Pennsylvania Code › Title 55 - HUMAN SERVICES › Part II - Public Assistance Manual › Subpart D - Determination of Need and Amount of Assistance › Chapter 178 - RESOURCE PROVISIONS FOR CATEGORICALLY NMP-MA AND MNO-MA › Subchapter A - GENERAL PROVISIONS FOR MA RESOURCES COMMON TO ALL CATEGORIES OF MA › GENERAL PROVISIONS FOR MA RESOURCES › Section 178.2 - Definitions

Current through Register Vol. 54, No. 28, July 13, 2024
The following words and terms, when used in this
						  chapter, have the following meanings, unless the context clearly indicates
						  otherwise:
Annuity
-An investment contract or
						  policy which gives the right to receive fixed, periodic payments, either for
						  life or a term of years.
Applicant/recipient
-A person who is
						  applying for, or receiving, MA or a group of related persons who are living
						  together and who choose to apply for, or receive, MA as one group.
Assets
-Income and resources of the
						  individual and of the individual's spouse, including income or resources which
						  the individual or the individual's spouse is entitled to but does not receive
						  because of action by one of the following:
(i) The individual or the individual's
						spouse.
(ii) A person or a court or
						administrative body with legal authority to act in place of, or on behalf of,
						the individual or the individual's spouse.
(iii) A person or a court or administrative
						body acting at the direction or upon the request of the individual or the
						individual's spouse.
Burial reserve
-Funds or other
						  resources, whether revocable or irrevocable, held in trust or under contract
						  with a financial institution or a funeral director and designated for burial
						  expenses. The term may also be known as funeral reserves, funeral agreements,
						  prepaid funeral agreements, burial funds, burial agreements or similar
						  names.
Burial space
-Conventional grave sites,
						  crypts, burial drawers, mausoleums, urns and other repositories customarily
						  used to deposit the remains of deceased persons.
Community spouse
-The spouse living at
						  home who has a spouse who had lived at home but is now an institutionalized
						  spouse.
Disposition of property
-The transfer
						  of ownership of, or an interest in, a property. This can be accomplished by the
						  sale, exchange or transfer of the title, or by diminishing the value of an
						  interest through the placing of an encumbrance or by adding a person to the
						  title.
Equity value
-The FMV less legal
						  encumbrances, including liens and mortgages.
FMV
-
Fair Market
						  Value
-The price which property can be expected to sell for on the open
						  market or would have been expected to sell for on the open market in the
						  geographic area in which the property is located.
Fair consideration
-Compensation in
						  cash or in kind which is approximately equal to the FMV of the transferred
						  property.
IRC
-Internal Revenue Code
						  (26 U.S.C.A. §§
													1 -
						  1043.
Immediate family
-The child, the
						  biological or adoptive parent of a child under 21 years of age, the spouse of
						  the parent, and the brother, sister, stepbrother, step-sister, half-brother or
						  half-sister who are under 21 years of age. The immediate family members must be
						  living together.
Institutionalized individual/person
-An
						  individual who is receiving nursing facility care.
Institutionalized spouse
-The spouse
						  who is receiving skilled care, heavy care/intermediate services or intermediate
						  care in a nursing facility or other medical institution, including services in
						  an ICF/MR facility, for a period likely to last for at least 30 consecutive
						  days.
Irrevocable trust
-A trust which
						  cannot, in any way, be revoked by the grantor.
Jointly-owned resources
-Resources
						  which have more than one owner.
LRR
-
Legally Responsible
						  Relative
-The spouse of a person, or the natural or adoptive parent of
						  a child under the age of 21.
Liquid resources
-Resources that are in
						  cash or financial instruments which can normally be converted to cash. The term
						  includes cash on hand, savings and checking accounts, stocks, bonds, mutual
						  fund shares, money certificates, promissory notes and mortgages.
Look-back date/look-back period
-The
						  specified period of time immediately before the date of an institutionalized
						  individual's application for MA benefits which determines the earliest date on
						  which a transfer of assets for less than FMV can result in ineligibility for
						  MA.
MCCA
-The Medicare Catastrophic
						  Coverage Act of 1988 (Pub. L. 100-360, 102 Stat. 683) (July 1, 1988).
Motor vehicle
-A passenger car, truck,
						  motorcycle or other motor vehicle that can be used to transport persons or
						  goods, and is of a type permitted to travel on highways of this
						  Commonwealth.
NFC
-
Nursing Facility
						  Care
-Skilled care, heavy care/intermediate services or intermediate
						  care in a nursing facility or other medical institution.
Nonliquid resources
-Real or personal
						  property not considered liquid resources.
Nonresident property
-Real property
						  that is not used as the principal place of residence by the
						  applicant/recipient, his spouse or his dependent minor or incompetent adult
						  children.
Parent
-The natural or adoptive
						  parent.
Personal property
-Privately owned
						  possessions which are not real property. The term includes cash, bank accounts,
						  stocks, bonds, mortgages, cash value of life insurance policies, household
						  furnishings, personal effects, motor vehicles, boats and Federal, State and
						  local tax refunds.
Real property
-Land, buildings, mobile
						  homes and improvements thereto.
Rebuttable presumption
-A rule of
						  evidence which permits the Department to assume that when certain facts are
						  true, other facts are true, without having proof of those other facts. The
						  presumption is automatic, and can be disproved or rebutted only by the
						  applicant/recipient presenting evidence at a prehearing conference or a
						  Departmental fair hearing. If the applicant/recipient presents no evidence at
						  the prehearing conference or at the fair hearing to disprove the presumption,
						  the presumption remains unrebutted and stands.
Resident property
-Real property used
						  as the principle place of residence by the applicant/recipient, his spouse or
						  his dependent minor or incompetent adult children.
Resource
-Real or personal property
						  which a person has or can make available for partial or total support,
						  including equitable interests and partial interests. The term does not include
						  credit.
Revocable trust
-A trust which can be
						  revoked by the grantor, including a trust which provides that it can be
						  modified or terminated only by a court, and a trust which is called irrevocable
						  but will terminate if some action is taken by the grantor.
SSI
-
Supplemental Security
						  Income
-The benefit amount paid to an eligible person or to an eligible
						  person and his eligible spouse under Title XVI of the Social Security Act
						  (42 U.S.C.A. §§
													1381 -
						  1383d.
Spouse
-A person who is married to
						  another by legal ceremony or by common-law.
Trust
-An arrangement in which a
						  grantor transfers property to a trustee with the intention that it be held,
						  managed or administered by the trustee for the benefit of the grantor or other
						  designated individuals. The term also includes any legal instrument or device
						  that is similar to a trust, but excludes trusts established by will, which are
						  subject to §
												178.4 (relating to treatment of
						  resources for all categories of MA).
Trustee
-An individual or entity such
						  as an insurance company or bank that manages a trust.
UV
-
Uncompensated
						  Value
-The amount remaining after the FMV of a property at the time of
						  transfer is reduced by the following amounts in the order listed:
(i) The cost of sale/transfer and
						encumbrances.
(ii) The amount of
						compensation received.
Undue hardship
-Exists when denial of
						  MA would deprive the individual of medical care and endanger the individual's
						  health or life; also exists when the individual or a financially dependent
						  family member would be deprived of food, clothing, shelter or other necessities
						  of life.
The provisions of this §
														178.2 amended under sections
							 201(2) and 403(b) of the Public Welfare Code (62 P. S. §§
															201(2) and
							 403(b)).
This section cited in 55 Pa. Code §
														178.71 (relating to burial
							 spaces); 55 Pa. Code §
														178.84 (relating to resources of
							 children under 21 years of age and families with children under 21 years of
							 age); 55 Pa. Code §
														178.161 (relating to personal
							 property exclusions); 55 Pa. Code §
														178.163 (relating to resources of
							 children under 21 years of age and families with children under 21 years of
							 age); 55 Pa. Code §
														178.101 (relating to disposition
							 of property and fair consideration provisions for transfer during the period of
							 January 4, 1991, through July 29, 1994); 55 Pa. Code §
														178.104 (relating to disposition
							 of assets and fair consideration provisions for transfers on or after July 30,
							 1994); 55 Pa. Code §
														178.121 (relating to general); 55
							 Pa. Code §
														178.124 (relating to resource
							 eligibility for the institutionalized spouse); 55 Pa. Code §
														178.161 (relating to personal
							 property exclusions); 55 Pa. Code §
														178.171 (relating to disposition
							 of property and fair consideration provisions for transfers during the period
							 of January 4, 1991, through July 29, 1994); and 55 Pa. Code §
														178.174 (relating to disposition
							 of assets and fair consideration provisions for transfers on or after July 30,
							 1994).