- NJ has gotten really tough on approving transfers of a parent’s home to a child who provided care to their parent to avoid nursing home placement.
- Here is a case where the state approved both Medicaid benefits to the parent and the transfer of the parent’s home to the caregiving child.
Facts of the Case
Mom applied for Medicaid benefits in 2020. She was medically approved after her hospitalization. Daughter requested a caregiver child exemption whereby she could transfer mom’s home to her without incurring a transfer penalty. Burlington County denied the request and the daughter filed a fair hearing appeal.
Federal and State Law Governing the Caregiver Child Exemption
The New Jersey regulations regarding the child caregiver exemption are based on the federal statute. (42 U.S.C. § 1396p(c)(2)(A)(iv), N.J.A.C. 10:71-4-7(d) AND N.J.A.C. 10:71-4.10(d)). The statute provides that if the “equity interest in a home” is transferred to a son or daughter who provided care that prevented institutionalization for at least two years, the transfer is exempt from penalty. It was undisputed that Petitioner’s daughter provided needed care at home.
Mom was (mostly) non-ambulatory. She could use a walker, but was unable to negotiate stairs, go to the toilet or bathe herself on her own. Daughter gave her sponge baths in bed, dressed her and prepared all of her meals and cut up her food so she could eat. Petitioner was unable to get out of bed or in and out of a chair without assistance.
In addition to the help listed above, daughter also took care of other aspects of Mom’s life, including making arrangements for her medical care, doing her shopping, ordering and picking up her medications, doing her laundry and cleaning. She also transported Mom to doctor’s appointments.
Daughter took six weeks’ family leave from her employment to care for her mother. Daughter made certain that Mom was okay during the day. When she returned from work, she would change her mother’s diapers, prepare dinner, and administer her evening medications.
Daughter did make payments intermittently to medical personnel and caregivers when she was unable to care for her mother.
The Appellate Court Reversed the County Denial of Medicaid
Caregiver exemption cases are extremely fact sensitive. Because of daughter’s care in this case, the state Appellate Court granted Mom Medicaid and allowed the daughter to take ownership of the house. Under the circumstances of this case, an exemption from a transfer penalty was justified.
To discuss your NJ Medicaid appeal, please contact Fredrick P. Niemann, Esq. toll-free at (855) 376-5291 or email him at fniemann@hnlawfirm.com. Please ask us about our video conferencing or telephone consultations if you are unable to come to our office.
By Fredrick P. Niemann, Esq. of Hanlon Niemann & Wright, a Freehold Township, Monmouth County, NJ Appeal of Medicaid Denial Attorney