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Marianne Johnson, EBS for Bayfield County, heard from the daughter of a nursing home resident who was facing a divestment penalty amounting to more than $41,000 for selling a parcel of land at less than fair market value. Marianne worked with the daughter and her local Information and Assistance specialist to submit documentation for an undue hardship waiver. The waiver was granted and the family was greatly relieved to have one less looming bill to worry about.
Monetary Impact = $41,000
10/31/2023
Story #122
Mary Rheinschmidt, EBS in Lincoln County, helped a client reduce her divestment penalty period by 104 days! The client came to Mary to apply for LTC Medicaid. It was first discovered that her long-term burial insurance was not checked as irrevocable, so the client was over the asset limit. Mary quickly helped resolve this with the funeral home and submit the documentation to the Consortium. The next issue was the client had made numerous loans to family members within the lookback period. All of the loans were verbal, and only some had been paid back in full. Mary helped gather all of the client's bank statements, copies of checks, and client's notes for the past five years, and painstakingly reviewed them with her supervising attorney. Mary also helped the client request some additional repayments by the family members, further reducing the total divested amount. IM had originally assessed a divestment penalty period of 168 days, but with Mary's detailed work, they were able to reduce the penalty period to 64 days. Because the client had her functional screen in June, her penalty period had already been served, and her Family Care started in August. The family was thrilled!
8/31/2022
Story #26
Emily Reuter, EBS in Grant County, recently won a Medicaid fair hearing about a case involving a divestment. The client's husband had advanced dementia, and although she had been providing nearly all of his care in their home, his condition had worsened, and she was unable to provide 24-hour care herself. The ADRC helped with the Family Care application, but the client had sold the couple's home to their grandson a few months before because they could not afford to keep paying the mortgage. The client explained that she was worried that if they lost their home to foreclosure, they would have nowhere to live. The couple was paying rent to their grandson to continue living there. The sale price of the home was equal to the outstanding balance on the mortgage, which was a little less than the assessed value. Income Maintenance, however, used the current Zestimate on Zillow to set the fair market value for the house, turning what should've been a $12,000 divestment penalty into a $111,000 divestment! IM then denied a subsequent undue hardship waiver request, saying that the grandson could just give the house back. Emily helped the clients request a fair hearing to dispute IM's determination of the fair market value of the house and argue that the sale was not done to qualify for Medicaid. The administrative law judge agreed that IM's use of the Zestimate was inappropriate and that the sale of the house was an allowed divestment because it was not done with the intent to qualify for Medicare. Thanks to Emily's hard work and advocacy, the client's husband is now getting the care he needs!
Monetary Impact = $100,000
8/31/2022
Story #24