Friedberg v. Schweiker

721 F.2d 445 (1983)

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Friedberg v. Schweiker

United States Court of Appeals for the Third Circuit
721 F.2d 445 (1983)

  • Written by Liz Nakamura, JD

Facts

Miriam Crane was a long-term resident of Linwood Convalescent Center (LCC), a skilled nursing facility (SNF), and resided there from 1974 until her death. Crane received only custodial care, not skilled nursing care, during her residence at LCC. While residing at LCC, Crane was admitted to Atlantic City Medical Center (ACMC) for inpatient hospital care on seven separate occasions to treat distinct illnesses and injuries. Crane was discharged from ACMC back to LCC for a period of at least 60 days between each separate inpatient hospitalization. After Crane’s death, Ruth Friedberg (defendant), the executor of Crane’s estate, petitioned for review of the secretary of Health and Human Service’s (secretary) (plaintiff) final decision denying coverage for Crane’s admissions to ACMC after July 1977. The secretary held that Crane had exceeded her allotted 150 days of inpatient coverage per spell of illness by July 1977 and that all subsequent inpatient admissions were not entitled to coverage. Friedberg argued that Crane was entitled to coverage for all seven ACMC admissions because Crane spent at least 60 days in custodial-only care at LCC between each inpatient admission. The district court reversed the secretary’s denial of coverage, holding that custodial care in a SNF did not constitute a continuation of a spell of illness. The secretary appealed.

Rule of Law

Issue

Holding and Reasoning (Per curiam)

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