The New Jersey Long Term Care Ombudsman (NJLTCO) is part of a national advocacy program, authorized by the federal Older American’s Act.

The NJLTCO advocates for residents of long-term care facilities by investigating and resolving complaints made by or on behalf of those residents.

Examples of the types of complaints commonly investigated by the NJLTCO:

  • Financial exploitation
  • Improper transfer or discharge
  • Inappropriate use of chemical or physical restraints
  • Physical, verbal or mental abuse, deprivation of services necessary to maintain residents’ physical and mental health or unreasonable confinement
  • Poor quality of care, including inadequate personal hygiene and slow response to requests for assistance
  • Violation of residents’ rights or dignity

The NJOLTCO frequently encounters inappropriate financial/billing practices by nursing home staff and/or their financial agents. Some examples of questionable practices:

 Asking a nursing home resident to sign documents he or she doesn’t understand that give the nursing home access to or control over the resident’s income or financial accounts.

 Submitting change of address requests to a resident’s financial institution without the resident knowing or being capable of authorizing.

 Asking the Social Security Administration to send a resident’s social security income directly to the nursing home (or billing company) instead of to the resident, without informed consent of the resident, resident’s representative, or legal representative.

 Moving large amounts of money from a resident’s account to the nursing home before the resident has even accrued a debt with the nursing home or withholding Personal Needs Allowance funds for outstanding balances due to the facility.

 Moving or threatening to move a resident to a nursing home in a different county in order to “speed up” Medicaid approval.  Receiving a resident’s income for weeks or months after the resident has moved out or asking for “proof” that the resident “needs” that income before releasing it.

 Purchasing pre-planned funeral arrangements or cancelling health and life insurance policies without informed consent of the resident, resident’s representative, or legal representative.

 Petitioning courts to serve as Medicaid Representative when the resident already has a guardian or submitting Medicaid applications for residents who have guardians.

Importantly, non-lawyer Medicaid Representatives/Advisors/Application Assistors may provide limited services, they cannot provide advice in matters that require the professional judgment of a lawyer. Services that require the professional judgment of a lawyer include strategies (through wills, trusts, powers of attorney, guardianships, asset transfers, spend-down of resources, gifts, estate planning and tax implications, and marriage and divorce) to facilitate Medicaid eligibility. In New Jersey, providing advice on strategies to become eligible for Medicaid is prohibited because it involves the unauthorized practice of law.

The NJ Office of the Long-Term Care Ombudsman’ pamphlet on questionable nursing home financial practices –

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Attached is a news article about a company called Advanta Medicaid Specialists, a so-called specialist in helping to obtain Medicaid benefits for nursing facility residents. The company, comprised of a non-attorney employees, convinced the families of many nursing home residents to retain the company to assist with filing for nursing facility Medicaid benefits, but failed to deliver the promised services while retaining the many thousands of dollars paid by the families –

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