In the Matter of Mildred Keri

Ninety-year-old Mildred Keri lived alone but depended on her sons, Richard Keri (plaintiff) and Charles Keri, for care. Mildred’s irreversible dementia made her increasingly difficult, and she became a hazard to herself, necessitating relocation to a nursing home. Most of Mildred’s net worth consisted of her house, valued at approximately $170,000. Her pension and Social Security provided a monthly income of $1,575. Richard estimated that Mildred’s monthly nursing-home costs would be approximately $6,500, vastly exceeding her monthly income. He believed that if mentally competent, Mildred would want her home’s value to pass to her sons, who were named as beneficiaries in her will, rather than be used to pay for her nursing care. Consequently, Richard filed a petition seeking guardianship of Mildred and court approval for a proposed Medicaid spend-down plan. Under the plan, Richard would sell Mildred’s home and divide $92,000 of the proceeds equally between himself and Charles. The transfer would trigger a 16-month penalty period during which Mildred would be Medicaid ineligible. However, the remaining $78,000 in proceeds would cover Mildred’s expenses for that period. After the penalty period, Medicaid would cover Mildred’s nursing-home expenses. In contrast, if the house remained in Mildred’s possession or was sold with Mildred retaining the proceeds, then Mildred would be Medicaid ineligible until that asset was depleted, leaving nothing to pass to her sons. The trial court granted Richard guardianship but rejected the spend-down plan. The appellate division affirmed the plan’s rejection, and Richard appealed.