For the first time, the Division of Medical Assistance and Health Services (DMAHS), New Jersey’s Medicaid agency, held that an applicant for nursing home Medicaid was eligible for benefits despite the fact that she made a substantial gift within the look-back period and owned an $80,000 annuity. M.W. v. Division of Medical Assistance and Health.. read more →
The New Hampshire legislature has enacted a new law that allows nursing homes to sue anyone who received an asset transfer from a nursing home resident, and also makes the resident’s fiduciaries liable for the cost of care under certain circumstances. This new legislation became law on July 2, 2013. The law, enacted under Title.. read more →
In an August 29, 2013 unpublished decision, the Appellate Division considered and affirmed the trial court’s denial of a nursing home’s motion to dismiss a personal injury and wrongful death claim brought by the estate of a former resident. Levonas v. Regency Heritage Nursing and Rehabilitation Center (Docket No. A-4995-11T4, Aug. 29, 2013). In Levonas, the.. read more →
Reversing state agency and appeals court rulings, the highest court of the State of Washington ruled that a guardian cannot be charged with neglect based on the guardian’s good-faith decision to provide care for the ward in her home rather than place her in a nursing home against the ward’s wishes. Raven v. Department of Social and.. read more →
A federal district court judge in New Jersey granted a Medicaid applicant’s motion for a preliminary injunction, thereby enjoining the State from counting an annuity owned by her husband as an available resource in determining her eligibility for Medicaid. Flamini v. Velez, Civil No. 1:12-cv-07304 (D.N.J. July 19, 2013) Elizabeth Flamini entered a skilled nursing.. read more →
A Medicaid applicant who made payments to her daughter for more than four years and claimed those payments were made to cover the cost of monthly payments for her mentally ill daughter’s rent could not prove the payments were made for a purpose other than to qualify for Medicaid because she did not prove that.. read more →
A Rhode Island trial court holds that a niece who signed a nursing home admissions agreement on behalf of her aunt did not sign as a responsible party, and is therefore not personally liable for her aunt’s unpaid nursing home bill. Sunny View Nursing Home, Inc. v. Gorman (R.I. Super. Ct., No. KC 11-0491, Dec. 4,.. read more →
New Jersey’s Medicaid rules are complicated, and seem like they’re always changing. One such change in the rules that occurs on a regular basis is the State Medicaid agency’s amendment to the Medicaid program’s “penalty divisor.” On December 10, 2012, a Medicaid Communication, or notice, was released by the Division of Medical Assistance and Health.. read more →
An appeals court in New Jersey held that a nursing home resident’s adult child who signed a nursing home admission agreement as the “Responsible Party” can be sued in his/her individual capacity for monies owed to the facility for services rendered to the resident if the adult child fails to use the resident’s financial resources.. read more →
Federal district court in New Jersey denied a Medicaid applicant’s request for an injunction directing the state to disregard his wife’s purchase of a life estate in their daughter’s home when determining his eligibility for nursing home Medicaid benefits. The Court ruled that issues of fact were in dispute, preventing an injunction from being issued… read more →
The Director of New Jersey Medicaid recently decided that, when a couple is institutionalized, the resources of the couple are not combined when determining Medicaid eligibility. Rather, the resources of each spouse must be considered separately. Therefore, when only one spouse applies for Medicaid benefits and that spuse’s resources alone do not exceed the resource.. read more →
For most of her life, V.P. resided in her home with her adult son, R.P. V.P. suffered from many significant impairments, including spinal scoliosis and other degenerative diseases of the spine, hypertension, diabetes, gastroesophageal reflux disease, anxiety, and frequent urinary tract infections. As a result of her poor health, V.P. relied upon her son R.P… read more →
A New Jersey appeals court held that a Medicaid applicant who transferred money to her daughter and then a few months later received a life estate in her daughter’s home made a gift to the daughter rather than engage in a bona fide transaction involving the purchase of a life estate, resulting in the imposition.. read more →
Ohio’s First District Court of Appeals has joined other state and federal courts across the country in ruling recently that Ohio improperly imposed a penalty period on a Medicaid applicant whose wife purchased an annuity during the look-back period. The Court held that Ohio’s regulations regarding the purchase of annuities are improperly restrictive, and are.. read more →
A.D., a retired physician, began residing at Bergen Regional Medical Center (Bergen Regional), a nursing home, in October 2004. She was 80 years old at the time. She began receiving Medicaid benefits in late 2004. In 2006, the Bergen County Board of Social Services (Board) discovered two Keogh accounts at Citibank in A.D.’s name valued.. read more →
In an August 10, 2010 opinion that was approved for publication, the New Jersey Appellate Division addressed the Federal Arbitration Act (“FAA”) and its impact on New Jersey’s Nursing Home Responsibilities and Rights of Residents Act (“Residents’ Rights Act”). Estate of Ruszala v. Brookdale Living Communities, Inc., No. A-4403-08T1 (N.J. Super. App. Div. Aug. 10,.. read more →
Heriberto Pumarejo transferred the ownership of his home to his son, Herbert Pumarejo, Jr., for one dollar. About two years later, Mr. Pumarejo became a patient at the Arnold Walter Nursing Home. Kathryn Pumarejo, Herbert’s wife and the resident’s representative, signed an agreement in which she agreed to pay all nursing home bills that were.. read more →
In what may be considered a victory of judicial deference over equity, this week our Appellate Division affirmed Medicaid’s denial of eligibility to an incapacitated applicant, based on the applicant’s ownership of assets that she was not aware she owned. In W.B. v. Division of Medical Assistance and Health Services (“DMAHS”), No. A-5658-07T1 (N.J. App… read more →
(The A.N. case, described below, was decided on administrative appeal in 2007 and affirmed the denial of Medicaid benefits. I represented the Medicaid applicant, A.N. You may ask why I would resurrect an administrative decision more than 2 year old which I lost. It’s a legitimate question. The answer is that I believe the case will.. read more →
Each of us who have been forced to admit a loved one into a nursing home or care facility due to chronic long-term illness hopes and expects that he or she will receive good care there. But what does good long-term care look like? Would we recognize good care if we saw it? An interesting.. read more →
The case of Detloff v. Absecon Manor Nursing Center, Docket No. A-5941-07T2 (App. Div., August 4, 2009) arose out of the care and treatment provided to decedent while she was admitted at defendant Absecon Manor, a long-term care facility. Plaintiff, executrix of the estate of Mary Mazzei, filed a complaint alleging nursing malpractice supported by.. read more →
Here is updated information on trends in the characteristics and numbers of nursing home residents in the United States. The Division of Health Care Statistics (DHCS), the National Center for Health Statistics, has announced the internet release of Series 13, No 167 of the National Nursing Home Survey (NNHS) Overview Report for the year 2004… read more →
Over the past several years, nursing homes have become dumping grounds for young and middle-age people with mental illness, according to Associated Press interviews and an analysis of data from all 50 states. And that has proved a prescription for violence, as Jackson’s case and others across the country illustrate. Younger, stronger residents with schizophrenia,.. read more →
This year, the Guardianship Association of New Jersey, Inc. (GANJI) held its 13th Annual Conference on Guardianship on October 30th at the New Jersey Law Center in New Brunswick, NJ. The conference was entitled “Surrogate Decision-Making: A Holistic Approach.” The Program Schedule is attached here – 13th-annual-conference-on-guardianship-10-31-08. As can be seen, there was a wide.. read more →
The word is really starting to get out about the collaborative divorce process! The October 17th edition of the Family Circle Magazine has a GREAT article on collaborative divorce entitled “The Friendly Divorce”. The article identifies four (4) benefits to couples who choose to divorce using the collaborative divorce process: Less Bitterness; Lower Expenses; Quicker Results; and, a Custom Solution… read more →
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