We just won another Medical Assistance appeal issue. In this case, Medical Assitance was initially denied for nursing home benefits and the son of the Medical Assistance applicant was handed an invoice from the nursing home for over $100,000. Needless to say, he was upset. We were able to successfully argue that that the transactions at issue were not Medicaid Penalty transfers and that full Medical Assistance benefits should have been granted from day 1. We received the Administrative Law Judge opinion today removing approximatley 98% of the penalty. Client is happy.
A very common situation for my clients (or potential clients) find themselves in is the chaotic situation of transferring their parent from a hospital to an area nursing home for rehabilitation. It is in this situation, when emotions are high, people are tired, that the nursing home will, at the last second, wants the son or daughter admitting the parent to sign a 60+ page nursing home contract. Of course, the nursing home contact (usually the nursing home admissions director) is very friendly and advises that “don’t worry” this is just for your parent’s assets and does not obligate you to use your own funds for nursing home expenses. Often times the nursing home will demand that the contract be signed before admission (even if the hospital is in the process of discharging from the hospital). Often times this is an extremely hectic situation and the last thing that is on the son’s or daughter’s mind is a careful review of the nursing home contract. To be clear: under no circumstances should the contract be signed until an elder law attorney reviews the contract. It is a very routine question to ask the nursing home to allow time for their elder law attorney to review the contract. No matter how friendly the director of admissions person is, if there is a shortfall in payment or the Medical Assisstance application goes awry, the nursing will look for however signed the contract to pay the nursing home bill in full. I had a recent case where the nursing home assured the son that there was nothing to worry about and had him sign the contract in his name. The nursing home handeled the Medical Assistnace application. Unfortunately, the Medical Assistance application was denied. The next day, the nursing home delivered an invoice to the son for immediate payment for $100,000 for unpaid nursing home bills. Nursing home contracts are sophisticated documents with good attorneys hired by the nursing home that will use this contract against you. It is absolutely critical that an elder law attorney review that contract as soon as possible. If the contract is already signed, then the situation becomes more complex. In either event, a competent elder law attorney should be immediately contacted.