When a person transfers resources or income, take the following actions:
- Determine what was received in return for the resource or income and how much it was worth. Use receipts, contracts, written statements, or other documents to verify what was received and how much it was worth.
- Determine the fair market value of the property at the time of transfer.
If real property was transferred, verify the fair market value using a reputable realtor or other community member knowledgeable of property values (banker, tax assessor, auctioneer, etc.).
If personal property was transferred, determine the fair market value using:
- an institution with knowledge of the property value at the time of the transfer; or
- a person with knowledge of the transfer and/or the value at the time of the transfer.
- If the person claims they spent the money received from the transfer, ask them to explain how they spent the money.
To verify that the money was spent, use receipts, items purchased, written statements, or other documents. Also consider the person's daily living expenses and possible purchases made with cash.
Use judgment when determining if the funds are still available. It is not necessary for the person to account for every dollar. Instead, the person must be able to show that the funds from the transfer are no longer available.
If the net value of all transfers is $5,000 or less, determine whether the transfer was allowable and, if not, calculate the length of the penalty period.
If the net value of all transfers is more than $5,000, refer the case to HFS Long Term Care - Asset Discovery Investigation (LTC-ADI) using HFS 3654A Long Term Care - Asset Discovery Investigation (LTC-ADI) Referral Form. The referral packet must include all available information and documents related to the total transfer. LTC-ADI will notify the FCRC of the outcome of its review including the length of the penalty period which must be imposed, if applicable.
Refer LTC cases to the OIG Longterm Care - Asset Discovery Investigation (LTC-ADI) when the value of all questionable or unexplained transfers totals more than $5,000 in the 60 months before the application or request for LTC services. Do not refer cases to LTC-ADI when there are no questionable or unexplained transfers or the questionable transfers do not exceed $5,000.
Example: Mrs. M entered a nursing home 6 months ago and applies for LTC this month. She provides bank statements for the last 12 months. There is nothing on the Form 3654 to indicate there may have been any unallowable transfers. The bank statements show she had about $30,000 in her account until 6 months ago. Her accounts show $5000 went to the nursing home every month and that she now has $120 in her account. There is nothing on the Form 3654 to indicate there may have been any unallowable transfers. She has no unexplained transfers. The FCRC does not refer the case to LTC-ADI.
Example: Mr. J entered a nursing home 4 months ago and applies for LTC this month. He provides bank statements for the last 12 months. Eight months ago, the bank statements show $35,000 was withdrawn and Mr. J was left with a balance of $18,000. Beginning four months ago, Mr. J began paying his nursing home charges at $5,000 each month and his account is now $0. Mr. J did not explain what happened to the $35,000 withdrawal. The FCRC refers the case to LTC-ADI on Form 3654A since the unexplained transfers exceed $5,000.
Refer cases to LTC-ADI by sending all required documentation via e-mail, interoffice or US mail, or fax to:
HFS.OIG.LTC-ADI@illinois.gov [Please include the type of referral in the subject line (ex: LTC referral -Trust).]
Office of Inspector General
Long Term Care - Asset Discovery Investigation (LTC-ADI)
404 N. 5th Street
Springfield, IL 62702
If the FCRC discovers an unusually large transfer as a result of verifications received after an IL444-0267LTC has been sent for an application that was not initially referred to LTC-ADI, contact LTC-ADI to discuss possible referral at that time. Review by LTC-ADI in such circumstances will be on a case by case basis.
When a non-allowable transfer is identified and a penalty is imposed, notify the applicant of the starting date and length of the penalty period. If an appeal is filed by the applicant regarding a determination by the FCRC or the LTC-ADI, notify the LTC-ADI.