Patrick W. Finnerty, Director Department of Medical Assistance Services v. Ann Robinson

CourtCourt of Appeals of Virginia
DecidedDecember 4, 2007
Docket0621072
StatusUnpublished

This text of Patrick W. Finnerty, Director Department of Medical Assistance Services v. Ann Robinson (Patrick W. Finnerty, Director Department of Medical Assistance Services v. Ann Robinson) is published on Counsel Stack Legal Research, covering Court of Appeals of Virginia primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Patrick W. Finnerty, Director Department of Medical Assistance Services v. Ann Robinson, (Va. Ct. App. 2007).

Opinion

COURT OF APPEALS OF VIRGINIA

Present: Judges Frank, Clements and Senior Judge Coleman Argued at Richmond, Virginia

PATRICK W. FINNERTY, DIRECTOR DEPARTMENT OF MEDICAL ASSISTANCE SERVICES MEMORANDUM OPINION * BY v. Record No. 0621-07-2 JUDGE ROBERT P. FRANK DECEMBER 4, 2007 ANN ROBINSON

FROM THE CIRCUIT COURT OF HENRICO COUNTY Daniel T. Balfour, Judge

Usha Koduru, Assistant Attorney General (Robert F. McDonnell, Attorney General; David E. Johnson, Deputy Attorney General; Kim F. Piner, Senior Assistant Attorney General, on brief), for appellant.

No brief for appellee.

Patrick W. Finnerty, Director, Department of Medical Assistance Services, appeals from a

decision of the Circuit Court of Henrico County issued pursuant to the Virginia Administrative

Process Act, Code § 2.2-4000 et seq. (the VAPA), reversing the decision of the hearing officer as to

the fair market value of the residence of Ann Robinson. Specifically, appellant contends the trial

court erred in finding there was no substantial evidence to support the hearing officer’s finding that

the county’s tax assessment of the subject property reflected its fair market value. For the reasons

stated, we reverse the trial court and remand for further proceedings.

* Pursuant to Code § 17.1-413, this opinion is not designated for publication. BACKGROUND

On October 29, 2004, Henrico County assessed Ann Robinson’s real property for $125,100.

On January 6, 2005, Mrs. Robinson, age 92, sold her home for $70,000. No agent was involved in

the transaction. The settlement statement of the sale from Mrs. Robinson’s property showed an

outstanding mortgage lien of $16,038.62. Mrs. Robinson entered a convalescent home on April 5,

2005, and, on September 9, 2005, she applied for Medicaid benefits for long-term care.

Relying on the $55,100 difference between the $125,100 assessed value and the $70,000

sales price, the Department of Social Services (DSS) denied Mrs. Robinson Medicaid coverage on

October 17, 2005 due to the “uncompensated transfer” of her property. DSS imposed a penalty

period of 13 months, determined by dividing the $55,100 deficit by the monthly nursing facility rate

of $4,060.

Mrs. Robinson hired a private appraiser who determined the fair market value of her

property to be $85,000 as of January 2005. The appraiser noted the property was in disrepair and

estimated the “Deferred Maintenance and Cost to Cure” would be $19,590. The appraisal listed

four “comparable” properties to be valued at $124,000, $124,000, $105,000 and $129,950.

Mrs. Robinson appealed the decision of DSS to a hearing officer of the Department of

Medical Assistance Services. Before the hearing officer, a DSS eligibility worker testified that

Medicaid regulations do not allow them to deviate from the tax assessment. The hearing officer

rejected Mrs. Robinson’s appraisal and, based on the county tax assessment, determined the fair

market value of the property to be $125,100.

Mrs. Robinson then appealed the hearing officer’s decision to the circuit court. 1 Upon

review, the court reversed the hearing officer’s ruling, finding:

1 The issue on appeal before the circuit court was that “evidence supports the fact that fair market value compensation was paid.” Mrs. Robinson did not challenge the methodology or -2- IT IS HEREBY ORDERED that the Court rules that there was not substantial evidence on the record to support the decision that the Hearing Officer entered in this matter; specifically as it relates to the use of a County assessed value, rather than a residential real estate appraisal that was filed; and specifically as it relates to her failure to consider the mortgage that was outstanding to reduce the value of the residence and real estate; along with the specific failure to consider the cost of a real estate commission to sell this property at its fair market value on the open market.

The court further found the issue failed to fall within the area of experience and

specialized competence of the agency, and remanded the case to the agency to correct the

decision.

This appeal follows.

ANALYSIS

Essentially, appellant contends the trial court erred in finding there was not substantial

evidence to support the hearing officer’s determination of the fair market value. 2 Since we

resolve this appeal on the “substantial evidence” question, we need not address appellant’s

remaining issues.

legality of utilizing the tax assessment, but challenged only its accuracy as reflecting the actual fair market value of the property. 2 Appellant’s questions presented are:

I. Whether the Circuit Court improperly rejected Medicaid policy that relies on a property tax assessment from the county’s tax assessor’s office in evaluating a transfer of property for the purpose of determining Medicaid eligibility? II. In substituting its own judgment for Medicaid policy, did the Circuit Court violate Virginia Code § 2.2-4025, where the validity of any statute, regulation, standard or policy upon which the agency has acted shall not be subject to review by the court? III. Considering the entire record, did the Circuit Court fail to find there was substantial evidence in the record to support the agency’s decision?

-3- The trial court reviewed the factual findings of the hearing officer and concluded there

was not “substantial evidence” to support that finding. 3 See Code § 2.2-4027 (designating “the

substantiality of the evidentiary support for findings of fact” as subject for review by the circuit

court).

On appeal of an agency decision, “[t]he sole determination as to factual issues is whether substantial evidence exists in the agency record to support the agency’s decision. The reviewing court may reject the agency’s findings of fact only if, considering the record as a whole, a reasonable mind necessarily would come to a different conclusion.”

Chippenham & Johnston-Willis Hosps., Inc. v. Peterson, 36 Va. App. 469, 475, 553 S.E.2d 133,

136 (2001) (quoting Johnston-Willis, Ltd. v. Kenley, 6 Va. App. 231, 242, 369 S.E.2d 1, 7

(1988)). See also Code § 2.2-4027 (“Whether the fact issues are reviewed on the agency record

or one made in the review action, the court shall take due account of the presumption of official

regularity, the experience and specialized competence of the agency, and the purposes of the

basic law under which the agency has acted.”).

Under the VAPA, the circuit court reviews the agency’s action in a manner “‘equivalent

to an appellate court’s role in an appeal from a trial court.’” J. P. v. Carter, 24 Va. App. 707,

721, 485 S.E.2d 162, 169 (1997) (quoting Sch. Bd. v. Nicely, 12 Va. App. 1051, 1061-62, 408

S.E.2d 545, 551 (1991)). ‘“In this sense, the General Assembly has provided that a circuit court

acts as an appellate tribunal.”’ Giannoukos v. Virginia Bd. of Medicine, 44 Va. App. 694, 699,

607 S.E.2d 136, 138 (2005) (quoting Gordon v. Allen, 24 Va. App. 272, 277, 482 S.E.2d 66, 68

(1997)).

Our analysis, consistent with our standard of review, is whether “considering the record

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Related

Giannoukos v. Virginia Board of Medicine
607 S.E.2d 136 (Court of Appeals of Virginia, 2005)
Chippenham & Johnston-Willis Hospitals, Inc. v. Peterson
553 S.E.2d 133 (Court of Appeals of Virginia, 2001)
J.P. v. Carter
485 S.E.2d 162 (Court of Appeals of Virginia, 1997)
Gordon v. Allen
482 S.E.2d 66 (Court of Appeals of Virginia, 1997)
Board of Supervisors v. Donatelli & Klein, Inc.
325 S.E.2d 342 (Supreme Court of Virginia, 1985)
School Bd. of County of York v. Nicely
408 S.E.2d 545 (Court of Appeals of Virginia, 1991)
Johnston-Willis, Ltd. v. Kenley
369 S.E.2d 1 (Court of Appeals of Virginia, 1988)

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