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U.S. nursing homes' new tactic to collect debts: Seizing power of attorney from patients' relatives

Monday, January 26, 2015 15:07

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An ethical person – like a politician, banker or lawyer – may know right from wrong, but unlike a politician, a moral person lives it. “Marx and Engels never tried to refute their opponents with argument. They insulted, ridiculed, derided, slandered, and traduced them, and in the use of these methods their followers are not less expert. Their polemic is directed never against the argument of the opponent, but always against his person.” – Socialism http://chasvoice.blogspot.com/

If you haven’t already cleared your remaining savings and other assets off the table, you probably should not rule it out until checking out this new government/corporatist fraud.

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The New York Times | January 26, 2015 | Last Updated: Jan 26 11:16 AM ET

Piotr Redlinski/The New York TimesDino and Lillian Palermo at the Mary Manning Walsh Nursing Home, which filed a guardianship petition asking the court to give a stranger full legal power over Lillian Palermo and complete control of her money, in New York, Oct. 31, 2014.

NEW YORK — Lillian Palermo tried to prepare for the worst possibilities of aging. An insurance executive with a Ph.D. in psychology and a love of ballroom dancing, she arranged for her power of attorney and health care proxy to go to her husband, Dino, eight years her junior, if she became incapacitated. And in her 80s, she did.

Dino Palermo, who was the lead singer in a Midtown nightclub in the 1960s when Lillian’s elegant tango first caught his eye, now regularly rolls his wife’s wheelchair to the piano at the Catholic nursing home in Manhattan where she ended up in 2010 as dementia, falls and surgical complications took their toll. He sings her favourite songs, feeds her home-cooked Italian food, and pays a private aide to be there when he cannot.

It’s a strategic move to intimidate. Nursing homes do it just to bring money.

But one day last summer, after he disputed nursing home bills that had suddenly doubled Lillian Palermo’s copays, and complained about inexperienced employees who dropped his wife on the floor, Dino Palermo was shocked to find a six-page legal document waiting on her bed.

It was a guardianship petition filed by the nursing home, Mary Manning Walsh, asking the court to give a stranger full legal power over Lillian Palermo, now 90, and complete control of her money.

Few people are aware that a nursing home can take such a step. Guardianship cases are difficult to gain access to and poorly tracked by New York state courts; cases are often closed from public view for confidentiality.

Piotr Redlinski/The New York Times: Nursing homes are using a New York State statute created to protect the infirm as a way to get paid.

It’s so cruel. Mr. Palermo loves his wife, he’s there every single day, and they just threw him to the courts.

But the Palermo case is no aberration. Interviews with veterans of the system and a review of guardianship court data conducted by researchers at Hunter College at the request of The New York Times show the practice has become routine, underscoring the growing power nursing homes wield over residents and families amid changes in the financing of long-term care.

In a random, anonymized sample of 700 guardianship cases filed in Manhattan over a decade, Hunter College researchers found more than 12 percent were brought by nursing homes. Some of these may have been prompted by family feuds, suspected embezzlement or just the absence of relatives to help secure Medicaid coverage.

But lawyers and others versed in the guardianship process agree that nursing homes primarily use such petitions as a means of bill collection – a purpose never intended by the Legislature when it enacted the guardianship statute in 1993.

At least one judge has ruled that the tactic by nursing homes is an abuse of the law, but the petitions, even if they are ultimately unsuccessful, force families into costly legal ordeals.

The Palermo case is no different than any other nursing home bill that they had difficulty collecting. When you have families that do not co-operate and an incapacitated person, guardianship is a legitimate means to get the nursing home paid.

“It’s a strategic move to intimidate,” said Ginalisa Monterroso, who handled patient Medicaid accounts at the Mary Manning Walsh Nursing Home until 2012, and is now chief executive officer of Medicaid Advisory Group, an elder care counselling business that was representing Dino Palermo in his billing dispute. “Nursing homes do it just to bring money.”

“It’s so cruel,” she added. “Mr. Palermo loves his wife, he’s there every single day, and they just threw him to the courts.”

Brett D. Nussbaum, a lawyer who represents Mary Manning Walsh and many other nursing homes, said Dino Palermo’s devotion to his wife was irrelevant to the decision to seek a court-appointed guardian in July, when the billing dispute over his wife’s care reached a stalemate, with an outstanding balance approaching $68,000.

Nina Bernstein/The New York Times Dino and Lillian Palermo

“The Palermo case is no different than any other nursing home bill that they had difficulty collecting,” Nussbaum said, estimating that he had brought 5,000 guardianship cases himself in 21 years of practice. “When you have families that do not co-operate and an incapacitated person, guardianship is a legitimate means to get the nursing home paid.”

Source: http://chasvoice.blogspot.com/2015/01/us-nursing-homes-new-tactic-to-collect.html

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