reglab/statecodes huggingface dataset:
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:05 - Long-term care resource requirements › Section 67:46:05:07 - Return of transferred resource

Current through Register Vol. 51, page 10, July 15, 2024
If the asset which was transferred according to §
									67:46:05:06 is returned to the
	 individual and the individual notifies the Department as required by §
									67:46:02:09 and provides the
	 Department with verification of the return, all eligibility conditions,
	 including the resource limit, will be reevaluated.
General Authority:
SDCL
		28-6-1.
Law Implemented:
SDCL
		28-6-1.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:05 - Long-term care resource requirements › Section 67:46:05:08.01 - Life estates purchased in another individual's home

Current through Register Vol. 51, page 10, July 15, 2024
Purchase of a life estate interest in another individual's home is
	 considered a transfer of an asset for less than fair market value unless the
	 purchaser resides in the home for a period of at least 12 consecutive months
	 after the date of the purchase. For purposes of determining the period of
	 ineligibility under §
									67:46:05:09, the value of the
	 interest in the life estate is the purchase price of the life estate.
If the purchaser resides in the home for 12 consecutive months or more,
	 the department shall determine whether the life estate interest was purchased
	 for fair market value. If the department determines that the life estate
	 interest was purchased for an amount greater than fair market value, the
	 purchase is considered a transfer of an asset for purposes of establishing
	 eligibility and shall apply the provisions of §
									67:46:05:06. If the department
	 determines the purchase of the life estate interest was for fair market value
	 or less and the individual or the individual's spouse or child who is either
	 under age 21 or is blind or permanently and totally disabled is no long living
	 in the home, the department shall count the current value of the life estate as
	 a resource countable toward the resource limit established in §
									67:46:05:30. If the department
	 determines the purchase of the life estate interest was for fair market value
	 or less and the individual or the individual's spouse or child who is either
	 under age 21 or is blind or permanently and totally disabled continues to live
	 in the home, the home is considered home property according to §
									67:46:05:15.
The department counts the value of a life estate as a resource
	 countable toward the resource limit established in §
									67:46:05:30, unless the life
	 estate is considered home property according to §
									67:46:05:15.
General Authority:
SDCL 28-6-1.
Law Implemented:
SDCL
		28-6-1.
Inclusion of transfers to purchase life estates,
		42 U.S.C. §
												1396 p(c)(1)(J).
Life estate value, §
											67:46:05:08.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:05 - Long-term care resource requirements › Section 67:46:05:09 - Calculating period of ineligibility

Current through Register Vol. 51, page 10, July 15, 2024
The department shall establish a period of ineligibility for long-term
	 care services if an asset has been disposed of for the purpose of establishing
	 Medicaid eligibility. The period of ineligibility is determined by dividing the
	 uncompensated value of the transferred assets by the monthly state-wide average
	 of long-term care costs for private pay individuals for the state's current
	 fiscal year.
The department shall impose a partial month period of ineligibility if
	 the sum arrived at in the above calculation results in a partial month
	 remainder, rounded up to a whole day.
General Authority:
SDCL
		28-6-1,
		28-6-3.1.
Law Implemented:
SDCL
		28-6-3.1.
Disposal of resources for purposes of establishing eligibility,
		§
											67:46:05:06; Facility's average
		per diem charge, §
											67:16:04:58.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:05 - Long-term care resource requirements › Section 67:46:05:09.02 - Ineligibility if assets transferred

Current through Register Vol. 51, page 10, July 15, 2024
If an asset is disposed of for the purpose of establishing Medicaid
	 eligibility and the asset was disposed of for less than fair market value
	 within the look-back periods established in §
									67:46:05:06.01, the period of
	 ineligibility is determined under the provisions of §
									67:46:05:09.
The department shall apportion the number of months of ineligibility
	 equally between the individual receiving home and community based or nursing
	 facility services and the individual's spouse who is applying for home and
	 community based or nursing facility services if the following conditions
	 exist:
(1) Both the individual and the
  individual's spouse are residing in a nursing facility or receiving home and
  community based waiver services or if one spouse is in a nursing facility and
  the other is receiving home and community based waiver services;
(2) The department had previously determined
  that the individual residing in a nursing facility or receiving home and
  community based waiver services was ineligible because of a transfer and the
  individual is currently serving out a period of ineligibility; and
(3) The spouse would otherwise be eligible
  for nursing facility or home and community based waiver services except for the
  period of ineligibility.
If more than one transfer occurs, the periods of ineligibility are
	 consecutive. If a period of ineligibility is in effect and a transfer occurs,
	 the period of ineligibility for the additional transfer is added to the period
	 of ineligibility already in effect.
If the individual is an applicant, the period of ineligibility begins
	 the date the applicant is eligible for nursing facility or home and community
	 based waiver services but for the period of ineligibility or the date after a
	 prior period of ineligibility has ended, whichever is later. If the individual
	 is a recipient, the period of ineligibility begins with the date the applicant
	 became eligible for nursing facility or home and community based waiver
	 services, the first day of the month after the transfer occurred or the date
	 after a prior period of ineligibility has ended, whichever is
	 later.
General Authority:
SDCL 28-6-1, 28-6-3.1.
Law Implemented:
SDCL
		28-6-3.1.
Disposal of resources for purposes of establishing eligibility,
		§
											67:46:05:06.
Lengthening look-back period for all disposals to five years,
		42 U.S.C. §
												1396p(c)(1)(B)(i).
Authority for states to accumulate multiple transfers into one
		penalty period, 42 U.S.C.
		§
												1396p(c)(1)(H).
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:05 - Long-term care resource requirements › Section 67:46:05:09.03

Current through Register Vol. 51, page 10, July 15, 2024
General Authority:
SDCL
		28-6-1.
Law Implemented:
SDCL
		28-6-1.
Calculating period of ineligibility, §
											67:46:05:09.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:05 - Long-term care resource requirements › Section 67:46:05:10 - Period of ineligibility waived under certain circumstances

Current through Register Vol. 51, page 10, July 15, 2024
The department may waive the period of ineligibility specified in
	 §§
									67:46:05:09 and
	 67:46:05:15 if:
(1) The individual or someone acting on the
  individual's behalf provides clear and convincing evidence that the individual
  has no other means of support and denial of nursing facility or home and
  community based waiver services assistance would deprive the individual of
  food, clothing, shelter, or other necessities of life or medical care, the
  absence of which would endanger the individual's health or life; and
(2) The individual or someone acting on the
  individual's behalf must either demand the return of the asset that was
  transferred or receive the fair market value for the asset; and
(3) If the asset is not returned upon demand
  or fair market value is not received, the individual or someone acting on the
  individual's behalf must either:
(a) Retain an
  attorney who must initiate a civil action for the recovery of the asset or its
  fair market value; or
(b) If the
  transfer was the result of a crime of theft or exploitation, the individual or
  someone acting on the individual's behalf must report the incident to a local
  law enforcement agency.
The home and community based waiver provider or the nursing facility in
	 which the individual is residing may file a waiver application on behalf of the
	 individual if the waiver application is done with the consent of the individual
	 or the individual's personal representative.
An individual may appeal a denial of a waiver request under the
	 provisions of chapter 67:17:02. The burden of proof is with the individual and
	 there must be clear and convincing evidence that justifies the
	 waiver.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:05 - Long-term care resource requirements › Section 67:46:05:11 - Rebuttal of intent to transfer

Current through Register Vol. 51, page 10, July 15, 2024
Intent to transfer a resource for purposes of establishing eligibility
	 for services under this article may be rebutted. The individual or the
	 individual's spouse must be able to show that there were other resources at the
	 time the transfer was made which met the individual's care and maintenance
	 needs and there was no evidence of a disability or medical condition which
	 would have required long-term care assistance or an increased expense beyond
	 the current or future means of financial support.
The provisions of this section do not apply to Medicaid-qualifying
	 trusts.
General Authority:
SDCL
		28-6-1.
Law Implemented:
SDCL
		28-6-1.
Disposal of resources for purposes of establishing eligibility,
		§
											67:46:05:06.
Medicaid-qualifying trust, §
											67:46:05:33.
Resource available under Medicaid-qualifying trust, §
											67:46:05:34.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:05 - Long-term care resource requirements › Section 67:46:05:12 - Compensation for resource

Current through Register Vol. 51, page 10, July 15, 2024
The compensation for a resource includes all money, real or personal
	 property, food, shelter, or services received by the individual or eligible
	 spouse at or after the time of transfer in exchange for the resource only if
	 the compensation was provided pursuant to a binding and legally enforceable
	 agreement in effect at the time of the transfer. Compensation also includes all
	 money, real or personal property, food, shelter, or services received prior to
	 the actual transfer if they were provided pursuant to a written, binding and
	 legally enforceable agreement in effect at the time the compensation for the
	 resource is provided whereby the eligible individual would transfer the
	 resource or otherwise pay for such items.
General Authority:
SDCL
		28-6-1.
Law Implemented:
SDCL
		28-6-1.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:05 - Long-term care resource requirements › Section 67:46:05:13 - Availability of income and resources. Repealed

Current through Register Vol. 51, page 10, July 15, 2024
General Authority:
SDCL
		28-6-1.
Law Implemented:
SDCL
		28-6-1.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:05 - Long-term care resource requirements › Section 67:46:05:14 - Classification of real property. Repealed

Current through Register Vol. 51, page 10, July 15, 2024
General Authority:
SDCL
		28-6-1.
Law Implemented:
SDCL
		28-6-1.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:05 - Long-term care resource requirements › Section 67:46:05:15 - Home property exclusion

Current through Register Vol. 51, page 10, July 15, 2024
If an individual's eligibility for long-term care assistance is based on an application that was received by the department before January 1, 2006, the individual's home property is excluded from assets, if it continues to be the individual's principal place of residence or continues to be occupied by and is the primary residence of the individual's spouse, child, stepchild, grandchild, parent, stepparent, grandparent, aunt, uncle, niece, nephew, brother, sister, stepbrother, stepsister, half-brother, half-sister, cousin, or in-law, who is dependent on the individual.
The value of the individual's ownership interest in a jointly owned home is an excluded resource for as long as a sale of the property would cause undue hardship, due to loss of housing, to a co-owner. To show an undue hardship, the individual must provide clear and convincing evidence that the co-owner uses the property as the co-owner's principal place of residence, would have to move if the property were sold, and has no other readily available housing.
If an individual's eligibility for long-term care assistance is based on an application that was received by the department after December 31, 2023, the individual's home property interest, up to an equity value of seven hundred and thirteen thousand dollars, is excluded from the individual's assets if it continues to be the individual's principal place of residence.
If the equity interest in the home is greater than the amount specified, the individual is ineligible for long-term care medical assistance, regardless of whether the individual will be returning to the home to live.
The equity limit contained in this section does not apply if the individual's spouse, or child who is under age twenty-one, is blind or permanently and totally disabled and is lawfully residing in the home.
Nothing in this rule prevents the individual from using a reverse mortgage or home equity loan to reduce the total equity interest in the home.
General Authority:
SDCL 28-6-18.
Law Implemented:
SDCL 28-6-17.
Liens, adjustments and recoveries, and transfers of assets, 42 U.S.C. §
												1396p(f). Period of ineligibility waived under certain circumstances, §
											67:46:05:10.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:05 - Long-term care resource requirements › Section 67:46:05:16 - Transfer of home property not affecting eligibility

Current through Register Vol. 51, page 10, July 15, 2024
A transfer of home property by an applicant for or recipient of
	 long-term care services does not affect eligibility when the transfer is to one
	 of the following individuals:
(1) A
  spouse;
(2) A son or daughter under
  age 21;
(3) A son or daughter
  meeting the SSI definition of blind or disabled;
(4) A son or daughter who has resided in the
  home for at least two years immediately prior to the date the applicant or
  recipient entered the long-term care facility and who provided care to the
  applicant or recipient which enabled the applicant or recipient to remain at
  home rather than enter a medical institution or a skilled or intermediate care
  facility; or
(5) A brother or
  sister who has an equity interest in the home property and who resided in the
  home for at least one year immediately prior to the date the applicant or
  recipient entered the medical institution or a skilled or intermediate care
  facility.
General Authority:
SDCL
		28-6-1,
		28-6-3.1.
Law Implemented:
SDCL
		28-6-3.1, Pub. L. No. 100-360 (102
		Stat. 761).
Determination of disability, §
											67:46:03:18; Determination of
		blindness, §
											67:46:03:19.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:05 - Long-term care resource requirements › Section 67:46:05:17 - Transfer of property not affecting eligibility

Current through Register Vol. 51, page 10, July 15, 2024
A transfer of a resource does not affect eligibility for long-term care
	 services when the transfer is to a son or daughter meeting the definition of
	 blind or disabled according to §§
									67:46:03:02,
	 67:46:03:18, and 67:46:03:19 or
	 when the transfer is from one spouse to another or to another person for the
	 sole benefit of the spouse.
A transfer after August 10, 1993, does not affect eligibility for
	 long-term care services when the transfer is to a trust established solely for
	 the benefit of one of the following:
(1) A son or daughter who meets the
  definition of disabled or blind according to §§
									67:46:03:02,
  67:46:03:18, and
  67:46:03:19;
(2) An individual
  under age 65 who meets the definition of disabled according to §
									67:46:03:18; or
(3) An individual who has a Medicaid income
  trust and the amount placed into the trust does not exceed amounts necessary to
  pay the monthly nursing facility rate.
General Authority:
SDCL
		28-6-1,
		28-6-3.1.
Law Implemented:
SDCL
		28-6-1,
		28-6-3.1.
Medicaid income trust, §
											67:46:05:33.01.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:05 - Long-term care resource requirements › Section 67:46:05:18 - Temporary absence from home property

Current through Register Vol. 51, page 10, July 15, 2024
In order to establish temporary absence as opposed to home property
	 abandonment, the individual must present convincing evidence at the time of
	 application, such as a physician's statement, indicating that residence in the
	 long-term care facility is temporary. Temporary absence must be reestablished
	 at 12-month intervals. Home property is abandoned if the individual is unable
	 to provide convincing evidence that the absence is temporary or that a return
	 to the home is realistic.
General Authority:
SDCL
		28-6-1.
Law Implemented:
SDCL
		28-6-1.
Transfer of home property not affecting eligibility, §
											67:46:05:16.
Conversion of recipient's excludable resource, §
											67:46:05:29.
Resource limit, §
											67:46:05:30.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:05 - Long-term care resource requirements › Section 67:46:05:19 - Home property abandonment

Current through Register Vol. 51, page 10, July 15, 2024
Home property is considered a nonliquid resource to the individual when
	 it no longer can be excluded under §
									67:46:05:15 or
	 67:46:05:18. Admission of the
	 individual into a long-term care facility or another change in residence,
	 whichever occurs first, is presumed to be establishing another principal place
	 of residence.
General Authority:
SDCL
		28-6-1.
Law Implemented:
SDCL
		28-6-1.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:05 - Long-term care resource requirements › Section 67:46:05:20 - Real property held in trust

Current through Register Vol. 51, page 10, July 15, 2024
Real property held in trust is not considered a resource for long-term
	 care assistance if the applicant or recipient has restricted access to the
	 principal, which includes required approval of the secretary of interior or a
	 duly appointed representative.
General Authority:
SDCL 28-6-1.
Law Implemented:
SDCL
		28-6-1.
Definitions, §
											67:46:05:01; Exclusion of Indian
		lands, 20 C.F.R. §
												416.1234.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:05 - Long-term care resource requirements › Section 67:46:05:21 - Nonbusiness income-producing property

Current through Register Vol. 51, page 10, July 15, 2024
Income-producing real or personal property is excluded as a resource if
	 it meets the following requirements:
(1) It is essential to
  self-support;
(2) The individual's
  equity in the property is less than $6,000; and
(3) The individual's net annual return on the
  equity is at least six percent. The net annual return requirement must be met
  every year. However, if the property produces less because of circumstances
  beyond the individual's control, there must be a reasonable expectation that
  the property will again produce six percent income within 24 months following
  the last day of the tax year in which the income fell below six percent of the
  equity.
If equity in the property exceeds $6,000 and the six percent net annual
	 return is met, the equity in excess of $6,000 must be combined with other
	 countable resources and applied toward the resource limit.
If the net annual return is less than six percent of the equity value,
	 the total equity is an includable resource.
If more than one nonbusiness income-producing property is involved, the
	 total equity value of all nonbusiness income-producing property is considered
	 within the $6,000 limit and the return rate of six percent of equity applies to
	 each property. Any property which does not meet the six percent return rate
	 must be counted toward the resource limit together with any equity which
	 exceeds the $6,000 limit.
Liquid resources are not considered property essential to self-support
	 except when used as part of a trade or business.
General Authority:
SDCL 28-6-1.
Law Implemented:
SDCL
		28-6-1.
Resource limit, §
											67:46:05:30.
Exclusion of property of a trade or business essential to
		self-support, 20 C.F.R.
		§
												416.1222.
Exclusion of nonbusiness property essential to self-support,
		20 C.F.R. §
												416.1224.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:05 - Long-term care resource requirements › Section 67:46:05:22 - Nonbusiness property used to produce goods or services

Current through Register Vol. 51, page 10, July 15, 2024
Personal property such as equipment and tools which is essential for
	 the individual's daily activities for self-support is excluded from resources
	 as long as the equity value does not exceed $6,000.
Real property used to produce food or livestock for personal
	 consumption in the individual's home is excluded from resources as long as the
	 equity value does not exceed $6,000.
Any equity value in excess of $6,000 must be included as a
	 resource.
The six percent net annual return provisions required under §
									67:46:05:21 do not apply to
	 property meeting the conditions of this section.
General Authority:
SDCL
		28-6-1.
Law Implemented:
SDCL
		28-6-1.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:05 - Long-term care resource requirements › Section 67:46:05:23 - Property representing governmental authority

Current through Register Vol. 51, page 10, July 15, 2024
Property essential to self-support which represents the authority
	 granted by a government agency to engage in an income-producing activity, such
	 as a special license or permit, is an excluded resource.
General Authority:
SDCL
		28-6-1.
Law Implemented:
SDCL
		28-6-1.
Property not considered essential to self-support, §
											67:46:05:25.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:05 - Long-term care resource requirements › Section 67:46:05:24 - Trade or business property

Current through Register Vol. 51, page 10, July 15, 2024
Real or personal property essential for self-support is excluded from
	 resources if it is used for the individual's trade, business, or employment. If
	 the property is normally used for these purposes but is not currently being
	 used because of circumstances beyond the individual's control, the property is
	 excluded from resources when there is a reasonable expectation that the use
	 will resume within 12 months from its last use. If the property is not being
	 used because the individual is disabled, the property is excluded from
	 resources when there is a reasonable expectation that the use will resume
	 within 24 months of its last use.
General Authority:
SDCL
		28-6-1.
Law Implemented:
SDCL
		28-6-1.
Property not considered essential to self-support, §
											67:46:05:25.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:05 - Long-term care resource requirements › Section 67:46:05:26 - Other property

Current through Register Vol. 51, page 10, July 15, 2024
Real or personal property owned by the applicant or recipient which
	 produces no income or is not excluded in this chapter shall be considered a
	 resource according to its equity value.
General Authority:
SDCL
		28-6-1.
Law Implemented:
SDCL
		28-6-1.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:05 - Long-term care resource requirements › Section 67:46:05:27 - Conversion or sale of recipient's resource

Current through Register Vol. 51, page 10, July 15, 2024
The conversion or sale of a recipient's resource may not be considered
	 as income. The changed resource, whether liquid or nonliquid in nature, is a
	 resource subject to all the resource criteria for continuing eligibility and is
	 considered a countable resource in the month following the month in which the
	 conversion occurred.
General Authority:
SDCL
		28-6-1.
Law Implemented:
SDCL
		28-6-1.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:05 - Long-term care resource requirements › Section 67:46:05:28 - Sale price paid in installments

Current through Register Vol. 51, page 10, July 15, 2024
If an individual is entitled to receive installment payments for
	 property that was sold, the current balance of the unpaid principal is
	 considered a resource for eligibility purposes.
General Authority:
SDCL
		28-6-1.
Law Implemented:
SDCL
		28-6-1.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:05 - Long-term care resource requirements › Section 67:46:05:29 - Conversion of recipient's excludable resource

Current through Register Vol. 51, page 10, July 15, 2024
An excludable resource which is converted to a nonexcludable resource
	 is considered in the resource limit the first day of the month following the
	 conversion. A resource which loses its exclusionary status is considered in the
	 resource limit the first day of the month following the change of
	 status.
General Authority:
SDCL
		28-6-1.
Law Implemented:
SDCL
		28-6-1.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:05 - Long-term care resource requirements › Section 67:46:05:30 - Resource limit

Current through Register Vol. 51, page 10, July 15, 2024
The resource limit, including both liquid and nonliquid resources, for
	 long-term care assistance is $2,000 for an individual and $3,000 for an
	 individual with a spouse if both spouses begin receiving long-term care
	 services in the same month.
General Authority:
SDCL 28-6-1.
Law Implemented:
SDCL
		28-6-1.
Limitation on resources,
		20 C.F.R. §
												416.1205.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:05 - Long-term care resource requirements › Section 67:46:05:31 - Personal property excluded from resources

Current through Register Vol. 51, page 10, July 15, 2024
The following items shall be excluded when determining the value of
	 resources:
(1) One automobile is
  excluded regardless of its value if it is used for necessary transportation for
  the individual or couple or a member of the individual's or couple's household;
  and
(2) Household goods, personal
  effects, and all items essential to everyday living.
General Authority:
SDCL 28-6-1.
Law Implemented:
SDCL
		28-6-1.
Exclusion of household goods and personal effects,
		20 C.F.R. §
												416.1216; Exclusion of the automobile,
		20 C.F.R. §
												416.1218.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:05 - Long-term care resource requirements › Section 67:46:05:32 - Trust considered a resource

Current through Register Vol. 51, page 10, July 15, 2024
If the individual, the individual's spouse, or someone, including a
	 court or administrative body, authorized to act on behalf of the individual or
	 the individual's spouse has the legal power to dissolve the trust or invade the
	 principal and use the proceeds, the principal of the trust is considered a
	 resource.
General Authority:
SDCL
		28-6-1.
Law Implemented:
SDCL
		28-6-1.
Consideration of revocable and irrevocable trusts, §
		67:46:05:32.02.
Trusts excepted from consideration as a resource, §
		67:46:05:32.03.
Income from trust, §
											67:46:04:16.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:05 - Long-term care resource requirements › Section 67:46:05:32.01 - Establishment of trust

Current through Register Vol. 51, page 10, July 15, 2024
The department considers that an individual has established a trust or
	 similar legal device if assets of the individual were used to form all or part
	 of the corpus of the trust and if the trust was established by one of the
	 following persons:
(1) The
  individual;
(2) The individual's
  spouse;
(3) A person, including any
  court or administrative body, with legal authority to act in place of or on
  behalf of the individual or the individual's spouse; or
(4) A person, including any court or
  administrative body, acting at the direction or request of the individual or
  the individual's spouse.
The provisions of this section do not apply to testamentary
	 trusts.
General Authority:
SDCL
		28-6-1.
Law Implemented:
SDCL
		28-6-1.
Consideration of revocable and irrevocable trusts, §
											67:46:05:32.02.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:05 - Long-term care resource requirements › Section 67:46:05:32.02 - Consideration of revocable and irrevocable trusts

Current through Register Vol. 51, page 10, July 15, 2024
A trust or similar legal device established under the provisions of
	 §
									67:46:05:32.01 is subject to this
	 section regardless of the purpose for which it is established, whether the
	 trustee has or exercises any discretion under the trust, whether there are
	 restrictions on when or whether distribution may be made from the trust, or
	 whether there are restrictions on the use of any distribution from the
	 trust.
If the trust is a revocable trust, the principal of the trust is
	 considered a resource which is available to the individual. A payment from the
	 trust to or for the benefit of the individual is considered income to the
	 individual. Except for trustee and legal fees, any other payment made from the
	 trust is considered a resource which was disposed of by the individual to
	 establish eligibility for Medicaid.
If the trust is an irrevocable trust and contains any provisions under
	 which payment from the trust may be made to or for the benefit of the
	 individual, the entire portion of the principal or income on the principal from
	 which payment to the individual could be made is considered a resource and any
	 payment from that portion of the principal or income to or for the benefit of
	 the individual is considered income to the individual. Except for trustee and
	 legal fees, any other payment made from the trust is considered a resource
	 which was disposed of by the individual to establish eligibility for Medicaid.
	 The department considers any portion of the principal or income on the
	 principal from which a payment to the individual or for the benefit of the
	 individual may not be made under any circumstances to be a resource which was
	 transferred for purposes of establishing eligibility for
	 Medicaid.
General Authority:
SDCL
		28-6-1.
Law Implemented:
SDCL
		28-6-1.
Trusts excepted from consideration as a resource, §
											67:46:05:32.03.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:05 - Long-term care resource requirements › Section 67:46:05:32.03 - Trusts excepted from consideration as a resource

Current through Register Vol. 51, page 10, July 15, 2024
Except for payments from the trust to the beneficiary or for the
	 benefit of the beneficiary, §
									67:46:05:32.02 does not apply to
	 any of the following trusts:
(1) A
  Medicaid income trust created under the provisions of §
									67:46:05:33.01;
(2) An irrevocable trust containing the
  assets of an individual who is disabled and under age 65 if the trust is
  established for the sole benefit of the individual and provides that upon the
  death of the individual and before any other distribution is made from the
  trust, the department shall receive all amounts remaining in the trust up to an
  amount equal to the total medical assistance paid on behalf of the individual;
  and
(3) An irrevocable trust
  containing the assets of an individual who is disabled which meets the
  following conditions:
(a) The trust is
  established and managed by a nonprofit association;
(b) The association must maintain the
  individual's assets in a separate account but may pool the individual's account
  with others for purposes of investments and the management of funds;
(c) The accounts in the pool must be
  established solely for the benefit of individuals who are disabled and must be
  established by the individual, the individual's parent, grandparent, legal
  guardian, or by the court;
(d) The
  trust must provide that upon the death of the individual or termination of the
  trust during the individual's lifetime, whichever is sooner, the department
  shall receive any amounts remaining in the individual's trust subaccount up to
  an amount equal to the total medical assistance paid on behalf of the
  beneficiary. The association may retain reasonable administrative fees and
  expenses, not to exceed the annual amount normally charged by the association
  for that trust subaccount;
(e)
  Funds of an individual age 65 or older that are transferred to this trust are
  subject to the transfer penalty provisions contained in chapter
  67:46:05.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:05 - Long-term care resource requirements › Section 67:46:05:32.04 - Trust waived under certain circumstances

Current through Register Vol. 51, page 10, July 15, 2024
If an individual is determined ineligible because of a trust, the
	 department may waive its consideration of the trust as an available resource if
	 the individual can clearly show that all efforts have been made to recover
	 assets placed into the trust and the individual's continuing care or well-being
	 is seriously threatened because of the ineligibility for long-term care
	 assistance.
General Authority:
SDCL
		28-6-1,
		28-6-3.1.
Law Implemented:
SDCL
		28-6-3.1.
Disposal of resources for purposes of establishing eligibility,
		§
											67:46:05:06.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:05 - Long-term care resource requirements › Section 67:46:05:32.05 - Trustee required to provide annual accounting

Current through Register Vol. 51, page 10, July 15, 2024
The trustee must provide the department with an annual accounting of
	 the trusts financial transactions. Failure to provide the accounting may result
	 in ineligibility for the beneficiary.
General Authority:
SDCL
		28-6-1.
Law Implemented:
SDCL
		28-6-1.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:05 - Long-term care resource requirements › Section 67:46:05:33 - Medicaid-qualifying trust

Current through Register Vol. 51, page 10, July 15, 2024
A Medicaid-qualifying trust is a nontestamentary trust or a similar
	 legal device established before August 11, 1993, by the individual or the
	 individual's spouse or by someone acting on the individual's or spouse's behalf
	 that uses the individual's or spouse's funds. Under the terms of the trust, the
	 individual may be the beneficiary of all or part of the payments from the trust
	 or similar legal device and the distribution of payments is determined by one
	 or more trustees who are permitted to exercise discretion regarding the
	 distribution to the individual.
This section applies regardless of the purpose for which the trust was
	 established.
General Authority:
SDCL 28-6-1.
Law Implemented:
SDCL
		28-6-1.
Disposal of resources for purposes of establishing eligibility,
		§
											67:46:05:06; Treatment of
		potential payments from Medicaid qualifying trusts,
		42 U.S.C. §
												1396
		(a)(k).
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:05 - Long-term care resource requirements › Section 67:46:05:33.01 - Medicaid income trust

Current through Register Vol. 51, page 10, July 15, 2024
A Medicaid income trust is a nontestamentary trust or a similar legal
	 device established after August 10, 1993, for the sole benefit of the
	 beneficiary. A Medicaid income trust must meet the following
	 requirements:
(1) It is composed only
  of the beneficiary's own pension, social security, or other income;
(2) It requires the trustee, without option
  or discretion, to pay monthly to the beneficiary the amount of income paid into
  the trust. However, the amount paid to the beneficiary may not exceed 300
  percent of the maximum SSI standard benefit amount when added to the
  beneficiary's other monthly income not paid into the trust;
(3) It requires the trustee to pay monthly to
  the nursing facility, HCBS, or HCBWS provider the amount of income remaining in
  the trust to reduce the payment amount needed from the department. However, the
  trustee may encroach upon income remaining in the trust for the direct
  administration of the trust and for items necessary for the beneficiary's
  health if such items are not covered by medical assistance or the long-term
  care facility; and
(4) It provides
  that upon the death of the individual and before any other distribution is made
  from the trust, the department must receive all amounts remaining in the trust
  up to an amount equal to the total medical assistance paid on behalf of the
  beneficiary after September 30, 1993.
If income placed in the trust exceeds the amount paid out of the trust
	 for medical services, the excess is subject to penalties under the transfer of
	 assets provisions in this chapter.
General Authority:
SDCL
		28-6-1.
Law Implemented:
SDCL
		28-6-1.
SSI standard benefit amount, §
											67:46:04:13.
Definition of HCBS, §
											67:54:04:01.
Definition of HCBWS, §
											67:44:03:01.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:05 - Long-term care resource requirements › Section 67:46:05:34 - Resource available under Medicaid-qualifying trust

Current through Register Vol. 51, page 10, July 15, 2024
The amount considered available to an individual from a
	 Medicaid-qualifying trust is the maximum undistributed amount that may be
	 permitted under the terms of the trust assuming the full exercise of discretion
	 by the trustee, whether or not discretion is exercised. The maximum amount
	 available is a resource.
General Authority:
SDCL 28-6-1.
Law Implemented:
SDCL
		28-6-1.
Treatment of potential payments from Medicaid qualifying trusts,
		42 U.S.C. §
												1396
		(a)(k).
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:05 - Long-term care resource requirements › Section 67:46:05:35 - Bank accounts

Current through Register Vol. 51, page 10, July 15, 2024
Deposits in a bank, savings and loan, or similar institution are
	 considered liquid resources whether they are in the form of a checking or
	 savings account or a certificate of deposit. Deposits held in joint accounts
	 are considered available to the applicant or recipient when the applicant or
	 recipient has control or can direct the disposition of funds from the accounts.
	 Accounts held in joint ownership with other eligible individuals are divided
	 equally among the eligible individuals. Deposits counted as income in the month
	 the income was received are not a countable resource until the month following
	 the month of receipt of the income.
General Authority:
SDCL
		28-6-1.
Law Implemented:
SDCL
		28-6-1.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:05 - Long-term care resource requirements › Section 67:46:05:36 - Savings bonds

Current through Register Vol. 51, page 10, July 15, 2024
Savings bonds are considered a liquid asset to the extent of their
	 current value. Bonds held in co-ownership with another person are deemed
	 available to the applicant or recipient when the applicant or recipient is the
	 actual purchaser or has the authority to cause the bond to be cashed. Bonds
	 purchased with money that was counted as income in the month the income was
	 received are not a countable resource until the month following the month of
	 receipt of the income.
General Authority:
SDCL
		28-6-1.
Law Implemented:
SDCL
		28-6-1.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:05 - Long-term care resource requirements › Section 67:46:05:37 - Life insurance

Current through Register Vol. 51, page 10, July 15, 2024
The department shall exclude a life insurance policy if an individual
	 owns the policy and the policy has a face value of $1,500 or less. If the face
	 value of the policy exceeds $1,500 the cash surrender value is considered a
	 resource. If the individual owns more than one life insurance policy on the
	 same insured, the face value of all the policies must be added together. If the
	 total of the face values exceed $1,500, the cash surrender value of all the
	 policies is considered a resource. The $1,500 face value exclusion applies to
	 each individual separately. Life insurance policies which do not have a cash
	 surrender value, such as term insurance and burial insurance which by its terms
	 can only be used to pay the burial expenses of the insured, are not included
	 when determining the total value of all policies.
Dividend accumulations received but left in the custody of the insurer
	 to accumulate interest are not a value of the policy but are considered a
	 resource.
Dividends reverted to increase the policy death benefit and cash
	 surrender value are considered policy additions and are not included in the
	 face value when determining whether a policy is a countable or excluded
	 resource. If the policy is a countable resource, the cash surrender value of
	 these dividends is included in the resource value of the policy. If the policy
	 is excluded as a resource the cash surrender value of these dividends is not
	 considered when determining the individual's countable
	 resources.
General Authority:
SDCL
		28-6-1.
Law Implemented:
SDCL
		28-6-1.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:05 - Long-term care resource requirements › Section 67:46:05:38 - Stocks, notes, loans, and mortgages

Current through Register Vol. 51, page 10, July 15, 2024
The department shall include as a resource and subject to the limits of
	 §
									67:46:05:30, stocks, mutual fund
	 shares, promissory notes, mortgages, loans, or municipal, corporate, or
	 government bonds owned by the applicant or recipient which can be sold or
	 discounted. The amount included as a resource is the amount for which they can
	 be sold or discounted and must be the highest estimated money price which the
	 stocks, notes, mortgages, or bonds will bring if offered for sale in the open
	 market.
After March 31, 2006, funds used to purchase a promissory note, make a
	 loan, or carry a mortgage on property sold by the applicant or recipient is
	 considered to be a transfer of an asset for less than fair market value unless
	 the promissory note, loan, or mortgage meets the requirements of
	 42 U.S.C. §
										1396 p(c)(1)(I), as amended to August 1,
	 2006. If the department determines that the promissory note, loan, or mortgage
	 was transferred for less than fair market value, the value of the note, loan,
	 or mortgage is the outstanding balance due as of the date of the individual's
	 application for long-term care assistance.
Nothing in this rule prevents the department from considering
	 promissory notes, loans, and mortgages made or purchased before April 1, 2006,
	 as a transfer of an asset for less than fair market value according to §
									67:46:05:06.
General Authority:
SDCL
		28-6-1.
Law Implemented:
SDCL
		28-6-1.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:05 - Long-term care resource requirements › Section 67:46:05:39 - Irrevocable prepaid burial contracts

Current through Register Vol. 51, page 10, July 15, 2024
Irrevocable prepaid burial contracts between an applicant or recipient
	 and another person for the purpose of defraying burial expenses shall be
	 excluded as a resource.
General Authority:
SDCL
		28-6-1.
Law Implemented:
SDCL
		28-6-1.
Prearranged funeral trusts, ch
		55-11.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:05 - Long-term care resource requirements › Section 67:46:05:40 - Income not spent in month received

Current through Register Vol. 51, page 10, July 15, 2024
Income received during a month that is not spent but is actually saved
	 becomes a resource in the following month.
General Authority:
SDCL
		28-6-1.
Law Implemented:
SDCL
		28-6-1.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:05 - Long-term care resource requirements › Section 67:46:05:41 - Distinguishing resources from income

Current through Register Vol. 51, page 10, July 15, 2024
Resources are those assets an individual or couple already has at the
	 beginning of a month or at the time of application which are not counted as
	 income for that month. Income, in general, is money received by an individual
	 or couple during a particular month.
General Authority:
SDCL
		28-6-1.
Law Implemented:
SDCL
		28-6-1.