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

Today we begin our adventure through the case of Glastonbury Healthcare Center, Inc. v. Esposito. And I do mean adventure. The end result is the nursing home was successful in its claim against the resident’s son for over $100,000. Our job is to understand how they won their case and how you can avoid having the same happen to you.

There is so much ground to cover in this case that it is going to take several posts to dissect it all.

The players involved:

• Carmine Esposito – the Defendant;
• Josephine Esposito – the Defendant’s mother and resident of Glastonbury Healthcare Center;
• Glastonbury Healthcare Center – the Plaintfiff;
• Lucy Higgins – admissions officer for Glastonbury Healthcare center;
• Laura Catarino – Connecticut DSS case worker;
• Attorney Michael Bellobuono – represented Carmine Esposito.

On April 1, 1998 Josephine became a resident of Glastonbury Healthcare Center.

Carmine Esposito met with the admissions officer Lucy Higgins on April 2nd. Lucy presented Carmine with the Admissions Agreement at that meeting and Carmine signed it under the power of attorney from Josephine. He did not sign the agreement as Responsible Party. The contract contained two significant provisions:

• 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.”

So, the first question we need to answer is this: Is Carmine Esposito bound to the terms of the contract even though he never signed it as Responsible Party? The Court says “yes.”

The Court recognized that Carmine Esposito was not bound by the written contract to Glastonbury Healthcare Center because he did not sign it as Responsible Party. However, the Court did find Carmine Esposito bound by an oral contract to Glastonbury Healthcare Center based on the following facts.

• Carmine sought to get his mother into Glastonbury Health Care Center. He was informed that Glastonbury Health Care Center would not accept his mother without a source of payment for her;
• He knew and intended that source of payment to be Connecticut Medicaid. In fact, he had, prior to meeting with plaintiff’s representative, Lucy Higgins, applied through DSS for Connecticut Medicaid assistance;
• At the meeting to complete his mother’s admission and to sign the Admission Agreement, Higgins informed Carmine that he was the responsible party and that his obligations included those stated in Article IV (2) and (4);
• The court finds that Higgins summarized those obligations for Carmine and although he never verbally consented to comply with them, he did not object;
• His silence at being informed of his obligations as a responsible party led Glastonbury Health Care Center to reasonably conclude he was accepting those obligations. Under such circumstances his silence constituted his consent to the provisions of Article IV (2) and (4) and created an oral contract to comply with those provisions.

And that is how you can be held to the terms of a contract that you did not even sign. Carmine neglected to hire a Connecticut Medicaid Attorney at several key events:

1. Filing for Connecticut Medicaid Benefits;
2. Entering into written and oral contracts with a nursing home;
3. Receiving notice from DSS that there were problems with the application.

Having an experienced Connecticut Medicaid Attorney at the starting point would have avoided problems 2-3 and in all likelihood have saved Carmine over $100,000.

Are you like Carmine?

Related posts:

1. How To Get Sued By a Nursing Home: Negligence
2. How To Get Sued By a Nursing Home: Estoppel
3. Is Your Delay Causing a Breach of Contract?