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 that are unexplained or questionable totaling over $10,000 during the lookback period to Long Term Care Asset Discovery Investigation (LTC-ADI) using HFS 3654A Referral Form. FCRCs will review reported transfers totaling $10,000 or less.
Send Form 3654A to LTC-ADI by:
Illinois Department of Human ServicesJB Pritzker, Governor · Dulce Quintero, Secretary
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