Incorrect Decision Reached Regarding Status of Community Spouse. A nursing home resident’s spouse was denied a Community Spouse Monthly Income Allowance when she moved to the Philippines after her husband was admitted to a nursing home. She was attempting to secure a visa to return to the U.S. at the time of the hearing and […]
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Georgia’s Medicaid Manual cannot be enforced when it conflicts with federal law. Applicant resided in an assisted living facility until she went to a nursing home in 2008 and applied for Medicaid. Prior to that time, her vacant home was placed on the market and sold. To accomplish the sale, Petitioner conveyed her life estate […]
Ignorance of QIT Requirement Does Not Excuse Failure to Comply. Nursing home resident’s son assisted with her October 25, 2007 Medicaid application. At the intake interview on November 7, 2007, he disclosed that he opened a QIT with $50. He did not fund it further by transferring her excess income into the trust until that […]
Assessment of transfer penalty on sale of life estate affirmed. Conservators sold life estate for $1,500, then sold the applicant’s home for $55,000 after putting $13,397 into repairing the home. A transfer of resource penalty was assessed because the life estate interest was .58914 percent of the home value, which is well below $1,500. On […]
No penalty may be assessed where resources are transferred directly to a disabled child. A nursing home resident transferred approximately $24,000 to a disabled child. DFCS imposed a transfer penalty because the funds were transferred directly to the child instead of to a trust for the child. The caseworker’s decision was reversed because 42 U.S.C. 1396p(c)(2)(B)(iii) […]
Hire a Lawyer. An unrepresented nursing home resident applied for Medicaid on December 21, 2007. A 981 was issued after an intake interview on December 27, 2007. However, the 981 erroneously omitted a request for documentation regarding retirement income and social security benefits. The caseworker realized her error on February 5, 2008 (3 days after […]
Community Spouse Resource Allowance administratively raised. Evidence was stipulated that the combined marital income of the couple did not result in post-eligibility income for the Community Spouse that equaled or exceeded the MMMNA. Therefore, the Community Spouse Monthly Income Allowance (CSMIA), 42 U.S.C. § 1396r-5(d)(1)(B), was inadequate to raise the Community Spouse’s post-eligibility income to the […]
Valuation; value of transferable promissory note. Petitioner filed a motion for summary determination and respondent failed to answer. The issue was whether petitioner’s resources exceeded $2,000 during the month in question. Approximately six years prior to the application, in 2002, Petitioner had loaned $66,000 under a promissory note that paid $15 of principal, no interest […]
Transfer of resources penalty affirmed. Nursing home resident applied for Medicaid in January 2008. During review, caseworkers discovered a home assessed at $90,351, was transferred to a close friend for $40,000 within the lookback period. Additionally, $10,000 was withdrawn from the resident’s account and several small checks and a vehicle were issued to the friend. […]
Treatment of retirement accounts. Section Section 2332 indicates that an applicant must apply for periodic benefits, but does not indicate whether the individual must take a minimum distribution from “each” account or whether the individual can aggregate the retirement accounts for purposes of determining whether a sufficient minimum distribution was taken. The ALJ looked to 26 C.F.R. § […]
