Md. Code Regs. 32.03.03.05

Current through Register Vol. 51, No. 24, December 2, 2024

Section 32.03.03.05 - Resident Eligibility for Subsidy

A. An applicant is eligible to receive a subsidy paid to the licensee on the applicant's behalf when the following conditions are met:

(1) The applicant is a resident 62 years old or older, or has been accepted for admission as a resident, in a facility operated by a licensee, which has enrolled in the Program and executed a service agreement with the local office;

(2) The applicant is determined to be functionally eligible for a subsidy, based on a functional assessment;

(3) The applicant is determined to be financially eligible for a subsidy, based on a review and verification of the financial information provided; and

(4) Unless the licensee is a nonprofit corporation, the applicant is not a parent, child, spouse, aunt, uncle, niece, nephew, first cousin, or in-law of:

(a) The licensee, or

(b) Any partner or officer of the licensee.

B. To be functionally eligible for a subsidy, an applicant shall be:

(1) Physically or mentally impaired; and

(2) In need of assistance with the activities of daily living provided by the assisted living program.

C. To be financially eligible for a subsidy, an applicant shall meet the following conditions:

(1) The applicant's net monthly income is less than the approved monthly fee for the services provided;

(2) The applicant's net annual income is not higher than 60 percent of the State median income as determined by the U.S. Department of Housing and Urban Development;

(3) Subject to §H of this regulation, the applicant's resources are not greater than $19,000 if single, or $25,000 if married; and

(4) The applicant may not have disposed of or transferred more than 5 percent of such applicant's net worth in the previous 5 years for less than fair market value unless the transfer was into a:

(a) Trust for an immediate family member who was medically dependent; or

(b) Special needs trust that meets the requirements of COMAR 10.09.24.08-2C.

D. Calculation of Resources.

(1) When calculating the amount of an applicant's or subsidized resident's resources, the net fair market value of all assets owned by the applicant or subsidized resident shall be totaled, with the exception of the following:

(a) One personal automobile;

(b) Customary household goods;

(c) Personal effects;

(d) Life insurance policies with a total cash surrender value of not more than $5,000, including available accrued dividends and interest;

(e) Real property that satisfies the exclusion requirements of §§E-G of this regulation;

(f) Burial spaces for a person and the person 's immediate family;

(g) An irrevocable burial fund of any amount, which has been set aside for the burial or funeral of the individual or the individual's spouse; and

(h) Amounts in burial funds that satisfy the requirements of §D(2) of this regulation.

(2) Burial Funds.

(a) In determining the resources of a person and the person's spouse, if any, there shall be excluded an amount up to $5,000 per person of funds specifically set aside in a burial fund for the person or the person's spouse.

(b) Interest earned on excluded burial funds and appreciation on the value of excluded burial arrangements shall be excluded from resources if left to accumulate and become a part of the burial fund.

(c) Funds or interest earned on funds and appreciation in the value of burial arrangements, which have been excluded from resources because they are burial funds, shall be used solely for that purpose.

(d) An individual's $5,000 exclusion as described under §D(2)(a) of this regulation shall be reduced by amounts in an irrevocable burial fund as described under §D(1)(g) of this regulation.

E. Real property that was the primary residence of the applicant at the time of admission to a facility is excluded from the calculation of the applicant's resources for 1 year from the date of admission. After 1 year, the value of the applicant's interest in the property shall be counted as part of an applicant's or subsidized resident's resources, unless the:

(1) Secretary grants an extension under §G of this regulation; or

(2) Residence is occupied by the applicant's or subsidized resident's:

(a) Spouse;

(b) Unmarried child younger than 21 years old; or

(c) An immediate family member who is medically or financially dependent.

F. For the purposes of §§C and E of this regulation, an unmarried child younger than 21 years old shall be considered financially dependent without documentation other than age, and an immediate family member who has been determined to be blind or disabled by the Social Security Administration or by the State Medical Review Team as a part of determining their eligibility for Medical Assistance, shall be considered medically dependent.

G. The Secretary may grant an extension of the 1-year period specified in §E of this regulation if the applicant demonstrates why the property could not be sold within the year despite timely and good faith efforts.

H. The resource limits for applicants shall increase on July 1 of each year beginning July 1, 2021, by the percentage, if any, by which the Consumer Price Index for the most recent calendar year exceeds the Consumer Price Index for the previous calendar year, rounded to the nearest dollar. The Department shall publish annually the resource limits.

Md. Code Regs. 32.03.03.05

Regulations .05, Group Sheltered Housing for the Elderly, repealed and new Regulations .01_.11, Senior Assisted Living Group Home Subsidy Program, adopted effective August 23, 1999 (26:17 Md. R. 1325)
Regulation .05 amended as an emergency provision effective January 10, 2002 (29:6 Md. R. 565); emergency status extended at 29:9 Md. R. 743; amended permanently effective May 27, 2002 (29:10 Md. R. 827); amended effective 47:15 Md. R. 713, eff. 7/27/2020