Nursing Home and Law Firm Have the Authority to Pursue a Medicaid Appeal on Behalf of a Resident

An Ohio court of appeals holds that a nursing home may act as authorized representative for a Medicaid applicant even though the applicant’s agent under a power of attorney signed the designated representative form, and that a law firm does not need to be an authorized representative in order to pursue an appeal on behalf of the Medicaid applicant. Merritt v. Ohio Department of Job and Family Services (Ohio Ct. App., No. CA2019-09-160, April 27, 2020).

Nursing home resident Jerome Merritt named his son his agent in a power of attorney document that gave the agent broad powers, including powers related to governmental benefits. Mr. Merritt applied for Medicaid benefits, but the state denied his application due to excess resources. Mr. Merritt’s son, in his role as agent under the power of attorney, signed a designation of authorized representative (DAR) form, authorizing the nursing home to be his authorized representative for Medicaid application purposes. The nursing home hired a law firm to represent it in the case, and the law firm filed an appeal.

The state denied the appeal, claiming that the law firm and nursing home did not have authority to represent Mr. Merritt because the DAR was signed by Mr. Merritt’s agent, not Mr. Merritt. The court affirmed the denial of benefits, and the nursing home appealed on Mr. Merritt’s behalf. The state argued that the grant of authority to the attorney to pursue the case violated the rule that a DAR is nontransferable.

The Ohio Court of Appeals, Twelfth District, reverses, holding that the nursing home and law firm have the authority to appeal on Mr. Merritt’s behalf. The court holds that the DAR form and the POA established that the nursing home was Mr. Merritt’s authorized representative and could request a hearing on his behalf. In addition, the court holds that the attorney does not need to be an authorized representative. According to the court, nothing in the law requires legal counsel for an authorized representative to establish that they too are an authorized representative

For the full text of this decision, go to: http://www.supremecourt.ohio.gov/rod/docs/pdf/12/2020/2020-Ohio-2674.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.