Carpenter v. STATE, DEP. OF HEALTH AND HOS.

944 So. 2d 604, 2006 WL 2692580
CourtLouisiana Court of Appeal
DecidedSeptember 20, 2006
Docket2005 CA 1904
StatusPublished
Cited by19 cases

This text of 944 So. 2d 604 (Carpenter v. STATE, DEP. OF HEALTH AND HOS.) is published on Counsel Stack Legal Research, covering Louisiana Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Carpenter v. STATE, DEP. OF HEALTH AND HOS., 944 So. 2d 604, 2006 WL 2692580 (La. Ct. App. 2006).

Opinion

944 So.2d 604 (2006)

Louise M. CARPENTER
v.
STATE of Louisiana, DEPARTMENT OF HEALTH AND HOSPITALS.

No. 2005 CA 1904.

Court of Appeal of Louisiana, First Circuit.

September 20, 2006.
Rehearing Denied October 25, 2006.

*606 Peter J. Losavio, Baton Rouge, Counsel for Plaintiff/Appellee Louise M. Carpenter.

Neal R. Elliot, Jr., Baton Rouge, Counsel for Defendant/Appellant State of Louisiana, Department of Health and Hospitals.

Before: PETTIGREW, DOWNING, and HUGHES, JJ.

HUGHES, J.

This is an appeal by defendant, the Department of Health and Hospitals for the State of Louisiana, from a judgment by the 19th Judicial District Court restoring Medicaid benefits to plaintiff, Louise M. Carpenter. For the reasons that follow, we affirm.

FACTS AND PROCEDURAL HISTORY

On February 5, 2004, Louise M. Carpenter, then ninety-two years of age, moved from the home of her daughter Sheryl Bergeron, where Ms. Carpenter had lived since 1989, into a full care nursing home. On March 22, 2004, Ms. Bergeron filed a Medicaid application on her mother's behalf for long-term care benefits through the Department of Health and Hospitals for the State of Louisiana (DHH). The DHH's routine "resource eligibility screening" of Ms. Carpenter's assets detected that $29,339.68, the balance of a Legg Mason brokerage account in Ms. Carpenter's name, had been transferred to Ms. Bergeron at a point close in time to Ms. Carpenter's relocation to the nursing facility and Ms. Bergeron's application for benefits.[1]

The DHH viewed this transaction as a "transfer of resources for less than fair market value." According to the DHH's Medicaid Eligibility Manual, it is presumed that such a transfer has been effected in *607 order for an applicant to enhance his or her eligibility for Medicaid's long-term care benefits. On April 27, 2004, after written notice, the DHH denied Ms. Carpenter's benefits from February 5, 2004 through November 1, 2004. This amount of time represents a pro rata calculation applying an estimated average monthly private pay cost for long-term care of $3,000.00 per month to the $29, 339.68 figure.

Upon Ms. Bergeron's appeal, an administrative hearing was held on July 21, 2004. At the hearing, Ms. Bergeron opposed DHH's position that the transaction represented a transfer of assets for less than fair market value. She sought to show that, pursuant to a written care agreement that she and her mother signed in 1989 when her mother moved in with her, the $29,339.68 represented compensation for Ms. Bergeron's services in caring for her mother for the ensuing fifteen years until her mother required placement in the nursing home. Ms. Bergeron's evidence included the written care agreement, which set out terms by which Ms. Carpenter would pay Ms. Bergeron $1,000.00 per month, due on demand by Ms. Bergeron, in compensation for a wide array of care and services during Ms. Carpenter's residence with her daughter. The agreement is dated March 1, 1989 and signed by Ms. Carpenter and Ms. Bergeron as well as two witnesses. The witnesses to the agreement appeared and testified under oath at the hearing.

After the hearing, the administrative law judge took the matter under advisement and on August 19, 2004 she released her summary of the evidence, findings of fact, and "conclusions and recommendations." The administrative law judge concluded that DHH had properly denied Ms. Carpenter's benefits for the time period in question. Ms. Bergeron filed a petition for judicial review with the 19th Judicial District Court, alleging (1) that the transfer of resources by Ms. Carpenter to her daughter Ms. Bergeron was for a purpose unrelated to Medicaid eligibility, and (2) that the transfer was for fair market value.

The matter was briefed and oral arguments heard on June 24, 2005. From the bench, the judge reversed, finding the administrative law judge's decision arbitrary and an unwarranted exercise of discretion. On July 26, 2005 judgment was signed.

DHH appeals and asserts the following assignments of error: that the trial court (1) misapplied the standard of review, (2) erred in "failing to properly take into consideration the support of the administrative record," and (3) erred in reversing the administrative law judge's decision on the grounds that the decision was arbitrary and an unwarranted exercise of discretion.

Standard of Review

The Louisiana Administrative Procedure Act provides for judicial review over administrative adjudications. Louisiana Revised Statutes 49:964(G) states that:

The court may reverse or modify the decision if substantial rights of the appellant have been prejudiced because the administrative findings, inferences, conclusions, or decisions are:
(1) In violation of constitutional or statutory provisions;
(2) In excess of the statutory authority of the agency;
(3) Made upon unlawful procedure;
(4) Affected by other error of law;
(5) Arbitrary or capricious or characterized by abuse of discretion or clearly unwarranted exercise of discretion; or
(6) Not supported and sustainable by a preponderance of evidence as determined by the reviewing court. In the application of this rule, the court shall *608 make its own determination and conclusions of fact by a preponderance of evidence based upon its own evaluation of the record reviewed in its entirety upon judicial review. In the application of the rule, where the agency has the opportunity to judge the credibility of witnesses by first-hand observation of demeanor on the witness stand and the reviewing court does not, due regard shall be given to the agency's determination of credibility issues.

In this case, DHH appears to be claiming that the trial court erred in applying the "arbitrariness" standard in LSA-R.S. 49:964(G)(5) and not the "preponderance of the evidence" standard of LSA-R.S. 49:964(G)(6), which requires a reviewing court to give "due regard" to the administrative agency or tribunal's credibility determinations based on "first-hand observation."

Louisiana Revised Statutes 49:964(G)(5) and (6) address different considerations. Louisiana Revised Statutes 49:964(G)(5) "is used in reviewing conclusions and exercises of agency discretion," thus, this provision applies to questions of law and mixed questions of fact and law. Robert Force & Lawrence Griffith, The Louisiana Administrative Procedure Act, 42 La. L.Rev. 1227, 1285-86 (1982). Distinctly, LSA-R.S. 49:964(G)(6) "is used in reviewing the facts as found by the agency," which, according to the statute provision, includes credibility determinations. Id.

In this case, the trial court announced its decision from the bench: "I am going to rule that the decision of the board was arbitrary, clearly an unwarranted exercise of its discretion, and order that the documents be sufficient to prove that this was not an illegal transfer." (Record 169). The subsequent judgment reads: "After hearing and reviewing all evidence in this matter . . . the law and evidence are in favor of the Plaintiff in her demand against Louisiana Department of Health and Hospitals." (Record 165). The court's phrasing and language suggest that the court considered both the "arbitrariness" and "preponderance of the evidence" standards. We find that the trial court considered both LSA-R.S. 49:964(G)(5) and LSA-R.S. 49:964(G)(6) and thus did not misapply the standard of review. This assignment of error is without merit.

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Bluebook (online)
944 So. 2d 604, 2006 WL 2692580, Counsel Stack Legal Research, https://law.counselstack.com/opinion/carpenter-v-state-dep-of-health-and-hos-lactapp-2006.