How Will a Back Payment From the VA Affect a Nursing Home Resident's Medicaid Benefits?
A family member in a nursing home has Medicaid pending. He was clearly qualified, but last week he became eligible for servic...
Read moreAn ElderLawAnswers law firm has won an important legal victory in preventing an Indiana nursing facility from forcing a 98-year-old Medicaid resident to move to a part of the facility set aside for patients whose care is funded by Medicaid. Lemons v. Westminster Village North, Inc. (Preliminary Injunction Order, Marion Sup. Ct., Div. 7, No. 49D07-0303-PL-000604, April 16, 2003).
Katherine Lemons, 98, had lived in the same room at Westminster Village North for several years. But things were about to change when the U.S. Center for Medicare and Medicaid Services (CMS), the federal agency that oversees the Medicaid program, ordered Westminster to consolidate its Medicaid beds in one segregated "distinct part" of the nursing home. Previously, Medicaid patients had been mixed in with other residents throughout the Westminster facility.
As part of its effort to comply with CMS''s order, Westminster tried to move Ms. Lemons to a newly created segregated Medicaid unit. Represented by ElderLawAnswers member firm Severns & Bennett of Indianapolis, Ms. Lemons challenged the facility's efforts. An Indiana trial court has now ruled that the attempted move is contrary to Indiana law, which states that residents can be moved only for medical reasons or to protect their own welfare. The court issued a preliminary injunction requiring Westminster to retain Ms. Lemons in her present room, pending further orders of the court.
The case raises broader questions about the legality of CMS''s efforts to move Medicaid patients into segregated units. The federal Nursing Home Reform Law explicitly prohibits nursing homes from discriminating against Medicaid residents in the provision of services. The law also requires nursing homes to protect the privacy of residents' financial information, which would appear to be violated when all the residents of a segregated unit have one payment sourceMedicaid.
A copy of the court''s order can be downloaded in PDF from the Web site of the National Senior Citizens Law Center.
(If you do not have the free PDF reader installed on your computer, download it here.)
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