Christensen v. North Dakota Department of Human Services
796 N.W.2d 390
N.D.2011Background
- Edward Christensen, a resident of a long-term care facility, appealed a DHS finding denying Medicaid for April–August 2008.
- Tom Christensen, Edward’s nephew, was his attorney-in-fact and managed his finances.
- Edward’s real estate in California and proceeds from its sale were at issue as to asset availability.
- St. Rose Care Center agreed not to evict Edward in exchange for payment of proceeds; part of proceeds were withheld for taxes.
- Edward applied for retroactive Medicaid benefits for April 2008; eligibility was denied based on assets exceeding limits.
- The ALJ and DHS concluded the assets were actually available until September 2008 when proceeds were paid to the facility.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether the California real estate and sale proceeds were actually available assets under rules | Christensen contends he did not have actual control over the assets | DHS held assets were actually available until proceeds were transferred | assets were actually available; eligibility disqualified April–August 2008 |
| Whether an alleged oral agreement affected asset availability | oral agreement negated transferability of assets | contract not binding; assets still available | court need not determine binding effect; assets remained actually available under facts |
| Standard of review and burden of proof for Medicaid eligibility | Christensen lacked evidence to show non-availability of assets | applicant bears burden; must exhaust assets | DHS decision sustained; applicant failed to prove assets not actually available |
Key Cases Cited
- Reinholdt v. North Dakota Dep’t of Human Servs., 2009 ND 17, 760 N.W.2d 101 (ND 2009) (standard for reviewing agency decisions; asset status)
- Rennich v. North Dakota Dep’t of Human Servs., 2008 ND 171, 756 N.W.2d 182 (ND 2008) (burden and standard of review in agency appeals)
- Oyloe v. North Dakota Dep’t of Human Servs., 2008 ND 67, 747 N.W.2d 106 (ND 2008) (eligibility rules; actually available assets")
- Estate of Pladson v. Traill County Soc. Servs., 2005 ND 213, 707 N.W.2d 473 (ND 2005) (interpretation of actually available assets)
- Hendrickson v. Olson., 2009 ND 16, 760 N.W.2d 116 (ND 2009) (scope of review; factual vs legal questions)