Appellant’s health improved significantly such that she did not need the facility services; facility provided proper notification of intent to discharge.
Category: Outcome of Fair Hearing
Appeal 1800679
Notice of discharge meets regulatory requirements; nursing facility involved appellant and his guardian in discharge planning; fact that appellant has not found place he wants to live is out of control of nursing facility; physician indicated appellant medically cleared for discharge; place to which appellant will be discharged is safe and appropriate.
Appeal 1803838
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.
Appeal 1800557
MMMNA should be increased because adjustments are needed in the calculations; no exceptional circumstances.
Appeal 1800590
Appellant transferred assets during look-back period; disqualifying transfer; transfers not made for fair market value; evidence needs contemporaneous third party independent corroboration to be persuasive; appellant’s age and health did not support argument that transfers were made for purposes other than qualifying for MassHealth.
Appeal 1714972
- Issue is whether MassHealth was correct in determining that the appellant had given away real estate in part to qualify for MassHealth benefits. Appeal denied.
Appeal 1800158
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.
Appeal 1800544
Facility notified appellant of debt owed; facility provided reasonable and appropriate notice of the debt owed; appellant failed to pay; physician confirmed that 24-hour care by a home health agency will meet appellant’s needs.
Appeal 1716522
- 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.
Appeal 1709521
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.
MassHealth Appeals 