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. § […]
Resource limit firm; debt not a factor. Petitioner’s application for benefits was denied twice because the Petitioner’s agent was unable to secure information requested by the caseworker. Petitioner’s agent was not able to gain control over the resources until a conservatorship was approved in February, 2008. As of March 1, 2008, Petitioner had $23,453.89 in […]
Outline of Georgia Guardianship and Conservatorship Process and Timeline Process Begins When Petition is filed O.C.G.A. § 29-4-10(a). Any interested person, including the proposed ward, may file a petition for the appointment of a guardian. Such petition shall be filed in the court of the county in which: (1) The proposed ward is domiciled; (2) […]
In M.K. v. Division of Medical Assistance, Superior Court of New Jersey, Appellate Division (2016), the Division imposed a period of ineligibility for benefits because she transferred ownership of her home to her daughter, J.K., for less than fair-market value within sixty months of entering a nursing home facility (the look-back period). The applicant argued […]
An applicant filed three Medicaid applications from February 7 through November 26, and all of them were denied for failure to submit necessary financial verification. A fair hearing was conducted on November 26, 2018 where the ALJ gave the applicant additional time to supply verification. Once that verification was supplied, on May 14, 2019, the […]
In a Memorandum decision, the Supreme Court of New York, Appellate Division, Fourth Department, held that a nursing home may bring a plenary action in its own right against the agency designated to declare Medicaid eligibility. A transfer of resources penalty of 11.74 months had been imposed and the nursing home sought a declaratory judgment […]
2022 Special Needs Planning Symposium We don’t always give a shout-out for symposiums sponsored by others, but we’ll make an exception here. The 2022 Special Needs Planning Symposium looks like an all-star cast for anyone on the West Coast who works with special needs individuals (especially if you can’t make it to Stetson). Two sessions […]
In Maryland Department of Health and Mental Hygiene v. Centers for Medicare and Medicaid Services, 542 F.3d 424 (2008), the State of Maryland petitioned for review of a final decision of the Centers for Medicare & Medicaid Services (CMS) disapproving an amendment to the Maryland State Medicaid Plan (SMP). Maryland’s SMP would have eliminated deductions […]
In Timm v. Mont. Dep’t of Pub. HHS, 2008 MT 126 (2008), Linda Timm entered the nursing home in July 2002. The Timm family applied for Medicaid on November 1, 2002 reporting, among other resources, the Community Spouse’s one-third interest in J & R Transportation, Inc., worth roughly $20,150. The Department completed its first resource […]
On July 1, 2021, the Biden-Harris Administration, through the U.S. Departments of Health and Human Services (HHS), Labor, and Treasury, and the Office of Personnel Management, issued “Requirements Related to Surprise Billing; Part I,” an interim final rule that will restrict excessive out of pocket costs to consumers from surprise billing and balance billing. Surprise billing […]
Selected articles from Current Awareness in Aging Research E-Clippings: Staff Shortages Are Hammering Long-term Care Facilities, Home Care Agencies, and Families Pandemic-inspired retirement may be short-lived for many More than 41million dementia cases globally are undiagnosed – study Signs of Early Alzheimer’s May Be Spotted in Brain Stem The quality, not quantity, of cardiovascular fat […]
Attorney General Chris Carr is warning Georgians about the latest version of the grandparent scam. The scam still starts with a phone call from someone pretending to be your grandchild, one of his/her friends, a lawyer or a law enforcement officer. The caller then describes an urgent scenario requiring that thousands of dollars be sent immediately, […]
The Office of the Attorney General, on September 17, 2021, announced that the office’s Medicaid Fraud Control Unit has indicted Dr. Guy Jordan for Medicaid Fraud and for False Statements. The Hall County Grand Jury returned the indictment on September 15, 2021. “We will not stop protecting taxpayer dollars, and we thank the Hall County […]
Attorney General Chris Carr, on September 20, 2021, released an update on telecom companies’ progress in implementing the Anti-Robocall Principles he signed onto in 2019. Since September 2019, companies that agreed to these Principles have identified more than 52 billion spam or spoofed numbers calls, authenticated the caller ID numbers of hundreds of billions of […]
News Sources: ThinkAdvisor, 4 Signs your Client is Ready for a Roth IRA Conversion Morningstar, The ABCs of Estate Planning for IRAs Under the Secure Act Financial Advisor, Gray Divorce and Avoiding Retirement Ruin Health Affairs, Care for Elders, Prices and More (September 2021 issue) KHN, Telehealth’s Limits: Battle Over State Lines and Licensing Threatens […]
Divorce is one of the most aggressive Medicaid planning tools. Divorce should not be approached lightly and should not be attempted without an attorney. Most Medicaid plans can be completed without the necessity of divorce. Even when divorce appears to be the answer, a simpler procedure, commonly known as a “Catholic divorce” (e.g., an action […]
On September 1, 2021, the Administration for Community Living posted a guest blog titled “BE WITH: Combating Social Isolation, Loneliness, and Suicide Risk. The blog post describes “how one project is helping build capacity within the aging network to help address social isolation and loneliness and prevent suicide amongst older adults.” Contributors include Laura Shannonhouse, […]
As you plan for your future, there are steps you can take to make life easier for yourself and your loved ones. Here are a few to consider: Issue Yes No N/A Do you have a financial power of attorney? If so, is it broad enough to address issues such as retirement accounts, stocks, and […]
National Institutes of Health: The Amazing Brain: A Sharper Image of the Pyramidal Tract Administration for Community Living: DOL announced an alliance with AAAED to promote people with disabilities in the national organization’s workplace equity efforts Webinars from National Paralysis Center Volunteer and Advocacy Opportunities, Wednesday, August 18 Virtual Support Groups, August 26th National Consumer […]
In 2021, the life-time estate and gift tax exemption is $11.7 million per donee (dead person or giftor). The exemption is scheduled to roll back to pre-2018 levels in 2026 unless extended by Congress. IRS Notice IR-2019-189 accompanied final regulations known as Anti-Claw Back regulations. These regulations essentially state that if you make a gift […]
The Georgia Council on Aging (Co-Age) recently announced its legislative priorities going into the 2022 legislative session. They are: Restore funding to home and community based services which was cut when Governor Kemp ordered that every department reduce spending. Appropriate $300,000 to $500,000 to increase funding for the Long-Term Care Ombudsman program. Allow Medicaid to […]
In In re Estate of Wertzer, 330 Ga. App. 294 (2014), the primary issue was whether the probate court had the authority to enter an order establishing a visitation schedule with the father, over the objection of the mother, who had been appointed Sierra Wetzer’s guardian and conservator. The Court held that the probate court […]
On July 30, 2021, Georgia Attorney General Chris Carr announced the indictment of Borin Khoun on four counts of Theft by Taking in Gwinnett County Superior Court. The press release states: “Our Prosecution Division is committed to stopping criminals who perpetrate identity theft and financial fraud,” said Attorney General Chris Carr. “People who prey on […]
The National Institute of Nursing Research announced an upcoming webinar: On September 14, 2021, Dr. Mi-Kyung Song will present “Addressing One of the Most Enduring Challenges in Health Care: End-of-Life Decision Making” from 10:00 to 11:00 a.m. (ET). In this NINR Director’s Lecture, Dr. Song will present her intervention research to develop and test an […]
National Institutes of Health (NIH): Tips to Make Mealtimes Easier for People with Alzheimer’s Decoding Heart-Brain Talk to Prevent Sudden Cardiac Deaths Researchers identify a cellular defect common to familial and sporadic forms of Amyotrophic lateral sclerosis (ALS) Device allows paralyzed man to communicate with words Scientists uncover how decisions about what we see are […]
Former OCGA § 24-3-18 (now § 24-4-826) provides a hearsay exception for medical reports in civil cases without requiring the doctor to testify at trial. Bell v. Austin, 278 Ga. 844, 845 (1) (a) (607 SE2d 569) (2005). See Owensby v. Williams, 355 Ga. App. 695 (2020) (Stating in footnote 2 that former OCGA § […]
The best way to avoid fraud is to be aware and to do your due diligence when someone asks for or demands money. For example, there are scammers calling, impersonating law enforcement, and telling callers they must pay money or they will be arrested. See City of Portland – Phone Scam Fraud Impersonating Police Office. […]
After a loved one dies, it is sometimes necessary to open an estate to access accounts or other property owned by the deceased individual. If so, the first step is to determine whether the deceased person had a Will. Although Georgia does not require that you hire a lawyer to represent you, we strongly advise […]
WFSU Public Media reported that Group Homes For Those With Developmental Disabilities Face A Growing Worker Shortage. Developmental disability service providers are the latest to join a list of employers who say they’re facing a worker shortage. Advocates say direct support professionals who left the industry because of health concerns surrounding the COVID-19 pandemic aren’t […]
The Rule Against Perpetuities routinely stumps law students and lawyers, and can turn home-made documents into disasters. A deed, trust Will, or other document that violates the Rule Against Perpetuities may be invalid in part or in whole, causing anticipated distributions to be uncertain or preventing them from happening at all. See Wikipedia: Rule Against […]
Georgia Counties and Cities with links to Probate Court, Clerk of Superior Court, Legal Organ and other relevant information. General Links: Georgia Chamber of Commerce Georgia Probate Court GeorgiaPublicNotice.com | Search and View Published Legal Notices Georgia Superior Courts Georgia Superior Court Clerks Cooperative Authority | Includes Contact Information for County’s Legal Organ O.C.G.A. § […]
Murchison v. Smith, 270 Ga. 169 (1998). Ms. Annie Bell Smith was diagnosed with terminal lung cancer in December 1994. On January 31, 1995, she executed a will leaving the bulk of her estate to her brother-in-law, Caesar Smith and his wife Lois Smith, who were assisting Ms. Smith and providing her with care. Ms. […]
In re Estate of Diaz, 271 Ga. 742 (1999). Leanora Diaz (Diaz) died on April 3, 1997. During the year leading up to her death, her estranged husband served divorce papers on her. Her children begged her to get medical help and, after she refused, they tried to have her involuntarily committed. Following a hospital […]
Ashford v. Van Horne, 276 Ga. 636 (2003). Dr. Alexander Ashford and his wife were estranged after marrying in 1968. Mrs. Ashford filed for divorce in 1999 after a lengthy separation. Dr. Ashford died in 2001 during the divorce proceedings. In 1988, Dr. Ashford’s sister drove him to see an attorney. There, Dr. Ashford produced […]
In Wilder v. Virginia Hospital Assn., 496 U.S. 498 (1990), the Supreme Court stated: Medicaid is a cooperative federal-state program through which the Federal Government provides financial assistance to States so that they may furnish medical care to needy individuals. § 1396. Although participation in the program is voluntary, participating States must comply with certain […]
In Georgia Department of Community Health v. Medders, 292 Ga. App. 439, 2008 Ga. App. LEXIS 804 (2008) the Court stated the appellate standard of review as follows: “In addressing this appeal, we are mindful of the narrow scope of judicial review applicable to administrative agency matters. A court cannot “substitute its judgment for that […]
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