A New York trial court entered judgment against a woman who refused to contribute to her spouse’s nursing home expenses, finding that because she had adequate resources to do so, an implied contract was created between her and the State of New York entitling the state to repayment of Medicaid benefits it paid on the.. read more →

McHugh Fuller, a law firm which focuses on nursing home abuse and neglect, ran a full-page ad in The Toccoa Record, a Georgia newspaper. The ad stated that Heritage Healthcare of Toccoa, a nursing home owned by PruittHealth, was cited for deficiencies in the care of its residents. Also in the ad, the law firm invited.. read more →

A New Jersey appeals court ruled that payments to the spouse of a Medicaid recipient from an annuity purchased with the spouse’s “resource allowance” were properly considered “income” to the spouse under the Medicaid rules. J.G. v. Division of Medical Assistance and Health Services J.G., who was married to M.G. for 67 years, suffered from Alzheimer’s.. read more →

In this case, a New Jersey appeals court held that a disabled New Jersey resident eligible for Personal Care Assistance (PCA) services since 2009 was no longer eligible for PCA services under the Medicaid requirements. J.R. v. Division of Medical Assistance and Health Services, Docket No. A-0648-14T3 (App. Div.,  April 18, 2016 J.R. was diagnosed.. read more →

The New York State Bar Association has issued a brochure to help consumers understand the benefits of utilizing an elder law attorney to assist (1) in the preparation of Medicaid applications and (2) in planning for yourself or a loved one to protect assets when seeking eligibility for public benefits based upon financial need. The.. read more →

The Alzheimer’s Association has issued its 2016 Alzheimer’s Disease Facts and Figures report. The report is “a statistical resource for U.S. data related to Alzheimer’s disease, the most common cause of dementia, as well as other dementias.” Aside from providing a definition of Alzheimer’s disease (“Alzheimer’s disease is a degenerative brain disease and the most common cause of.. read more →

A New Jersey appeals court held that a needs-based credit applied to the accounts of residents of an assisted living facility counts as income for Medicaid eligibility purposes. R.W. v. Division of Medical Assistance and Health Services (N.J. Super. Ct., App. Div., No. A-4911-13T1, Feb. 22, 2016). This case was brought by several residents of the.. read more →

After he was admitted to a nursing home in 2013, petitioner, R.P., accrued unpaid bills of $264,146 for nursing care services. As a result, three successive Medicaid applications were filed on R.P.’s behalf. It was undisputed that R.P. lacked the capacity to assist with any of the Medicaid applications. The first Medicaid application, filed in.. read more →

M.S. is a 73-year old residing in at a long-term care facility. She is a hemiplegic who suffers from obesity, diabetes, arthritis, osteoporosis and COPD. Because she is completely paralyzed on her left side, she had been using a manual one-arm wheelchair. She filed an application to the Division of Medical Assistance and Health Services.. read more →

Happy New Year to clients, supporters, friends and readers. Last month, an article on this blog ranked the 25 most popular blog posts and website articles on the Vanarelli Law Office website in 2015. Since then, I decided to narrow my focus a little. In this post, I focused solely on blog posts, and created.. read more →

Nancy Gimenez-Watson was a resident of Brighton Gardens of Edison, an assisted living facility (ALF) operated by Sunrise Senior Living and its parent company. Mrs. Watson was in the “Reminiscence Plus” program for residents diagnosed with Alzheimer’s disease or dementia. In April 2008, Mrs. Watson choked on her food. After a Brighton Gardens nurse administered.. read more →

The Superior Court of New Jersey, Appellate Division, affirmed a decision of the Director of New Jersey Medicaid reversing a ruling of an Administrative Law Judge (ALJ) who reduced C.W.’s Medicaid ineligibility penalty previously assessed for transferring assets for less than fair market value. C.W. v. Division of Medical Assistance and Health Services, Docket No. A-2352-13T2.. read more →

Plaintiff Wilson Bermudez was a patient at Kessler Institute for Rehabilitation’s West Facility for five weeks, during which his treatment included 24-hour rehabilitative nursing “to address complex medical, nursing, and rehabilitative needs.” When Bermudez later sued Kessler for injuries he allegedly sustained, he included claims under the New Jersey Nursing Home Responsibilities and Rights of.. read more →

In Singer v. Emeritus Senior Living Center, following a series of falls and the later death of Elizabeth Singer, her family sued the Emeritus Senior Living Residence, claiming that the last of those falls led to Mrs. Singer’s cognitive decline and hastened her death. Plaintiff’s expert was a board certified psychiatrist. At the conclusion of.. read more →

In DeSimone v. Springpoint Senior Living, the son of a deceased CCRC resident sued the owner/operator and CEO of five continuing care retirement communities (“CCRCs”) in New Jersey. The suit, which was brought individually and as a class action, alleged violations of the CCRC Act and the Consumer Fraud Act (“CFA”), in addition to common.. read more →

After reading about the Macallan Group d/b/a/ Home Care Assistance of Red Bank, New Jersey from a “value pack coupon” she received, Gale Rosenthal contracted with them to provide home aides to assist her in her home. According to the coupon advertisement she received, the aides were bonded and insured. After she discovered that jewelry.. read more →

New Jersey’s Appellate Court ruled that, under the appropriate circumstances, it is equitable to require a disabled 89 year old veteran to receive end-of-life care in a VA facility against his wishes rather than at home in order to use his limited income to continue paying alimony to his ex-wives. .Rizzolo v. Rizzolo, 2015 NJ Super.. read more →

A New York trial court ruled that residents of a continuing care retirement community (CCRC) breached their contract when they applied for Medicaid before spending down their assets.  Good Shepherd Villages v. Yezzi (NY Slip Op 51900 – NY: Supreme Court, Broome 2014).  Peter and Hazel Yezzi signed a contract with Good Shepard Village (the “Good.. read more →

An Administrative Law Judge found a Medicaid applicant eligible for benefits even though the applicant was impoverished because her spouse gambled away a substantial inheritance. M.Y v. Union County Board of Social Services M.Y., a 96 year old woman, suffered from dementia, could not care for her own needs, and was destitute. She was admitted.. read more →

To be eligible for Medicaid, applicants must meet two requirements: financial requirements and medical requirements. I’ve posted many articles on this blog over the years discussing the financial requirements of the Medicaid program in New Jersey, and offering various strategies to accelerate financial eligibility for the program. However, I have surprising few posts discussing Medicaid’s.. read more →

As discussed in a prior blog post, a major overhaul of Medicaid will be introduced in New Jersey in the coming months. The new Medicaid program is called Managed Long Term Services and Supports (MLTSS). The MLTSS implementation date has been repeatedly adjourned, and the next date scheduled to put the new program into effect.. read more →

An appeal of a claim for Medicaid benefits that was filed late may be considered when the applicant shows that the filing deadline should be extended due to “extraordinary and extenuating circumstances.” Reuter v. Division of Medical Assistance and Health Services, Docket No. A-0514-13T2 (App. Div., October 17, 2014) Plaintiff, Greta Reuter, a nursing home.. read more →

Gifts made during the Medicaid look-back period result in a penalty, or period of ineligibility, unless the applicant can prove that the gifts were made exclusively for some purpose other than to qualify for Medicaid. S.L. v. Division of Medical Assistance and Health Services, Docket No. A-3520-11T4 (App. Div., September 2, 2014) In December 2009,.. read more →

The Medicaid programs in New Jersey which help residents pay long-term care costs are about to get a major overhaul. Currently, there are three (3) Medicaid programs in New Jersey that pay for long-term care costs. The Medicaid-Only Medicaid program pays the costs of caring for nursing home residents. A companion program, Global Options for.. read more →

A nursing home resident’s adult child who signs an admission agreement as the “Responsible Party” can be sued in his/her individual capacity for services rendered to the resident, if the adult child fails to use the resident’s financial resources to pay for care provided by the facility. Manahawkin Convalescent v. O’Neill, 217 N.J. 99 (2014)… read more →