Current through all regulations passed and filed through September 16, 2024
(A)
This rule
describes the treatment of transfers involving life estates when an
institutionalized individual is requesting medicaid payment for long-term care
services.
(B)
The following steps must be taken to determine whether
a transfer involving a life estate, as defined in rule 5160:1-3-05.17 of the
Administrative Code, was an improper transfer in accordance with rule
5160:1-6-06
of the Administrative Code:
(1)
Review the life estate instrument to determine the
nature of the life estate and the rights, responsibilities, and/or restrictions
placed on the life estate owner and/ or the remainderman, as defined in rule
5160:1-3-05.17 of the Administrative Code.
(2)
Determine the
effective date of the creation of a life estate in accordance with rule
5160:1-3-05.17 of the Administrative Code.
(3)
Calculate the
fair market value of a life estate in accordance with rule 5160:1-3-05.17 of
the Administrative Code.
(C)
Life estates
established with an institutionalized individual's property.
(1)
If the life
estate was established within the applicable look-back period and the terms of
the establishing instrument prohibit the life estate from being sold or
transferred, the fair market value of the life estate will be presumed
improperly transferred.
(2)
If an institutionalized individual improperly
transferred ownership of his or her home but retained a life estate in the
home, the improper transfer amount, with respect to the home transfer, is the
difference between the fair market value of the home and the fair market value
of the life estate.
(D)
Life estates held
by an institutionalized individual.
(1)
An institutionalized individual's purchase of a life
estate interest in another individual's home within the applicable look-back
period is presumed to be an improper transfer unless the institutionalized
individual resided in the home for a period of at least one year after the date
of purchase. If such purchase is deemed improper, the fair market value of the
life estate will be the improper transfer amount.
(2)
Where the
purchase price of a life estate in another individual's home is greater than
the fair market value of the life estate, the amount of the difference will be
considered improperly transferred, even if the individual resided in the home
for at least one year.
(E)
If an
institutionalized individual transfers or sells a life estate held by the
institutionalized individual within the applicable look-back period, the
institutionalized individual must receive fair market value, calculated in
accordance with rule 5160:1-3-05.17 of the Administrative Code, for the life
estate. If the institutionalized individual receives less than fair market
value for the life estate, the fair market of the life estate will be presumed
improperly transferred.
Replaces: 5160:1-3- 05.17
