A hearing examiner erred in determining that an apartment that a Medicaid recipient had never occupied was the 'return home unit' simply because the recipient's daughter vacated it to live in her mother's former apartment. Coutu v. Dep't of Human Services (R.I. Super. Ct., No. C.A. 01-509, April 2, 2002).
Claire Coutu and her husband owned a residential building containing three apartments, one on each floor. The couple lived in the first floor apartment and Mrs. Coutu's daughter, Jacqueline Covaco, lived on the third floor apartment and paid rent to her parents. The second floor unit was rented to a longtime tenant. Mrs. Coutu entered a nursing home in 1995 and began receiving Medicaid assistance. Mrs. Cavaco then became the co-owner of the property with her mother, although Mr. Coutu continued to live in the first floor unit. After Mr. Coutu's death in 1998, Mrs. Covaco moved to the first floor apartment and rented out the third floor unit, reasoning that if her mother was released from the nursing home, it would be easier for her return to her own first floor apartment and live there with Mrs. Covaco rather than move in with Mrs. Cavaco on the third floor.
As part of a re-certification process in September 2000, the Department of Human Services (DHS) concluded that the third floor unit was "the intent to return home unit,' which is excluded as a resource. The agency determined that since the "return home unit" was rented, any rents received should be calculated as income to Mrs. Coutu alone. Based on this, DHS advised Mrs. Coutu that she would have to begin paying a share of her medical expenses. A hearing officer basically accepted the agency''s determination.
The Rhode Island Superior Court holds that the hearing examiner's determination was erroneous, arbitrary and capricious. The court notes that the DHS Manual requires DHS to exclude an apartment vacated by a recipient when she enters a nursing home. 'It does not allow DHS to choose another unit and unilaterally determine that the recipient will occupy it if she returns home in spite of the fact that it was never her principal place of residence,' the court writes. The court rules that the first floor apartment should be excluded from rental income as the "return home unit," and the income generated by the second and third floor rental units should be split between mother and daughter equally.
The full text of this decision can be downloaded in PDF (Adobe Acrobat) format from: https://www.courts.state.ri.us/superior/pdf/01-509.pdf
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