A Delaware court rules that the state properly denied a Medicaid application for excess income because nothing in federal law prohibits a state from taking into account the income of an incapacitated nursing home resident when determining Medicaid eligibility. Genesis Healthcare v. The Delaware Department of Health and Social Services (Del. Super. Ct., No. N17A-11-001 AML, June 22, 2018).

After Ruth Jones entered a nursing home, the nursing home determined she was incapacitated and applied for Medicaid benefits on her behalf. The state told Ms. Jones that due to her excess income, she would need a Miller Trust, but Ms. Jones’s daughter had trouble getting guardianship and the trust was delayed. The state denied Ms. Jones benefits due to excess income.

The nursing home appealed on Ms. Jones’s behalf, arguing that federal law prohibits states from taking into account an incapacitated person’s income when determining Medicaid eligibility. The nursing home cited federal regulations that provide that property that cannot be liquidated is not available to the applicant. The state denied the appeal, and the nursing home appealed to court.

The Delaware Superior Court affirms, holding that the state properly denied Ms. Jones’s Medicaid application due to excess income. According to the court, the regulations cited by the nursing home apply only to Supplemental Security Income applications. The court rules that there is nothing in the law or regulations that prevents a state from taking into account the income of an incapacitated person when determining their eligibility for Medicaid.

For the full text of this decision, go to: https://courts.delaware.gov/Opinions/Download.aspx?id=274880

© 2015 MATTHEW L. MERCER | Attorney at Law

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