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Page 4 of 11 § 10:71-4.5 Resource eligibility standards Because the amount of countable resources available to a Medicaid recipient was properly evaluated as of the first day of every month, an ALJ's determination that the recipient's eligibility was terminated on the last day of the month in which her countable resources, which had increased due to the death of her husband, exceeded the permitted amount was incorrect. The ruling below was properly modified to utilize the correct date. In re Froehner, OAL Dkt. No. HMA 0056-2018, 2018 N.J. AGEN LEXIS 1142, Final Agency Determination (June 5, 2018). Transfer penalty was properly imposed on the Medicaid eligibility of an applicant despite her claim that her transfer of her residence to her daughter was properly disregarded by reason of the "caregiver exemption." Though there was no doubt that the applicant's daughter provided care for the applicant and sacrificed a great deal for her comfort, care, and support, the level of care provided by the daughter did not rise to the level qualifying for the caregiver's exemption. C.S. v. Bergen Cnty. Bd. of Social Servs., OAL DKT. NO. HMA 03190-17, 2017 N.J. AGEN LEXIS 789, Initial Decision (October 17, 2017). Once a Medicaid recipient was declared incompetent by reason of dementia, he in fact did not have "access" to the cash value of his life insurance policies for the purpose of resource counting and that value could not be used as a basis to terminate his benefits based on the existence of excess resources. Nor was a delay in the verification of financial information good grounds to terminate the recipient's benefits. Both of these circumstances were byproducts of a five-month delay between the filing of a verified complaint for guardianship in the Superior Court and the issuance, by that court, of an order granting the same and the additional delay occasioned by the guardian's need to obtain Letters of Guardianship and a related bond. R.P. v. Gloucester Cnty. Bd. of Social Servs., OAL DKT. NO. HMA 05302-17, 2017 N.J. AGEN LEXIS 734, Initial Decision (September 28, 2017). Institutionalized spouse who failed to cause her attorney-in-fact to elect against the estate of her deceased husband within the statutory 6-month period was properly found to have transferred those assets into the inter vivos trust of the deceased spouse for less than FMV and such amounts were properly considered in determining and imposing a transfer penalty on the Medicaid eligibility of the institutionalized spouse. R.L. v. DMAHS et al., OAL DKT. NO. HMA 09762-14, 2017 N.J. AGEN LEXIS 669, Initial Decision (August 30, 2017). Transfer penalty imposed upon an applicant for Medicaid-only benefits on account of the sale of his home was properly calculated based on tax-assessed value for the property of $ 220,500, adjusted by use of the 2015 Equalized Valuation Ratio to $ 217,305. No value could be assigned to the repairs that were alleged by the applicant to be required because the certificate of occupancy inspection report was unsigned and no estimates of the cost of the repairs that were allegedly needed were submitted. Moreover, the value of the property had to be adjusted upward to account for the additional benefit resulting from the presence, on the property, of a billboard that was subject to a 30-year lease. M.T. v. DMAHS et al., OAL DKT. NO. HMA 02698-17 (ON REMAND HMA 13332- 16), 2017 N.J. AGEN LEXIS 557, Initial Decision (July 18, 2017). Social services board erred in denying an application for Medicaid due to excess resources allegedly possessed by the applicant because the fund at issue was a retroactive payment of Social Security disability benefits. Using the methodologies and requirements for SSI as required, and per 20 C.F.R. § 416.1233(a), such funds should have been excluded from the applicant's resources for a period of nine months. Once those funds were removed from the calculation, the applicant did not possess "excess resources" supporting the denial of the application. T.S. v. Essex Cnty. Bd. of Social Servs., OAL DKT. NO. HMA 05476-17, 2017 N.J. AGEN LEXIS 363, Initial Decision (June 2, 2017). Assets held in a trust of which a Medicaid applicant was both a grantor and a co-trustee were not "countable assets" for the purpose of determining the applicant's eligibility because the trust expressly provided that the applicant could not receive any amounts from the trust under any circumstances. Also, the trust was created more than ten years prior to the date on which the applicant sought Medicaid benefits. M.K. v. Morris Cnty. Bd. of Social Servs., OAL DKT. NO. HMA 05523-17, 2017 N.J. AGEN LEXIS 347, Initial Decision (May 25, 2017). DMAHS director reversed an ALJ's Initial Decision finding that an applicant was eligible for the Medicaid Only program. While the ALJ concluded that the applicant's resources exceeded the resource limit by pennies and was