Page 149

Page 7 of 11 § 10:71-4.5 Resource eligibility standards Medicaid Only Institutional benefits were properly denied by a county board of social services to an elderly applicant on the ground that her countable resources exceeded the eligibility ceiling. Though the applicant's caregiver/daughter claimed that the execution by the applicant of a power of attorney giving the daughter total power over all of the applicant's affairs, including her financial affairs, combined with the purported existence of a signed deed to the applicant's house, was sufficient to render the property "inaccessible," the applicant remained the owner of the property and its value was such that she was ineligible for the program. E.C. v. Passaic Bd. of Social Servs., OAL DKT. NO. HMA 16475-15, 2016 N.J. AGEN LEXIS 121, Initial Decision (March 14, 2016). Income stream that was available from a testamentary trust benefiting, inter alia, an applicant for Medicaid constituted a "resource" for the applicant that exceeded the resource ceiling in governing law and thus disqualified the applicant from qualifying for Medicaid. There was no merit to the applicant's claim that the trustee of the trust had validly determined to not invade the corpus of the trust for her nursing home care on the ground that it was not an "emergency" within the meaning of the trust because, in reality, the applicant herself had full discretion to approve or disapprove any proposed payment. S.V. v. Ocean Cnty. Bd. of Social Servs., OAL DKT. NO. HMA 02069-15, 2016 N.J. AGEN LEXIS 78, Initial Decision (February 23, 2016). County board of social services was right to conclude that the countable resources of a 78 year old widow included a checking account that contained more than $ 70,000 even though her son, who was a co-owner of the checking account, insisted that nearly $ 60,000 of those funds were the proceeds from the sale of his house in which his mother had no legal interest. The widow was not under any disability or guardianship and the manner in which the account was titled - as an "or" account - meant that the widow had unrestricted access to all of the funds contained therein. S.M. v. Camden Cnty. Bd. of Social Servs., OAL DKT. NO. HMA 04755-15, 2015 N.J. AGEN LEXIS 456, Initial Decision (November 20, 2015). Funds held in an escrow account on which the N.J. Office of the Public Guardian held a lien were not "available" to an applicant who was seeking eligibility for the Medicaid Only program within the meaning of governing rules and was not properly included in the "countable resources" on which an eligibility decision was properly based. C.H. v. Essex Cnty. Bd. of Social Servs., OAL DKT. NO. HMA 08484-15, 2015 N.J. AGEN LEXIS 604, Initial Decision (September 24, 2015). Medicaid recipient was properly found ineligible for continuing benefits based on her receipt of $ 26,855.97 in proceeds from a settlement of a lawsuit because such proceeds were a "resource" and a "countable resource" as defined in governing law; because the recipient was unable to detail how she used the proceeds; and because its receipt meant that her monthly income exceeded the applicable income ceiling. D.B. v. Union Cnty. Bd. of Soc. Servs., OAL DKT. NO. HMA 10797-15, 2015 N.J. AGEN LEXIS 509, Initial Decision (August 25, 2015). Now-deceased resident of a nursing home could not be said to have had "access" to funds generated by the sale of her home, which funds were stolen by her two daughters and could not be recovered notwithstanding the valiant efforts of her grandson, with whom she had resided and who was the executor of the resident's estate. Because those funds were not "available" to the resident to apply to the cost of her care, the eligibility penalty imposed on her Medicaid benefits was properly removed. This was true even though the resident (or the grandson) did not file suit against the daughter who resided in South Carolina because both lacked resources with which to pursue litigation in a different state. K.V. v. Cape May Cnty. Bd. of Social Servs. and DMAHS, OAL DKT. NO. HMA 2005- 14, 2015 N.J. AGEN LEXIS 392, Initial Decision (July 29, 2015). Assets held by a 1999 trust granted by a nursing home resident who applied for Medicaid benefits in 2013 were treated as resources of the resident that were properly considered in determining whether her resources exceeded the eligibility ceiling. The fact that the trust permitted the resident to withdraw any amount that she wished provided that she replaced those assets within 24 hours rendered the trust assets "available" to the resident even if the condition on the withdrawal - which was that the assets be replaced within 24 hours - could not be satisfied. Because that provision created a "circumstance" under which the resident could access trust assets, the trust corpus was an available resource for purposes of Medicaid eligibility. L.L. v. Ocean Cnty. Bd. of Social Servs., OAL DKT. NO. HMA 3611-14, 2015 N.J. AGEN LEXIS 393, Initial Decision (July 22, 2015).