Nursing Home Wins $100,000 From Son For His Medicaid Mistake
I’ve talked before about Responsible Party issues. You can find them in almost every every nursing home admissions contract these days. In most cases, when the family member (or even nursing home staff) messes up the Medicaid nursing home eligibility process the nursing home ends up suing the family member for unpaid nursing home bills based on that person signing the nursing home admission contract.
This works because almost all nursing home admission contracts include onerous terms to guarantee payment to the nursing home. If you have a nursing home admission contract that you already signed or are considering signing, take a close look at it right now.
If you do not sign an admissions contract with responsible party provisions, then you might think you are in the clear. But you might be wrong according to at least one court. Let’s take a look at this case.
The parties involved in this case are:
- Nursing Home
Josephine is Carmine’s mother. She entered a nursing home. The next day Carmine met with the nursing home admissions representative Lucy. Lucy presented Carmine with the Admissions Agreement at that meeting. Carmine signed it under the power of attorney from Josephine. He did not sign the agreement as Responsible Party. The contract contained two significant provisions:
In Article IV (2), the Responsible Party agrees “to provide all information that may be requested […] in connection with the application [for Medicaid] in accordance with any deadlines established[…].”
And, in Article IV (4), the Responsible Party agrees: “to act promptly and expeditiously to establish and maintain eligibility for medicaid assistance, including but not limited to taking any and all necessary action to insure that the resident’s assets are appropriately reduced and to remain within allowable limits for […] Medicaid Assistance […].”
So, the first question we need to answer is this: Is Carmine bound to the terms of the contract even though he never signed it as Responsible Party? The Court in this case said “yes.”
The Court ruled the nursing home could not hold Carmine to the written contract. That was because he did not sign it as Responsible Party. However, the Court did find Carmine bound by an oral contract to the nursing home based on the following facts.
- Carmine sought to get his mother into the nursing home. The nursing home told him they would not accept his mother without a source of payment for her;
- He knew and intended that source of payment to be Medicaid. In fact, he had, prior to meeting with the nursing home applied for Medicaid assistance without an experienced Medicaid attorney;
- At the meeting to complete his mother’s admission and to sign the Admission Agreement, Lucy informed Carmine that he was the responsible party and that his obligations included those stated in Article IV (2) and (4);
- The court found that Lucy summarized those obligations for Carmine. While he never verbally consented to comply with them, he did not object;
- The nursing home could reasonably conclude Carmine accepted those obligations because of his silence. Under such circumstances his silence constituted his consent to the provisions of Article IV (2) and (4). That consent created an oral contract to comply with those provisions.
And that is how a nursing home can sue you on the terms of a contract that you never signed. People like Carmine neglect to hire a Woodlands Texas Medicaid Attorney at several key events:
- Filing for Texas nursing home Medicaid Benefits;
- Entering into written and oral contracts with a nursing home;
- Receiving notice from the Medicaid agency that there were problems with the application.
Having an experienced Texas Medicaid Attorney at step #1 could have avoided problems 2-3 and in all likelihood have saved Carmine over $100,000. Nursing Home Medicaid mistakes are expensive so make sure you do it right the first time. If you do not want to be like Carmine and would prefer to put the power of the experience of Attorney Richard Shea to work for your case then call us at (832) 592-7913 to discuss your case.
Are you like Carmine?