{
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  "name": "DENNIS H. JOYNER, EXECUTOR OF THE ESTATE OF LEOLA H. JOYNER, Plaintiff v. NORTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES, Defendant",
  "name_abbreviation": "Joyner v. North Carolina Department of Health & Human Services",
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    "judges": [
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    "parties": [
      "DENNIS H. JOYNER, EXECUTOR OF THE ESTATE OF LEOLA H. JOYNER, Plaintiff v. NORTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES, Defendant"
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      {
        "text": "ERVIN, Judge.\nRespondent North Carolina Department of Health and Human Services appeals from an order overturning its decision to impose a transfer sanction upon Decedent Leola H. Joyner and finding that DHHS acted erroneously when it terminated Decedent\u2019s long-term care Medicaid benefits. On appeal, DHHS contends that the trial court erred by concluding that the execution of deeds of trust applicable to Ms. Joyner\u2019s residence did not constitute the \u201ctransfer\u201d or \u201cdisposal\u201d of an asset within the meaning of applicable provisions of federal law. As an alternative basis for upholding the result reached by the trial court, Respondent Dennis H. Joyner contends that, even if the execution of deeds of trust constituted the \u201ctransfer\u201d or \u201cdisposition\u201d of an asset, the transfers or dispositions at issue here were made for the required fair market value. After careful consideration of DHHS\u2019 challenges to the trial court\u2019s order in light of the record and the applicable law, we conclude that the trial court\u2019s order should be reversed and that this case should be remanded to the Nash County Superior Court for further proceedings not inconsistent with this opinion.\nI. Factual and Procedural Background\nOn 1 March 2006, Ms. Joyner executed two promissory notes secured with two correlating deeds of trust executed in favor of her son, Mr. Joyner. The first note purported to reimburse Mr. Joyner for past expenditures that had been made on his mother\u2019s behalf in the amount of $68,000.00. The second note, in the amount of $88,615.80, was executed for the purpose of compensating Mr. Joyner for personal services which he had agreed to render to his mother in the future under the terms of a personal services agreement signed on 1 March 2006. The amount set out in these two sets of notes and deeds of trust was sufficient to fully encumber Ms. Joyner\u2019s residence.\nMs. Joyner had been a Medicaid recipient since November 2005. On 26 June 2006, the Nash County Department of Social Services informed Ms. Joyner that her long-term care Medicaid benefits would terminate as a result of the 1 March 2006 notes and deeds of trust. According to DSS, the notes and deeds of trust executed on that occasion constituted uncompensated transfers of Ms. Joyner\u2019s assets.\nMs. Joyner appealed the denial of her long-term care benefits to a local DSS hearing officer. After failing to persuade the DSS hearing officer of the merits of her position, Ms. Joyner sought review by a state hearing officer. Ms. Joyner died on 30 January 2007 without having received a decision with respect to the issues raised by her appeal.\nOn 29 May 2007, Mr. Joyner was appointed executor of Ms. Joyner\u2019s estate. On 15 July 2008, the state hearing officer issued a tentative opinion upholding the denial of Ms. Joyner\u2019s claim. In her decision, the hearing officer treated both transactions as uncompensated transfers, finding that the amount associated with past expenditures evidenced in the first note and deed of trust was \u201cnot provided for in a written agreement at the time the services were rendered\u201d and that the amount evidenced in the second note and deed of trust stemmed from an impermissible transfer for future services. Ms. Joyner\u2019s estate sought review of the state hearing officer\u2019s decision by the chief hearing officer. On 21 January 2009, the chief hearing officer issued an opinion affirming the hearing officer\u2019s decision to deny Ms. Joyner\u2019s claim for long-term care benefits. Ms. Joyner\u2019s estate appealed the final agency decision to the Nash County Superior Court.\nThe estate\u2019s appeal came on for hearing before the trial court at the 7 December 2009 civil session of the Nash County Superior Court. On 7 January 2010, the trial court entered an order reversing the final agency decision. In its order, the trial court concluded as a matter of law:\n3. That 42 U.S.C. \u00a71396p(c)(l)(A) provides that the \u201cstate [Medicaid] plan must provide that if an institutionalized individual . . . disposes of assets for less than fair market value . . . the individual is ineligible for medical assistance.\u201d\n4. Substantial evidence in the record in this case shows that Leola H. Joyner did not dispose of or transfer any asset when she executed the notes and deeds of trust on March 1, 2006.\n5. The Respondent\u2019s decision to impose a transfer sanction on Leola H. Joyner was in violation of federal law because there was, in fact, no transfer or disposal of any asset.\n6. The Respondent acted erroneously when it terminated Leola H. Joyner\u2019s long-term care Medicaid.\n7. That Respondent acted without substantial justification in pressing its claim against the Petitioner and there are no special circumstances that would make the award of attorney\u2019s fees unjust.\nBased on these conclusions of law, the trial fcourt ordered that (1) the final agency decision terminating Ms. Joyner\u2019s long-term care benefits should be reversed, (2) the estate should be reimbursed for expenses incurred as a result of this action, and (3) the estate should be awarded $3,300.00 in attorneys\u2019 fees. DHHS noted an appeal to this Court from the trial court\u2019s order.\nII. Legal Analysis\nA. Standard of Review\n\u201cThe Administrative Procedure Act [APA] governs the standard of review of an administrative agency\u2019s decision.\u201d Elliot v. N.C. Dept. of Human Resources, 115 N.C. App. 613, 616, 446 S.E.2d 809, 811 (1994), aff\u2019d, 341 N.C. 191, 459 S.E.2d 273 (1995). According to N.C. Gen. Stat. \u00a7 150B-51(b), in reviewing the actions of an administrative agency:\nthe court may affirm the decision of the agency or remand the case to the agency or to the administrative law judge for further proceedings. It may also reverse or modify the agency\u2019s decision, or adopt the administrative law judge\u2019s decision if the substantial rights of the petitioners may have been prejudiced because the agency\u2019s findings, inferences, conclusions, or decisions are:\n(1) In violation of constitutional provisions;\n(2) In excess of the statutory authority or jurisdiction of the agency;\n(3) Made upon unlawful procedure;\n(4) Affected by other error of law;\n(5) Unsupported by substantial evidence admissible under [N.C. Gen. Stat. \u00a7\u00a7] 150B-29(a), 150B-30, or 150B-31 in view of the entire record as submitted; or\n(6) Arbitrary, capricious, or an abuse of discretion.\nN.C. Gen. Stat. \u00a7 150B-51(b). \u201cWhen under the applicable version of the APA a petition for review of an agency decision is filed in superior court, the superior court acts as an appellate court; both this [C]ourt and the superior court must utilize the same standard of review.\u201d D.B. v. Blue Ridge Ctr., 173 N.C. App. 401, 405, 619 S.E.2d 418, 422 (2005).\n\u201cIf it is alleged that an agency\u2019s decision was based on an error of law then a de novo review is required. A review of whether the agency decision is supported by the evidence, or is arbitrary or capricious, requires the court to employ the whole record test.\u201d Walker v. N.C. Dept. of Human Resources, 100 N.C. App. 498, 502, 397 S.E.2d 350, 354 (1990) (citation omitted), disc. review denied, 328 N.C. 98, 402 S.E.2d 430 (1991). \u201cUnder a de novo review, the court considers the matter anew and freely substitutes its own judgment\u201d in place of the court below. In re Appeal of the Greens of Pine Glen Ltd. P\u2019ship, 356 N.C. 642, 647, 576 S.E.2d 316, 319 (2003). \u201cThe whole record test generally requires examination of the entire record, including the evidence which detracts from the agency\u2019s decision.\u201d D.B., 173 N.C. App. at 405, 619 S.E.2d at 422. \u201cThe \u2018whole record\u2019 test does not permit the reviewing court to substitute its judgment for the agency\u2019s as between two reasonably conflicting views; however, it does require the court to take into account both the evidence justifying the agency\u2019s decision and the contradictory evidence from which a different result could be reached.\u201d Watson v. N.C. Real Estate Comm., 87 N.C. App. 637, 639, 362 S.E.2d 294, 296 (1987) (citations and quotations omitted), disc. review denied, 321 N.C. 746, 365 S.E.2d 296 (1988). \u201cUltimately, the reviewing court must determine whether the administrative decision had a rational basis in the evidence.\u201d Henderson v. N.C. Dept. of Human Resources, 91 N.C. App. 527, 531, 372 S.E.2d 887, 890 (1988) (citation omitted). We will now apply the applicable standard of review to the issues that have been presented to us for review.\nB. Substantive Legal Issues\n1. Transfer of Assets\nOn appeal, DHHS argues that the trial court erred by determining that Ms. Joyner had not impermissibly transferred or disposed of assets in violation of the relevant statutory provisions governing the operation of the Medicaid program. As a result of the fact that the first question raised by DHHS\u2019 challenge to the trial court\u2019s order involves the application of specific statutory provisions to undisputed facts, we review the first aspect of DHHS\u2019 challenge to the trial court\u2019s order utilizing a de novo standard of review. After carefully examining the arguments presented by the parties concerning the proper construction of the relevant statutory provisions, we conclude that the trial court erroneously determined that the transactions at issue here did not involve \u201ctransfers\u201d or \u201cdispositions\u201d of Ms. Joyner\u2019s assets.\nThe transactions at issue here both involve the execution of a deed of trust for the purpose of securing an indebtedness evidenced by a note. \u201cThe deed of trust results in legal title to the property being in the trustee.\u201d Sprouse v. North River Ins. Co., 81 N.C. App. 311, 316, 344 S.E.2d 555, 559, disc. review denied, 318 N.C. 284, 348 S.E.2d 344 (1986). A \u201cdeed of trust is \u2018essentially a security\u2019 by which \u2018the legal title to real property is placed in one or more trustees, to secure the repayment of a sum of money or the performance of other conditions.\u2019 \u201d In re Foreclosure of Azalea Garden Bd. & Care, Inc., 140 N.C. App. 45, 51, 535 S.E.2d 388, 393 (2000) (quoting Black\u2019s Law Dictionary 414 (6th ed. 1990)). Applying these well-established legal principles to the facts at issue in this case, we conclude that the transfer of the title to Ms. Joyner\u2019s residence for the purpose of securing the notes involved a transfer or disposition of one of Ms. Joyner\u2019s assets. We now consider whether this transaction constituted a \u201cdisposal\u201d or a \u201ctransfer\u201d of an asset under the applicable Medicaid provisions.\n42 U.S.C. \u00a7 1396p(c)(l)(A) provides that:\nIn order to meet the requirements of this subsection for purposes of section 1396a(a)(18) of this title, the State plan must provide that if an institutionalized individual or the spouse of such an individual . . . disposes of assets for less than fair market value on or after the look-back date specified in subparagraph (B)(i), the individual is ineligible for medical assistance for services described in subparagraph (C)(i) ... during the period beginning on the date specified in subparagraph (D) and equal to the number of months specified in subparagraph (E).\nIn compliance with this statutory provision, the General Assembly enacted N.C. Gen. Stat. \u00a7 108A-58.1, which provides that:\nExcept as otherwise provided herein, an individual who is otherwise eligible to receive medical assistance under this Part is ineligible for Medicaid coverage and payment for the services specified in subsection (d) during the period specified in subsection (c) if the individual or the individual\u2019s spouse transfers an asset for less than fair market value on or after the \u201clook-back date\u201d specified in subsection (b).\nAs a result, the relevant federal statutory provision speaks to a \u201cdisposing of assets\u201d while the relevant state statutory provision speaks to \u201ctransfers of assets.\u201d\nIn seeking to persuade us to uphold the trial court\u2019s order, Mr. Joyner argues that the use of the word \u201ctransfer\u201d in N.C. Gen. Stat. \u00a7 108A-58.1(a) conflicts with the use of the word \u201cdispose\u201d in 42 U.S.C. \u00a7 1396p(c)(l)(A). According to Mr. Joyner, the relevant provisions of 42 U.S.C. \u00a7 1396p(c)(l)(A) control over the conflicting provisions of any state implementing statute, such as N.C. Gen. Stat. \u00a7 108A-58.1(a), so that the ultimate question before us is the extent, if any, to which Ms. Joyner \u201cdisposed\u201d of an asset. In light of this analysis, Mr. Joyner further argues that the execution of a deed of trust does not constitute a \u201cdisposition.\u201d We disagree.\nAdmittedly, in the event of a conflict between federal and state Medicaid statutes, the federal statutes must be deemed controlling. N.C. Gen. Stat. \u00a7 108A-58.1(f)(1) (stating that \u201c[t]his section shall be interpreted and administered consistently with governing federal law, including 42 U.S.C. \u00a7 1396p(c)\u201d). A careful review of the relevant statutory provisions convinces us, however, that there is no conflict between 42 U.S.C. \u00a7 1396p(c)(l)(A) and N.C. Gen. Stat. \u00a7 108A-58.1.\nAs the title of 42 U.S.C. \u00a7 1396p indicates, this section of the United States Code addresses \u201cLiens, adjustments and recoveries, and transfers of assets.\u201d 42 U.S.C. \u00a7 1396p. 42 U.S.C. \u00a7 1396p(c)(l)(A) requires state Medicaid plans to satisfy 42 U.S.C. \u00a7 1396(a)(18), which provides that such state plans must \u201ccomply with the provisions of [42 U.S.C. \u00a7] 1396p [] with respect to liens, adjustments and recoveries of medical assistance correctly paid, transfers of assets, and treatment of certain trusts.\u201d 42 U.S.C. \u00a7 1396a(a)(18). 42 U.S.C. \u00a7 1396p(c), which specifies the period of Medicaid ineligibility, provides, in pertinent part, that:\n(D)(i) In the case of a transfer of assets made before February 8, 2006, the date specified in this subparagraph is the first day of the first month during or after which assets have been transferred for less than fair market value and which does not occur in any .other period of ineligibility under this subsection.\n(ii) In the case of a transfer of asset made on or after February 8, 2006, the date specified in this subparagraph is the first day of a month during or after which assets have been transferred for less than fair market value, or the date on which the individual is eligible for medical assistance under the State plan and would otherwise be receiving institutional level care described in sub-paragraph (C) based on an approved application for such care but for the application of the penalty period, whichever is later, and which does not occur during any other period of ineligibility under this subsection.\n(E)(i) With respect to an institutionalized individual, the number of months of ineligibility under this subparagraph for an individual shall be equal to-\nil) the total, cumulative uncompensated value of all assets transferred by the individual (or individual\u2019s spouse) on or after the look-back date specified in subparagraph (B)(i), divided by\n(II) the average monthly cost to a private patient of nursing facility services in the State (or, at the option of the State, in the community in which the individual is institutionalized) at the time of application.\n(ii) With respect to a noninstitutionalized individual, the number of months of ineligibility under this subparagraph for an individual shall not be greater than a number equal to-\nil) the total, cumulative uncompensated value of all assets transferred by the individual (or individual\u2019s spouse) on or after the look-back date specified in subparagraph (B)(i), divided by\n(II) the average monthly cost to a private patient of nursing facility services in the State (or, at the option of the State, in the community in which the individual is institutionalized) at the time of application.\n(iii) The number of months of ineligibility otherwise determined under clause (i) or (ii) with respect to the disposal of an asset shall be reduced-\n(I) in the case of periods of ineligibility determined under clause (i), by the number of months of ineligibility applicable to the individual under clause (ii) as a result of such disposal, and\n(II) in the case of periods of ineligibility determined under clause (ii), by the number of months of ineligibility applicable to the individual under clause (i) as a result of such disposal.\n(iv) A State shall not round down, or otherwise disregard any fractional period of ineligibility determined under clause (i) or (ii) with respect to the disposal of assets.\n42 U.S.C. \u00a7 1396p(D-E). A careful reading of 42 U.S.C. \u00a7 1396p as a unified whole clearly indicates that Congress used the words \u201ctransfer\u201d and \u201cdispose\u201d interchangeably. As a result of the fact that these two words are used as synonyms in the relevant statutory provisions, the fact that Congress did not delineate any situations in which a \u201cdisposition\u201d and a \u201ctransfer\u201d had different meanings, the fact that Congress did not specifically define either \u201ctransfer\u201d or \u201cdisposition,\u201d and the fact that nothing in the context in which either word is used suggests the appropriateness of anything other than the ordinary meaning of either word, we are required to use the plain meanings of both words in construing the relevant statutory language. Johnson v. United States, 529 U.S. 694, 707, 146 L. Ed. 2d 727, 740, 120 S. Ct. 1795, 1804 (2000); Wood v. Stevens & Co., 297 N.C. 636, 643, 256 S.E.2d 692, 697 (1979) (citing In re Trucking Co., 281 N.C. 242, 252, 188 S.E.2d 452, 458 (1972) and State v. Wiggins, 272 N.C. 147, 153, 158 S.E.2d 37, 42 (1967), cert. denied, 390 U.S. 1028, 20 L. Ed. 2d 285, 88 S. Ct. 1418 (1968)).\nA \u201ctransfer\u201d is \u201c[a]ny mode of disposing of or parting with an asset or an interest in an asset, including a gift, the payment of money, release, lease, or creation of a lien or other encumbrance.\u201d Black\u2019s Law Dictionary 1636 (9th ed. 2009). Similarly, the expression \u201cdispose of\u201d is defined in part as \u201cto transfer into new hands or to the control of someone else.\u201d Webster\u2019s Third New International Dictionary 654 (1966); see also Black\u2019s Law Dictionary 471 (6th ed. 1990) (defining \u201cdispose of\u2019 in part as \u201cto alienate or direct the ownership of property as disposition by will\u201d and \u201cto alienate, relinquish, part with, or get rid of\u2019). As should be obvious, these definitions, like the relevant statutory provisions, treat \u201ctransfers\u201d and \u201cdispositions\u201d as synonymous. In light of that understanding, which precludes any determination that the relevant provisions of federal and state law are in conflict with each other, we conclude that Ms. Joyner\u2019s transfer of the title to her residence through the execution of deeds of trust for the purpose of securing notes payable to Mr. Joyner constituted the \u201cdisposal\u201d of an asset for purposes of 42 U.S.C. \u00a7 1396p and the \u201ctransfer\u201d of an asset for purposes of N.C. Gen. Stat. \u00a7 108A-58.1 and that the trial court erred by concluding otherwise.\n2. Payment of Compensation\nAs an alternative basis for upholding the trial court\u2019s order, Mr. Joyner argues that the transfers in question were supported by adequate compensation for purposes of 42 U.S.C. \u00a7 1396p and N.C. Gen. Stat. \u00a7 108A-58.1 (a). Although the trial court did not address the issue of whether either transfer was made for \u201cfair market value\u201d at any point in its order, we must still attempt to ascertain if we \u201ccan reasonably determine from the record whether [a party\u2019s] asserted grounds for challenging the agency\u2019s final decision warrant reversal or modification of that decision under the applicable provisions of N.C. [Gen. Stat.] \u00a7 150B-51(b).\u201d N.C. Dept. of Env\u2019t and Natural Res. v. Carroll, 358 N.C. 649, 665, 599 S.E.2d 888, 898 (2004). Thus, we turn to the issue of whether the asset transfers evidenced and secured by the notes and deeds of trust reflected the required \u201cfair market value.\u201d\na. First Note and Deed of Trust\nThe first note and deed of trust relate to expenditures which Mr. Joyner had made on Ms. Joyner\u2019s behalf prior to the execution of the instruments in question. As the hearing officer\u2019s findings of fact reflect, the reimbursement of these expenditures was \u201cnot provided for in a written agreement at the time the services were rendered.\u201d Mr. Joyner contends, however, that the note and deed of trust evidencing and securing this $68,000.00 amount \u201cwere executed in fulfillment of the longstanding agreement between [Ms.] Joyner and [Mr.] Joyner\u201d and that they should, for that reason, be deemed to support a determination that the transfer in question reflected the fair market value of services that Ms. Joyner actually received.\nThe principal authority upon which DHHS relied in concluding that the past expenditures upon which the first note and deed of trust are predicated did not suffice to support these instruments was the North Carolina Adult Medicaid Manual, which is an \u201cinternal instructional reference for DHHS employees in the application of DHHS policy and interpretation of the federal Medicaid requirements.\u201d Martin v. N.C. Dept. of Health and Human Serv., 194 N.C. App. 716, 720, 670 S.E.2d 629, 633 (2009). As we read the relevant provisions of the Medicaid Manual, they clearly require \u201ca written agreement for compensation at the time the care of service was received\u201d under all circumstances involving the transfer of \u201ccash or other assets to a family member, relative, or friend for care or services that were provided in the past.\u201d Medicaid Manual \u00a7 2240 XI.H.1. and 2. Although the provisions of the Medicaid Manual are clearly entitled to some consideration in attempts to understand the rules and regulations governing eligibility for Medicaid benefits, Cloninger v. N.C. Dept. of Health and Human Serv., _ N.C. App. _, _, 691 S.E.2d 127, 130-31, disc. review denied, 364 N.C. 324, 700 S.E.2d 748 (2010); Estate of Wilson v. Division of Soc. Servs., 200 N.C. App. 747, 750-53, 685 S.E.2d 135, 138-40 (2009), we have previously stated that the Medicaid Manual \u201cmerely explains the definitions that currently exist in federal and state statutes, rules and regulations\u201d and that \u201c[violations of or failures to comply with the MAF [Medicaid] Manual [are] of no effect\u201d unless the act or omission in question amounts to a \u201cfailure to meet the requirements set out in the federal and state statutes and regulations^]\u201d Okale v. N.C. Dept. of Health and Human Servs., 153 N.C. App. 475, 478-79, 570 S.E.2d 741, 743 (2002). As a result, the mere fact that the \u201cwritten agreement\u201d requirement appears in the Medicaid Manual does not, without more, justify upholding DHHS\u2019 determination that the transfer associated with the first note and deed of trust was not supported by adequate compensation.\nIn addition to its reliance on the Medicaid Manual, DHHS points to the well-established legal principle that \u201c[p]ast consideration or moral obligation is not adequate consideration to support a contract\u201d and that \u201c[s]ervices performed by one family member for another, within the unity of the family, are presumptively \u2018rendered in obedience to a moral obligation and without expectation of compensation.\u2019 \u201d Estate of Graham v. Morrison, 156 N.C. App. 154, 159, 576 S.E.2d 355, 359 (2003) (citing Jones v. Winstead, 186 N.C. 536, 540, 120 S.E.2d 89, 90-91 (1923) and quoting Jones v. Saunders, 254 N.C. 644, 649, 119 S.E.2d 789, 793 (1961)). Although Mr. Joyner cites findings of fact by both the trial court and the hearing officer in support of his claim to have successfully rebutted the presumption that the expenditures that underlie the first note and deed of trust were provided on a gratuitous basis, we do not find this argument persuasive because the trial court was not, under the applicable standard of review, entitled to make factual findings and because the hearing officer\u2019s findings of fact do not directly address the extent to which Mr. Joyner rebutted the presumption that care and services provided to family members are rendered \u201cin obedience to a moral obligation\u201d and were, therefore rendered on the basis of an inappropriate legal standard. When a trial court \u201cclearly heard the evidence and found the facts against [a party] under a misapprehension of the controlling law,\u201d \u201cthe factual findings may be set aside on the theory that the evidence should be considered in its true legal light.\u201d A.M.E. Zion Church v. Union Chapel A.M.E. Zion Church, 64 N.C. App. 391, 411-12, 308 S.E.2d 72, 85 (1983) (citing Helms v. Rea, 282 N.C. 610, 620, 194 S.E.2d 1, 8 (1973), and McGill v. Lumberton, 215 N.C. 752, 744, 3 S.E.2d 324, 326 (1939)), disc. review denied, 310 N.C. 308, 312 S.E.2d 649 (1984). As a result, since the agency never addressed the ultimate issue that must be resolved in connection with Mr. Joyner\u2019s challenge to DHHS\u2019 decision to treat the first note and deed of trust as an uncompensated transfer, this case must be remanded to the trial court for further remand to the agency for the entry of a new decision containing adequate findings of fact and conclusions of law relating to the issue of whether the expenditures evidenced and secured by the first note and deed of trust constituted uncompensated transfers, with the agency to make the necessary credibility determinations concerning the extent to which the parties had actually agreed that Mr. Joyner would be compensated for the expenditures that underlie the first note and deed of trust at or prior to the time at which those expenditures were made or whether the first note and deed of trust amounted to an after-the-fact attempt to circumvent the applicable rules against uncompensated asset transfer by Medicaid recipients on remand.\nb. Second Note and Deed of Trust\nThe second note and deed of trust relate to a lump sum payment that Ms. Joyner agreed to make to Mr. Joyner for services to be provided in the future. The nature and type of services that Mr. Joyner was to provide to Ms. Joyner, the hourly rate at which Mr. Joyner expected to be reimbursed for services provided to Ms. Joyner, and the number of personal service hours that the parties expected that Mr. Joyner would provide to Ms. Joyner were spelled out in the agreement. Instead of providing that payment would be made on a periodic basis as services were rendered, however, the agreement required the payment of a lump sum amount calculated using the specified hourly rate, the number of hours of care anticipated to be provided each week, and Ms. Joyner\u2019s life expectancy on the date upon which the agreement was executed. The agreement contained no provision for any sort of adjustment to the lump sum amount based on the date upon which Ms. Joyner died or any inability on the part of Mr. Joyner to provide the required services. Although both parties agree that the relevant provisions of federal and state law permit personal service agreements, they disagree sharply over the terms and conditions under which such agreements are permissible and whether the agreement at issue here falls in the permissible or impermissible category.\nIn concluding that the agreement evidenced by the second note and deed of trust resulted in an impermissible uncompensated transfer, the agency relied on language contained in the Medicaid Manual specifically providing that \u201c[transfers for services to be provided in the future are unallowable because they have not been compensated\u201d and that \u201c[a] transfer for future compensation is sanctionable.\u201d Medicaid Manual VILA. As we have previously noted, the Medicaid Manual, standing alone, does not have binding effect. However, unlike the \u201cwritten agreement\u201d requirement relating to payment for past services, we believe that the prohibition on anticipatory lump sum payments of the type at issue here represent a proper application of the statutory reference to \u201cfair market value\u201d and should be upheld.\nApplication of the \u201cfair market value\u201d concept, as that term is utilized in connection with contracts for personal services, implies consideration of the nature of the service received and the value of the service in question. Turner v. Furniture Co., 217 N.C. 695, 697, 9 S.E.2d 379, 380 (1940) (stating that, in the event that there is \u201cno agreement as to the value of services to be paid for services, the person performing them is entitled to recover what they are reasonably worth, based on the time and labor expended, skill, knowledge and experience involved, and other attendant circumstances\u201d); Environmental Landscape Design v. Shields, 75 N.C. App. 304, 307, 330 S.E.2d 627, 629 (1985) (stating that \u201cthe reasonable value of services rendered is largely determined by the nature of the work and the customary rate of pay for such work in the community and at the time the work was performed\u201d). Thus, the concept of fair market value as implied in the present context focuses on the actual work performed and the market value of that work.\nAs a practical matter, it is very difficult for us to see how a lump sum advance payment for future services could ever actually represent the fair market value of those services for purposes of 42 U.S.C. \u00a7 1396p(c)(l)(A) or N.C. Gen. Stat. \u00a7 108A-58.1(a). Simply put, there are too many contingencies that must be addressed and accounted for in order to determine whether such a lump sum amount actually reflected the market value of what was received. See Bedell v. Commisioner, 30 F.2d 622, 624 (2d Cir. 1929) (stating that \u201cit is absurd to speak of a promise to [provide a service] in the future as having a \u2018market value,\u2019 fair or unfair\u201d). For example, as we have already suggested, the recipient may not live as long as is anticipated in the calculation utilized to develop the lump sum payment or the provider might become unable to render all of the service called for in the agreement throughout the relevant period. As a result, we conclude that the lump sum payment arrangement contemplated by the agreement underlying the second note and deed of trust simply did not reflect the fair market value of the services, if any, that Ms. Joyner actually received pursuant to that contract and that the hearing officer appropriately concluded that the transaction evidenced in and secured by the second note and deed of trust constituted an uncompensated transfer.\n3. Attorney\u2019s Fees\nAside from challenging the trial court\u2019s decision on the merits, Respondent also argues that the trial court erred by awarding attorney\u2019s fees in favor of Ms. Joyner\u2019s estate pursuant to N.C. Gen. Stat. \u00a7 6-19.1. We agree.\nIn awarding attorney\u2019s fees to the estate, the trial court concluded that DHHS \u201cacted without substantial justification in pressing its claim.\u201d However, an agency need not have been legally correct in order to avoid liability for attorney\u2019s fees. An award of attorney\u2019s fees pursuant to N.C. Gen. Stat. \u00a7 6-19.1 is not appropriate in the event that the agency\u2019s position \u201cwas rational and legitimate to such degree that a reasonable person could find it satisfactory or justifiable in light of the circumstances then known to the agency.\u201d Crowell Constructors v. State ex rel. Cobey, 342 N.C. 838, 844, 467 S.E.2d 675, 679 (1996) (citing Pierce v. Underwood, 487 U.S. 552, 565, 101 L. Ed. 2d 490, 504, 108 S. Ct. 2541 (1988). As we have already noted, the argument advanced by DHHS rested on the plain meaning of the relevant statutory provisions. Even if we had declined to accept the interpretation of the statutory language at issue here advanced by DHHS, we would have reached the conclusion that the agency\u2019s refusal to acquiesce in Mr. Joyner\u2019s interpretation of the relevant statutory provisions rested on a reasonable view of the controlling legal authorities. As a result, we cannot agree with the trial court that DHHS\u2019 position lacked \u201csubstantial justification,\u201d Daily Express, Inc. v. Beatty, _ N.C. App. _, _, 688 S.E.2d 791, 802 (2010) (reversing an attorney\u2019s fees award even though the agency\u2019s legal position was ultimately determined to be incorrect because the agency\u2019s interpretation \u201chad some level of support in both logic and the language enacted by the General Assembly\u201d), and reverse its decision to award attorney\u2019s fees to Mr. Joyner.\nIII. Conclusion\nThus, for the reasons set forth above, we conclude that the trial court erred by finding that the execution of the deeds of trust in question did not constitute a \u201ctransfer\u201d or \u201cdisposal\u201d of assets for purposes of 42 U.S.C. \u00a7 1396p(c)(l)(A) and N.C. Gen. Stat. \u00a7 108A-58.1(a), that further proceedings are necessary to determine whether the transactions evidenced in and secured by the first note and deed of trust reflected fair market value, that the agency correctly determined that the transaction evidenced in and secured by the second note and deed of trust constituted an uncompensated transfer, and that the trial court erred by awarding attorney\u2019s fees to Ms. Joyner\u2019s estate. As a result, the trial court\u2019s order should be, and hereby is, reversed and this case should be, and hereby is, remanded to the trial court for further remand to DHHS for the purpose of conducting additional proceedings not inconsistent with this opinion.\nREVERSED AND REMANDED.\nChief Judge MARTIN and Judge McGEE concur.\n. As a result of the complexity of the present record, it may be helpful to point out that the final agency decision challenged in the estate\u2019s request for judicial review simply adopted the findings and conclusions contained in the hearing officer\u2019s decision. As a result, the agency decision actually at issue before the trial court as a result of the estate\u2019s request for judicial review is the hearing officer\u2019s decision.\n. The arguments advanced in the parties\u2019 briefs focus on the \u201ctransfer\u201d or \u201cdisposition\u201d issue rather than the issue of whether an \u201casset\u201d was involved. As a result, we need not address or definitively resolve the question of whether the \u201ctransfers\u201d or \u201cdispositions\u201d at issue here involved an \u201casset.\u201d\n. In his brief, Mr. Joyner argues, in reliance on Shannonhouse v. Wolfe, 191 N.C. 769, 774, 133 S.E. 93, 96 (1926) (holding that the power to \u201chave entire control, disposal, and management of any and all property whether real or personal, which shall at any time be given or conveyed to [certain trustees] for the said community house or of the income or profits or furtherance of any of the activities of said community house\u201d did not authorize \u201cthe execution of a mortgage upon the property for the purpose of building a house\u201d on the grounds that \u201cthe mere naked power of sale implied in the word \u2018disposal\u2019 \u201d \u201cdoes not necessarily imply or delegate the power to mortgage\u201d), that the term \u201cdispose of\u2019 does not include anything short of a sale of the entire \u201cbundle of rights\u201d associated with ownership of a tract of real property. Aside from the fact that enforcing the notes and deeds of trust will, in time, result in transferring the entire value of Ms. Joyner\u2019s residence to Mr. Joyner, we believe that the decision in Shannonhouse was heavily influenced by the nature of the instrument under consideration in that case, which created a charitable trust. As a result, we do not believe that the word \u201cdispose\u201d has the limited meaning contended for by Mr. Joyner or that Shannonhouse controls the outcome in this case.\n. Although Mr. Joyner argues that this provision of the Medicaid Manual does not apply to the present case on the grounds that the record contains no indication that he ever provided services to Ms. Joyner on an uncompensated basis and that such evidence is a prerequisite to the effectiveness of the \u201cwritten agreement\u201d requirement, we need not decide which party has the better of this disagreement given our conclusion that the Medicaid Manual does not control the outcome in this case.\n. DHHS has cited no authority in its brief tending to suggest that the legal status of the Medicaid Manual has changed since Okale, and we have not found any such authority in the course of our own research.\n. In addition, while Mr. Joyner attempts to draw a distinction between the provision of care and the making of out-of-pocket expenditures, we agree with DHHS that both the provision of care and the making of out-of-pocket expenditures should be treated in the same manner for the purpose of applying the applicable uncompensated transfer rules.\n. In his brief, Mr. Joyner argues that DHHS was prohibited from utilizing an approach to determining whether a particular transfer was uncompensated that was more restrictive than the rules applied in determining eligibility for the Supplemental Security Income (SSI) program, 42 U.S.C. \u00a7 1396a(a)(10)(C)(i)(III), and that the calculation of the lump sum amount specified in the agreement between Ms. Joyner and Mr. Joyner was calculated consistently with the Program Operations Manual System employed by that program. However, the rules upon which this aspect of Mr. Joyner\u2019s argument rely only apply to the determination of \u201cincome and resource eligibility.\u201d 42 U.S.C. \u00a7 1396a(r)(2)(B). As a result of the fact that the methodology utilized in connection with the imposition of a transfer sanction is not relevant to the determination of Medicaid \u201cincome and resource eligibility,\u201d this aspect of Mr. Joyner\u2019s argument lacks merit.\n. As a result of our decision to reverse the trial court\u2019s order and to remand this case for further proceedings at the agency level, we also reverse the trial court\u2019s determination that DHHS should \u201creimburse [Mr. Joyner] for the cost incurred for care from the date Nash DSS terminated long-term care Medicaid benefits to the date of [Ms.] Joyner\u2019s death[.]\u201d",
        "type": "majority",
        "author": "ERVIN, Judge."
      }
    ],
    "attorneys": [
      "Attorney General Roy Cooper, by Assistant Attorney General Joel L. Johnson, for respondent-appellant.",
      "Fields & Cooper, PLLC, by Mark E. Edwards, for petitionerappellee."
    ],
    "corrections": "",
    "head_matter": "DENNIS H. JOYNER, EXECUTOR OF THE ESTATE OF LEOLA H. JOYNER, Plaintiff v. NORTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES, Defendant\nNo. COA10-670\n(Filed 2 August 2011)\n1. Public Assistance \u2014 Medicaid\u2014improper transfer or disposal of assets\nThe trial court erred by determining that decedent\u2019s execution of the pertinent deeds of trust did not constitute a transfer or disposal of assets in violation of 42 U.S.C. \u00a7 1396p(c)(l)(A) and N.C.G.S. \u00a7 108A-58.1(a) governing the operation of the Medicaid program.\n2. Public Assistance \u2014 Medicaid\u2014uncompensated transfer lump sum payment arrangement\nThe Department of Health and Human Services did not err by concluding that a transaction evidenced in and secured by a second note and deed of trust constituted an uncompensated transfer that terminated decedent\u2019s long-term care Medicaid benefits. The lump sum payment arrangement contemplated by the agreement did not reflect the fair market value of the services, if any, that decedent actually received pursuant to that contract.\n3. Attorney Fees \u2014 substantial justification \u2014 plain meaning of statute\nThe trial erred by awarding attorney fees in favor of decedent\u2019s estate under N.C.G.S. \u00a7 6-19.1. Defendant agency\u2019s position did not lack substantial justification, and the argument advanced rested on the plain meaning of the relevant statutory provisions.\nAppeal by respondent from order entered 7 January 2010 by Judge Walter H. Godwin, Jr., in Nash County Superior Court. Heard in the Court of Appeals 1 December 2010.\nAttorney General Roy Cooper, by Assistant Attorney General Joel L. Johnson, for respondent-appellant.\nFields & Cooper, PLLC, by Mark E. Edwards, for petitionerappellee."
  },
  "file_name": "0278-01",
  "first_page_order": 288,
  "last_page_order": 303
}
