TN 12 (08-00)

A. Policy — Exceptions for transfer of a home

1. Transfer to a Spouse or Child

The period of ineligibility for transferring a resource at less than fair market value will not apply if the individual or individual's spouse transfers title to a home to his/her:

• spouse (including a separated spouse); or

• child under age 21 regardless of student or marital status; or

• child of any age or any marital status who is blind or disabled.

2. Transfer to a Sibling

The period of ineligibility for transferring a resource at less than fair market value will not apply if the individual or individual's spouse transfers title to a home to a sibling of the transferor:

• who has ownership interest (including life estate and equitable ownership) in the home; and

• who was residing in the transferor's home for at least 1 year immediately before the date the transferor becomes institutionalized.

NOTE: See SI 01150.122B for discussion of “residing in transferor's home” as it applies to this exception. See SI 01150.122D for discussion of “institutionalization as it applies to this exception. See SI 01110.500 for discussion of the types of ownership.

3. Transfer to a Son or Daughter

In addition to the exception for the children listed in SI 01150.122A.1., the period of ineligibility will not apply if the individual or the individual's spouse transfers title to a home to a son or daughter who:

• was residing in the transferor's home for at least 2 years immediately before the date the individual becomes institutionalized; and

• who provided care to the individual which permitted the individual to reside at home instead of in an institution.

NOTE: See SI 01150.122B for discussion of “residing in transferor's home” as it applies to this exception. See SI 01150.122C for discussion of “providing care” as it applies to this exception. See SI 01150.122D for discussion of “institutionalization” as it applies to this exception.

B. Policy — Residing in the transferor's home

For the purpose of determining whether the individual qualifies for the transfer of a home exception, the home must have been transferred to a person who resided in the transferor's home. A person resides in the transferor's home if it is that person's primary place of residence. We follow the same criteria that are used to determine an eligible individual's place of residence when determining the FLA and ISM (SI 00835.020).

C. Policy — Providing care for the transferor

The transfer of a home exception requires that the son or daughter (who received the transferred home) provided care that enabled the transferor to reside at home instead of in an institution or facility. Such care is substantial but not necessarily full-time care. A son or daughter is providing care for purposes of this exception if he/she does most of the following for the transferor on regular basis:

• prepares meals;

• shops for food and clothing;

• helps maintain the home;

• assists with financial affairs (banking, paying bills, taxes);

• runs errands;

• provides transportation;

• provides personal services;

• arranges for medical appointments;

• assists with medication.

NOTE: The issue of providing care needs to be developed only when the resource is transferred to a son or daughter who is not blind or disabled, and who resides with the transferor for at least 2 years prior to the transferor becoming institutionalized.

D. Policy — Institutionalization

For purposes of the transfer of a home exceptions, the following individuals are considered to be institutionalized:

• an individual who is an inpatient in a nursing facility;

• an individual who is an inpatient in a medical treatment facility and for whom Medicaid payments are made based on a level of care provided in a nursing facility;

• an individual who is eligible for home or community based services under a waiver granted under section 1915(c) or (d). (See SI 01310.207.)

NOTE: An individual who meets one of these 3 criteria is considered institutionalized for purposes of this exception regardless of the FLA determination (e.g., FLA-A vs.
FLA-D).

E. Procedure — Documenting transfer of home exception

Follow this procedure to develop whether one of the home transfer exceptions applies.

1. Evidence

• Verify that the home was transferred, to whom, the amount of compensation if any, and the date of transfer using the individual's statement either signed or recorded on a DROC, and appropriate documents (e.g., sales agreement, deed, mortgage documents).

• Verify the relationship of the transferor to the individual receiving the home (spouse, child, sibling). Information on the supplemental security record (SSR), master beneficiary record (MBR), or Numident may be used.

• As needed, verify that the child to whom the home was transferred meets the SSI requirements for blindness or disability. (See SI 01150.121D)

• As needed, verify an allegation that a sibling had an ownership interest in the home using appropriate documents.

• As needed, verify an allegation that a sibling was residing in the home for at least one year prior to the individual becoming institutionalized using available documents or with a signed statement by a knowledgeable third party.

• As needed, verify an allegation that the individual's son or daughter resided in the individual's home for at least 2 years and provided care that enabled the individual to live outside an institution using available documents or a signed statement by a knowledgeable third party.

• As needed, verify that the individual is/was institutionalized and the dates.

2. Making the Determination

• Determine whether the individual meets one of these exceptions.

• If one of these exceptions applies, do not apply a period of ineligibility. Process the case normally.

• Document the file with the adjudicator's determination. For example “Home transferred on 2/5/00 to individual's disabled child. Meets exception for transfer of a home per SI 01150.122. Period of ineligibility does not apply.”

• If the exception does not apply, consider the exception for transferring a resource exclusively for a purpose other than to obtain SSI (SI 01150.125D).

3. Systems Input

• Record the evidence used to verify these issues on the EVID screen on the Shared Processes Menu (MSOM EVID 001.001 ).

• Record the determination on MSSICS using the File Documentation Notes section of the Property/Cash Given or Sold (RGIV) page or on the DROC screen (MSOM MSSICS 022.010 ). On non-MSSICS cases, use a Report of Contact.

4. Medicaid Notification

Notify the State Medicaid agency about the transferred resource unless the SSI claim is denied (SI 01150.012).

F. References

Place of residence, SI 00835.020

Notifying State Medicaid agency, SI 01150.012

Home and community based services, SI 01310.207

MSSICS DROC screen, MSOM MSSICS 022.010

Evidence screen, MSOM EVID 001.001