Kenneth Vercammen, Esq is Chair of the ABA Elder Law Committee and presents seminars to attorneys and the public on Wills, Probate and other legal topics related to Estate Planning and Elder law. He is author of the ABA's book "Wills and Estate Administration. Kenneth Vercammen & Associates,
2053 Woodbridge Avenue - Edison, NJ 08817
(732) 572-0500 More information at www.njlaws.com/

Monday, June 28, 2021

Adult Protective Services contact info

 Adult Protective Services: 

Division of Aging Services
NJ Department of Human Services 

For contact information for a specific APS unit go to: 

http://www.state.nj.us/humanservices/doas/home/ 

adultpsp.html 

or call 

609-588-6501 

In 1993, the Adult Protective Services Act was passed in New Jersey 

Abuse 

Means the willful infliction of physical pain, injury or mental anguish, unreasonable 

confinement, or the willful deprivation of services necessary to maintain a person’s physical and mental health. 

Neglect 

Means an act or failure to act by a vulnerable adult or his/her caregiver which results in the inadequate provision of care or services 

necessary to maintain the physical and mental health of the vulnerable adult, and which places the vulnerable adult in a situation which can result in serious injury or which is life- threatening. 

Exploitation 

Means the act or process of illegally or improperly using a person or his resources for another person’s profit or advantage. 

Vulnerable Adults 

Are persons eligible for services under the APS Program, defined as being 18 years or older, residing in a community setting and subject to abuse, neglect or exploitation, but who, because of physical or mental illnesses or disabilities lack sufficient understanding or capacity to make, communicate or carry out decisions 

their well-being. 

concerning 

INTERVENTION OR SELF- DETERMINATION? 

The Purpose of APS is to: 

Stabilize a crisis situation using the least intrusive methods while respecting an individual’s right to self-determination. 

An APS worker cannot: 

  •  Remove a vulnerable adult from his or her home
    without a court order
  •  Force an adult with capacity to accept services
  •  Move an individual to an alternate living situation without his/her agreement or a legal representative’s agreement

APS’ guiding principle is at the same time its most difficult ethical issue – the right of a competent adult to make his or her own decisions. 

“Who do we serve – the community/ family member/agency who makes the referrals, or the clients themselves?” 

The responsibility of APS is to the 

client! 

Until you’ve lost the ability to make rational decisions, you retain the 

right to make dumb ones!! 

Elder Abuse 

• Elder abuse is defined as any knowing, intentional or negligent act by a caregiver or any person that causes 

harm or serious risk of harm to a vulnerable adult. 

•All 50 states have Elder Abuse Prevention Laws; however, there is no uniform reporting therefore the problem remains greatly h 

(National Center on Elder 

idden Abuse, 2005) 

Types of Abuse 

There are many types of abuse: 

•Physical—inflicting pain or injury •Sexual—non consensual sexual contact •Neglect—failure to provide food, shelter, 

healthcare etc 

•Emotional—inflicting mental pain, anguish and distress 

What is Financial Exploitation? 

Financial exploitation is the misappropriation of assets of an elder individual through coercion, misrepresentation or theft. 

Some signs are:
•Forcing vulnerable adults to c 

benefit the perpetrator
•Forging the signature of a vulnerable adult •Encouraging the vulnerable adult to sign a deed, will or Power of Attorney through coercion or deception •Promising life long care in exchange for money. 

(National Center on Elder Abuse, 2005) 

hange their wills to 

Financial Exploitation can also mean... 

• Exploitation carried out by someone in a fiduciary capacity -- a legally appointed agent like a power of attorney, lawyer or guardian who is overcharging or 

stealing money 

•Exploitation by fraud i.e. unlicensed investment brokers, unethical pre-paid burial practices, telemarketing schemes 

(www.aic.gov.au/publications) 

Reasons Why Victims do not Report 

The elderly may be reluctant to report abuse themselves because of fear of retaliation, lack of physical and/or cognitive ability to report, or because they don’t want to get the abuser (90% of whom are family members) in trouble. 

Don’t Assume ASK ?s 

Don’t just assume – ask the client questions if necessary to get more information. For example: 

  • Ask how client gets food, medications or other necessities; how do they pay his/her bills
  • Ask the client if he/she has a support system or someone who assists them
  • Ask the client if he/she is afraid of someone or feel they are being taking advantage of

To make a Referral 

The Referral Source should be the person with first hand information about the client 

The Referral Source should relay as must 

information as possible including: 

  • Client’s name, address, phone number
  • DOB and Social Security number
  • Diagnoses – health and/or mental health issues
  • Family members/support systems (services/agencies involved)
  • A specific allegation of abuse, neglect or exploitation

Confidentiality 

All records and communications pertaining to any report, evaluation or service provided pursuant to the Adult Protective Services Act 

(P.L. 1993, Ch. 249, C52.:27D) are confidential and not subject to OPRA. 

APS is permitted to share the results of an APS assessment when directed to do so by a court of competent jurisdiction or when disclosure of information is necessary for the Division or the APS provider to perform its responsibilities as set forth by statute. 

Mandatory Reporting 

As of April 2010, all health care professionals, police, paramedics, dentists, social workers and YOU must report abuse! 

I’m calling APS! 

It’s the LAW. 

A person making a good- faith report to APS has: 

• A right to confidentiality of his/her identity 

  • Protection from civil and criminal liability, as well as professional disciplinary action, including protection against retaliation by an employer
  • Protection for providing information, records or services related to a report of suspected mistreatment 

NJSA 2A:17-56.23b The Executor or Estate Administrator must have a search performed to confirm no child support owed , otherwise they are responsible for child support owed.

    NJSA 2A:17-56.23b The Executor or Estate Administrator must have a search performed to confirm no child support owed , otherwise they are responsible for child support owed.

   Judgment for child support lien against net proceeds of probate or settlement; priority

      The statute specifically states that the lien shall stay the distribution of net proceeds to a prevailing party or beneficiary until the child support judgment is satisfied. 

     How does this impact an estate? If a beneficiary of an estate in NJ is an individual of legal age, and the net proceeds to that individual beneficiary exceeds $2,000, a child support judgment search must be ordered from a search company capable of certifying the results of that search. 

     No proceeds of the estate may be distributed to that individual beneficiary until and unless the judgment search shows that the beneficiary is not a child support judgment debtor or if he/she is a child support judgment debtor, until the judgment is paid off and a warrant of satisfaction is in possession of the estate.

Compliance with Child Support Lien Law 

N.J.S.A. 2A:17-56.23b requires Executors to undertake a search, using a private firm, to determine if the party receiving money as a result of a settlement or judgment, or in a number of other situations, is a child support debtor. If so, the amount of child support owed is a lien against the net proceeds. The statute provides as follows: 

· Before distributing any net proceeds of a settlement, judgment, inheritance or award to the prevailing party or beneficiary: 

1.   The prevailing party or beneficiary shall provide the attorney, insurance company or agent responsible for the final distribution of such funds with a certification that includes the prevailing party’s or beneficiary’s full name, mailing address, date of birth and social security number; and 

2.   The attorney representing the prevailing party or beneficiary shall initiate a search of New Jersey judgments, through a private judgment search company that maintains information on child support judgments to determine if the prevailing party or beneficiary is a child support judgment debtor. N.J.S.A. 2A:17-56.23b(b); 

· If the certification of the search company shows that the prevailing party or beneficiary is not a child support judgment debtor, the net proceeds may be paid to the prevailing party or beneficiary immediately. If the certification shows that the prevailing party or beneficiary is a child support judgment debtor, the attorney, insurance company or agent that initiated the search shall contact the Probation Division of the Superior Court to arrange for the satisfaction of the child support judgment. N.J.S.A. 2A:17-56.23b(c). See Strickland v. 212 Corp. of N.J., 380 N.J. Super. 248 (Law Div. 2005). 

https://www.njcourts.gov/attorneys/assets/appellate/practitionersguide.pdf

       2A:17-56.23b. Judgment for child support lien against net proceeds of settlement; priority
1. a. A judgment for child support entered pursuant to P.L.1988, c.111 (C.2A:17-56.23a) and docketed with the Clerk of the Superior Court shall be a lien against the net proceeds of any settlement negotiated prior or subsequent to the filing of a lawsuit, civil judgment, civil arbitration award, inheritance or workers' compensation award. The lien shall have priority over all other levies and garnishments against the net proceeds of any settlement negotiated prior or subsequent to the filing of a lawsuit, civil judgment, civil arbitration award, inheritance or workers' compensation award unless otherwise provided by the Superior Court, Chancery Division, Family Part. The lien shall not have priority over levies to recover unpaid income taxes owed to the State. The lien shall stay the distribution of the net proceeds to the prevailing party or beneficiary until the child support judgment is satisfied.

       As used in this act "net proceeds" means any amount of money, in excess of $2,000, payable to the prevailing party or beneficiary after attorney fees, witness fees, court costs, fees for health care providers, payments to the Medicaid program under section 6 of P.L.1979, c.365 (C.30:4D-7.1), reimbursement to the Division of Employment Security in the Department of Labor, the employer or employer's insurance carrier for temporary disability benefits that may have been paid pending the outcome of a workers' compensation claim as provided by section 1 of P.L.1950, c.174 (C.34:15-57.1), reimbursement to an employer or the employer's workers' compensation insurance carrier as provided in R.S.34:15-40, and other costs related to the lawsuit, inheritance or settlement are deducted from the award, proceeds or estate; "prevailing party" or "beneficiary" shall not include a partnership, corporation, limited liability partnership, financial institution, government entity or minor child; and "agent" means an authorized representative of the prevailing party or beneficiary, a union representative, an executor or administrator of a decedent's estate, an arbitrator or any other person or entity if such person or entity is responsible for the distribution of net proceeds to a prevailing party or beneficiary.

b. Before distributing any net proceeds of a settlement, judgment, inheritance or award to the prevailing party or beneficiary:

(1)the prevailing party or beneficiary shall provide the attorney, insurance company or agent responsible for the final distribution of such funds with a certification that includes the prevailing party's or beneficiary's full name, mailing address, date of birth and Social Security number; and

(2)the attorney representing the prevailing party or beneficiary shall initiate a search of child support judgments, through a private judgment search company that maintains information on child support judgments, to determine if the prevailing party or beneficiary is a child support judgment debtor.

If the prevailing party or beneficiary is not represented by an attorney, the judgment search shall be initiated by the opposing attorney, insurance company or agent before the proceeds are distributed to the prevailing party or beneficiary. In the case of a workers' compensation action, the Administrative Office of the Courts shall, at least once every 60 days, transmit information on child support judgment debtors to the Division of Workers' Compensation in the Department of Labor. The information shall include the debtor's name, Social Security number, the amount of the child support judgment, the Probation Division case number and the Probation Division office to which the judgment is payable. The Division of Workers' Compensation shall match the data received on child support judgment debtors against the information it maintains for individuals who have filed workers' compensation claims with the division. When a match is identified, the Division of Workers' Compensation shall notify the appropriate judge of compensation of the child support judgment before the decision, award, determination, judgment or order approving the settlement is rendered. The judge of compensation shall incorporate in the decision, award, determination, judgment or order approving the settlement, an order requiring the employer or the employer's insurance carrier to contact the Probation Division to satisfy the child support judgment out of the net proceeds of the workers' compensation award, order or settlement before any such monies are paid to the employee. The Division of Workers' Compensation shall be immune from any civil liability that may arise from any information provided by the division or any order issued by a judge of compensation relating to a child support judgment, in accordance with this section. In the case of judgments or settlements resulting from a labor arbitration involving employees of a school board or school district, a judgment search shall be initiated by the school board or district prior to the release of any net proceeds to the employees and only if there is an income withholding for child support active against the employee in the records of the school board or district. In the case of an inheritance, the executor or administrator of the decedent's estate shall initiate the judgment search. The judgment search company shall provide a certification to the attorney, insurance company, agent or party initiating the lawsuit identifying whether or not the prevailing party or beneficiary is a child support judgment debtor.

In the case of net proceeds that are to be paid through a structured settlement or other payment plan, the attorney, insurance company or agent shall be required to conduct the child support judgment search only at the time of settlement or prior to the distribution of the first payment under the plan. If a child support judgment is identified, the attorney, insurance company or agent shall provide the Probation Division with a copy of the structured settlement or payment plan within 30 days of identifying the child support judgment.

If there are no attorneys representing either party in a civil lawsuit, the party bringing the lawsuit shall initiate the judgment search and shall be required to file the certification with the court at least 10 working days prior to the trial or with the stipulation that the certification shall be filed at the time of the settlement or dismissal of the lawsuit.

For monies deposited with the court, no distribution of funds shall be made until the attorney, prevailing party or beneficiary provides the Clerk of the Superior Court with a copy of the certification showing that the prevailing party or beneficiary is not a child support judgment debtor.

The fee for a judgment search which is required by this section shall not exceed $10 for each name of a child support judgment debtor that is searched. The fee for a judgment search is chargeable against the net proceeds as a cost of the settlement, judgment, inheritance or award.

c. If the certification shows that the prevailing party or beneficiary is not a child support judgment debtor, the net proceeds may be paid to the prevailing party or beneficiary immediately. If the certification shows that the prevailing party or beneficiary is a child support judgment debtor, the attorney, insurance company or agent that initiated the search shall contact the Probation Division of the Superior Court to arrange for the satisfaction of the child support judgment. The attorney, insurance company or agent shall notify the prevailing party or beneficiary of the intent to satisfy the child support judgment prior to the disbursement of any funds to the prevailing party or beneficiary. Upon receipt of a warrant of satisfaction for the child support judgment, the attorney, insurance company or agent shall pay the balance of the settlement, judgment, award or inheritance to the prevailing party or beneficiary. If the net proceeds are less than the amount of the child support judgment, the entire amount of the net proceeds shall be paid to the Probation Division as partial satisfaction of the judgment.

If there are no attorneys representing either party in a civil lawsuit and the certification filed with the court shows that the prevailing party or beneficiary is a child support judgment debtor, the court shall order that the opposing party pay the amount of the child support judgment to the Probation Division before any funds are paid to the prevailing party or beneficiary. The court shall also insure that any judgment related to the lawsuit docketed with the Clerk of the Superior Court reflect the Probation Division's superior claim to such funds.

d. An attorney, insurance company or agent shall not be liable for distributing net proceeds to the prevailing party or beneficiary based on the results of a judgment certification showing the prevailing party or beneficiary is not the debtor of a child support judgment, if it is later shown that the prevailing party or beneficiary provided inaccurate personal information on the initial certification to the attorney, the insurer or agent.

e. An attorney, insurance company or agent who, in accordance with this act, satisfies a child support judgment from the net proceeds of a settlement, judgment, inheritance or award, shall not be liable for payments which otherwise would have been made pursuant to subsection a. of this section which were not so identified to the attorney, insurance company or agent at the time of satisfaction.

f. An attorney, insurance company or agent who, in accordance with this act, satisfies a child support judgment from the net proceeds of a settlement, judgment, inheritance or award, shall not be liable to the prevailing party or beneficiary or to that party's creditors.

g. An attorney shall not be required to challenge a child support judgment unless retained by the prevailing party or beneficiary to do so.

h. A private judgment search company is prohibited from using any information provided by an attorney, insurance company or agent in accordance with this act for any purpose other than: (1) determining if the prevailing party or beneficiary is the debtor of a child support judgment; and (2) preparing a certification as required pursuant to subsection b. of this section.

i. To the extent feasible and permitted by the Rules of Court, the Administrative Office of the Courts may share information on a child support judgment debtor with an insurance carrier for the sole purpose of complying with the provisions of P.L.2000, c.81 (C.2A:17-56.23b et al.).

L.2000,c.81, s.1.

 

 

No evidence of lack of capacity for Will or undue influence In the Matter of the Estate of Willson

 No evidence of lack of capacity for Will or undue influence In the Matter of the Estate of Willson

      Plaintiff appealed from the grant of summary judgment in favor of defendant and the denial of plaintiff's motion for partial summary judgment. 

      Defendant was decedent's second wife, while plaintiff was decedent's daughter with his first wife. Two years after decedent and defendant married, decedent executed a will dividing his residuary estate between plaintiff and defendant; in addition, plaintiff was given a $100,000 bequest. 

     Thereafter, decedent made several revisions to his Will that kept the equal distribution of the residuary estate but eliminated the $100,000 bequest to plaintiff. In each of the revised wills, defendant was named co-executor alongside decedent's attorney. In the years leading up to his death, decedent executed a will giving his residuary estate entirely to plaintiff and naming her sole executor; however, decedent soon after changed his will to name defendant as the sole executor and beneficiary. Thereafter, decedent's health began to decline, although his physician found that decedent was oriented to time, place, person and situation. 

     Decedent contacted his attorney and requested that plaintiff's inheritance be limited to $200,000.    

        Decedent executed a new will and a memorandum explaining his decision to limit plaintiff's inheritance. 

      Following decedent's death, plaintiff filed a caveat to decedent's will along with a counterclaim alleging decedent lacked testamentary capacity to change his wills and beneficiary designations. Defendant moved for summary judgment while plaintiff cross-moved for partial summary judgment seeking a presumption of undue influence. The trial court granted judgment to defendant, concluding that plaintiff's claim of decedent's lack of testamentary capacity was based on speculation. Instead, the trial court found that the evidence supported finding decedent possessed testamentary capacity at the time he executed the revised will. The trial court also found no evidence of undue influence. On appeal, the court affirmed the grant of summary judgment to defendant for the reasons expressed by the trial court. source

https://www.law.com/njlawjournal/almID/1593537987NJA535018T/


 

Medicaid and court reject certain payments to caregivers without proof of level of care D.Z. v. Ocean County Bd. of Soc. Serv.

 Medicaid and court reject certain payments to caregivers without proof of level of care

D.Z. v. Ocean County Bd. of Soc. Serv.

Petitioner appealed the decision imposing a penalty for assets she transferred during the look-back period.

| 

       Petitioner appealed the decision finding her eligible for Medicaid benefits but imposing a penalty for assets she transferred during the look-back period. Petitioner requested a fair hearing as to the penalty. 

       At the hearing, son and power of attorney testified petitioner hired three health care aides to assist her at home in the years before she was transferred to a nursing facility. The aides assisted petitioner with dressing, ambulating, bathing, cooking and cleaning in rotating shifts. One aide lived with petitioner full time for several months. Son testified his attempt to secure testimony from the aides was futile. 

      ALJ found petitioner paid three aides for home health care, those payments were not subject to the look-back penalty and modified the amount of the penalty. Agency director adopted ALJ's decision in part and reversed it in part. 

     Director found petitioner did not establish the type of services provided to her, the amount she paid for the services and the prevailing rates in the community for similar services. 

         Court found agency's decision was supported by substantial credible evidence. There was no evidence the rate petitioner paid was warranted by the aides' skill level and training, the evidence was imprecise as to the amount paid and agency could not determine the fair market value of the services petitioner received.

https://www.law.com/njlawjournal/almID/1592939409NJA596217T/

 

June 23, 2020 at 12:00 AM

     

Docket

·       Practice Area: Health Care Law

·       Date filed: 2020-06-23

·       Court: Appellate Division

·       Judge: Per Curiam 

·       Case Number: A-5962-17T3

Case Digest Summary

NOT FOR PUBLICATION WITHOUT THE 

APPROVAL OF THE APPELLATE DIVISION 

This opinion shall not "constitute precedent or be binding upon any court." Although it is posted on the internet, this opinion is binding only on the parties in the case and its use in other cases is limited. R. 1:36-3. 

D.Z.,
Petitioner-Appellant, 

v. 

OCEAN COUNTY BOARD OF SOCIAL SERVICES, 

Respondent-Respondent. _______________________________ 

Submitted May 28, 2020 – Decided June 23, 2020 

Before Judges Suter and DeAlmeida. 

On appeal from the New Jersey Department of Human Services, Division of Medical Assistance and Health Services. 

SB2 Inc., attorneys for appellant (Laurie M. Higgins, on the briefs). 

Gurbir S. Grewal, Attorney General, attorney for respondent Division of Medical Assistance and Health Services (Melissa H. Raksa, Assistant Attorney General, of counsel; Jacqueline R. D'Alessandro, Deputy Attorney General, on the brief). 

SUPERIOR COURT OF NEW JERSEY APPELLATE DIVISION
DOCKET NO. A-5962-17T3 

PER CURIAM
Petitioner D.Z. appeals from the December 18, 2019 amended final 

agency decision of the Division of Medical Assistance and Health Services (DMAHS) finding her eligible for Medicaid benefits but imposing a penalty of $207,525.93 for assets D.Z. transferred during the five-year look-back period established in N.J.A.C. 10:71-4.10. We affirm. 

I.
The following facts are derived from the record. D.Z., through her son 

and power of attorney, R.Z., applied to respondent Ocean County Board of Social Services, a county welfare agency (CWA), for Medicaid benefits. The CWA found D.Z. eligible for benefits as of August 1, 2016, but imposed an eligibility penalty for August 1, 2016, to April 25, 2018, because she transferred $210,579.16 during the look-back period. 

D.Z. requested a fair hearing with respect to the transfer penalty. The matter was transferred to the Office of Administrative Law, where a fair hearing was held before an Administrative Law Judge (ALJ). At the hearing, R.Z. testified that D.Z. hired three health care aides to assist her at her home in the years before she was transferred to a nursing facility. He identified the aides by 

A-5962-17T3 

their full names, although we refer to them as E.D., L.O., and N.L. to protect D.Z.'s confidential medical records. 

R.Z. testified the aides assisted D.Z. with dressing, ambulating, bathing, cooking, cleaning, and laundry in rotating shifts of two and one-half days each. He testified that one aide lived with D.Z. full time for several months. According to R.Z., E.D. and L.O. were paid approximately $13 to $15 per hour, and N.L. was paid approximately $700 to $750 per week. 

D.Z. paid the aides by check. On approximately 125 checks, she wrote "cash" as the payee and the individual aide's first name or nickname in the memo line. R.Z. testified that D.Z. sometimes wrote checks for more than the aide was due in pay, with the excess to be used to purchase items for D.Z. In those instances, the notation in the memo line contained both the aide's first name and the name of the store at which the purchase was to be made. According to R.Z., he had authority to sign his mother's checks and wrote some of the checks admitted into evidence for the aides' services and other expenses. 

On most of the checks, the handwritten name in the memo section matched the signed endorsement on the back of the check. However, two of the checks had only the name of a store written in the memo section, with a signed endorsement on the back by one of the aides. Two other checks were endorsed 

A-5962-17T3 

by someone other than the person listed in the memo section. One check endorsed by N.L. had no name in the memo section. 

A few additional checks were written to three additional aides identified by R.Z. as substitutes when one of the three regular aides was unavailable. One check was written to Sears with a notation in the memo line of "carpet cleaning." Two checks were written to D.Z.'s homeowners' association for fees and three checks were written to the township to pay local property taxes on her residence. 

The three aides did not testify at the hearing. R.Z. testified that his attempt to secure their testimony proved futile. 

On May 11, 2018, the ALJ issued an initial decision modifying the amount of the transfer penalty. The ALJ found D.Z. proved by a preponderance of the evidence she paid E.D., L.O., and N.L. for home health care and the payments were not subject to the look-back penalty because they were exclusively for a purpose other than to qualify for Medicaid. N.J.A.C. 10:71-4.10(j). 

In addition, the ALJ determined D.Z.'s payment of homeowners' association fees, local property taxes, and the carpet cleaning expense were excludable from the transfer penalty. The ALJ ordered that the transfer penalty 

A-5962-17T3 

be reduced by the amounts D.Z. paid to the three aides and for personal expenses.This totaled a reduction of $104,425.23 from the transfer penalty. 

On July 12, 2018, the Director of DMAHS issued a final agency decision adopting in part, and reversing in part, the ALJ's initial decision. The Director determined D.Z. failed to establish the type of services provided to her, the compensation she provided for those services, or that the compensation was not greater than the prevailing rates for similar care or services in the community. See N.J.A.C. 10:71-4.10(b)(6)(ii) and (j). 

The Director also concluded that although the ALJ's credibility determination was entitled to deference, the record did not satisfy the residuum rule. See N.J.A.C. 1:1-15.5(b). That rule provides that when an ALJ relies on hearsay testimony, "some legally competent evidence must exist to support each ultimate finding of fact to an extent sufficient to provide assurances of reliability and to avoid the fact or appearance of arbitrariness." Ibid. 

The Director found the record contained no evidence: (1) of a caregiver agreement establishing the expectations of care and compensation for services between D.Z. and her aides; or (2) that the aides were certified home health aides 

1
constituted payments excluded from the transfer penalty. 

The ALJ found D.Z. did not prove her payments to the temporary aides 

A-5962-17T3 

warranting compensation at the rates D.Z. paid. In addition, the Director determined the checks in evidence: (1) did not show a consistent pattern of payments; (2) showed multiple payments to the same aide on the same day in one instance; (3) demonstrated payments to L.O. at a time R.Z. testified N.L. lived with his mother fulltime; and (4) were issued at a time when D.Z.'s daughter-in-law, according to her testimony, was caring for D.Z. The Director also concluded the record did not establish what services were provided to D.Z. by the aides during the overnight hours. 

The Director, therefore, reversed the ALJ's initial decision to the extent it deducted from the transfer penalty the payments D.Z. claimed were for the services of the aides. The Director adopted the portion of the ALJ's initial decision directing the CWA to deduct from the transfer penalty $3,053.23 to reflect D.Z.'s payments for homeowners' association fees, local property taxes, and carpet cleaning. This resulted in a transfer penalty of $207,525.93. 

This appeal followed. D.Z. raises the following arguments for our consideration: 

POINT I 

RESPONDENT FAILED TO MAKE NEW OR MODIFIED FINDINGS OF FACT AS REQUIRED BY LAW UPON REJECTING THE ALJ'S FINDINGS OF FACT. 

A-5962-17T3 

POINT II 

RESPONDENT DEFERENCE ASSESSMENT WITNESSES. 

POINT III 

FAILED TO THE OF THE 

TO GIVE PROPER FACT FINDER'S CREDIBILITY OF 

RESPONDENT REVIEWED AN INCOMPLETE RECORD, WITHOUT THE TRANSCRIPT, IN ORDER TO ASSESS THE TESTIMONY AND EVIDENCE SUBMITTED TO THE COURT. 

POINT IV 

RESPONDENT INCORRECTLY APPLIED THE RESIDUUM RULE IN ASSESSING THE ALJ'S INITIAL DECISION. 

After D.Z. submitted her brief, the Director moved for a limited remand. The Director sought to clarify what she described as "a fundamental misunderstanding caused by a lack of analysis in the" final agency decision. We granted the motion. 

On December 18, 2019, the Assistant Commissioner of DMAHS issued an amended final agency decision. The amended final agency decision reiterates the findings in the earlier final agency decision and concludes D.Z. 

has not been able to rebut the presumption that these transfers for less than fair market value were to qualify for Medicaid. And, because [D.Z.] has provided 

A-5962-17T3 

inadequate support to rebut the presumption, [D.Z.] cannot show that the transfers were not made in order to qualify for Medicaid. 

The Assistant Commissioner again reversed the ALJ's initial decision to the extent it ordered the CWA to reduce the transfer penalty by the amounts D.Z. claimed to have paid her aides and adopted the portion of the ALJ's initial decision ordering a reduction in the transfer penalty to reflect D.Z.'s payment of homeowners' association fees, local property taxes, and personal expenses. 

In a reply brief filed after issuance of the amended final agency decision, D.Z. raised the following arguments: 

POINT I 

RESPONDENT SHALL NOT EV ALUA TE THE MERITS OF PETITIONER'S TRANSFERS OF ASSETS BUT ONLY DETERMINE WHETHER OR NOT THE TRANSFER[S'] PURPOSE WAS TO ESTABLISH MEDICAID ELIGIBILITY. 

POINT II 

RESPONDENT ACKNOWLEDGES THAT THE ALJ FOUND THAT PETITIONER RECEIVED SERVICES FROM THE CAREGIVERS FOR HER PAYMENTS, WHICH SHOULD REBUT THE PRESUMPTION. 

II.
"An administrative agency's decision will be upheld 'unless there is a clear 

showing that it is arbitrary, capricious, or unreasonable, or that it lacks fair 

A-5962-17T3 

support in the record.'" R.S. v. Div. of Med. Assistance & Health Servs., 434 N.J. Super. 250, 261 (App. Div. 2014) (quoting Russo v. Bd. of Trs., Police & Firemen's Ret. Sys., 206 N.J. 14, 27 (2011)). "The burden of demonstrating that the agency's action was arbitrary, capricious or unreasonable rests upon the [party] challenging the administrative action." E.S. v. Div. of Med. Assistance & Health Servs., 412 N.J. Super. 340, 349 (App. Div. 2010) (alteration in original) (quoting In re Arenas, 385 N.J. Super. 440, 443-44 (App. Div. 2006)). "[I]f substantial credible evidence supports an agency's conclusion, a court may not substitute its own judgment for the agency's even though the court might have reached a different result." Greenwood v. State Police Training Ctr., 127 N.J. 500, 513 (1992). 

"Medicaid is a federally-created, state-implemented program that provides 'medical assistance to the poor at the expense of the public.'" In re Estate of Brown, 448 N.J. Super. 252, 256 (App. Div. 2017) (quoting Estate of DeMartino v. Div. of Med. Assistance & Health Servs., 373 N.J. Super. 210, 217 (App. Div. 2004)); see also 42 U.S.C. § 1396-1. To receive federal funding the State must comply with all federal statutes and regulations. Harris v. McRae, 448 U.S. 297, 301 (1980). 

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Pursuant to the New Jersey Medical Assistance and Health Services Act, N.J.S.A. 30:4D-1 to -19.5, DMAHS is responsible for administering the Medicaid program in our State. Through its regulations, DMAHS establishes "policy and procedures for the application process . . . ." N.J.A.C. 10:71-2.2(b). "[T]o be financially eligible, the applicant must meet both income and resource standards." Brown, 448 N.J. Super. at 257; see also N.J.A.C. 10:71-3.15; N.J.A.C. 10:71-1.2(a). 

Because Medicaid funds are limited, only those applicants with income and non-exempt resources below specified levels may qualify for government- paid assistance. To qualify for the Medicaid Only program, an individual applicant may not have resources that exceed $2000. N.J.A.C. 10:71-4.5(c). Resources are defined "as any real or personal property which is owned by the applicant . . . and which could be converted to cash to be used for his or her support and maintenance." N.J.A.C. 10:71-4.1(b). 

An applicant who transfers or disposes of resources for less than fair market value during a sixty-month look-back period before the individual becomes institutionalized or applies for Medicaid is penalized for making the transfer. 42 U.S.C. §1396p(c)(1)(E); N.J.A.C. 10:71-4.10(m)(1). Transfers within the look-back period are presumed to be made to obtain earlier Medicaid 

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eligibility than that to which the applicant would otherwise be entitled. N.J.A.C. 10:71-4.10(j). The presumption may be rebutted with "convincing evidence that the assets were transferred exclusively (that is, solely) for some other purpose." Ibid. If the applicant does not overcome the presumption, a transfer penalty denies Medicaid benefits during the period the applicant should have been using the transferred resources for medical care. See W.T. v. Div. of Med. Assistance & Health Servs., 391 N.J. Super. 25, 37 (App. Div. 2007). 

If the applicant transfers any resource within the look-back period, the transfer is reviewed, and the resource's fair market value is ascertained, as is the consideration received for the transferred resource. N.J.A.C. 10:71-4.10(c). The difference between the fair market value of the resource and the compensation received by the applicant is the "uncompensated value . . . ." N.J.A.C. 10:71-4.10(c)(2). If the uncompensated value of the transferred resources, combined with other countable resources, exceeds the resource limit for Medicaid eligibility, a transfer penalty is assessed. N.J.A.C. 10:71- 4.10(m)(1). 

Having carefully reviewed the record and applicable legal principles, we conclude the agency's decision is supported by substantial credible evidence in the record as a whole. R. 2:11-3(e)(1)(D). Accordingly, we affirm the Assistant 

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Commissioner's amended final agency decision for the reasons set forth therein. We add the following comments. 

The Assistant Commissioner did not reject the ALJ's determination that R.Z. credibly testified that D.Z. paid aides to assist her. She concluded, however, that D.Z. did not establish that the amount she paid the aides reflected fair market value for the services she received. As the Assistant Commissioner noted, the record contains no service contract memorializing the aides' compensation rate, the services they were expected to provide, or that they were licensed caregivers whose skill warranted the compensation they received. We acknowledge DMAHS regulations do not require a written contract or licensing for home health services to qualify as exempt from the transfer penalty. However, the absence of a contract and proof of licensing here significantly hindered the agency's ability to determine the services D.Z. received, the rate she paid for those services, and whether that rate was warranted by the aides' skill level and training. 

In addition, the evidence was imprecise with respect to the compensation paid to the aides. Among other things, the checks upon which D.Z. relied were made out to "cash," in some instances conflated the aides' compensation with D.Z.'s personal expenses without clear delineation, and were issued at 

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inconsistent frequencies. Because the agency could not determine the fair market value of the services D.Z. received or the amount of compensation she gave to the aides, the agency could not award a credit against the transfer penalty commensurate with the fair market value of services rendered. Based on this record, we cannot conclude the Assistant Commissioner's determination D.Z. failed to overcome the presumption that the transfers were for a purpose other than qualifying for Medicaid was arbitrary, capricious, or unreasonable. 

We have reviewed petitioner's remaining arguments and conclude they lack sufficient merit to warrant discussion in a written opinion. R. 2:11- 3(e)(1)(E). 

Affirmed. 

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