Title 19 Nursing Home Issues
With rates hovering around $10,000 a month, few seniors can afford to pay for long-term nursing home care out of pocket. Fortunately, through proper planning, many seniors can qualify for Medicaid (also called Title 19 or medical assistance), a program that pays for many of the expenses associated with long-term care. However, there are strict eligibility requirements that a senior must meet, and serious disputes with nursing homes result from seemingly minor errors.
Lewis, Lewis & Ferraro, L.L.C., and its West Hartford-area lawyers assist clients and families at all stages of the Medicaid/Title 19 process. We handle everything from initial applications to litigation involving nursing homes.
In order to qualify for Title 19 assistance in Connecticut, the elderly person must have no more than $1,600 worth of assets, plus some exempt assets, which include a home and money for burial expenses.
Too often, those attempting to qualify for Title XIX will transfer assets to others, whether children or charities, in order to get below the threshold to meet eligibility requirements. The issue with this is that federal law requires an examination of all asset transfers that took place within five years of the application. If any transfers during that time are suspicious, Medicaid benefits may be denied or penalty periods may be assessed.
The West Hartford attorneys of Lewis, Lewis & Ferraro regularly assist applicants in gathering information about asset transfers. We also handle fair hearings, where we can explain the details of the transfer and why our client should not be denied benefits.
Fair Hearings Following A Denial Or Acceptance With A Penalty Period
If your application was denied, or if it was accepted but with a penalty period attached, you have the right to a proceeding known as a fair hearing. At this hearing, additional documentation and other evidence can be introduced to explain your financial condition and your qualifications for benefits. Although you may appear at a fair hearing on your own, it is highly recommended that you retain a lawyer to appear on your behalf.
As experienced Medicaid attorneys, we understand the nature of fair hearings and are capable of resolving issues that arise within them. Our experience as litigators allows us to present your case persuasively and maximizes the likelihood of obtaining benefits and doing so with little to no penalty period.
Lawsuits By Nursing Homes
It is a sad reality that nursing homes in Connecticut and around the nation have increased the frequency with which they file lawsuits against family members who assist in filling out Medicaid applications and getting their loved ones admitted to nursing homes under the program. These lawsuits are complex and are a real threat to families. Here is a rough outline of how many of them arise:
An elderly person becomes ill and needs to go to the nursing home soon. You or another family member signs the admissions paperwork and the senior is admitted to the home. By signing, you become the “responsible party,” which means you are responsible for making sure the senior becomes covered under Title 19. There are a number of potential problems here, such as:
- The senior may have assets you did not know about or had too much income, which made him or her ineligible for Medicaid.
- The senior may have transferred assets in a questionable manner in the five years before nursing home admittance.
- You may have made a mistake in the paperwork, as happens often due to the emotional nature of the experience.
- The nursing home rarely gives you time to consult a lawyer, so you had no one to help you review the documents before sending them in.
When these problems arise, the nursing home can sue you, as the responsible party, in an effort to get you to pay the money it would have received from Medicaid, had the senior been covered.
How The Lawyers Of Lewis, Lewis & Ferraro Can Help
Our West Hartford firm is, above all, a litigation firm. We have successfully handled a number of lawsuits filed by nursing homes in Title XIX matters. Our attorneys understand how to resolve Title 19 issues by dealing with the Connecticut Department of Social Services through hearings and related procedures. We also vigorously defend clients in court whenever needed.
We believe this is one of the most important issues in all of elder law, and we are passionate about it. We will aggressively protect your interests and those of your elderly loved one.
Contact A West Hartford Nursing Home Lawyer For A Free Consultation
For help with anything from Medicaid applications to nursing home litigation, you can turn to the attorney of Lewis, Lewis & Ferraro, L.L.C. For your free initial consultation, call 860-881-2719 or contact us online. Our offices are in West Hartford, Bristol and Stafford Springs for your convenience.