After a trial court, expressing its disagreement with the legislative policy underlying special needs trusts, placed only a portion of the net settlement proceeds of a lawsuit brought on behalf of a severely disabled person into a special needs trust and ordered the remaining funds be paid directly to the disabled person, resulting in the.. read more →
An Appeals Court affirmed an agency decision denying a Medicaid applicant’s request for a fair hearing because it was filed more than seven months after a denial notice was sent advising him he had twenty days to request a fair hearing, even though the notice was sent directly to the applicant rather than to his.. read more →
A.F. is a quadriplegic as a result of an accident that occurred 20 years ago. She is totally disabled and needs personal assistance to perform all activities of daily living. For many years, A.F. has relied upon Medicaid benefits to provide her with the assistance she desperately needs. Under regulations, the Medicaid agency must re-determine.. read more →
A New Jersey appeals court ruled that a Medicaid applicant who began paying her daughter after the daughter provided two years of free caregiving did not rebut the presumption that a transfer of assets to a relative who previously provided services for free is an uncompensated transfer of assets for Medicaid purposes. E.B. v. Division of.. read more →
The veteran in this case had been residing in a medical facility operated by the Department of Veterans Affairs (VA) for several years. He was incompetent and had no dependents. The veteran had been receiving VA pension benefits based upon financial need. The Director of the VA facility was serving as veteran’s payee. The veteran.. read more →
W.M. was admitted to a nursing home in Cranford, New Jersey. In December 2013, W.M.’s wife, E.M., filed a Medicaid application for W.M. with the local Medicaid agency, the Union County Division of Social Services (“the County”). In January 2014, the County requested additional information and/or documents about W.M.’s income, life insurance, and household expenses… read more →
A.F. was diagnosed with Alzheimer’s disease and osteoarthritis in 2007. She also had difficulty walking. Her husband, T.F., was in failing health, with Parkinson’s disease and COPD, and had other mobility issues. Beginning in 2012, T.F. could not care for A.F. due to his own health problems. T.F. died of lung cancer in 2015. J.F.,.. read more →
In September 2015, Y.M. was declared an incapacitated person, and the Office of the Public Guardian (OPG) was appointed as Y.M.’s guardian. Y.M. was a resident of Hudson View nursing home. The month after its appointment as guardian, OPG filed a Medicaid application on behalf of Y.M. After the application was denied, Hudson View filed.. read more →
The following blog post is adapted from an article on NJ.com: A few years ago, Tracey Mitchell’s dad needed to go into a nursing home. Mitchell had no complaints about the care he received, but three months before he died, a surprise arrived via regular mail. It was a lawsuit alleging Mitchell owed $49,000 to the.. read more →
If you are choosing a nursing home, a May 11, 2018 article by Paula Span in the New York Times suggests an interesting addition to your arsenal of information: the Yelp app. The article is No Luck Finding the Right Nursing Home Maybe Yelp Can Help According to Span, Yelp reviews are a useful addition, not.. read more →
Between April 2, 2018 and April 11, 2018, the New Jersey Superior Court, Appellate Division, issued six separate opinions involving Medicaid. While this is unusual, what is even more striking is that all six cases involve the same appellate court panel, and the same attorney representing each of the appellants. In these cases, the law.. read more →
After J.C. was admitted to a nursing facility, her son, S.C., submitted an application to the Camden County Board of Social Services for Medicaid benefits on her behalf. The county welfare board notified J.C. that she was eligible for long-term care benefits but her transfer of assets for less than full market value during the.. read more →
There were three Medicaid applications filed on behalf of E.M. The first was filed in 2012 by his daughter, after his admission to a subacute care center. At the time, E.M. was suffering from dementia and was on a ventilator and feeding tube. This Medicaid application was denied for failure to provide documents to Medicaid,.. read more →
Some states make it harder for those caring for an aging parent, according to a new survey by Caring.com. While some states were praised for providing an affordable and helpful environment for caregivers, other states ended up at the bottom of the affordability list. “It hasn’t always been so expensive, but the cost of caring.. read more →
A.M. appealed a gift penalty imposed by the Medicaid agency based on a transfer of assets. The penalty was imposed based on $100,000 in distributions to beneficiaries of an irrevocable trust established by A.M. with her assets. A.M. asserted that the transfer penalty was inappropriate because she established the trust and transferred assets into the.. read more →
A New Jersey appeals court upheld the denial of Medicaid benefits to an applicant who failed to provide necessary verifications, rejecting the claim that the Medicaid agency’s failure to assist with the application prejudiced the applicant. P.B. v. Division of Medical Assistance and Health Services (N.J. Super. Ct., App. Div., No. A-5405-15T2, Dec. 8, 2017). P.B.’s daughter.. read more →
Before Mr. Trotman was admitted to a nursing home, he resided in a home that he owned. He had difficulty maintaining the home and paying the bills, so his daughter began paying his bills in 2007. In December 2011, Mr. Trotman asked his daughter to assume full responsibility for the property, which then was also.. read more →
After being sued by Medicaid applicant in federal court, the Director of New Jersey Medicaid, who had previously denied benefits because the applicant transferred assets to a trust more than 5 years before, instead stated the application was denied because, under the terms of the trust, the trustee was permitted to pay the applicant’s rent… read more →
E.H. submitted a Medicaid application to the Hudson County Division of Welfare (HCDW) and designated Future Care Consultants (FCC) as her designated authorized representative (DAR). Shortly thereafter, the HCDW denied the application because E.H. failed to provide her husband’s bank records for the five-year look-back period. FCC appealed the denial, submitting a request for a.. read more →
Lawsuit for Unpaid Bills by Nursing Home Against Resident’s Power of Attorney Dismissed, and Attorneys Fees Awarded
A Superior Court judge in Ocean County dismissed a lawsuit filed by a nursing home for unpaid bills against a power of attorney appointed by a former resident, and ordered the nursing home to pay legal fees incurred by the power of attorney, ruling that the law prohibited the nursing home from requiring the power.. read more →
After being denied Medicaid because of a $70,000 joint bank account she maintained with her son, the Medicaid applicant, S.M., appealed the case to An administrative hearing. S.M. argued that Medicaid had failed to consider that her son was the sole source of $60,000 of those bank funds. After the ALJ affirmed Medicaid’s denial, and.. read more →
Nursing home resident Joseph Gamma died after falling off his bed at the facility. His estate sued the nursing home. One of the claims the estate asserted was that the nursing home had violated the New Jersey Nursing Home Responsibilities and Residents’ Right Act (“the Nursing Home Act”). At the conclusion of the trial, the.. read more →
Applying New Jersey’s filial support law, an appeals court in Pennsylvania affirmed a decision denying a Pennsylvania residential facility’s effort to hold the elderly New Jersey parents of an adult resident liable for the unpaid balance of his specialized services. Melmark v. Schutt (Pa. Super., No. 2253 EDA 2016, July 19, 2017). New Jersey resident Alexander (Alex).. read more →
A U.S. district court ruled that a group of Medicaid applicants do not have a private right of action to sue the state for not issuing Medicaid eligibility determinations with 45 days and that the applicants were not denied due process by the delay. Evangelical Lutheran Good Samaritan Society, Inc. v. Randol (U.S. Dist. Ct., D… read more →
In this case, the Division of Medical Assistance and Health Services (DMAHS), New Jersey’s state Medicaid agency, affirmed the denial of a Medicaid application filed by Grace M. Vinci (G.V.) by the Monmouth County Division of Social Services (MCDSS) finding that G.V. had resources in excess of $2,000 available to her, namely, resources contained in.. read more →
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