June 25

Guardianship Funds Must Go to Estate to Reimburse Medicaid Claim

New York’s highest court rules that the funds in a deceased nursing home resident’s guardianship account must pass to the resident’s estate to pay a Medicaid claim instead of being used to reimburse the nursing home that had a claim against the guardianship account. Shannon v. Westchester County Dept. of Social Servs. (N.Y., No. 80, June 10, 2015).

Eastchester Rehabilitation & Health Care Center applied for a guardian for resident Edna Shannon and also applied for Medicaid on her behalf. The court appointed a guardian, and the state granted Ms. Shannon Medicaid benefits. The nursing home filed a claim with the guardian for services provided Ms. Shannon that were not covered by Medicaid. The court approved the sale of Ms. Shannon’s home, and the money went into the guardianship account.

After Ms. Shannon died, the state filed a claim against her estate for reimbursement of Medicaid expenses. The nursing home argued its claim accrued before the state’s claim because the state did not have a lien against Ms. Shannon’s home. The state argued that it was a preferred creditor, and the trial court agreed. The nursing home appealed, and the appeals court reversed, holding that the nursing home is entitled to reimbursement from the guardianship account before any funds pass to the estate. The state appealed.

The New York Court of Appeals, the state’s top court, reverses, holding that all money from the guardianship account must pass to the estate. The court concludes that state law permits a guardianship account to retain only property needed to satisfy the administrative costs of the guardianship, not to pay a claim against the incapacitated person that arose before that person’s death.

For the full text of this decision, go to: https://www.nycourts.gov/ctapps/Decisions/2015/Jun15/80opn15-Decision.pdf

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June 22

Medicaid Applicant Can Appeal Decision that Has Not Yet Been Enforced

An Ohio appeals court rules that a trial court improperly dismissed an appeal by a Medicaid applicant for lack of justiciability because the decision had not been enforced yet. Stolzenburg v. Ohio Dept. of Job & Family Servs. (Ohio Ct. App., 3rd Dist., No. 2-15-01, June 8, 2015).

Nursing home resident Larry Stolzenburg applied for Medicaid benefits. The Medicaid agency found that Mr. Stolzenburg had made an improper transfer and imposed a penalty period. Mr. Stolzenburg appealed the decision to the Ohio Department of Job and Family Services (ODJFS), and after a hearing, the ODJFS affirmed the decision.

Mr. Stolzenburg appealed the ODJFS’s decision to court (Mr. Stolzenburg died while the case was pending and his executor was substituted). The trial court dismissed the appeal for lack of justiciability, holding that ODJFS’s decision does not adversely affect Mr. Stolzenburg until the Ohio Department of Medicaid (ODM) takes action to enforce the state’s decision. The estate appealed.

The Ohio Court of Appeals reverses, holding that the case is justiciable. According to the court, “the possibility that parties might settle a case following a court’s judgment or that a prevailing party might not enforce a court’s judgment do not affect justiciability and the court’s ability to enter judgment in the first place.  Applying the common pleas court’s reasoning, no case would be justiciable . . . “

For the full text of this decision, go to: http://www.supremecourt.ohio.gov/rod/docs/pdf/3/2015/2015-Ohio-2212.pdf

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June 18

State Can Impose Second Penalty Period on Same Transfers of Assets

A Massachusetts appeals court rules that the state may impose a second penalty period based on the same transfers of assets after one of the transfers was cured and the applicant reapplied for benefits before the first penalty period was over. Burt v. Director of the Office of Medicaid (Mass. Ct. App., No. 13-P-1853, May 29, 2015).

Catherine Harrington made two separate transfers of assets—one for $45,000 and one for $134,834. She applied for Medicaid benefits in December 2006. Based on the transfers, the state imposed a penalty period until December 2008. More than 60 days after Ms. Harrington was notified about the penalty period, her niece returned the $45,000 transfer. In June 2008, Ms. Harrington filed a second application for benefits. The state imposed a new penalty period, running from March 2008 until July 2009, for the $134,834 transfer that occurred before the first application.

Ms. Harrington appealed, arguing that her penalty period should have begun in December 2006 and that it was impermissible for the state to impose a new penalty period for the same transfer she was already penalized for. Under Massachusetts regulations, because the transfer was cured more than 60 days after the notice about the penalty period, Ms. Harrington had to reapply for benefits. The state argued its regulation requires it to review a new application in its entirety and make a new determination about when the applicant is “otherwise eligible.” The trial court affirmed the state’s decision, and Ms. Harrington appealed.

The Massachusetts Court of Appeals affirms, holding that the state’s imposition of the second penalty period does not violate state or federal law. According to the court, “nothing in the plain language of the regulations requires that the start date for the recalculated penalty period be the same day that the prior penalty period began.” The court rules that an applicant does not become “otherwise eligible” at a time when nursing home services are being paid for and that Ms. Harrington was paying for services until March 2008.

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June 8

Former Nursing Home Resident Received Proper Notice of Hearing When Case Placed on Docket

In a nursing home’s lawsuit against a former nursing home resident for unjust enrichment, an Ohio appeals court rules that although notice of the trial court’s hearing was initially sent to the wrong address for her attorney, the resident received proper notice because the court placed the hearing on its docket. Gibsonburg Health, LLC v. Miniet (Ohio Ct. App., 6th Dist., No. S-14-023, May 15, 2015).

Elena Miniet moved to a nursing home in 2008. In August 2012, she lost her Medicaid benefits and did not pay the nursing home from October 2012 through November 2013, when she was discharged. The nursing home sued Ms. Miniet for unjust enrichment and breach of contract, among other things. Ms. Miniet filed a motion to dismiss. The trial court denied the motion, and set a hearing date on the court docket. Because the court did not have the right address for Ms. Miniet’s attorney, her attorney did not receive notice of the hearing until six days before it was scheduled.

At the hearing, the trial court found in favor of the nursing home, ruling that Ms. Miniet had been unjustly enriched and ordering her to pay $13,837 in damages. Ms. Miniet appealed, arguing she did not receive due process because her attorney did not receive proper notice of the hearing.

The Ohio Court of Appeals affirms, holding that Ms. Miniet received “adequate notice to satisfy [her] right to due process under the facts of this case” because “date of the hearing had been on the court’s docket for over a month before [Ms. Miniet’s] counsel received actual notice.”

For the full text of this decision, go to: http://www.supremecourt.ohio.gov/rod/docs/pdf/6/2015/2015-Ohio-1863.pdf

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June 1

Spousal Support Is Obligation of Deceased Spouse’s Estate (Pa. Super.)

The executrix of Ronald Renninger, Sr.’s estate appealed an order requiring the estate to pay spousal support to Ronald’s common law wife. The executrix argued that the trial court erred in its order because the divorce abated due to Ronald’s death and an order for support cannot be granted following the death of a party to the divorce action. The appellate court disagreed.

The court held that the trial court entered an interim support order while Ronald was alive awarding support from the time of the wife’s filing of the support action until the date of death. This is consistent, according to the court, with a longstanding rule that a spouse can collect unpaid support as a creditor of the deceased spouse’s estate. Thus, the lower court did not err in denying the support action simply because Ronald died during the pendency of the action. The court also disagreed with the executrix’s contention that the wife was not entitled to receive support due to her violence toward Ronald. The court held that the Executrix has the burden of presenting clear and convincing evidence to establish a defense to spousal support and the Executrix’s evidence that both parties sought mutual personal protection orders against each other is merely evidence of a troubled relationship and not sufficient evidence to overcome a spousal support obligation. For these reasons, the court affirmed the spousal support award from the date Ronald’s wife filed her petition until his date of death.

Moser v. Renninger, 2015 WL 1959448 (May 1, 2015)

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