When a hardship waiver is requested following imposition of a penalty period due to a non-allowable transfer of resources or income, the person must verify:
- attempts to recover the uncompensated value of the resources or income;
- referral to the police or other law enforcement/regulatory agencies in cases involving alleged theft, fraud, elder abuse or other misappropriation of resources or income;
- any medical condition, mental capacity, or other factors which may have affected the person at the time of the transfer; and
- the resulting impact of the denial of medical assistance for nursing home, SLF, or DoA HCBS waiver services.
In the case of a favorable decision, either all or part of the penalty period may be waived.
Use the following criteria to determine whether to waive all or part of a penalty period imposed for a non-allowable transfer of resources or income:
- Is credible and convincing evidence presented that the person has taken all equitable and legal means to recover the uncompensated value of resources or income transferred?
- In cases of alleged theft, fraud, elder abuse, or other misappropriation of resources or income, is there evidence that the matter has been referred to the police or other law enforcement or regulatory agencies?
- Is there evidence of legal attempts to recover the value of resources or income from the professional advisor in situations where resources or income were transferred for less than FMV due to legal, financial or other professional advice?
- Is there credible and convincing evidence suggesting the transfers were not made primarily to qualify for assistance, such as: resources or income were not transferred to family members; transfers were made for FMV; transfers were not made close to an application for LTC services?
- Is there evidence the person's medical condition, mental capacity, financial ability, or other factors may have affected the person at the time of the transfer, or may affect the person's ability to pursue recovery?
- Would the denial of assistance force the person to move, or prevent the person from joining their spouse in a facility, or from entering a facility in close proximity to family?