Short answer: The common failures are depositing income late (not in the month received), depositing only part of the income source, and paying money out of the trust to the person; any month the countable income ends up over the cap is an ineligible month.
HHSC’s QIT rules are strict about timing and amounts:
- Late deposits. Income must be directed to the trust during the calendar month it is received. HHSC’s own example: a resident’s $3,600 of July income was not deposited until August 23, so all $3,600 counted for July and the person was ineligible that month. For a person already on Medicaid, HHSC requests restitution of the vendor payment for any ineligible month.
- Partial deposits. The entire income source named must go in. The one allowance is the first month the trust is set up, when a partial deposit does not invalidate it.
- Payouts to the person. Cash distributions or paying personal items (HHSC’s example is hair salon services) count as income that month.
- Wrong program. A QIT works for nursing facility and HCBS waiver Medicaid, but not for Community Attendant Services, SSI, QMB or SLMB.
VA aid and attendance is exempt from both eligibility and co-payment, but becomes countable for the co-payment if deposited into the QIT. Someone reliable (often a family member or professional) should run the trust account every month.