We first blogged this story back in July of 2011. While the story is a couple years old the lessons to be learned are very timely.
Hereâ€™sanother important reminder on how much of a stickler Medicare and Medicaid canbe when it comes to denying benefits: the Matter ofKomanoff Ctr. for Geriatric & Rehabilitative Medicine v Daines (N.Y. Sup. Ct., App. Div., 2ndDept., No. 2010-05776, June 28, 2011) (here summarized on ElderLawAnswers.com.)
Itâ€™sthe case of Bernadette Jordan and how she entered a nursing home and filed forMedicaid only to find that the State ruled her ineligible for a period of 14.31months. Apparently, Mrs. Jordan had transferred funds from a revocable trust toher daughter, to repay expenses that her daughter had shouldered in getting herto the nursing home. States are skeptical of such transfers, and often examinethem carefully. In this case they found that the transfers were made at lessthan fair market value for purposes of Medicaid eligibility, and so denied Mrs.Jordan Medicaid benefits.
OnMrs. Jordanâ€™sbehalf, her nursing home called a hearing and later appealed. After all, theexpenses the daughter paid were documented and done with the assumption that they would be repaidwith assets from the trust. The State still denied benefits. The problem wasthat there was no written document at thetime of the expenditure that specified the agreement to repay thedaughterâ€™s expenditures.
Themoral of the story is documentation. By documenting your interactions andintentions you can provide hard proof and avoid getting caught on atechnicality. In Mrs. Jordanâ€™s case, 14.31 months is a long time to wait fornursing home benefits.
Applications for Medicare and Medicaid areimportant and should not be taken lightly. If you, or a loved one, need to makeplans for long-term care, then you need to schedule a consultation with usright away, before you take any actions. Remember, goodplanning is no accident.