On appeal from a Final Decision of the Division of Medical Assistance and Health Services, No. 4489-08.
NOT FOR PUBLICATION WITHOUT THE APPROVAL OF THE APPELLATE DIVISION
Before Judges Cuff and Payne.
V.S., an applicant for Medicaid benefits, appeals from a final decision of defendant Division of Medical Assistance and Health Services (DMAHS) denying Medicaid benefits and imposing a twenty-three month and fourteen day ineligibility period following transfer of her ownership interest in her house to her only child. V.S. argued the transfer was payment for years of financial support and care by her son and recent renovations to the house. We affirm.
The facts are largely undisputed. V.S. resided in a house in Philadelphia. She lived there with her husband and son, Frank S., until her husband abandoned the family in 1968. Frank S. was thirteen years of age at the time. He testified that he began contributing $100 to $200 each week to the household. He continued to support his mother and to defray the costs of keeping and maintaining the house through high school, college and after he moved out of V.S.'s house in 1981. When he left her house, Frank S. agreed to continue to support his mother, and V.S. promised to leave the house to him.
In 2004, V.S. fell and broke her shoulder. She was able to return to her home after rehabilitation, and Frank S. started to make "senior friendly" improvements to the house. As depicted in the photographs received in evidence, those improvements included new siding and windows, new kitchen cabinets and appliances, new bathroom fixtures, new carpeting, and installation of a first floor bathroom. Records received in evidence document $26,548 in expenditures; the first check is dated July 11, 2006, approximately two years after the fall.
V.S. executed three undated promissory notes to her son in the amounts of $250,000, $350,000 and $400,000. The notes stated:
FOR VALUE RECEIVED over the later years of my life for monies and services advanced and provided to me by my beloved son [F.S.] a partial list, of which is attached hereto, known as Exhibit A....
Exhibit A was never made a part of the record.
On September 25, 2007, V.S. transferred her home to her son by deed. The stated consideration was $1. A realtor supplied a certification that V.S. was competent at the time she executed the deed. The value of the house was $155,000 at the time of transfer.
In March 2008, V.S. fell a second time and broke her hip. She did not return to her home. On March 11, 2008, Frank S. applied for Medicaid benefits on her behalf. The Gloucester County Board of Social Services found that V.S. transferred her house to her son for less than fair market value within the look-back period and imposed a twenty-three month and fourteen day Medicaid ineligibility period.
V.S. appealed. Following a hearing, an Administrative Law Judge (ALJ) issued an Initial Decision reversing the county agency decision. He found that Frank S. had an equity interest in the house in excess of the $155,000 fair market value due to his financial contributions over the years and the cost of the physical renovations to the house.
The DMAHS Director rejected the ALJ decision and reinstated the period of Medicaid ineligibility finding that "the proofs presented, the timeline put forth, and the documents entered into evidence do not support a finding that the transfer was for fair market value." The Director found that the amount of equity purportedly held by Frank S. in his mother's house was not supported by "any tangible evidence that he made those expenditures in the amount or frequency alleged." Furthermore, the Director invoked the presumption reflected in N.J.A.C. ...