In order to keep a community spouse from being impoverished when their partner enters a nursing home, federal laws allow the community spouse to keep a certain amount of assets and income. The amount of assets the community spouse is allowed to keep is termed the community spouse resource allowance (CSRA). The amount of income the community spouse is allowed to keep is called the minimum monthly maintenance needs allowance (MMMNA).

The Covid-19 Pandemic made everything topsy-turvy. Businesses shut down, supplies were sometimes scarce, and families were distanced. It seemed like the coronavirus could be a legitimate excuse for the failure to get almost anything done in a timely manner. But what if this were the cited reason for causing planning delays in a Medicaid eligibility case? Was this a valid argument? An Ohio appeals court says no but only because of a technicality.

A.V. suffered from Alzheimer’s disease and was admitted to a nursing home in January 2021. Thereafter, she submitted a Medicaid application for benefits. On her application, she reported several transfers for less than fair market value during the look-back period. She transferred various amounts to her kids and grandkids for things like wedding gifts, help with a down payment on a home, and car purchases. A.V. had specific dates and amounts for each recipient and presented verification to the Medicaid office. All transfers totaled roughly $25,000.

In accordance with 42 U.S. Code § 1396p(c)(2)(C), a Medicaid applicant will not be ineligible for benefits due to transfers during the look-back period if the applicant demonstrates to the state that the transfers were made for a purpose other than to qualify for benefits.