After suffering a stroke and spending a period of time in a rehabilitation facility, A.K. was discharged to her home, where she spent the following two years prior to moving to a long-term care facility. Her daughter lived with her for the two-year period. A.K. attended a therapeutic day care program. The daughter worked outside the home, but each morning she would get A.K. up and ready for her day program. She arranged for a friend or family member to wait with her mother for the day program bus, and to stay with her mother when she was not there. Thereafter, A.K. suffered another stroke, was admitted to a nursing home, transferred her home to her daughter as a “caregiver child” under the Medicaid rules and applied for Medicaid benefits. The “caregiver child” exception was denied and a penalty was assessed by the Camden County Board of Social Services because the applicant’s daughter had a job outside the home. A.K. appealed.

The issue on appeal was whether the care-giving service provided by the daughter was the key factor in permitting the mother to remain at home. The administrative law judge determined that it was, despite her employment. The administrative law judge found that the daughter went to great lengths to ensure her mother was cared for while she worked, including arranging for the day program and for assistance from family and friends. The judge concluded that the daughter’s “devotion and level of care for her mother exemplified the reason the caregiver exemption was drafted.” The decision was adopted by the Director.

A.K. v. Camden County. Board. of Social Services, OAL Dkt. No. HMA 11760-16, initial decision (November 3, 2016), rev’d and remanded, Dir. (February 17, 2017; and, A.K. V Division of Medical Assistance and Health Services, OAL Dkt. No. HMA 11760 – 2017 (Initial Decision on remand (September 11, 2017), aff’d, Dir. (December 8, 2017)

For additional information concerning Medicaid and public benefits planning, visit:

NJ Medicaid and Public Benefits Planning