State’s decision to terminate Petitioner’s benefits under the Katie Beckett Waiver reversed.

Topic: Health Law, Decided by: Judge Malihi 
Docket Number: ***** , Decision Date: January 3, 2014 
Attachment: Click here to download the decision. 

State maintained that Petitioner did not meet the requisite Level of Care because he did not actually receive skilled nursing services recommended by his physicians.  However, Respondent’s own Manual indicates that a determination of whether an individual meets the Skilled Nursing Facility Level of Care hinges upon whether such services are required.  The fact that Petitioner did not actually receive skilled nursing services recommended by his physicians was by no means indicative of a lack of need for such services.  Petitioner was unable to receive rehabilitative services in the amounts recommended by his physician due to circumstances unrelated to a determination of what Petitioner actually required.

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