Nursing Home Does Not Have Authority to Pursue Medicaid Appeal on Behalf of Resident Post-Death

A New Jersey appeals court rules that a nursing home that was given authority to apply for Medicaid on a resident’s behalf by the resident’s agent under a power of attorney does not have authority to appeal the Medicaid case after the resident’s death. L.M. v. Division of Medical Assistance and Health Services (N.J. Super. Ct., App. Div., No. A-6014-17T1, April 30, 2020).

L.M. entered a nursing home, and her husband, acting as her agent under a power of attorney, authorized the nursing home to act as L.M.’s designated authorized representative (DAR) to apply for Medicaid benefits on her behalf. The state imposed a transfer penalty due to uncompensated transfers from L.M.’s bank accounts. The nursing home asked for an undue hardship waiver, arguing that L.M.’s husband and children unlawfully converted L.M.’s funds without her consent.

New Jersey denied the waiver, and the nursing home appealed. L.M. died while the appeal was pending. The state denied the appeal, concluding that the nursing home did not have the authority to act on L.M.’s behalf. The nursing home appealed, arguing that the DAR regulations authorized the DAR to continue after L.M.’s death.

The New Jersey Superior Court, Appellate Division, affirms, holding that the nursing home did not have authority to pursue an appeal on L.M.’s behalf. According to the court, the regulations did not provide that “the designation of a representative by someone holding the applicant's power of attorney survives the applicant's death.” The court rules that once L.M. died, the nursing home’s “authority as her DAR expired because it was aware [her husband’s] authority to execute the DAR had also ended.”

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