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sb2's Litigation Results In Avoidance Of $340K Penalty Period And $120K In Benefits To MA Skilled Nursing Facility

In a recent case in Massachusetts, sb2’s client, a skilled nursing facility (SNF), instituted litigation against a resident’s agent through a power of attorney document.  Less than nine months prior to entering the SNF, the resident transferred ownership of her home and her vacation property to her agent.  Upon entering the SNF, the resident was insolvent.  After a long application period, the resident was denied due to the disqualifying transfer of the two properties, valued at more than $340,000.  For months, the resident’s attorney told the SNF that he was going through the process of returning the properties in order to cure the penalty period.  With exponentially growing balances, and no real evidence of action on the part of the resident’s agent, the SNF turned to sb for assistance.

sb2 intervened and actively pursued the return of the properties through litigation.  With the pressure of litigation, the resident’s agent returned the property to the resident.  sb promptly provided evidence of the cure to the Medicaid office and the penalty period was removed.  Within three months of filing litigation, sb was able to remove the penalty that had prevented the SNF from receiving Medicaid payment for over a year and a half.  As a result, the application was granted and Medicaid benefits were approved for the resident retroactive to the resident’s admission to the SNF.

Due to sb2's dogged efforts, the SNF avoided a penalty period that would have lasted until late 2014, and cost them more than $340,000.  Instead, the SNF received more than $120,000 in back benefits, in addition to future benefits for the resident – all at a cost of less than 10 percent of the outstanding balances.

Across the country, sb has encountered many facilities that have run into similar problems with unresponsive counties.  If this scenario sounds familiar, don’t miss out on one more month’s benefits; contact sb today to find out how we can assist you with your Medicaid eligibility issues.