Stutz v. Ohio Dept. of Job & Family Serv.
2017 Ohio 7287
| Ohio Ct. App. | 2017Background
- Plaintiff Barbara Stutz entered a nursing home in March 2014 and was approved for Medicaid July 1, 2014; she owned a preexisting life estate while her sons held the remainder.
- The Agency later treated the life estate as a Medicaid asset and calculated its value at $24,941 using Ohio Adm.Code 5160:1-3-05.17(F) (county auditor value × age factor).
- Stutz obtained local appraisals valuing the life estate near $2,000 and sold her life estate to her sons for $1,800 in November 2014.
- The Agency concluded the sale was for less than fair market value and imposed a Restricted Medicaid Coverage Period (RMCP); Stutz administratively appealed and lost.
- Van Wert Common Pleas affirmed the agency, finding Stutz failed to follow the rebuttal procedure in Ohio Adm.Code 5160:1-3-07.2(D) and that the specific life-estate valuation rule controlled over the general fair-market-value definition.
- On appeal to the Third District, Stutz argued the agency should have used the general fair-market-value definition and that she effectively rebutted the presumption of an improper transfer by selling at market value as she understood it.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Proper method to value life estate | Stutz: use general "fair market value" definition (Adm.Code 5160:1-3-05.1(B)(4)) and actual local appraisals | Agency: specific rule (Adm.Code 5160:1-3-05.17(F)) governs life-estate valuation | Held: Specific life-estate formula controls; agency valuation correct |
| Mechanism to rebut presumption of improper transfer | Stutz: her sale and appraisals rebut the presumption | Agency: rebuttal requires following the procedure in Adm.Code 5160:1-3-07.2(D), including attempts to sell at the statutory value | Held: Rebuttal mechanism exists; Stutz failed to follow it or show she attempted sale at statutory value |
| Sufficiency of evidence challenging agency valuation | Stutz: three experts/realtors said life estate had little/no value | Agency: those opinions do not show the statutory method is unreasonable | Held: Stutz did not prove agency method unreasonable or irrational; evidence insufficient |
| Necessity of attempting to sell at statutory value | Stutz: not required because she relied on local market evidence | Agency: attempts to dispose at the statutory fair market value are part of rebuttal | Held: Attempt to sell at the value set by the statute/following rebuttal procedures is required; Stutz did not meet burden |
Key Cases Cited
- Roosevelt Properties Co. v. Kinney, 12 Ohio St.3d 7 (1984) (administrative regulations are presumed reasonable; challenger bears burden to prove otherwise)
- Summerville v. Forest Park, 128 Ohio St.3d 221 (2010) (specific statutory provisions control over general ones absent contrary legislative intent)
- Big Bob's, Inc. v. Ohio Liquor Control Comm., 151 Ohio App.3d 498 (2003) (appellate courts have plenary review over purely legal questions)
- Nye v. Ohio Bd. of Examiners of Architects, 165 Ohio App.3d 502 (2006) (scope of appellate review of administrative decisions explained)