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Medicaid: Personal Services Contract Rejected

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. The ALJ found that if Petitioner did live 10 more years, the per hour rate paid to Ms. Hailey would be 87 cents per hour.  The ALJ concluded that “given the disparity between the contractual terms and the federal minimum wage, Petitioner’s transfer to Ms. Hailey under the contract was not a fair market transfer, that valuable consideration was not given under such contract terms and affirmed imposition of the penalty.

  • On appeal, the Decision of Commissioner affirmed the Initial Decision. One of the Commissioner’s reasons for doing so was evidence that Ms. Hailey was not providing services since Petitioner had three falls after entering the nursing home, and evidence that Ms. Hailey could not continue providing services due to her own financial obligations.

Bossen v. Department (April 29, 2009).

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