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Clark v. Ohio Department of Job and Family Services

Court of Appeals of Ohio, Eighth District, Cuyahoga

December 21, 2017

LEONARD CLARK PLAINTIFF-APPELLEE
v.
OHIO DEPARTMENT OF JOB AND FAMILY SERVICES DEFENDANT-APPELLANT

         Administrative Appeal from the Cuyahoga County Court of Common Pleas Case No. CV-15-851879

          ATTORNEYS FOR APPELLANT Michael DeWine Ohio Attorney General BY: Theresa Hanna Assistant Attorney General Health & Human Services Section.

          ATTORNEY FOR APPELLEE Michael Siegert Kennedy, PC Law Offices.

          BEFORE: Boyle, J., McCormack, P.J., and Celebrezze, J.

          JOURNAL ENTRY AND OPINION

          MARY J. BOYLE, J.

         {¶1} Defendant-appellant, Ohio Department of Job and Family Services ("ODJFS"), appeals from the Cuyahoga County Common Pleas Court's decision remanding an administrative appeal by plaintiff-appellee, Leonard Clark. On appeal, ODJFS raises one assignment of error for our review:

Because Mr. Clark's agency-level appeal request was untimely, the lower court erred by failing to either affirm the Administrative Appeal Decision, which dismissed Mr. Clark's administrative appeal request, or dismiss Mr. Clark's appeal to court for failure to exhaust administrative remedies.

         {¶2} We find merit to ODJFS's assignment of error and reverse and remand for the common pleas court to dismiss Clark's appeal.

         I. Procedural History and Factual Background

         {¶3} Clark applied for Medicaid benefits with ODJFS in February 2015. Clark was a resident of Walton Manor, a nursing home, and sought the benefits to pay for the cost of care. On June 8, 2015, however, ODJFS denied Clark's application, finding that his resources exceeded the maximum allowed for eligibility. Clark appealed ODJFS's denial, but ODJFS overruled Clark's appeal on September 1, 2015.[1] Attached to ODJFS's state hearing decision was a notice, explaining the decision as well as the formal steps that Clark needed to take if he disagreed with the decision and wanted to file an appeal. Specifically, the notice stated, "Your written request must be received by the Bureau of State Hearings within 15 calendar days from the mailing date of this notice."

         {¶4} After the hearing, but before the appeal deadline passed, the nursing facility policy administrator for the Ohio Department of Medicaid, Cheryl Guyman, emailed Walton Manor, informing the staff member in charge of Clark's case that ODJFS's denial of benefits was improper. Guyman stated, "The hearing officer is not basing his decision on the most recent CMS guidance which is in the State Medical Director Letters. You need to request an Administrative Appeal Request by email or phone" Unfortunately, when the staff member tried to forward this information to Clark's attorney, she sent it to the incorrect email address. As a result, Clark's attorney did not receive it until September 18, 2015. Upon receiving this information, Clark's counsel and Walton Manor appealed the administrative decision on behalf of Clark on September 18, 2015.

         {¶5} On September 22, 2015, ODJFS dismissed Clark's request as untimely. Clark appealed to the Cuyahoga County Court of Common Pleas, contesting the dismissal as error. The court determined that Clark's "request for an administrative appeal with the Ohio Department of Job and Family Services was improperly denied as being untimely and remanded the appeal to ODJFS for a hearing on the merits in accordance with the correct eligibility criteria. On April 6, 2017, ODJFS appealed the lower court's decision to this court.[2]

         II. Law and Analysis

         A. ...


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