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Family not responsible for nursing home bill

Published on April 25th, 2010

The legal website called Leagle reported the case of ARNOLD WALTER NURSING HOME v. PUMAREJO.  The nursing home sued the family of a resident when Medicaid did not pay for some services.  However, the Court found that the family is not financially responsible for the payment.

In February 2008, Heriberto Pumarejo became a patient at the nursing home. On February 19, 2008, Heriberto, as the resident, and his daughter-in-law Kathryn, as the resident representative, entered into a written agreement with the nursing home.  Heriberto agreed to pay, out of his own assets, for his nursing home care until he became eligible for payment by Medicaid.  Plaintiff was aware at that time that Heriberto had transferred ownership of his house, his only significant asset, to Herbert in 2006.  On May 6, 2008, Heriberto’s application for Medicaid was denied, based upon the 2006 transfer of his house to Herbert. In addition, because of the transfer, Heriberto would not become eligible for Medicaid coverage until September 21, 2011.

 

In June 2008, plaintiff billed Kathryn and Herbert directly for the care rendered to Heriberto to date. The amount of the bill was in excess of $23,000. They did not pay plaintiff, but they did remove Heriberto from the nursing home. They provided home care for him until his death on September 14, 2008. Heriberto’s estate is insolvent.

It is well established law that courts enforce the contract that the parties themselves have made and, further, that they do not make a better contract for either party. See McMahon v. City of Newark, 195 N.J. 526, 545-46 (2008). There can be no doubt that the written agreement between plaintiff and Kathryn contains no requirement that any assets other than Heriberto’s be used to satisfy his financial obligations if his Medicaid application were to be denied. It provided, in relevant part, as follows:

The Resident Representative agrees he/she shall be responsible only for making the necessary arrangements to have paid (either from Resident’s assets and/or from Medicaid, Medicate [sic] or assigned supplementary payments of insurance companies) the charges and other billings pursuant to the terms set forth below.

There is no specific provision in the agreement requiring any family member to return property that Heriberto had previously conveyed or gifted to them. We do not understand plaintiff to contend that the terms of its alleged oral agreement with Herbert went beyond those of its written contract with Kathryn.

 

 

Joe Pioletti
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