Longhi v. State, Dept. of Health and Rehabilitative Services, 96-2729
| Decision Date | 16 April 1997 |
| Docket Number | No. 96-2729,96-2729 |
| Parties | 22 Fla. L. Weekly D980 Linda LONGHI, Appellant, v. The STATE of Florida, DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES, Appellee. |
| Court | Florida District Court of Appeals |
Raymond L. Parri of Raymond L. Parri, P.A., Clearwater, for Appellant.
Frank H. Nagatani, Senior Attorney of the District Legal Office, Largo, for Appellee.
Linda Longhi appeals a final order entered by Department of Health and Rehabilitative Services (HRS) Hearing Officer Sandahl affirming HRS's denial of benefits under the Florida Medicaid Institutional Care Program. We affirm the denial of benefits for some but not all of the months contemplated by HRS's order.
On July 18, 1995, Geraldine Anderson, the daughter with whom Ms. Longhi lived, received a check in the amount of $46,946.70, representing the proceeds of a liquidated annuity that belonged to Ms. Longhi. Ms. Anderson deposited the check in her own individual account. This transaction amounted to a transfer of assets "without fair compensation" within thirty months of applying for nursing facility benefits. Rule 10C-8.0181(1), Florida Administrative Code, provides:
If an individual who is applying for or receiving nursing facility services or Home and Community Based Services transfers assets within 30 months of application without fair compensation, ineligibility for these services will exist for the number of months determined by dividing the total uncompensated value of the transferred assets by the statewide average monthly private-pay amount at the time of application, as determined by the department for care in a skilled facility.
But the rule goes on to provide: "If the client can successfully prove that the transfer occurred exclusively for a reason other than to become Medicaid eligible, no penalty will be imposed." Fla. Admin. Code R. 10C-8.0181(1)(b). See Pentuik v. Department of Health and Rehabilitative Servs., 584 So.2d 1098 (Fla. 1st DCA 1991). In its Manual 165-22, HRS concedes that the post-transfer "traumatic onset of disability" or diagnosis of a "previously undetected disabling condition" "may indicate that assets were transferred exclusively for some purpose other than establishing eligibility." At 1600-93.
Appellant had the burden to prove that her gratuitous transfer to her daughter "occurred exclusively for a reason or purpose other than to become eligible for Medicaid benefits." Pentuik, 584 So.2d at 1100.
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