WAG 01-02-01-a

Persons,Revised text and spouses of persons, who apply for medical assistance in a nursing home, supportive living facility, or through the Department on Aging (DoA) Home and Community Based Services (HCBS) waiver, are required to cooperate in determining their financial eligibility. If the personRevised text or the community spouse refuses or fails to cooperate in providing essential informationRevised text regarding the total value of income and resources owned by either spouse or both spouses or refuses consent to verification, the person is ineligible for medical assistance unless an undue hardship exists and a hardship waiver is granted (see PM 01-08-00).

All LTC applicants are required to complete and sign an additional financial information form related to reporting transfers of income and resources. By signing this form, the applicant gives consent to any investigation made by the Department to verify information on the form. If the applicant or representative refuses to sign this form, deny the application.