Elder law attorney Jim Koewler joins Suzanne to talk about what to do when a care facility threatens to discharge or evict a senior loved one. There are specific federal rules that apply when the reason for the discharge is failure to pay:
* No "failure to pay" if Medicaid application is pending
- If not first application, there must be difference from first
* Maybe no "failure to pay" if state hearing or appeal is pending
* Facility may try to discharge despite the Medicaid application
Just the fact that they are prohibited from these discharge threats doesn't mean they won't try. If they succeed because the family doesn't know any better, then they get away with it.
If someone wants to challenge a threat to discharge, make sure you follow all these steps:
* Appeal instructions are in the discharge notice
* Appeal to the appropriate governmental office
** Include a copy of the proposed discharge paperwork in your appeal
** Send a copy of your appeal to the facility
Have the written discharge notice before you began your appeal. You have 30 days, but don't wait to appeal — if you don't appeal soon enough, the facility can go ahead and discharge them. If you win your appeal after that, the facility is first in line to take them back, so long as they have the space.
Possible defenses against the discharge:
* Challenge the reason for discharge
** If discharge is for failure to pay, show there is aa pending application or appeal
* Challenge the choice of their new facility as not appropriate
** If it's your home, for instance, show how it can't meet the loved one's needs
* Challenge failure of proper notice
In a hearing, the nursing home or assisted living facility goes first, because they carry the burden of proof. When it's your turn, you're probably going to have to be specific about why the new place isn't appropriate. The hearing officer will assume because it was on the notice that it's appropriate, unless you say otherwise. Challenging them is not easy. Every family should have an elder law attorney, because all sorts of situations happen.
Watch on YouTube to see slides from Jim's presentation. Learn more about Jim Koewler at his website.
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