Bd v. Division of Medical Assistance & Health Serv.

937 A.2d 980, 397 N.J. Super. 384
CourtNew Jersey Superior Court Appellate Division
DecidedDecember 10, 2007
StatusPublished
Cited by4 cases

This text of 937 A.2d 980 (Bd v. Division of Medical Assistance & Health Serv.) is published on Counsel Stack Legal Research, covering New Jersey Superior Court Appellate Division primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Bd v. Division of Medical Assistance & Health Serv., 937 A.2d 980, 397 N.J. Super. 384 (N.J. Ct. App. 2007).

Opinion

937 A.2d 980 (2007)
397 N.J. Super. 384

B.D., Petitioner-Appellant,
v.
DIVISION OF MEDICAL ASSISTANCE AND HEALTH SERVICES and Hudson County Board of Social Services, Respondents-Respondents.

Superior Court of New Jersey, Appellate Division.

Argued October 29, 2007.
Decided December 10, 2007.

Mary E. WanderPolo argued the cause for appellant (Ms. WanderPolo and Nicholas F. Lewis, of counsel and on the brief).

Julie Hubbs, Deputy Attorney General, argued the cause for respondent Division *981 of Medical Assistance and Health Services (Anne Milgram, Attorney General, attorney; Lewis A. Scheindlin, Assistant Attorney General, of counsel; Ms. Hubbs, on the brief).

Respondent Hudson County Board of Social Services did not file a brief.

Before Judges STERN, C.S. FISHER and C.L. MINIMAN.[1]

The opinion of the court was delivered by

FISHER, J.A.D.

This appeal requires our examination of a type of Medicaid planning unlike those previously encountered. See, e.g., H.K. v. Dep't of Human Servs., 184 N.J. 367, 877 A.2d 1218 (2005); In re Keri, 181 N.J. 50, 853 A.2d 909 (2004); J.P. v. Div. of Med. Assistance & Health Servs., 392 N.J.Super. 295, 920 A.2d 707 (App.Div. 2007); W.T. v. Div. of Med. Assistance & Health Servs., 391 N.J.Super. 25, 916 A.2d 1066 (App.Div.2007); In re Labis, 314 N.J.Super. 140, 714 A.2d 335 (App.Div. 1998). Here, B.D., a seventy-seven-year-old woman, conveyed her $259,917 home to her grandson for $10,191.70 in cash, the discharge of a $67,374.89 mortgage, and a lease of part of the home "for life." In focusing on the lease, the Director of the Division of Medical Assistance and Health Services concluded that B.D. did not receive fair market value and, therefore, imposed a Medicaid eligibility penalty period. Because the otherwise unambiguous phrase "for life," which significantly bears on the lease's value, is clouded by its context, and because the lease's true scope cannot be wrung solely from the lease itself, we remand for an evidentiary hearing.

The record reveals that B.D. was deemed eligible to participate in the Caregiver Assistance/NJEASE Homecare Program. This program was designed to provide services for individuals, who are at risk of nursing home placement, with the opportunity to remain in their homes. Upon learning that B.D. had transferred her home to M.D., her grandson, the Hudson County Board of Social Services reviewed her eligibility to remain in the program and later concluded, because B.D. had "received $10,191.70 for property worth $238,191.70 in net value," that the transfer of her home required the imposition of a thirty-seven-month penalty period.

A hearing was requested and the matter forwarded to the Office of Administrative Law for the development of a record. The parties stipulated to the facts they deemed relevant, provided the administrative law judge (ALJ) with exhibits, and filed briefs. No evidentiary hearing was conducted.

The parties stipulated that, on January 22, 2004, B.D. was a seventy-seven-year-old woman, who owned and had lived in a two-family house in Kearny for many years. The home had been appraised in October 2003 as having a value of $259,917. At that time, $67,374.98 was due on a mortgage encumbering the property. B.D. was also then receiving $1,180 per month in rent for the first floor apartment and $200 per month for rent on part of the second floor from J.D., her granddaughter.

On January 22, 2004, B.D. contracted to transfer the property to her grandson, M.D., for $255,000. To consummate the transaction, M.D. obtained an $80,000 mortgage loan, from which the debt on the existing mortgage and other minor settlement *982 charges were paid; the remainder of the mortgage proceeds, $10,191.71, was given to B.D. As part of this transaction, B.D. also received what has been referred to as a "lifetime lease" for the second floor/attic apartment (the apartment).

The lease stated that the compensation received by M.D. for giving B.D. a "lifetime lease" was $175,000, which purports to represent the remaining value of the property transferred to M.D. The lease defined its duration as "[f]or the life of [B.D.]," but also, within the same sentence, referred to an actuarial table. Although the record on appeal does not contain this actuarial table, the parties' stipulation indicates that B.D.'s life expectancy was then 10.83 years.

The meaning and significance of the lease term rested at the heart of the contested matter before the ALJ. In finding that the transfer was for fair market value, the ALJ provided the following analysis of B.D.'s prepayment of $175,000 in rent for the term of the lease:

At the time of the sale, [B.D.'s] life expectancy, according to the actuarial tables contained in HCFA Transmittal # 64, was 10.83 years. As such, if [B.D.] were to live for that amount of time, and rent the apartment for its fair rental value, she would have paid out a total of $194,940 in rent.[[2]] So in effect, the value of her lifetime leasehold, plus the $80,000 cash she received, earned [B.D.] approximately $20,000 more than the property's fair market value. In conclusion, this court cannot find that the sale of [B.D.'s] home was for less than fair market value.

As a result, the ALJ set aside the board's imposition of a penalty period.

The Director reversed the ALJ's decision, finding that B.D. failed to demonstrate that she received fair market value in exchange for conveying her home to her grandson. Proceeding on an assumption that the lease would terminate upon B.D.'s death or her departure from the premises, the Director concluded that the prepayment of so much rent by a woman of such age and health did not fall within the bounds of fair market value. In other words, the Director concluded that a finding that B.D. received fair market value required an assumption that B.D. would make use of the premises for a ten-year period, but failed to consider that any lesser duration of the lease — which seemed likely in the circumstances — would render the prepayment of ten years' worth of rent unconscionable. For example, if B.D. obtained the benefit of the lease for a period of ten years, then the prepayment of $175,000 — without presently considering the additional value to M.D. of receiving so much rent in advance — extrapolates to a monthly rent of slightly less than $1,500 per month. Accepting as reliable B.D.'s expert report — as to which the Director was correctly dismissive[3] — it could be concluded *983 that B.D.'s retention of a full ten-year term for $175,000 might have merit since that would extrapolate to a rent payment of $1,458.33 per month. On the other hand, if B.D.'s death one year after the transfer caused a termination of the lease, she would have actually paid rent to her grandson at the rate of more than $14,500 per month — an amount no one would equate with fair market value. In light of these considerations, and the fact that B.D. was "wheelchair bound" and already in need of services through the program, the Director concluded that B.D. did not receive fair value for the lifetime lease because she would not likely occupy the premises for anywhere near 10.83 years.

The Director reached this same conclusion by analyzing the transaction from the point of view of B.D.'s grandson:

[B.D.] . . .

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937 A.2d 980, 397 N.J. Super. 384, Counsel Stack Legal Research, https://law.counselstack.com/opinion/bd-v-division-of-medical-assistance-health-serv-njsuperctappdiv-2007.