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Regional Rates for 2014

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Jan 222014
 

Page 54 of Medicaid Financial Eligibility Rules for Nursing Home Care in New York State describes how to calculate a penalty period when someone has made a gift. You need to know the regional rate in order to calculate the penalty period. The regional rates for 2014 are found in GIS 14 MA/03. The GIS tells you which counties are in which region. It reminds you to use the rate for the region in which the facility is located. The GIS may be found at the New York State Department of Health website: health.ny.gov.

The 2014 regional rates are:

CENTRAL: $8,645
Broome, Cayuga, Chenango, Cortland, Herkimer, Jefferson, Lewis, Madison, Oneida, Onondaga, Oswego, St. Lawrence, Tioga and Tompkins Counties

NORTHEASTERN: $9,212
Albany, Clinton, Columbia, Delaware, Essex, Franklin, Fulton, Greene, Hamilton, Montgomery, Otsego, Rensselaer, Saratoga, Schenectady, Schoharie, Warren and Washington Counties

WESTERN: $8,971
Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Niagara, Orleans and Wyoming Counties

NORTHEASTERN METROPOLITAN: $11,135
Dutchess, Orange, Putnam, Rockland, Sullivan, Ulster and Westchester Counties

NEW YORK CITY: $11,423
Bronx, Kings (Brooklyn), New York (Manhattan), Queens and Richmond (Staten Island)

LONG ISLAND: $12,112
Nassau and Suffolk Counties

ROCHESTER: $10,073
Chemung, Livingston, Monroe, Ontario, Schuyler, Seneca, Steuben, Wayne and Yates Counties

Substantial Home Equity Limit for 2014

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Dec 272013
 

Medicaid Financial Eligibility Rules for Nursing Home Care in New York State should be updated as follows:

HOME EQUITY LIMIT FOR 2014:
The home equity limit for Medicaid coverage of nursing facility services is $814,000 for 2014. GIS 13 MA/022, page 3.

Note that it was $803,000 for the year 2013. GIS 13 MA/02, page 3.

For an explanation of how this rule works, see pages 13-14 of Medicaid Financial Eligibility Rules for Nursing Home Care in New York State.

Resource Levels for 2014

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Dec 272013
 

Medicaid Financial Eligibility Rules for Nursing Home Care in New York State should be updated as follows:

RESOURCE LEVEL FOR THE MEDICAID APPLICANT FOR 2014:
The resource level for the Medicaid applicant is $14,550 for the year 2014. GIS 13 MA/022, page 2 and Attachment 2. Note that Attachment 1 lists the amount as $14,400, which was the 2013 amount; I assume this is a typo.

RESOURCE LEVEL FOR THE COMMUNITY SPOUSE FOR 2014:
For 2014, the minimum is $74,820 and the maximum is $117,240. GIS 13 MA/022, page 3 and Attachment 1.
For an explanation of how this rule works, see page 9 of Medicaid Financial Eligibility Rules for Nursing Home Care in New York State.

Income Levels for 2014

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Dec 272013
 

Medicaid Financial Eligibility Rules for Nursing Home Care in New York State should be updated as follows:

INCOME LEVEL FOR 2014 – MONTH ONE – PERSON IN A NURSING HOME WHO DOES NOT HAVE A COMMUNITY SPOUSE
The Medically Needy Income Level for a household of one for 2014 is $809 per month. GIS 13 MA/022, page 2 and Attachment 2.

INCOME LEVEL FOR 2014 – MONTH ONE – PERSON IN A NURSING HOME WHO DOES HAVE A COMMUNITY SPOUSE
The Medically Needy Income Level for a household of one for 2014 is $809 per month. GIS 13 MA/022, page 2 and Attachment 2.

INCOME LEVEL FOR 2014 – AFTER MONTH ONE – PERSON IN A NURSING HOME WHO DOES NOT HAVE A COMMUNITY SPOUSE
The person in the nursing home is allowed to keep a Personal Needs Allowance of $50 per month for 2014 if he does not have a community spouse. GIS 13 MA/022, Attachment 1.

INCOME LEVEL FOR 2014 – AFTER MONTH ONE – PERSON IN A NURSING HOME WHO DOES HAVE A COMMUNITY SPOUSE
The person in the nursing home is allowed to keep a Personal Needs Allowance of $50 per month for 2014 if he does have a community spouse. GIS 13 MA/022, Attachment 1.

INCOME LEVEL FOR 2014 – COMMUNITY SPOUSE
The community spouse is allowed to keep $2,931 per month of income for 2014. GIS 13 MA/022, page 3 and Attachment 1.

INCOME LEVEL FOR 2014 – LONG TERM HOME HEALTH CARE PROGRAM PARTICIPANT
The participant in a Long Term Home Health Care Program (also referred to as the “Lombardi Program” and “The Nursing Home Without Walls Program”) is allowed to keep a Personal Needs Allowance for Certain Waiver Participants Subject to Spousal Impoverishment Budgeting of $383 per month for 2014. GIS 13 MA/022, page 3.

Life estate valuations

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Dec 272013
 

GIS 13 MA/06 advises that GIS 12 MA/001 has the correct method for calculating the value of a life estate, but the IRS website addresses provided in GIS 12 MA/001 are incorrect. This problem has already been noted on this website.

Unfortunately, GIS 13 MA/06 also contains an incorrect web address.

GIS 13 MA/06 does note that the IRS website can be changed at any time. Thus, GIS 13 MA/06 suggests that interest rates can be found by going to the IRS website and typing the following term in the search box: “Section 7520 Interest Rates”

GIS 13 MA/06 suggests that Table S can be found by going to the IRS website and typing the following term in the search box: “Table S”

As previously noted on this website, GIS 12 MA/001 changed the method of calculating the value of a life estate. Page 40 of Medicaid Financial Eligibility Rules for Nursing Home Care in New York State describes the old rule which was changed by GIS 12 MA/001.

Income Levels for 2013

 Income  Comments Off on Income Levels for 2013
Jan 282013
 

Medicaid Financial Eligibility Rules for Nursing Home Care in New York State should be updated as follows:

INCOME LEVEL FOR 2013 – MONTH ONE – PERSON IN A NURSING HOME WHO DOES NOT HAVE A COMMUNITY SPOUSE
The Medically Needy Income Level for a household of one for 2013 is $800 per month. GIS 13 MA/02, at 2.

INCOME LEVEL FOR 2013 – MONTH ONE – PERSON IN A NURSING HOME WHO DOES HAVE A COMMUNITY SPOUSE
The Medically Needy Income Level for a household of one for 2013 is $800 per month. GIS 13 MA/02, at 2.

INCOME LEVEL FOR 2013 – AFTER MONTH ONE – PERSON IN A NURSING HOME WHO DOES NOT HAVE A COMMUNITY SPOUSE
The person in the nursing home is allowed to keep a Personal Needs Allowance of $50 per month for 2013 if he does not have a community spouse. GIS 13 MA/02, Attachment I.

INCOME LEVEL FOR 2013 – AFTER MONTH ONE – PERSON IN A NURSING HOME WHO DOES HAVE A COMMUNITY SPOUSE
The person in the nursing home is allowed to keep a Personal Needs Allowance of $50 per month for 2013 if he does have a community spouse. GIS 13 MA/02, Attachment I.

INCOME LEVEL FOR 2013 – COMMUNITY SPOUSE
The community spouse is allowed to keep $2,898 per month of income during 2013. GIS 13 MA/02, Attachment I.

Resource Levels for 2013

 Resources  Comments Off on Resource Levels for 2013
Jan 282013
 

Medicaid Financial Eligibility Rules for Nursing Home Care in New York State should be updated as follows:

RESOURCE LEVEL FOR THE MEDICAID APPLICANT FOR 2013:
The resource level for the Medicaid applicant is $14,400 for the year 2013. GIS 13 MA/02, Attachment I.

COMMUNITY SPOUSE RESOURCE ALLOWANCE FOR 2013:
For 2013, the minimum is $74,820 and the maximum is $115,920. The community spouse may keep $74,820 or the amount of the spousal share, up to $115,920, whichever is greater. The “spousal share” is the amount equal to one-half of the total value of the couple’s countable resources as of the beginning of the most recent continuous period of institutionalization of the institutionalized spouse. GIS 03 MA/02, Attachment I.

Regional Rates for 2013

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Jan 072013
 

Page 54 of Medicaid Financial Eligibility Rules for Nursing Home Care in New York State describes how to calculate a penalty period when someone has made a gift. You need to know the regional rates in order to calculate the penalty period. The regional rates for 2013 are found in GIS 13 MA/01. The GIS tells you which counties are in which region. It reminds you to use the rate for the region in which the nursing home is located. The GIS may be found at the New York State Department of Health website: health.ny.gov

The 2013 rates by region are as follows:
Central: $8,432
Northeastern: $8,950
Western: $8,682
Northern Metropolitan: $10,737
New York City: $11,350
Long Island: $12,034
Rochester: $9,782

New Life Expectancy Table

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Jan 042013
 

There is a new life expectancy table to use when determining if an annuity, promissory note, loan or mortgage is actuarially sound. GIS 12 MA/025 states that the life expectancy table in its attachment is to be used in place of the life expectancy table at 06 OMM/ADM-5.

Life Estate Calculation

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Oct 182012
 

The third full paragraph on page 40 of Medicaid Financial Eligibilty Rules for Nursing Home Care in New York State describes how to calculate the value of a life estate for Medicaid purposes.  At the time the book was published, 96 ADM-8, at 20, and Medicaid Reference Guide, at 353, stated that Social Service Districts may, but are not required to, use the life estate and remainder interest table attached to 96 ADM-8 when calculating the value of life estates and remainder interests.

Effective September 26, 2011, a different method must be used when calculating the value of a life estate or a remainder interest for Medicaid purposes.  11 OHIP/ADM-8, at 7; GIS 12 MA/001.  The Internal Revenue Service tables must now be used.  11 OHIP/ADM-8, at 7; GIS 12 MA/001.

In order to do the calculation, you must know the age of the life estate holder on the date of the transaction.

STEP ONE

When doing the calculation, the first step is to find the IRS code 7520 interest rate for the appropriate month and year.  11 OHIP/ADM-8, at 7.

The ADM contained a link which was supposed to take you to the 7520 interest rate table.  The link in the ADM was http://www.irs.gov/businesses/small/article/0,,id=112482,00.html

Unfortunately, if you use that link, you get the following error message from the IRS website: “We have redesigned the IRS.gov website to make it easier and faster to find the information you need.  If you have reached this page by selecting a bookmark that worked previously, it is likely the URL has changed.  To navigate to the new redesigned IRS website click on the homepage link.  You may also Search the site for specific information.  Once you have arrived at the desired page, please update your bookmark.”

To find the 7520 interest rate table, go to www.irs.gov

In the search box, type in: 7520

Click on SEARCH

Click on the link for 7520 interest rates.

You will be taken to a table which shows Section 7520 interest rates for the current year.

If you need the Section 7520 interest rates for a prior year, you will see “For prior years’ rates, please refer to Section 7520 Interest Rates for Prior Years” directly beneath the table for the current year.

However, this link does not work, either.

If you click on the link, it will take you to a list of years.  If you click on the year that you need, you will get a message telling you that you will be leaving the IRS website.  If you click on LEAVE IRS WEBSITE, you will be taken to a blank page.

Several non-IRS websites contain the Section 7520 rate tables for prior years.  To find one, google a search term such as: 7520 Rates 2011.

Once you get to a Section 7520 table that you are able to use, make a note of the interest rate for the month and year that you need.

STEP TWO

11 OHIP/ADM-8, at 7, says that the next step is to find Table S.

11 OHIP/ADM-8, at 7 stated that a direct link could be found at http://www.irs.gov/retirement/article/0,,id=206601,00.html

However, if you try this link, you will get the same error message from the IRS website that is shown in Step One, above.

To find Table S, go to www.irs.gov

In the search box, type in: Section 7520 Actuarial Table

Click on SEARCH

Click on the link for Actuarial Tables.

You will be taken to the Table of Contents for Publication 1457: Annuities, Life Estates & Remainders.

Click on TABLE S, which is in Section 1.

Note that this is an Excel spreadsheet.  If you do not have the Excel application on your computer, you might not be able to open this document.

You will see a table with headings Age, Annuity, Life Estate, Remainder and then Age, Annuity, Life Estate and Remainder again.  Above those headings, you will see that it says Interest at 0.2 Percent.  If you scroll down, it will say Interest at 0.4 Percent above the next table.  Keep scrolling down until you find the interest rate that you were told to use in Step One.

When you find the correct interest rate, scroll down until you find the row for the age of the person for whom you are calculating the life estate value.

Use the Life Estate column for that row.

EXAMPLE FROM 11 OHIP/ADM-8, AT 7

Calculate the value of a life estate owned by a 76-year old in July of 2011.  The fair market value of the property is $270,000.

Step One: find the IRS Code 7520 interest rate for the appropriate month and year.

For July 2011, it is: 2.4%.

Step Two: Find Table S.

Find the Interest at 2.4% heading.

Find the Life Estate column for a 76-year old: it is 0.21231.

$270,000 x 0.21231 = $57,323.70.  That is the value of the 76-year-old’s life estate.