How to Verify Status of Absent Member Confined to Hospital or Nursing Home

Last month, in Set House Rules on Extended Absences and Abandonment, we discussed what may happen if an entire household leaves your site for an unexplained extended absence. This month, we’ll look at a situation in which an individual member of a household is absent. Oftentimes, these members are absent due to medical reasons. For example, a household member may have had a stroke and requires skilled nursing care for an indefinite period of time, and is placed in a nursing home. Or a household member may be hospitalized for a month, recovering from injuries suffered in a car accident.

When a resident at your site must be confined to a hospital or nursing home, you must make a determination about the resident’s status with the household, regardless of how long the absence is. You have to verify and record the individual’s absence from the household as either temporary or permanent. The reason this determination must be made is that the absent resident’s status comes into play when you recertify the household. The status determines whether you count the resident as a household member, which dictates whether you include the individual’s income and/or allowances when calculating total household income and rent.

Sometimes the determination about temporary or permanent status is clear, but many times it is not. In some cases, the resident’s other household members have to make key decisions, and you need to get the right information from them to be sure you are following HUD rules pertaining to the absence. Regardless of which way the absence is eventually classified, it’s a good idea for you to have a record of the information you gathered and the responses the household provided. Such documentation will come in handy if HUD or others take issue with the decision you made.

We’ll review what HUD says you need to do to determine and verify the status of a resident confined to a hospital or nursing home. Then we’ll share a Model Form: Get Information for Determining Absentee Status of Resident in Hospital or Nursing Home, which you can copy and use to help you capture the information that went into your final determination.

Absentee Rule Basics

A fundamental HUD rule directs you to calculate income from every single household member. But if a household member is absent for some period of time, this affects your calculations when you recertify the household. The first step is to clarify whether the absence is temporary or permanent.

If temporary. The HUD Handbook says that if a resident is temporarily absent, you still must consider the resident a household member [HUD Handbook 4350.3, par. 3-6(E)(4)(f-g)].

If permanent. The HUD Handbook says that if a resident becomes permanently confined to a hospital or nursing home, the household gets to decide whether you should treat the resident as a household member [HUD Handbook 4350.3, par. 3-6(E)(4)(h)].

The HUD Handbook doesn’t define the terms “temporary” and “permanent.” Therefore, you have to make your determination based on the information you’re able to gather. The family may not be sure how long a household member could be confined and even the medical personnel caring for the resident can’t provide an exact time frame the member may be able to return home.

And a permanent absence may not even last “forever.” As a rule of thumb, though, if the absent resident has been confined for an indefinite amount of time and it could be mean months or possibly years until the absent resident is able to return to your site, you should treat the absence as permanent.

What Happens for Household

When the decision about whether to consider the absent resident as a household member falls to the family, it’s important that they understand the consequences of their decision—what counting and not counting the absent individual’s income or not receiving his or her allowances means. You should cover these six points with the household:

Effect of counting household member’s income. Let the household know that if it counts the absent resident as a household member, you must count the individual’s income as part of the household’s income. Advise the household that it also could be entitled to allowances for the absent resident that can lower the household’s adjusted income and rent.

Household’s right to remain at site. Tell the household that it may continue to live at the site regardless of whether it decides to count the absent resident as a member of the household. But explain that if the household chooses to keep the absent member as a member of the household, and this causes the household’s income to increase, it may be faced with paying more rent.

Effect on household’s assistance. Explain that if the household’s income exceeds your site’s eligibility limits, you will have to terminate its assistance and the household will have to pay the full market rent for the unit. Also explain that if the household chooses not to count the absent resident as a household member, the household could lose allowances that lower its rent.

Moving to smaller unit. Be sure to inform the household that HUD rules require you to re-evaluate whether the unit size continues to be appropriate for the household if it chooses not to count the absent resident as a household member. That means the household could have to move to a smaller unit.

Selection of new household head. If the absent resident was the head of the household and the remaining members choose not to count that individual as a household member, let them know that they must select a new household head. Then you’ll need to have the new head of the household fill out and sign new recertification paperwork and a new lease for the household.

Effect on households applying to live at your site. If the household in question is applying to live at your site, check to see whether counting the absent family member will affect whether the household meets your site’s income limits. If the absent individual’s income would bring them over the income limits, let them know that they won’t be eligible to live at your site if they count him or her. On the other hand, if the household needs the absent person’s allowances or the larger household size to qualify to live at your site, let them know. Be sure to explain that the household may not name the absent family member as the household head, spouse, or co-head.

In covering these various effects with the household, be sure that you don’t try to persuade the household to decide one way or the other. Remember that you must comply with HUD Handbook 4350.3 rules, which require the household to make the decision on its own. If the household chooses, for whatever reason, to have you count the absent individual as a household member, you must accept that decision.

Use Form to Document Decision

Using an absent resident status form like the one we’ve provided here helps you in three ways. First, following the form helps you make sure you’re getting the information you need by asking the right questions. Second, it helps bring consistency to the way you and your staff are handling the decision-making in absent resident situations. Third, completing the form gives you the documentation to support your decision in case HUD or anyone else questions it.

When the form is complete, place it in the household’s file. This way, your decision and the information you used to reach your decision are documented and easily accessible.