United States District Court, W.D. Virginia, Lynchburg Division
Guggenheimer Health & Rehabilitation Center, authorized representative for Charles E. Bedat, Plaintiff,
Daniel Cary, in his official capacity as Secretary of Health and Human Services, ET AL., Defendants.
K. MOON SENIOR UNITED STATES DISTRICT JUDGE.
Health & Rehabilitation Center (“the
Center”), purporting to act for Charles E. Bedat, filed
suit against Virginia's Secretary of Health and Human
Resources and its Director of the Department of Medical
Assistance Services (collectively, “Defendants”).
The Center is a long-term nursing home, and Mr. Bedat is an
elderly, disabled resident who receives 24-hour care from it.
The crux of the complaint is that Defendants' denial of
Bedat's application for Medicaid benefits-which he needs
to pay the Center-violated due process, various provisions of
Medicaid, the Americans with Disabilities Act, and the
Rehabilitation Act. The Center attached to its complaint an
undated “designation of authorized
representative” form signed by Bedat, which the Center
contends authorizes it to sue on his behalf. Defendants moved
to dismiss on several grounds, e.g., sovereign
immunity, estoppel, Rooker-Feldman doctrine,
Younger abstention, and failure to state a claim.
They also argued that the Center cannot litigate Bedat's
rights and thus lacks standing.
complaint alleges that Bedat suffered “dementia and
other cognitive” ailments and that he “lacked
mental capacity and/or the ability to manage his own affairs,
” thus negating the validity of the designation form
and the Center's concomitant standing to sue on his
behalf. Even if Bedat's incapacity does not undercut the
designation form, then the executed, dated, notarized, and
heretofore unrevoked power of attorney he granted to attorney
Henry C. Devening before the initiation of this lawsuit does.
Also, the Center does not have organizational standing.
Without a basis to litigate Bedat's claims for him, the
Center lacks standing, and the case must be dismissed without
are two kinds of motions to dismiss under Rule 12(b)(1) for
lack of jurisdiction. Both are implicated here. When a
defendant makes a facial challenge to jurisdiction, the
familiar Twombly/Iqbal standard applies-the
court assumes the truth of all well-pled facts, disregards
legal conclusions, and analyzes whether the facts satisfy the
law's requirements for jurisdiction. See Ben-Davies
v. Blibaum & Assocs., P.A., 695 Fed.Appx. 674, 676
(4th Cir. 2017) (quoting Kerns v. United States, 585
F.3d 187, 192 (4th Cir. 2009)). In a factual challenge,
however, a defendant asserts that some extrinsic fact
undermines jurisdiction, in which case the court regards
“the pleadings' allegations as mere evidence on the
issue” and may “consider materials outside the
pleadings.” The Piney Run Pres. Ass'n v. Cty.
Comm'rs of Carroll Cty., Md., 523 F.3d 453, 459 n.6
(4th Cir. 2008); Richmond, Fredericksburg & Potomac
R. Co. v. United States, 945 F.2d 765, 768 (4th Cir.
Center is a Virginia corporation located in Lynchburg,
Virginia. (Complaint ¶ 1). Bedat was admitted to the
Center on January 11, 2016, and has received care from it
since that date. (Id. ¶ 12). According to the
complaint, Bedat “is an elderly, disabled man who
suffers from various medical conditions, including dementia
and other cognitive physical ailments, that require him to
receive twenty-four hour care and assistance.”
(Id. ¶10). He allegedly “lacked mental
capacity and/or the ability to manage his own affairs.”
(Id. ¶ 11).
Center alleges that “Bedat designated [the Center] as
his Authorized Representative” sometime before October
3, 2016. (Complaint ¶¶ 1, 19). The basis of this
authorization is a form attached to the complaint and signed
by Bedat. (Dkt. 1-1). The form states that it
“authorizes specific person(s) from the facility to
handle the resident's dealings with Medicaid.”
(Id.). It purports to authorize “Vicky
Campbell” at the Center “to be [Bedat's]
authorized representative, ” and “also
authorize[s] any employees or agents of the [Center],
including attorneys hired by the [Center], to now represent
[Bedat] when . . . taking action as necessary to establish
[his] eligibility for Medicaid.” (Id.). The
form further states that Bedat “understand[s] and
agree[s] that any legal proceeding in regards to [his]
Medicaid eligibility may be pursued either in [his] name or
in the name of the facility, ” and it purports to waive
“any potential or actual conflicts of interest, which
may exist from this appointment of authorized
2016, six months after his admission to the Center, Bedat
applied for Medicaid coverage. (Complaint ¶ 14). But for
the denial of coverage, Medicaid would have paid Bedat, funds
which then would have paid for his care at the Center.
(Id. ¶¶ 13, 46). The Center alleges that
Defendants denied Bedat coverage in September 2016 because he
was “over resourced, ” (id. ¶ 16),
and Bedat undertook an administrative appeal, which was
denied on March 1, 2017. (Id. ¶¶ 18-24).
The Center then filed this lawsuit through counsel in
default rule in federal court is that one may litigate only
his own rights and interests, not those of others.
See, e.g., Domino's Pizza, Inc. v.
McDonald, 546 U.S. 470, 479 (2006); Laird v.
Tatum, 408 U.S. 1, 13-14 n.7 (1972); Freilich v.
Upper Chesapeake Health, Inc., 313 F.3d 205, 215 (4th
Cir. 2002) (holding doctor had no standing to assert
patients' ADA claims and observing “longstanding
principle that third parties themselves usually will be the
best proponents of their own rights”); Smith v.
Frye, 488 F.3d 263, 272 (4th Cir. 2007); Myers v.
Loudoun Cty. Pub. Sch., 418 F.3d 395, 400 (4th Cir.
2005); Hummer v. Dalton, 657 F.2d 621, 625-26 (4th
Cir. 1981) (holding plaintiff cannot act “as a
knight-errant” for others). “To have standing, it
is elementary that the [plaintiff's] own interests must
be implicated.” Gratz v. Bollinger, 539 U.S.
244, 289 (2003) (Stevens, J., dissenting).
Center, however, claims that it may litigate on behalf of Mr.
Bedat because it is, as the complaint's caption states,
his “authorized representative.” That
authorization, it says, springs from the designation of
authorized representative form.
Virginia, a person lacking mental capacity cannot enter into
a valid agreement. E.g., Edmunds v.
Chandler, 203 Va. 772, 777 (Va. 1962) (affirming lack of
mental capacity for person with IQ of 51 and mental
capability of a seven-year-old). One is competent to enter an
agreement if he or she “has sufficient mental capacity
to understand the nature of the transaction and agree to its
provisions.” Jones v. Peacock, 267 Va. 16, 19
(Va. 2004). And, as the Center correctly observes, every
adult is presumed competent. Brown v. Resort
Developments, 238 Va. 527, 529 (Va. 1989); Bigger v.
Doe, 960 F.2d 145, at *4 (4th Cir. 1992) (applying
Virginia law to determine competency); Bailey v.
Bailey, 54 Va.App. 209, 215 (Va. Ct. App. 2009);
Drewry v. Drewry, 8 Va.App. 460, 467 (Va. Ct. App.
1989); e.g., Chesapeake & O. Ry. Co. v.
Mosby, 93 Va. 93, 24 S.E. 916, 916 (Va. 1896). But the
face of the complaint plainly alleges that Bedat was stricken
with “dementia” and other cognitive ailments,
“lacked mental capacity, ” cannot manage his own
affairs, and requires 24/7 care and assistance. (Complaint
¶¶ 10-11). The Court holds that these allegations
are overwhelmingly sufficient to rebut the presumption of
Center's brief resists this conclusion, asserting that
“[n]owhere does Mr. Bedat allege that he lacks
all mental capacity or that he was incapable of
any type of competency.” (Dkt. 18 at ECF 17
(emphasis added)). The Center cannot run away from the
complaint's allegations so easily. Ashcroft v.
Iqbal, 556 U.S. 662, 679 (2009) (requiring courts to
“assume the veracity” of “well-pleaded
factual allegations”); Ben-Davies, 695
Fed.Appx. at 676 (quoting Kerns v. United States,
585 F.3d 187, 192 (4th Cir. 2009)) (instructing that facial
challenge to jurisdiction requires taking facts in the
complaint as true). The facts alleged simply don't bear
the fine distinctions and careful parsing the Center places
on them. It cannot plead without limitation or nuance (and
with a Rule 11(b) certification) that Bedat lacked mental
capacity, could not manage his own affairs, and has dementia,
and then-when the obvious issue of Bedat's capacity is
raised-backtrack in its brief. “It is well-established
that parties cannot amend their complaints through
briefing.” vonRosenberg v. Lawrence, 849 F.3d
163, 167 n.1 (4th Cir. 2017) (quoting S. Walk at
Broadlands Homeowner's Ass'n, Inc. v. Open Band at
Broadlands, LLC, 713 F.3d 175, 184 (4th Cir. 2013)).
Confronted with the complaint's allegations, the Center
can only hypothesize about Bedat's mental state. Without
citation to anything (be it the complaint or otherwise), the
Center asserts Bedat “still possessed sufficient
competency to the point that a form, benefitting him and not
adverse to his interests, could be explained to him and
knowingly executed by him.” (Dkt. 18 at ECF 17
(emphasis added)). The Court declines to credit such
speculation against the complaint's contrary, clear, and
one assumes Bedat was competent to assign power to act on his
behalf, Defendants point out another problem, one the Court
considers a factual challenge to jurisdiction. Defendants
provided a copy of a power of attorney (“POA”)
from Bedat to attorney Henry C. Devening. (Dkt. 11-8). The
POA authorizes Devening “to transact any and all of
[Bedat's] business and to do and perform all things and
acts relating to my property.” (Id. at 1). The
POA includes the power to collect, “demand[, ] and sue
for” any interests, monies, or sums which may become
due to Bedat; “execute and perform all and every other
act or acts” in furtherance of the “full and
complete power to handle any of [Bedat's] business or to
deal with any and all of [his] property of any kind”;
“make health care decisions for” Bedat; have
access to his medical records; admit Bedat to hospitals,
nursing homes, and hospice; and “do any and all things
which, in the opinion of [Bedat's] attorney, will be in
[Bedat's] best interests.” (Id. ...