DFCS directed to determine eligibility where application was pending for over one year. Petitioner filed an application for Medicaid on May 22, 2007. On June 18, 2007, a verification package was given to Petitioner’s daughter. On July 1, 2007, the application was denied for failure to provide verification. On July 25, 2007, Petitioner requested a […]
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Sole Benefit Trust rejected and transfer penalty imposed. An 86 year old applicant established an irrevocable trust for the benefit of his 64 year old daughter. However, the trust was not submitted to DCH Legal for approval and Petitioner submitted no evidence that the trust comported with Section 2346 relating to special needs trusts. Further, the […]
Transfer Penalty Reversed Where Home Was Returned. Three months prior to a nursing home admission, a 98 year old Petitioner purchased her daughters home for $406,300, plus personal property valued at $26,775. She paid by transferring securities valued at $484,766.78, and $51,691.78 was returned to Petitioner as an over-payment. Petitioner’s alleged hope was that she […]
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 […]
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 […]
