MO HealthNet applications and annual review forms require specific information regarding whether or not a participant and/or spouse has transferred property or resources. This information must be provided at application, annual review, or change in circumstance.
Staff must not:
- assume at application or review that a transfer has occurred
- automatically request information from a participant such as bank statements or tax returns for the months of the look-back period (see 1040.020.05 Establishing the Look-Back Date)
- request additional information from a participant regarding transfers unless:
- evidence from other sources indicates a transfer has occurred; or
- the participant or participant’s representative has reported a transfer
Note: When requesting information from electronic verification system (EVS) sources, such as Accuity, request information for the entire 60-month look back period as this does not create an additional burden for the participant.
If there is an indication the participant may have transferred real or personal property regardless of its value within the look-back period, further investigation must be completed. Staff must determine at the time of application; reapplication, at annual review, or upon discovery of the transfer, whether an individual made an improper transfer of real or personal property.
Staff will initiate an inquiry regarding potential improper transfers if any source of information received indicates a transfer has occurred, and will request documentation verifying the transfer, including details of any exchanges or transactions.
Appropriate documentation may include, but is not limited to the following:
- Deeds and mortgage statements or contracts, financial planning documents, trusts, annuities, or bank statements
- True and correct copies of federal income and gift tax returns that have been filed singly or jointly during the five tax years prior to the application date
If, after considering all information presented by the participant, an eligibility determination cannot be made, send a summary of the relevant information (including a copy of the deed, note, etc.) to the MO HealthNet Program and Policy Unit. Take no action based on this factor until the response is received. IM-14 Requests for Interpretation of Policy must always be submitted through proper supervisory channels.
Refer to IM Manual Section 1040.010.00 General Provisions of the December 1973 Eligibility Requirements manual to determine whether or not a transfer of property penalty must be imposed.
Section 1917 of the Social Security Act (42 U.S.C. 1396p) establishes that when all improperly transferred assets are returned to the transferor, this voids a transfer penalty. This exception applies to MO HealthNet nursing facility benefits (vendor level of care), Home and Community Based (HCB) Waiver Services, and Missouri’s Children with Developmental Disabilities (MOCDD) Waiver Services.
Transfer of Assets – Property Returned
If it is learned that a participant improperly transferred assets, and reports all assets have been returned to him/her by the individual the assets were initially transferred to, a transfer of property penalty will not be applied, or no longer imposed as of the date in which all assets are returned (whether returned during the application period or while the penalty is being served).
EXAMPLE: Mr. Acres entered a nursing facility on 10/01/2019. On 09/10/2019, Mr. Acres deeded his farm with a fair market value of $250,000.00, to his son. Mr. Acres is determined ineligible for vendor while he is serving a penalty period. On 12/10/2019, Mr. Acres’ son deeded the farm back to him. The first date of Mr. Acres’ potential eligibility for payment of vendor benefits will be 12/10/2019 as this transfer now meets an improper transfer of property exception because all assets improperly transferred, have been returned to Mr. Acres. Since the homestead sits on the farmland, the farm is not a countable resource. See 1030.010.10 Real Property as Available Resource.
When an improper transfer of property occurs and all property is returned after the prior quarter months, but prior to the eligibility decision, the transfer penalty may still be imposed in the prior quarter. See 1040.020.20 Eligible With the Property.
NOTE: If all assets are returned in the month of application and prior to the application eligibility determination date, but retention of the assets transferred would have caused ineligibility in the prior quarter due to excess resources, the transfer of property penalty period must include the prior quarter months, and end as of the date the assets were returned.
EXAMPLE: Ms. Vickers became institutionalized on 09/01/2019. She applied for vendor coverage on 01/01/2020 and requested prior quarter coverage. Ms. Vickers reported on her application that she gave her daughter $8,000 on 01/01/2019 to help her buy a house. Ms. Vickers reported her daughter gave the $8,000 back to her on 01/25/2020 while her application for vendor benefits is still pending. The transferred assets have been returned to Ms. Vickers, but the transfer penalty must be served during the prior quarter months because the funds would have caused Ms. Vickers to be ineligible due to excess resources in the prior quarter. The transfer penalty will be applied to the prior quarter months, and will end as of the date the money was returned to Ms. Vickers.
There is no transfer penalty reduction for a partial return of assets on an active vendor, HCB, or MOCDD case with the exception that a partial return of assets may reduce a transfer penalty on a pending application only if partial assets are returned prior to the eligibility determination, but not if partial assets are returned after the eligibility determination is made, and while the penalty period is already being served.
It is necessary to determine whether or not the assets returned to the participant and/or spouse must be considered as a resource (as of the month ownership of the asset(s) is returned to the transferor). See IM Manual reference 1030.000.00 Available Resources (OAA and PTD), 1030.010.10 Real Property as Available Resource, and apply normal resource counting rules.