Caretaker Exception Denied Because Child Did Not Provide Continuous Care

A New Jersey appeals court determines that the caretaker child exception does not apply to a Medicaid applicant who transferred her house to her daughter because the daughter did not provide continuous care for the two years before the Medicaid applicant entered a nursing home. M.K. v. Division of Medical Assistance and Health Services (N.J. Super. Ct., App. Div., No. A-0790-14T3, May 13, 2016).

J.K. lived with her mother, M.K.  In 2004, M.K. suffered health setbacks that required J.K. to help her with dressing, toileting, preparing meals, and housecleaning. In 2007, M.K. hired a home health aide to assist her for part of the day, but M.K. was alone five hours a day. In 2010, M.K. entered a nursing home, but left after one month, moving to her son's home for a five-month stay before reentering the facility. She then transferred her house to J.K. and applied for Medicaid.

The state denied M.K. Medicaid benefits based on the transfer. M.K. appealed, arguing that the transfer to her daughter fell under the caretaker child exception. After a hearing, the state affirmed the denial of benefits, concluding that J.K. did not provide a level of care preventing institutionalization for two years before M.K. entered the nursing home. M.K. appealed to court.

The New Jersey Superior Court, Appellate Division, affirms, holding that the caretaker child exception does not apply to the transfer because the two years immediately before M.K.'s institutionalization included "a period of approximately five months when J.K. provided no care for M.K., who resided with her son." The court rejected J.K.'s argument that she provided care for her mother for two years before she first entered the first nursing home because there was no evidence J.K. provided a level of care that prevented institutionalization and M.K. initially remained in the nursing home for only one month. 

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