Today we continue to examine the case of Glastonbury Healthcare Center, Inc. v. Esposito. In the first post, we found out how the Court bound a resident’s son to the terms of a nursing home contract that he never signed. Now, we are going to take a closer look at exactly how Carmine Esposito breached the contract which led to the nursing home prevailing in its claim for over $100,000 against him.

There are two provisions in the contract that Carmine was accused of breaching. These provisions are:

• In Article IV (2), the Responsible Party agrees “to provide all information that may be requested by the Connecticut Department of Social Services in connection with the application [for Connecticut medicaid assistance] in accordance with any deadlines established by the Department.”
• And, in Article IV (4), the Responsible Party agrees: “to act promptly and expeditiously to establish and maintain eligibility for medicaid assistance, including but not limited to taking any and all necessary action to insure that the resident’s assets are appropriately reduced and to remain within allowable limits for Connecticut Medicaid Assistance as established by the Connecticut Department of Social Services.”

Carmine applied for Connecticut Medicaid nursing home benefits on March 31, 1998. At the time of the application, his mother owned a GNMA bond worth $3,400 and there was a bank account at Mechanics Savings Bank with approximately $17,000 that the Department of Social Services treated as owned by the medicaid applicant, Josephine Esposito.

Following the application for Connecticut Medicaid, the Department of Social Services notified Carmine that he needed to reduce these assets to no more than $1,600.00. On November 18th, 1999 the Department of Social Services sent Carmine a letter demanding Josephine’s assets be reduced to $1,600 before November 30th or the application would be denied. The deadline passed and nothing had changed with Josephine’s assets.

On March 9, 2000 DSS sent Carmine another letter with a deadline of March 23, 2000 to reduce Josephine’s assets to the required level. The deadline passed and nothing was done with her assets. DSS denied the medicaid application on March 23, 2000.

Carmine applied for Medicaid in March of 1998 and did not get her assets down to the required limits until September of 2000. The Court determined this period of time was sufficient to hold Carmine responsible for breaching his contractual obligation to Glastonbury Health Care Center to “to act promptly and expeditiously to establish and maintain [Josephine's] eligibility for Medicaid.”

How long is too long? We do not have sufficient information from the courts to answer that question. It could be anywhere from 1 month to 30 months.

What is important to remember from this case is that every month the nursing home does not get paid through a resident’s own funds or medicaid, that is a month that somebody is responsible for payment. It could be the nursing home’s fault, the State of Connecticut’s fault, or it could be the resident’s family’s fault. Speak with a Connecticut Medicaid Attorney today to protect you and your family from these critical mistakes.

Related posts:

1. Nursing Home Wins $102,574 From Resident’s Son
2. How To Get Sued By a Nursing Home: Negligence
3. How To Get Sued By a Nursing Home: Estoppel