MassHealth determined that the appellant transferred assets when she paid her son and daughter-in-law for services under a personal care contract; compensation for a variety of personal services; the services she received were not worth the $48,550 that she paid but did have some value; remanded for MassHealth to redetermine the period of ineligibility.
Category: At Issue in Fair Hearing
Appeal 1117214
Notice is deficient in that it indicates the intention to discharge Appellant to her former home to live with her son. Appellant was admitted to the nursing facility with a diagnosis of Alzheimer’s disease and was clinically determined to require skilled nursing services; the only safe and appropriate setting for Appellant would be another skilled nursing facility capable of meeting the needs of a resident with Alzheimer’s disease. Accordingly, the subject 30-Day Notice of Intent to Discharge fails to indicate a safe and appropriate discharge location.
Appeal 1118365
Transfer of $36,000.00 was made exclusively for a purpose other than to qualify for MassHealth and therefore not a disqualifying transfer; Appellant transferred to her grandchildren a gift of $12,000.00 each; Appellant did so relying on tax advice and in an attempt to ease the financial burden of her grandchildren; at the time of the transfer the Appellant was 83 years old and although she had a number of medical issues she was in reasonably good health and there is no evidence that she transferred the funds with the knowledge that she would be entering a nursing home in 2010 or with the intent to establish eligibility for MassHealth benefits in 2011.
Appeal 1112754
Transfers to appellant’s son of $551,466.94 from appellant’s bank accounts between 6/20/08 and 5/12/10 as well as the payment of $107,433.98 to the son from proceeds of the sale of appellant’s residence on 12/01/10 are disqualifying transfers of a total of $658,900.92; there is no evidenced benefit received by appellant or her spouse for the transfer of $658,900.92 to the son over a two year period; the multiple transfers of money constitute outright gifts and thus multiple disqualifying transfers.
Appeal 1106404
At the time of the transfer the appellant was in good health, living on her own and decided to give a gift to her daughter who was having financial difficulties; no evidence the appellant transferred the funds with the intent to apply for MassHealth 3½ years later; the transfer of $10,000.00 was for a purpose other than to qualify for MassHealth and therefore not a disqualifying transfer.
Appeal 1107446
No evidence presented to show that the appellant received fair market value at the time she made the transfers to her son; the payments were done in advance of the services being provided by the appellant’s son; there was no testimony or evidence to demonstrate that this is a typical practice of property management; it is difficult to conclude that the transfers were made exclusively for a purpose other than to qualify for MassHealth when the appellant demonstrated that a contract was entered into after entering a facility and payments were made in advance of services being provided.
Appeal 1106530
Transfer took place before look-back period; deed was delivered to son earlier even though only recorded later; attorney testified to appellant’s earlier delivery of the deed to her son and informing him that it was a completed gift; transferred remainder interest and retained life estate.
Appeal 1104896
Adjust the MMMNA to account for the community spouse’s assisted living costs and adjustment to the SMNA; exceptional circumstances exist; an adjustment shall be made to accommodate the special support service that the community spouse needs at the assisted living facility; community spouse’s gross income is less than what she needs to meet the expenses caused by the exceptional circumstances.
Appeal 1014765
Transfer took place before look-back period; deed was delivered to son earlier even though only recorded later; son testified and provided evidence.
Appeal 1019516
Appellant, her husband and their daughter Rebecca and her husband Todd entered into a caregiver agreement; Appellant paid a lump sum of $50,000 in March 2007 for services that had been provided since September 2005 and were contemplated to continue to be provided for as long as possible into the unknown future; no enforcement mechanism available to appellant since the agreement could have been terminated “for whatever reason”; vague list of potential types of care to be provided with no concomitant hourly, daily, monthly or per-activity payment rate for the care; however, Appellant certainly received fair-market value for her housing and care; it was only a matter of financial circumstances that the $50,000 was not paid contemporaneously with the signing of the agreement in September 2005; thus, appellant’s payment of $50,000 to Rebecca on 3/31/07 was not a disqualifying transfer.
MassHealth Appeals 