A New Jersey appeals court rules that a nursing home that sued a father who transferred his home to his daughter before he entered the nursing home and applied for Medicaid failed to prove the transfer was fraudulent. Future Care Consultants v. Abraham (N.J. Super. Ct., App. Div., No. A-1533-16T2, Dec. 18, 2017). Alwyn Trotman owned property in New Jersey. When he was 90 years old, he had trouble keeping up the property, so he asked his daughter, Barbara Abraham, to assume responsibility for it. In 2011, Mr. Trotman executed a deed giving Ms. Abraham a 99 percent interest in…
A Michigan appeals court affirms a trial court decision certifying a class of continuing care retirement community residents who are suing the community for breach of contract and fraud after the community refused to refund residents’ full deposits. Erma Rogers Revocable Trust v. Erickson Retirement Communities (Mich. Ct. App., No. 332495, Dec. 12, 2017). Erma Rogers moved into a continuing care retirement community (CCRC) and signed an agreement that required her to pay an entrance deposit of $125,000. The agreement stated that the deposit was refundable once someone else was occupying the residence. After Ms. Rogers died, the market price…
A U.S. district court rules that a hospital stay does not have to be covered by Medicare in order to qualify a beneficiary for post-hospital skilled nursing facility benefits as long as the hospital stay was medically necessary. Elder v. Hargan (U.S. Dist. Ct., W.D. N.Y., No. 16-CV-290-FPG, Jan. 26, 2018). Medicare recipient William Elder entered the hospital to treat broken bones in his leg. After 10 days, the hospital discharged Mr. Elder to a skilled nursing facility (SNF) for rehabilitative services. Medicare denied coverage for the SNF care, ruling that Mr. Elder did not have a qualifying hospital stay…
Answering a certified question from the U.S. Court of Appeals for the Ninth Circuit, the Oregon Supreme Court holds that the state’s elder financial abuse statute does not apply to a case where a long-term care insurance company allegedly acted in bad faith to delay and deny claims. Bates v. Bankers Life and Casualty Company (Or., No. 2, Jan. 19, 2018). Residents of Oregon who purchased long-term care insurance policies from Bankers Life and Casualty Company sued the insurer in federal court. The policyholders claimed that the company violated Oregon’s elder financial abuse law by purposely developing procedures to delay…
A U.S. court of appeals rules that a long-term care insurance company breached its contract with a policyholder who purchased a “Reduced-Pay at 65” policy when it raised her premiums after age 65. Newman v. Metropolitan Life Insurance Company (U.S. Ct. App., 7th Cir., No. 17-1844, Feb. 6, 2018). Margery Newman purchased a long-term care insurance policy from Metropolitan Life Insurance Company when she was age 56. She chose an option called “Reduced-Pay at 65” in which she paid higher premiums until she reached age 65, when the premium would drop to half the original amount. The long-term care insurance…
A permanent and retroactive repeal of the law that overturned the Supreme Court decision in Arkansas Department of Health and Human Services, et al. v. Ahlborn 547 U.S. 268 (2006), was finally achieved in the budget deal signed into law by President Trump on February 9, 2018. Ahlborn had been overturned by Section 202 of the Bipartisan Budget Act of 2013 (BBA), which expanded states’ access to entire personal injury settlements and awards to recoup Medicaid costs spent on a beneficiary’s behalf. Originally set to take effect on October 1, 2014, it was twice delayed before finally coming into force…
Maryland’s highest court rules that the state can sue a nursing home for injunctive relief for improperly discharging residents in violation of the state nursing home resident’s rights law. State of Maryland v. Neiswanger Management Services, LLC. (Md., No. 28, Feb. 20, 2018). The Maryland attorney general sued a nursing home management company, alleging the company engages in a widespread pattern of unlawful discharges from its facilities. The state claimed the nursing homes discharged residents without conducting discharge planning, without giving proper notice, and without communicating with families, in violation of the state nursing home resident’s rights law. According to…
A new federal law is designed to address the growing problem of elder abuse. The law supports efforts to better understand, prevent, and combat both financial and physical elder abuse. The prevalence of elder abuse is hard to calculate because it is underreported, but according to the National Council on Aging, approximately 1 in 10 Americans age 60 or older have experienced some form of elder abuse. In 2011, a MetLife study estimated that older Americans are losing $2.9 billion annually to elder financial abuse. The bipartisan Elder Abuse Prevention and Prosecution Act of 2017 authorizes the Department of Justice…
The U.S. House of Representatives passed the Americans with Disabilities Act (ADA) Education and Reform Act (H.R. 620) which undercuts current enforcement of the ADA. Under the ADA, individuals with disabilities can go to court to enforce their rights and to press for timely removal of the barrier that impedes access. H.R. 620 instead creates a “notice and cure” period before an individual can bring suit. Under H.R. 620, the company need only make “substantial progress” after 120 days and never actually complete the project. No Senate companion exists and a number of Senators have already spoken out strongly…
The Centers for Medicare & Medicaid Services this week added new quality measures to its websites that allow patients to compare data on long-term care and inpatient rehabilitation facilities. The updates center on vaccination and infection rates. Long-Term Care Hospital Compare and Inpatient Rehabilition Facility Compare both now offer data on the percentage of employees at these facilities who were vaccinated for the flu, and will offer infection rates for two dangerous hospital-acquired infections: methicillin-resistant Staphylococcus aureus and Clostridium difficile. Some of the country’s most touted healthcare systems fail to prevent potentially-deadly C. diff infections, according to a recent analysis. C. diff infections can increase patient length of stay by more than 55% and may increase the cost of…
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