San Francisco, CA (Law Firm Newswire) May 16, 2016 – A lawsuit filed in November 2015 alleged that the California Department of Health and Human Services has deliberately failed to prevent the illegal practice of nursing homes “dumping” Medi-Cal residents into the hospital system.
Nonprofit organization California Advocates for Nursing Home Reform (CANHR) filed the lawsuit in San Francisco, California, on behalf of three nursing home residents covered by Medi-Cal. Medi-Cal is California’s Medicaid program. They alleged nursing homes refuse to readmit Medi-Cal patients after temporary hospitalization in order to make room for more private pay and Medicare patients.
“Many individuals hope to rely on Medi-Cal or Medicare in their later years. However, receiving care in a nursing facility or at home can be costly and uncertain, as demonstrated by the lawsuit,” said elder law attorney Michael Gilfix. “Therefore, it would be wise to avoid depending exclusively on federal support for quality long-term care services.”
The watchdog group claimed states are required under federal law to offer readmission hearings to hospitalized patients who wish to return to nursing homes. If the patient is granted a favorable judgment, they must promptly be readmitted to the facility. However, patients are allegedly forced to remain in hospitals due to the state’s failure to enforce readmission orders. The plaintiffs in the case have not been readmitted despite having won their hearings.
The alleged “dumping” practice has continued for a decade despite violating the Nursing Home Reform Act, according to CANHR. A nursing home’s failure to follow a readmission order is punishable by temporary suspension from receiving Medi-Cal funds. The California Department of Health Care Services has consistently denied CANHR’s claims that the state has the authority to enforce its own readmission orders.
“It is possible to remain eligible for Medi-Cal while still preserving many of your assets. The complexities of Medi-Cal can be navigated through proactive estate planning and the assistance of professionals. Without a financial safety net in place, people may be left lacking the care they need,” said Gilfix.
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