Current through Register Vol. 63, No. 9, September 1, 2024
(1) This rule applies to individuals applying
for or receiving Department-paid nursing facility services or home and
community-based care (see OAR
461-001-0030).
(2) An individual who completes a
disqualifying transfer of an asset in accordance with OARs
461-140-0210,
461-140-0220,
461-140-0242, and
461-140-0250 is disqualified
from receiving Department-paid nursing facility services or home and
community-based care. The length of a disqualification period
resulting from the transfer is the number of months equal to the uncompensated
value (see OAR 461-140-0250) for the transfer
divided by the following dollar amount:
(a) If
the initial month (see OAR
461-001-0000) is prior to
October 1, 1998-$2,595.
(b) If the
initial month is on or after October 1, 1998 and prior to
October 1, 2000-$3,320.
(c) If the
initial month is on or after October 1, 2000 and prior to
October 1, 2002-$3,750.
(d) If the
initial month is on or after October 1, 2002 and prior to
October 1, 2004-$4,300.
(e) If the
initial month is on or after October 1, 2004 and prior to
October 1, 2006-$4,700.
(f) If the
initial month is on or after October 1, 2006 and prior to
October 1, 2008-$5,360.
(g) If the
initial month is on or after October 1, 2008 and prior to
October 1, 2010-$6,494.
(h) If the
initial month is on or after October 1, 2010 and prior to
October 1, 2016-$7,663.
(i) If the
initial month is on or after October 1, 2016 and prior to
October 1, 2018--$8,425.
(j) If the
initial month is on or after October 1, 2018 and prior to
October 1, 2020 ---$8,784.
(k) If
the initial month is on or after October 1, 2020 and prior to
October 1, 2022---$9,551.
(l) If
the initial month is on or after October 1, 2022---
$10,342.
(3) For
transfers by an individual and the spouse of an individual:
(a) If there are multiple transfers by the
individual and the spouse of the individual, including any transfer less than
the applicable dollar amount identified in subsections (2)(a) to (2)(l) of this
rule, the value of all transfers are added together before dividing by the
applicable dollar amount identified in subsections (2)(a) to (2)(l) of this
rule.
(b) The quotient resulting
from the calculation in section (2) of this rule is not rounded. The whole
number of the quotient is the number of full months the financial group is
disqualified. This number might be zero full months. The remaining decimal or
fraction of the quotient is used to calculate a partial month disqualification,
which may be in addition to one or more full months. This remaining decimal or
fraction is converted to a number of days by multiplying the decimal or
fraction by the number of days in the month following the last full month of
the disqualification period, if any. If this calculation results in a fraction
of a day, the fraction of a day is rounded down.
(c) The date the disqualification begins is:
(A) For an individual who either transfers an
asset while they are already receiving Department-paid nursing facility
services or home and community-based care, or transfers an
asset on or after the date that is 60 months prior to the date of
request (see OAR
461-115-0030) but fails to
report the transfer at initial application, the first of the month following
the date the Department learns the asset was transferred and the timely
continuing benefit decision notice period ends (see OAR
461-175-0050), except that if
disqualification periods calculated in accordance with this rule overlap, the
periods are applied sequentially so that no two penalty periods
overlap.
(B) For an individual who
transfers an asset prior to submitting an application for services and being
determined eligible who reports the transfer at application, the date
of request for nursing facility services or home and
community-based care as long as the applicant or individual would
otherwise be eligible but for this disqualification period. If the applicant or
individual is not otherwise eligible on the date of request,
the disqualification begins the first date following the date of
request that the applicant or individual would be otherwise eligible
but for the disqualification period.
(d) If both spouses of a couple are applying
for or receiving Department-paid nursing facility services or home and
community-based care, part of the disqualification is apportioned to
each of them. If one member of the couple is serving a disqualification when
the other member of the couple applies for or starts receiving Department-paid
nursing facility services or home and community-based care,
any remaining disqualification is apportioned equally to each member of the
couple. If one spouse is unable to serve the resulting disqualification period
for any reason, the remaining disqualification applicable to both spouses must
be served by the remaining spouse.
(4) If an asset is owned by more than one
person, by joint tenancy, tenancy in common, or similar arrangement, the share
of the asset owned by the individual is considered transferred when any action
is taken either by the individual or any other person that reduces or
eliminates the individual's control or ownership in the individual's share of
the asset.
(5) For an annuity that
is a disqualifying transfer under section (11) of OAR
461-145-0022, the
disqualification period is calculated based on the uncompensated
value as calculated under OAR
461-140-0250, unless the only
requirement that is not met is that the annuity pays beyond the actuarial life
expectancy of the annuitant. If the annuity pays beyond the actuarial life
expectancy of the annuitant, the disqualification is calculated according to
section (6) of this rule.
(6) If an
individual or the spouse of an individual purchases an annuity on or before
December 31, 2005 or there is a potential disqualifying transfer under section
(11) of OAR 461-145-0022, and the only
requirement that is not met is that the annuity pays benefits beyond the
actuarial life expectancy of the annuitant, as determined by the Period Life
Table of the Office of the Chief Actuary of the Social Security Administration,
a disqualification period is assessed for the value of the annuity beyond the
actuarial life expectancy of the annuitant.
(7) Effective January 1, 2023, the Department
ends the disqualifications previously established under this rule based on an
income cap trust.
Statutory/Other Authority: ORS
413.085,
414.685, ORS
409.050,
411.060,
411.704 &
411.706
Statutes/Other Implemented:
42 USC
1396p, ORS
409.010,
411.060,
411.704 &
411.706
