Updated August 27, 2026. Quick answer: Nevada’s manual states the method and prints no current rate – every dollar figure in it is a worked example stamped 2004 or 2013. What Nevada does state, and what most states do not, is what happens to the leftover fraction: rounding down or disregarding any fractional period of ineligibility is prohibited. The fraction is converted into days instead.
What Nevada publishes
| What the state lists | Figure |
|---|---|
| What the manual divides by, transfers on or after February 8, 2006 | the average cost of care (at the time of application) |
| What it divides by for a single month’s transfers | the average monthly cost of nursing facility care |
| Treatment of the leftover fraction | rounding down or disregarding is prohibited |
| How a partial month is worked out | the monthly cost is divided by the days in that month to give a daily rate |
| Once a penalty has started | it cannot be interrupted or temporarily suspended |
| Multiple transfers in one month | combined and treated as one transfer |
| Overlapping penalty periods | imposed sequentially |
| Look-back, transfers on or after February 8, 2006 | 60 months |
| Look-back, transfers before that date | 36 months |
| The section that states the method | F-440.2 |
| Current dollar figure published in the manual | not found – see below |
How the penalty period is calculated
- Section F-440.2 of the Medical Assistance Manual states the arithmetic for transfers made on or after February 8, 2006: “The length of the penalty period is calculated by dividing the value of the transferred asset (at the time of transfer) by the average cost of care (at the time of application).” The two dates are deliberately different – the asset is valued when it moved, the divisor is taken when the person applied.
- Where a single asset or several assets are transferred in the same month, the manual says the penalty period is calculated using the total value of the assets divided by the average monthly cost of nursing facility care.
- Nevada refuses to let the fraction disappear. The manual states that “rounding down” or “disregarding” any fractional period of ineligibility is prohibited, and requires the percentage to be calculated so the penalty continues into the next month.
- The fraction is then turned into days. Case managers divide the monthly cost of care by the number of days in the month the penalty falls in to establish a daily rate, and the amount of the transfer is divided by that daily rate to give the days of a fractional penalty period.
- Multiple transfers inside the look-back are combined for a cumulative total and penalised as if they were one transfer – and the manual says this applies regardless of whether the combined value exceeds the state’s average cost of care.
- Where separate penalty periods would overlap, the manual says to calculate them individually and impose them sequentially; where they do not overlap, each transfer is treated as a separate event with its own penalty period.
- A new penalty cannot begin until any existing penalty period has expired, and once a penalty period is imposed the manual says it cannot be interrupted or temporarily suspended regardless of whether the person remains in or leaves long-term care.
- The look-back is 36 months for transfers made before February 8, 2006 and 60 months for transfers on or after that date, and the manual extends the earlier 36-month window to 60 months where the transfer involves a trust.
Once you have the figure above, the Medicaid penalty period calculator does the arithmetic. This page is the Nevada rate record; the calculator is the class parent.
What this page does not settle
- This page carries no current dollar figure because the manual carries none, and that was checked across the whole document rather than in the divisor section alone. F-400 extracts to 52,517 characters containing 16 dollar amounts and 8 distinct values. Every one of them sits inside a worked example that names its own year: $4,583 is labelled “(2004)”, and $7,139 with its derived daily rate of $230.29 belongs to an example set in July 2013.
- An example figure is not a published rate, and the difference is the whole point of this page. Dividing by $7,139 today would be using Nevada’s 2013 illustration as though it were Nevada’s current divisor.
- Because F-440.2 takes the divisor “at the time of application”, the operative number is whichever average cost of care the Division was using on the application date – so even the correct current figure is only correct for a particular application.
- The daily-rate step means the penalty’s end date depends on the length of the month it falls in. The same fraction produces a different number of days in February than in July, because the monthly cost is divided by the days in that specific month.
- The copy retrieved here carries the manual transmittal stamp MTL 04/23 and an 23 Oct 01 date in its running header. Nevada reissues sections on their own schedule, so a later transmittal would not appear in it.
Eligibility is decided by the state agency on the whole file, not by this one number. Nothing here is legal advice, and no one should transfer, retitle or give away property on the strength of a worksheet.
Sources
Each source above was retrieved and read against the state text on August 27, 2026. Every figure on this page was checked against those bytes.
Related: Nevada’s Medicaid home equity limit for a single applicant with no spouse or dependent child at home.