Current through all regulations passed and filed through September 16, 2024
(A)
This rule describes when transfers, by an
institutionalized individual or his or her spouse, involving a trust are
considered improper and subject to a restricted medicaid coverage period (RMCP)
in accordance with rule 5160:1-6-06.5 of the Administrative
Code.
(B)
This rule does not affect whether the contents of the
trust or payments or distributions from a trust are considered resources or
income to the institutionalized individual for purposes of determining base
eligibility under Chapters 5160:1-3, 5160:1-4, and 5160:1-5 of the
Administrative Code.
(C)
This rule applies to any revocable or irrevocable
trust, as defined in rule 5160:1-3-05.2 of the Administrative Code, that
contains assets of the institutionalized individual or his or her spouse, that
was established (other than by will) on or after the look-back date by:
(1)
The
institutionalized individual; or
(2)
The
institutionalized individual's spouse; or
(3)
A person,
including a court or administrative body, with legal authority to act in place
of or on behalf of the institutionalized individual or his or her spouse;
or
(4)
A person, including any court or administrative body,
acting at the direction or upon the request of the institutionalized individual
or his or her spouse.
(D)
In the case of a
trust that meets the requirements of paragraph (C) of this rule, only the
assets of the institutionalized individual or his or her spouse that are in the
trust, are subject to the provisions of this rule.
(E)
This rule shall
apply without regard to:
(1)
The purposes for which the trust was
established;
(2)
Whether the trustees have or exercise any discretion
under the trust;
(3)
Any restrictions on when or whether distributions may
be made from the trust; or
(4)
Any restrictions
on the use of distributions from the trust.
(F)
Unless otherwise
permitted under this chapter, any payments or distributions from a revocable or
irrevocable trust that are not made to the institutionalized individual or for
the benefit of the institutionalized individual shall be considered improperly
transferred and subject to an RMCP.
(G)
In the case of an
irrevocable trust:
(1)
Unless otherwise permitted under this chapter, if no
payment can be made to the institutionalized individual or for the
institutionalized individual's benefit, the assets of the trust will be
considered improperly transferred and subject to an RMCP in accordance with
rule 5160:1-6-06.5 of the Administrative Code.
(2)
When determining
the date that the assets of the trust were improperly transferred, the date of
transfer is the date of the establishment of the trust or the date that
payments or distributions to the individual were prohibited, whichever date is
later.
(3)
When determining the value of the transferred asset
under this provision, the value of the trust is its value on the date when the
trust was established or the date that payments or distributions to the
individual were prohibited, whichever date is later.
(4)
If any additional
assets of the institutionalized individual or his or her spouse are added to
the trust, such transfers will be considered separate improper transfers
subject to an RMCP.
(H)
This rule shall
not apply to any of the following trusts:
(1)
A special needs
trust as described in rule 5160:1-3-05.2 of the Administrative Code, except
when such a trust is added to or otherwise augmented after the individual
reaches age sixty-five. Any such addition or augmentation by the individual,
with his or her assets, after age sixty-five is considered an improper transfer
and subject to a RMCP.
(2)
A qualified income trust (QIT) as described in rule
5160:1-3-05.2 of the Administrative Code.
(3)
A pooled trust as
described in rule 5160:1-3-05.2 of the Administrative Code.
(4)
A supplemental
services trust as described in rule 5160:1-3-05.2 of the Administrative
Code.
Replaces: 5160:1-3- 05.2
