CHARLESTON, W.Va. -- The state of West Virginia tried to kick her out, but a judge has ruled that 77-year-old Helen Shank gets to stay at Golden Living Center in Morgantown.

Kanawha County Judge Tod Kaufman ruled on Wednesday that Medicaid must continue providing nursing home care for Shank, who is mentally ill and also a "brittle diabetic," according to court papers.

Kaufman overruled a decision by the West Virginia Department of Health and Human Services to take federal Medicaid benefits away from Shank, despite recommendations by several of her physicians and psychiatrists.

The case could have implications for other seniors with mental illness living in nursing homes, according to Shank's lawyer, Daniel Staggers of Keyser.

Shank has lived in the Golden Living Center since October 2004. But last year, a DHHR evaluator said she no longer qualified for nursing home care.

The DHHR decision to deny Shank long-term care benefits was upheld by State Hearing Officer Thomas E. Arness on October 20.

After that ruling, Kaufman issued a retraining order against DHHR on December 26, preventing the agency from taking Medicaid benefits away from Shank while her legal appeal before him was pending.

On Wednesday, Kaufman ruled Arness "abused his discretion in concluding that Ms. Shank was medically ineligible for Medicaid Long-Term Care (nursing facility) benefits."

In his legal order, Kaufman noted Shank "has been in and out of mental health and nursing facilities her entire adult life."

Dr. Ward Paine, a physician who treated Shank at the Golden Living Center, said she would be at a "very high risk of hospitalization" if she were released from the home.

Others agreed, including: Dr. Pamela Sullivan, another physician who saw Shank, and Dr. Janis Boury, a psychologist and case manager who gave Shank a mental-health evaluation in June 2008 after she was briefly admitted to Chestnut Ridge Hospital in Morgantown.

CHARLESTON, W.Va. -- The state of West Virginia tried to kick her out, but a judge has ruled that 77-year-old Helen Shank gets to stay at Golden Living Center in Morgantown.

Kanawha County Judge Tod Kaufman ruled on Wednesday that Medicaid must continue providing nursing home care for Shank, who is mentally ill and also a "brittle diabetic," according to court papers.

Kaufman overruled a decision by the West Virginia Department of Health and Human Services to take federal Medicaid benefits away from Shank, despite recommendations by several of her physicians and psychiatrists.

The case could have implications for other seniors with mental illness living in nursing homes, according to Shank's lawyer, Daniel Staggers of Keyser.

Shank has lived in the Golden Living Center since October 2004. But last year, a DHHR evaluator said she no longer qualified for nursing home care.

The DHHR decision to deny Shank long-term care benefits was upheld by State Hearing Officer Thomas E. Arness on October 20.

After that ruling, Kaufman issued a retraining order against DHHR on December 26, preventing the agency from taking Medicaid benefits away from Shank while her legal appeal before him was pending.

On Wednesday, Kaufman ruled Arness "abused his discretion in concluding that Ms. Shank was medically ineligible for Medicaid Long-Term Care (nursing facility) benefits."

In his legal order, Kaufman noted Shank "has been in and out of mental health and nursing facilities her entire adult life."

Dr. Ward Paine, a physician who treated Shank at the Golden Living Center, said she would be at a "very high risk of hospitalization" if she were released from the home.

Others agreed, including: Dr. Pamela Sullivan, another physician who saw Shank, and Dr. Janis Boury, a psychologist and case manager who gave Shank a mental-health evaluation in June 2008 after she was briefly admitted to Chestnut Ridge Hospital in Morgantown.

Dr. Logan Graddy, a psychiatrist at West Virginia University Hospital, diagnosed Shank as suffering from developing dementia, "a severe, persistent and progressive psychiatric illness."

In his legal order, Kaufman stated DHHR failed to follow federal Medicaid rules when it attempted to cut Shank's benefits.

Michael Bevers, a lawyer from the attorney general's office who represented DHHR, argued before Kaufman in December that Medicaid should not continue to pay for Shank to stay at the Golden Living Center.

Bevers previously declined to discuss the case.

For Shank to qualify for those benefits, Bevers argued, she must to fail to perform five activities of daily living: bathing, grooming, dressing, continence and orientation.

Those "standards" are contained in the West Virginia Medicaid manual.

When Kaufman granted his December injunction to keep Shank at Golden Living, he noted those activities were all related to physical disabilities.

That five-part state standard, Kaufman added, fails to consider other impacts suffered by patients with mental illnesses or diseases like cancer.

In his Wednesday ruling, Kaufman wrote, "The U.S. Congress defined a nursing facility as an institution which is primarily engaged in providing ... health-related care and services to individuals who because of their mental or physical conditions require care and services which can be made available to them only though institutional facilities."

Shank's failure to meet "the minimum five daily living deficits," which do not include any psychological problems, does not make her ineligible to receive Medicaid benefits under federal guidelines, Kaufman ruled.

Patsy Shank, her daughter, testified at the DHHR administrative hearing on October 14 that she had tried to care for her mother at her home without success.

DHHR can appeal Kaufman's ruling to the state Supreme Court, but has not done so yet.