PM 07-02-20

For long term care applications, persons who intend to enter a nursing home (NH) or SLF are asked questions about transfers of resources and income, but apply transfer policy only to those who actually go into a facility. If the person has not yet entered a facility when a decision is made, attach Notice of Anticipated Change (Form 2122) to the case record. Note any transfers that may be subject to a penalty period.

Refer long term care cases with reported transfers new materialthat are unexplained or questionable totaling over $5,000 during the lookback period to Long Term Care - Asset Discovery Investigation (LTC-ADI) New Textusing HFS 3654A Long Term Care - Asset Discovery Investigation (LTC-ADI) Referral Form. FCRCs will review reported transfers totaling $5,000 or less.

Send Form 3654A to LTC-ADI by:

  • E-mail (preferred)  [Please include the type of referral in the subject line (ex: LTC referral -Trust).]
  • Interoffice or US mail to -

Office of Inspector General

Long Term Care - Asset Discovery Investigation (LTC-ADI)

404 N. 5th Street

Springfield, IL 62702

  • Fax 217/524-3103