Christensen v. North Dakota Department of Human Services

2011 ND 77, 796 N.W.2d 390, 2011 N.D. LEXIS 72, 2011 WL 1435261
CourtNorth Dakota Supreme Court
DecidedApril 12, 2011
DocketNo. 20100263
StatusPublished
Cited by3 cases

This text of 2011 ND 77 (Christensen v. North Dakota Department of Human Services) is published on Counsel Stack Legal Research, covering North Dakota Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Christensen v. North Dakota Department of Human Services, 2011 ND 77, 796 N.W.2d 390, 2011 N.D. LEXIS 72, 2011 WL 1435261 (N.D. 2011).

Opinion

MARING, Justice.

[¶ 1] Edward Christensen appealed from a district court judgment affirming the order of the North Dakota Department of Human Services determining that he was ineligible for Medicaid benefits for the five-month period from April to August of 2008. We affirm, concluding the Department of Human Services did not err in determining Edward Christensen’s interests in certain real estate, and the proceeds from the sale of the real estate, were available assets disqualifying him from Medicaid eligibility.

I

[¶ 2] Edward Christensen has been a resident of St. Rose Care Center, a long-term nursing home facility, since 2004. Edward Christensen’s nephew, Tom Christensen, was his attorney-in-fact and handled his financial affairs. In 2007, Edward Christensen ran out of liquid assets and was unable to pay his bills to St. Rose Care Center. In November 2007, St. Rose Care Center’s attorney sent a letter to Tom Christensen indicating that St. Rose Care Center would evict Edward unless Tom Christensen made arrangements to pay Edward Christensen’s bills.

[¶ 3] In November 2007, Tom Christensen and the administrator at St. Rose Care Center entered into an agreement whereby Tom Christensen agreed to sell Edward Christensen’s interests in two parcels of real estate in California and pay the proceeds to St. Rose Care Center in exchange for St. Rose Care Center agreeing not to bring legal action to evict Edward Christensen. In April 2008, Tom Christensen entered into an agreement to sell Edward Christensen’s interest in one of the California properties for $22,500. The sale closed in late July 2008, and proceeds of the sale were placed in Edward Christensen’s checking account. Edward Christensen’s interest in the second California parcel sold in July 2008 for $2,500, and the proceeds again were placed in Edward Christensen’s checking account. On the advice of counsel, Tom Christensen withheld $1,800 of the sale proceeds for capital gains taxes, and the remaining $23,200 in proceeds was transferred to St. Rose Care Center by check in early September 2008.

[¶ 4] In July 2008, contemporaneous with the sale of the California properties, Edward Christensen applied for Medicaid benefits, retroactive to April 1, 2008. La-Moure County Social Services determined Edward Christensen was not eligible for benefits for the months of April, May, and June 2008 because he still owned an interest in the California properties and therefore was above the asset eligibility limit. LaMoure County further determined that Edward Christensen was ineligible for the months of July and August 2008 because the proceeds from the California sales were in his checking account and therefore were available assets, placing him above the asset eligibility limit. LaMoure County determined that Edward Christensen became eligible for Medicaid benefits com[393]*393mencing in September 2008 when the proceeds were paid to St. Rose Care Center.

[¶ 5] Edward appealed LaMoure County’s determination to the Department of Human Services, and a hearing was held before an administrative law judge (“ALJ”). The ALJ issued recommended findings and order, determining that the alleged oral agreement between Edward Christensen and St. Rose Care Center regarding the proceeds of the California property sales was not legally binding, and therefore those assets remained available to Edward Christensen until the proceeds were actually transferred to St. Rose Care Center in September 2008. The ALJ recommended affirming LaMoure County’s decision that Edward was not eligible for benefits for April through August 2008, but became eligible commencing in September 2008. The Department of Human Services adopted the ALJ’s recommended findings and order, and Edward appealed to the district court. The district court affirmed the order of the Department of Human Services.

II

[¶ 6] When a decision of an administrative agency is appealed from the district court to this Court, we review the agency’s decision and the record compiled before the agency. Reinholdt v. North Dakota Dep’t of Human Servs., 2009 ND 17, ¶ 10, 760 N.W.2d 101; Rennich v. North Dakota Dep’t of Human Servs., 2008 ND 171, ¶ 10, 756 N.W.2d 182. Courts exercise a limited review in appeals from administrative agency decisions under the Administrative Agencies Practice Act, N.D.C.C. ch. 28-32. Rennich, at ¶ 10. Under N.D.C.C. § 28-32-49, our standard of review of the agency’s decision is the same as the standard applied by the district court under N.D.C.C. § 28-32-46. Hendrickson v. Olson, 2009 ND 16, ¶ 8, 760 N.W.2d 116; Rennich, at ¶ 10; Oyloe v. North Dakota Dep’t of Human Servs., 2008 ND 67, ¶ 7, 747 N.W.2d 106. Accordingly, we will reverse the agency’s decision only if:

1. The order is not in accordance with the law.
2. The order is in violation of the constitutional rights of the appellant.
3. The provisions of this chapter have not been complied with in the proceedings before the agency.
4. The rules or procedure of the agency have not afforded the appellant a fair hearing.
5. The findings of fact made by the agency are not supported by a preponderance of the evidence.
6. The conclusions of law and order of the agency are not supported by its findings of fact.
7. The findings of fact made by the agency do not sufficiently address the evidence presented to the agency by the appellant.
8. The conclusions of law and order of the agency do not sufficiently explain the agency’s rationale for not adopting any contrary recommendations by a hearing officer or an administrative law judge.

N.D.C.C. § 28-32-46.

[¶ 7] In determining whether an agency’s findings of fact are supported by a preponderance of the evidence, we do not make independent findings of fact or substitute our judgment for that of the agency, but rather determine only whether a reasoning mind reasonably could have determined that the factual conclusions reached were proved by the weight of the evidence from the entire record. Hendrickson, 2009 ND 16, ¶ 8, 760 N.W.2d 116; Rennich, 2008 ND 171, ¶ 11, 756 N.W.2d 182. Questions of law are fully [394]*394renewable on appeal from an agency’s decision. Reinholdt, 2009 ND 17, ¶ 10, 760 N.W.2d 101; Rennich, at ¶ 11.

Ill

[¶ 8] Medicaid is a cooperative federal-state program designed to provide financial assistance to needy persons for their necessary medical care. Reinholdt, 2009 ND 17, ¶ 11, 760 N.W.2d 101; Oyloe, 2008 ND 67, ¶ 8, 747 N.W.2d 106. To be eligible for Medicaid benefits, a person must lack sufficient assets to pay the costs of their necessary medical care and services. Reinholdt, at ¶ 12; Oyloe, at ¶ 8. Medicaid is intended to be a payor of last resort, and an individual’s other available resources must be exhausted before Medicaid will pay for care. Reinholdt, at ¶ 12; Oyloe, at ¶ 8. The Department of Human Services has adopted rules compiled in N.D. Admin. Code ch. 75-02-02.1 to implement the program and determine eligibility for benefits. Reinholdt, at ¶ 12; Oyloe, at ¶ 7. An applicant for Medicaid benefits bears the burden of proving eligibility. N.D. Admin. Code § 75-02-02.1-02.1; Rennich, 2008 ND 171, ¶ 12, 756 N.W.2d 182; Oyloe,

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Bluebook (online)
2011 ND 77, 796 N.W.2d 390, 2011 N.D. LEXIS 72, 2011 WL 1435261, Counsel Stack Legal Research, https://law.counselstack.com/opinion/christensen-v-north-dakota-department-of-human-services-nd-2011.