Nursing Home Discrimination Against Medicaid Recipients
While it is illegal for a nursing home to discriminate against a Medicaid recipient, it still happens. To prevent such discri...
Read moreIn a major win for nursing home residents and their families, the U.S. Supreme Court has upheld the right to sue government-run nursing homes under the Federal Nursing Home Reform Act (FNHRA). In a 7-2 decision, the court decided that these plaintiffs could seek relief in federal court.
In 2019, the family of Gorgi Talevski, a patient with dementia who had been living at a state-owned nursing home in Indiana, sued the owner of the nursing home for violating Talevski’s rights.
They claimed that the facility’s alleged actions of overmedicating Talevski with psychotropic drugs and transferring him to a different facility without their permission were against the law. Talevski, a Medicaid recipient, died in 2021; his family asserted that his health had worsened as a result of the facility’s mistreatment.
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The FNHRA prohibits using chemical restraint for discipline or convenience, and transfers are only permitted under limited circumstances. The federal court dismissed the case, stating that Talevski had no right to sue under FNHRA. However, the 7th Circuit reversed the decision, and the U.S. Supreme Court has now agreed that Talevski’s family can in fact sue the nursing home.
The civil rights case, Health & Hospital Corp. of Marion County v. Talevski, became a closely watched legal battle across the nation. Under the Supreme Court’s ruling, individuals residing in publicly owned nursing facilities – and those who rely on government assistance programs such as Medicaid – can file federal lawsuits if they believe their rights have been violated.
In issuing its decision, the country’s highest court upheld its precedent in the Wilder v. Virginia Hospital Association case from 1990. That decision stated the Constitution’s Spending Clause authorizes federal lawsuits under Section 1983, which enforces the rights that are established by Congressional law.
While most government-run nursing homes are concentrated in Indiana, this decision will affect facilities that are owned by the state, county, or Veterans Administration.
Justice Elena Kagan said during oral arguments that while FNHRA is a big statute that says many things, “one of those things it does say to every nursing home facility [is that it] has to ensure that individual rights are respected and lays out in considerable detail what those rights are and says it’s [their] job to see that those rights are fulfilled.”
Advocates for older adults as well as people with disabilities, many of whom depend on public assistance programs, are lauding the ruling. In a news release issued by the American Civil Liberties Union, Susan Mizner, director of the organization’s Disability Rights Program, stated: “This decision is a crucial victory for the civil rights of nursing home residents, people with disabilities, and everyone protected under Titles VI and IX of the Civil Rights Act.”
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Read moreIn addition to nursing home care, Medicaid may cover home care and some care in an assisted living facility. Coverage in your state may depend on waivers of federal rules.
READ MORETo be eligible for Medicaid long-term care, recipients must have limited incomes and no more than $2,000 (in most states). Special rules apply for the home and other assets.
READ MORESpouses of Medicaid nursing home residents have special protections to keep them from becoming impoverished.
READ MOREIn addition to nursing home care, Medicaid may cover home care and some care in an assisted living facility. Coverage in your state may depend on waivers of federal rules.
READ MORETo be eligible for Medicaid long-term care, recipients must have limited incomes and no more than $2,000 (in most states). Special rules apply for the home and other assets.
READ MORESpouses of Medicaid nursing home residents have special protections to keep them from becoming impoverished.
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READ MOREThere are ways to handle excess income or assets and still qualify for Medicaid long-term care, and programs that deliver care at home rather than in a nursing home.
READ MORECareful planning for potentially devastating long-term care costs can help protect your estate, whether for your spouse or for your children.
READ MOREIf steps aren't taken to protect the Medicaid recipient's house from the state’s attempts to recover benefits paid, the house may need to be sold.
READ MOREThere are ways to handle excess income or assets and still qualify for Medicaid long-term care, and programs that deliver care at home rather than in a nursing home.
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READ MOREMost states have laws on the books making adult children responsible if their parents can't afford to take care of themselves.
READ MOREApplying for Medicaid is a highly technical and complex process, and bad advice can actually make it more difficult to qualify for benefits.
READ MOREMedicare's coverage of nursing home care is quite limited. For those who can afford it and who can qualify for coverage, long-term care insurance is the best alternative to Medicaid.
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