Caution to Guardians of Medicaid Recipients

Caution to Guardians of Medicaid RecipientsElders who are unable to apply for Medicaid on their own can appoint another individual, such as a spouse, friend, attorney, or child, to apply for Medicaid on their behalf. Sometimes, the state may appoint a person as a guardian on the elders’ behalf to manage the elder’s finances and apply for Medicaid. Appointed guardians must take their responsibility seriously and act promptly to secure Medicaid eligibility and payments on their ward’s behalf.

There are many different factors that go into filing for Medicaid and the application process. The recent case of Bloomfield Health Care Center of Connecticut v. Jason Doyon potentially exposes guardians to liability for failure to timely file Medicaid applications.

Bloomfield Case

In the Bloomfield case, the elder began residing at the Bloomfield Health Care Center of Connecticut in April 2013. When his Medicaid application failed in September 2013, the nursing home sought a conservator to assist the elder in applying for Medicaid. Upon being appointed as the elder’s guardian in April 2014, the conservator began to disburse proceeds from the elder’s social security income and the sale of his home to the elder. After waiting nine months, he filed for a Medicaid application in January 2015, which was denied due to lack of required information. The conservator then reapplied and was approved in August 2015.

However, Medicaid eligibility began on May 1, 2015, leaving a gap in payments and debts owed to the nursing home. The nursing home believed the conservator unnecessarily delayed applying for Medicaid and brought suit accusing him of negligence. The conservator filed a motion for summary judgment, arguing that he did not owe any duty of care to the nursing home. He also argued that the nursing home lacked standing to sue him, which the trial court agreed.

Reversed Judgement

The nursing home appealed and the appellate court reversed the trial court’s judgment. The nursing home demonstrated to the court that it was reasonably foreseeable that the nursing home would be harmed if the Medicaid application was not timely filed. The nursing home had specifically initiated a conservatorship proceeding so that a conservator would be appointed to apply for Medicaid on the elder’s behalf. Therefore, the court found that the conservator had a duty to the nursing home to exercise due care.

Although the Bloomfield case paints a cautionary picture, it is a case of limited scope. It is very fact specific and may not be applied broadly. However, the court showed an inclination to find liability on behalf of the guardian. The court’s ruling is a fair warning to guardians that they should apply for Medicaid in a timely manner and take all necessary steps in the application process to ensure they are not negligent.

Brooklyn Elder Law Litigation Lawyers at Korsinsky & Klein, LLP Assist Clients with Medicaid Issues

If you are facing issues with the Medicaid application process and want clarification pertaining to your duties and responsibilities, the Brooklyn elder law litigation lawyers at Korsinsky & Klein, LLP can help. Contact us online or call us at 212-495-8133 today for an initial consultation. Located in Brooklyn, New York, and Lakewood, New Jersey, we serve clients throughout Manhattan, Long Island, and Westchester, New York.