No evidence that appellant made transfer with intent other than to assist a specific child in need; medical event that caused appellant’s short-term placement in skilled nursing facility was not reasonably foreseeable; intent behind transfers was not to gain MassHealth eligibility.
Community spouse is entitled to her actual MMMNA amount; this amount is based on basic necessities such as shelter and utilities; appellant is on fixed income and has little savings and multiple medical conditions.
- Issue is whether the appellant’s jointly-held real estate should be deemed non-countable. MassHealth ordered to disregard appellant’s jointly-owned real estate from countable assets and to approve the application if otherwise eligible.
MassHealth application denied because verifications not submitted; missing verifications were assets of community spouse; community spouse’s refusal to cooperate with application process cannot be basis for denial of MassHealth application; appellant is mentally incompetent to assign rights of support to MassHealth.
Hearing officer agreed facility had sufficient grounds to discharge; appellant smoked without supervision in facility including in her room; danger to other residents; discharge notice met regulatory requirements; however, there was a lack of the required documentation by a physician.
Nursing facility did not meet its burden to support its discharge notice; nursing facility did not appear at hearing; nursing facility did not show good cause regarding failure to appear.
- Issue is whether MassHealth was correct in denying coverage prior to a date due to resource transfers. MassHealth ordered to rescind the notice and determine MassHealth eligibility without regard to the resource transfers.
Appellant properly assigned rights to support from his community spouse to MassHealth; obligation to provide asset verification was alleviated; MassHealth ordered to continue processing appellant’s application, seeking no further verifications from his ex-wife.
Community spouse refused to cooperate; assets have been kept separate; appellant is mentally incompetent and cannot assign to MassHealth any rights to support from her community spouse; application cannot be denied based on spouse’s refusal to cooperate.
- MassHealth determined that appellant is not eligible to receive MassHealth benefits due to excess countable assets. Ordered to rescind notice, re-open application, and determine the appellant’s eligibility based on the determination that the excess asset amount is now $0.