01-2-9257 In the Matter of Suspension or Revocation of License of J.R., R.N., App. Div. (per curiam) (22 pp.) In these appeals, appellant J.R. challenged two orders by the New Jersey State Board of Nursing. Her appeals were consolidated for purposes of this opinion. Appellant’s first appeal challenged the board’s corrected final order, which required her to undergo a psychological evaluation. However, appellant did not seek a stay of that order and had already undergone the psychological evaluation. Thus, appellant’s challenge to the board’s order requiring her to undergo a psychological evaluation was moot. As to the second order, the board determined that appellant was “incapable, for medical or any other good reason, of discharging the functions of a licensee in a manner consistent with the public’s health, safety and welfare.” There was substantial credible evidence to support the board’s conclusion. Particularly given the deferential standard of review, the board’s suspension of appellant’s license was not arbitrary, capricious or unreasonable. The appellate panel affirmed the board’s final order of discipline.
01-2-9232 R.W. v. Div. Of Med. Assistance and Health Servs. App. Div. (per curiam) (13 pp.) Appellants appealed from a final agency decision of respondent Division of Medical Assistance and Health Services, which reversed the initial decision of an administrative law judge and affirmed the decision of respondent Monmouth County Board of Social Services to terminate or deny appellants’ eligibility for the Global Options Medicaid waiver program. Appellants are residents of Francis Asbury Manor, a nonprofit assisted living facility. FAM is operated by United Methodist Homes of New Jersey, a nonprofit corporation. UMH is funded by the United Methodist Homes of New Jersey Foundation, a nonprofit corporation. Appellants received fellowship credits from the foundation’s Fellowship Fund of $2,500 to $9,000 per month, which reduced what they ultimately owed to FAM. The board determined that the fellowship credit was a vendor payment includable as unearned income. Because each appellants’ monthly fellowship credit placed them above the maximum qualifying income level of $2,130 per month for the GO program, the board terminated or denied their eligibility for benefits. DMAHS concluded that the board properly determined that these payments by a third party to the provider of assisted living services, which includes room and board, was income applicable to the residents’ accounts. Appellants provided no evidence of their monthly income or the actual distribution among FAM residents of the fellowship credits FAM received. Accordingly, it could not be determined whether or not the amounts set forth on appellants’ billing statements were paid in full or allocated to the accounts of other residents. The GO program is a needs-based program within the Medicaid Only program. As a condition of eligibility, applicants must comply with the applicable income standards. These regulations make clear that it is the individual seeking Medicaid eligibility who must actually receive the income being considered in the eligibility determination, not the assisted living facility. Appellants cited no authority supporting their position that in order to be considered income, the assisted living facility must actually receive payment. The fellowship credits should be included in the determination of appellants’ income. DMAHS correctly determined that the fellowship credits were vendor payments includable as unearned income in the determination of appellants’ eligibility for the GO program. DMAHS’ decision was affirmed.
