Section 16.03.05.841 - PENALTY EXCEPTIONS FOR ASSET TRANSFERSA participant is not subject to the asset transfer penalty for taking any action described in Subsections 841.01 through 841.15 of this rule.
01.Home to Spouse. The asset transferred was a home. Title to the home was transferred to the spouse.02.Home to Minor Child or Disabled Adult Child. The asset transferred was a home. Title to the home was transferred to the child of the participant or spouse. The child must be under age twenty-one (21) or blind or totally disabled under Social Security and SSI rules in 20 CFR Part 416.03.Home to Brother or Sister. The asset transferred was a home. Title to the home was transferred to a sibling of the participant or spouse. The sibling must have an equity interest in the transferred home and reside in that home for at least one (1) year immediately before the month the participant starts long-term care.04.Home to Adult Child. The asset transferred was a home. Title to the home was transferred to a child of the participant or spouse, other than a child under the age of twenty-one (21). The child must reside in that home for at least two (2) years immediately before the month the participant started long-term care. The adult child must prove they provided nursing facility level medical care to the participant which permitted them to live at home rather than enter long-term care. The child must not have received payment from Medicaid for home and community-based services provided to the participant.05.Benefit of Spouse. The assets were transferred to the participant's spouse or to another person for the sole benefit of the spouse.06.Transfer From Spouse. The assets were transferred from the participant's spouse to another person for the sole benefit of the participant's spouse.07.Transfer to Child. The assets were transferred to the participant's child, or to a trust established solely for the benefit of the participant's child. The child must be blind or totally disabled under Social Security and SSI rules in 20 CFR Part 416 . The child may be any age.08.Intent to Get Fair Market Value. The participant or spouse proves they intended to dispose of the assets at fair market value or for other adequate consideration.09.Assets Returned. All assets transferred for less than fair market value have been returned to the participant.10.Medicaid Qualification Not the Intent. The participant or spouse proves the assets were transferred exclusively for a purpose other than to qualify for Medicaid or to avoid recovery.11.Undue Hardship. The participant, their representative, or the facility in which they reside may request the hardship waiver. The hardship waiver must be requested in writing within ten (10) days of the date of the asset transfer penalty notice. Undue hardship exists if any of the conditions below apply.a. The participant proves they are not able to pay for their nursing facility services or their waiver services by any means.b. The participant proves that they have made reasonable efforts, consistent with their physical and financial ability, to recover the transferred asset. The participant must fully cooperate with the State of Idaho in efforts to recover the transferred asset and, upon request, must assign their rights to recover the asset to the State of Idaho.c. The participant proves they did not knowingly transfer the asset.d. The participant proves they would be deprived of food, clothing, shelter, or other necessities of life if the asset transfer penalty is imposed and they assign their rights to recover the asset to the State of Idaho.12.Exception to Fair Market Value. The amount received is adequate, even if not fair market value. This exception must meet one (1) of the conditions below. a. A forced sale was done under reasonable circumstances.b. Little or no market demand exists for the type of asset transferred and the lack of market demand was not created by a voluntary act of the participant to qualify for assistance or to avoid recovery.c. The asset was transferred to settle a legal debt approximately equal to the fair market value of the transferred asset.13.No Benefit to Participant. The participant received no benefit from the asset. This exception must meet one (1) of the conditions below.a. The participant or spouse held title to the property only as a trustee for another person and had no beneficial interest in the property.b. The transfer was done to clear title to property. The participant or spouse had no beneficial interest in the property. The defect in the title was not created to transfer assets to qualify for assistance or avoid recovery.14.Fraud Victim. The asset was transferred because the participant or spouse was the victim of fraud, misrepresentation, or coercion. The participant or spouse must take all possible steps to recover the assets or property, or its equivalent in damages and assign recovery rights to the State of Idaho.15.Transfer to Trust of Disabled Person. The assets were transferred to a trust established solely for the benefit of an individual under sixty-five (65) years of age who is disabled.Idaho Admin. Code r. 16.03.05.841