The Limit is the Limit, Part 3. Petitioner was originally admitted to Ridgewood Manor, a nursing home in Dalton, and later transferred in July 2007 to Shepherd Hills in Lafayette. Meanwhile, in May of 2007, her Community Spouse was admitted to a hospital and remained either hospitalized or in a nursing home until his death […]
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Use of Burial Funds for Care Results in them Being Treated as Income. In a one page decision, the ALJ affirmed an increase in Petitioner’s cost-share for December 2008 where Petitioner used funds set aside for burial for personal care. The ALJ noted this decision did not impact eligibility for any month other than December […]
Penalty Affirmed After Life Estate Conveyed; Hardship Waiver Unavailable Because No Legal Action was Taken to Recover Property. Petitioner, a divorced individual, acquired a life estate in business property with his ex-wife owning the remainder interest. He entered a nursing home in March 2008 and his Medicaid application was denied after the caseworker valued his […]
Transfer Penalty Reversed Where Care Services Were Provided Under Agreement. Petitioner was discharged from a nursing home to home in 2004, where she remained until she returned in 2008. At the time of discharge she agreed to transfer her property valued at $262,970 on the 2006 assessment (when the transfer occurred) if her son provided […]
Cash Value of Life Insurance Cannot Be Designated as Burial Fund. Denial of eligibility was affirmed where Petitioner had a life insurance policy with a face value of $25,000 and a cash value of $2,354 because cash value cannot be designated as a burial fund. Note: compare old Section 2312 with current Section 2312. OSAH-Unknown-Teate-3-2008.pdf (March 13, 2008).
When Determining Value, Equity Value is CMV Minus mortgages and Liens. Petition created a revocable living trust in 2006. In July 2006, her granddaughter charged in excess of $30,000 on Petitioner’s credit cards before the granddaughter was hospitalized. Thereafter, Petitioner fell behind on the mortgage and her home was in danger of foreclosure. Petitioner and […]
No QIT, No Medicaid if Income Exceeds Cap, Part 2. Petitioner entered a nursing home in June 2008 and filed an application for Medicaid. DFCS did not receive or act on the application until July 22, 2008. As a result of inaction, Petitioner did not know that a QIT was needed because income exceeded the […]
Life Insurance Snafu. Petitioner and Respondent stipulated facts in this case. Petitioner applied for nursing home Medicaid in March 2008. DFCS denied the application because Petitioner had three life insurance policies with a cumulative face value of $13,831. Since the face value exceeded $10,000, the cash value of the policies was counted toward Petitioner’s $2,000 […]
No Penalty For Transfer to Disabled Child. DFCS imposed a transfer of resources penalty where Petitioner transferred cash assets to a disabled daughter. DFCS’s reasoning was that cash assets were transferred to the disabled child outright as opposed to transferring them to a trust for her sole benefit. Citing 42 U.S.C. § 1396p(c)(2)(B)(iii) and Section 2342 of the […]
No QIT means No Medicaid If Income Exceeds Cap. Petitioner entered the nursing home in July 2007 and applied for Medicaid in August 2007. No one told Petitioner a qualified income trust was needed. A denial was sent in October and Petitioner reapplied in November 2007, establishing the QIT by December 17, 2007. Eligibility was denied for […]
