Single Premium Life Insurance Contract; Penalty Reversed. On November 5, 2008, Petitioner filed an application to purchase a Single Premium Pure Endowment Life Insurance Contract. She paid $89,500 for the policy which, in five years, would pay her children $91,327. The contract stated there was no cash surrender value and that no benefits would be […]
No Retroactive Application of Policy Changes Permitted; Payments for Renovations to Accommodate Petitioner Permitted; Payments Consistent with Prior Accepted Obligation Permitted. Petitioner was hospitalized with a stroke in 2008, after which she went to live with one of her sons until she was re-hospitalized in November 2008. Thereafter, she remained in a nursing home. Petitioner […]
Personal Services Contract rejected. Petitioner was admitted to a nursing home in October 2008, where she continued to stay. At the time, she had $36,332 in resources. Petitioner entered into a contract with Ms. Hailey to provide personal care services at the nursing home for life for $23,000. Her life expectancy was 10 more years. […]
VA Improved Pension Not Income. Petitioner applied for Medicaid on November 4, 2008. Petitioner was the surviving spouse of a veteran eligible for VA Improved Pension. At the time, the income cap was $2,022 and, if the Improved Pension was included in Petitioner’s income, then her gross monthly income exceeded the income cap. Of Petitioner’s $1,056 […]
Direct Transfer to disabled child allowed from date ALS was diagnosed. Petitioner made transfers directly to a disabled child with ALS. However some transfers were made prior to the determination of disability and others were made after the disability determination. DFCS attempted to penalize all transfers since they were directly to the disabled child rather […]
Increase CSRA in Superior Court, followed by Application and Fair Hearing. After admission to a nursing home, but prior to application for Medicaid, the Superior Court in Glascock County issued an order setting aside all of Petitioner’s marital resources for the Community Spouse’s benefit for the purpose of generating sufficient income to reach the MMMNA. […]
Transfer penalty cannot be imposed where transfer was exclusively for purpose other than to qualify for Medicaid. Petitioner was admitted to a nursing home with dementia and her doctor states she cannot make legal decisions. Petitioner owned her home jointly with her daughter following the death of Petitioner’s husband. The daughter then conveyed the home […]
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 […]
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 […]
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