transfer and sets a penalty period,
the individual is eligible for SoonerCare (Medicaid) only benefits during the
penalty period unless the individual requires a Medicaid Income Pension Trust
(MIPT) to be eligible. When a MIPT is required in order for the individual to
be income eligible for LTC, the individual must establish and fund a MIPT for
at least one month start the penalty period.
After one month, the individual may stop contributing to the MIPT in
order to have money to pay bills until the penalty period ends. When the individual chooses not to fund the
MIPT after the first month of SoonerCare (Medicaid) eligibility, the worker
closes the SoonerCare (Medicaid benefit.
(5) When the penalty period exceeds
60-calendar month look back period, AFS LTC staff explains the benefit of
withdrawing the LTC application and not reapplying until the 60-calendar months
from the last large transfer. This
avoids the requirement of serving the complete penalty period.
(A) For example, if the individual transferred
$300,000 on May 15, 2013 and $10,000 more on November 15, 2016 and applied for
nursing facility level of care on January 2, 2017, it is better to withdraw the
application and wait to apply until after May 15, 2018. When the individual waits until after May 15,
2018 to apply, the 60-calendar month look back period will have ended for the
large transfer. Using the Transfer of
Assets Calculator, $310,000 divided by the current average daily cost of
nursing home care, that for this example is $144.67, equals 2143 days. 2143 days equals a transfer penalty period
lasting until November 15, 2022. This
exceeds 60 months or 365 days times 5 that equals 1825 days. When the individual waits until after May 15,
2018 to apply, the large transfer occurred over five years ago and is not
considered for the January application.
The individual must serve a 70-calendar day transfer penalty for the
$10,000 transfer so he or she is not eligible until July 25, 2018.
(B) Contact Adult and Family Services Health
Related and Medical Services staff when assistance is needed to determine the
best case scenario for the individual.