State Cannot Deny Benefits Solely Because It Can't Confirm Information About Applicant's Wife

A New York appeals court rules that a state's decision denying a nursing home resident Medicaid benefits because it couldn't confirm information about the resident's wife violated state regulations. In the Matter of Waterfront Center for Rehabilitation and Healthcare (N.Y. Sup. Ct., App. Div., 4thDept., June 29, 2018).

A nursing home filed an application for Medicaid on behalf of a resident. The state denied the application because it could not confirm the demographic information, assets, and financial resources of the resident's estranged wife.

The nursing home appealed, arguing that the denial violated state regulations, which prohibit the state from denying an application solely because the state cannot obtain information about a legally responsible relative who is not living with the applicant. The state denied benefits again, and the nursing home appealed to court.

The New York Supreme Court, Appellate Division, annuls the state's decision. According to the court, the denial of benefits was inconsistent with the plain language of the state regulation because it failed to take anything into account other than the state’s inability to get information from the resident's wife.

For the full text of this decision, go to: https://www.nycourts.gov/courts/ad4/clerk/decisions/2018/06-29-18/PDF/0701.pdf

Did you know that the ElderLawAnswers database now contains summaries of more than 2,000 fully searchable elder law decisions dating back to 1993? To search the database, click here.