Nursing Home May Pursue Medicaid Benefits on Behalf of Resident

A Delaware trial court rules that a nursing home resident's guardian can authorize the nursing home to pursue a claim for Medicaid benefits on behalf of a resident, holding that the authorization is not an assignment of benefits. Green Valley SNF, LLC v. Delaware Dept. of Health and Social Services (Del. Super. Ct., No. 11A-11-007RBY, Aug. 29, 2012).

Pauline Bryner entered Green Valley nursing home. She suffered from dementia and was unable to manage her own affairs, but had no family to act on her behalf. When the nursing home applied for Medicaid benefits on Ms. Bryner's behalf, the application was denied. The court appointed a guardian for Ms. Bryner, and the guardian signed an "authorization statement" that authorized the nursing home to receive Medicaid benefits for services provided by the nursing home and to take action to secure benefits.

The nursing home appealed the denial of benefits, and the state determined the facility lacked standing because the assignment of public benefits is prohibited under state law. The nursing home appealed.

The Delaware Superior Court reverses, holding that the authorization statement is not an impermissible assignment of benefits, so the nursing home has standing to pursue a claim for Medicaid benefits. According to the court, the authorization statement does not assign "Ms. Bryner’s interest in public assistance benefits to someone like a creditor, the [a]uthorization [s]tatement simply presents [the nursing home] with the authority to pursue funds that it would ultimately be entitled to receive as remuneration from Ms. Bryner for her medical services as provided."

For the full text of this decision, go to:

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.