Tag: 5.04 Institutional Long-Term Care

DHA Case No. MDV 28/100729 (Wis. Div. Hearings and Appeals Mar. 9, 2009) (DHS) ↓ Download PDF Adivestment penalty may be “cured” by returning the divested resource, or its equivalent value, to the individual. In this case, the petitioner gave a 34% interest in her homestead to her son and his wife. They also all […] Read more

DHA Case No. MDV 66/71952 (Wis. Div. Hearings and Appeals Jan. 25, 2006) (DHS) ↓ Download PDF A divestment penalty may be “cured” by returning the divested resource, or its equivalent value, to the individual. In this case, the petitioner made multiple divestments during the lookback period totaling more than $200,000, but her son paid […] Read more

DHA Case No. MDV 147776 (Wis. Div. Hearings and Appeals Jul. 12, 2013) (DHS) ↓ Download PDF The divestment penalty period for an Institutional MA applicant begins on the first date the person (1) is institutionalized, (2) has applied for Medicaid, and (3) is otherwise eligible for Medicaid. In this case, the petitioner applied on […] Read more

DHA Case No. FCP 140118 (Wis. Div. Hearings and Appeals Jul. 13, 2012) (DHS) ↓ Download PDF Adivestment occurs when an institutionalized individual or spouse transfers assets for less than fair market value during the look-back period. In this case, the petitioner’s husband made cash withdrawals of $100,000 and $17,000 shortly before the application for […] Read more

DHA Case No. MDV 138459 (Wis. Div. Hearings and Appeals Apr. 24, 2012) (DHS) ↓ Download PDF A divestment occurs when an institutionalized individual transfers assets for less than fair market value during the look-back period. In this case, the petitioner’s bank statements showed withdrawals of $29,134.50 over two years. Her daughter and POA could […] Read more

DHA Case No. MRA 215653 (Wis. Div. Hearings and Appeals Dec. 20, 2024) (DHS) ↓ Download PDF An ALJ may increase the community spouse income allocation (CSIA) if the community spouse does not have enough income to pay his or her “necessary and basic maintenance needs.” In this case, ALJ Kelly Cochrane summarily ordered the […] Read more

DHA Case No. MGE 173712 (Wis. Div. Hearings and Appeals Sep. 7, 2016) (DHS) ↓ Download PDF To be income-eligible for Institutional MA, an applicant must qualify as either categorically needy (having a very low income) or medically needy, having income less than her monthly need—of which the cost of the nursing home is a […] Read more

DHA Case No. MDV 214223 (Wis. Div. Hearings and Appeals Nov. 27, 2024) (DHS) ↓ Download PDF A divestment penalty is generally imposed when an applicant reports a divestment and would be otherwise eligible. In this case, the petitioner originally applied in 2020 after creating an irrevocable trust, but no divestment penalty was imposed because […] Read more

DHA Case No. MGE 214773 (Wis. Div. Hearings and Appeals Nov. 1, 2024) (DHS) ↓ Download PDF The county agency is required to verify a Medicaid applicant’s income and assets, including potential divestments. In this case, the petitioner reported a $5,000 transfer to his sister for “paid bills” and his bank statements showed withdrawals of […] Read more

DHA Case No. MDV 214370 (Wis. Div. Hearings and Appeals Oct. 22, 2024) (DHS) ↓ Download PDF The transfer of an exempt asset (except a homestead) is not a divestment. In this case, the petitioner bought a car—though she could not drive herself—that her son used to transport her to medical appointments. About seven months […] Read more

DHA Case No. MRA 213346 (Wis. Div. Hearings and Appeals Aug. 30, 2024) (DHS) ↓ Download PDF An ALJ may increase the community spouse income allocation (CSIA) if the community spouse does not have enough income to pay his or her “necessary and basic maintenance needs.” In this case, ALJ Nicole Bjork increased the CSIA […] Read more

DHA Case No. MDV 177535 (Wis. Div. Hearings and Appeals Feb. 9, 2017) (DHS) ↓ Download PDF When a Medicaid applicant can show that transfers to family members were made for a purpose other than to qualify for Medicaid, those transfers are not divestments. In this case, the petitioner made more than a hundred small […] Read more

DHA Case No. MDV 190237 (Wis. Div. Hearings and Appeals Dec. 13, 2018) (DHS) ↓ Download PDF Any transfer of resources for less than fair market value is generally a divestment, but there is an exception if the resource was transferred “exclusively for some other purpose than to become eligible for MA.” In this case, […] Read more

DHA Case No. MDV 71/35825 (Wis. Div. Hearings and Appeals Aug. 28, 1998) (DHS) ↓ Download PDF It is generally a divestment to sell real estate for less than its fair market value. In this case, the petitioner sold his home on the market for $62,000, less than its tax-assessed value of $72,100. ALJ Kenneth […] Read more

DHA Case No. MDV 40/44764 (Wis. Div. Hearings and Appeals 2001) (DHS) ↓ Download PDF It is generally a divestment to sell real estate for less than its fair market value. In this case, the petitioner sold her duplex on the market for $72,500, less than its tax-assessed value of $95,900. ALJ Joseph Nowick concluded […] Read more