CMS sought to impose a civil monetary penalty on the successor of a fined nursing home where the successor accepted assignment of the provider agreement rather than going through the certification process for a new provider agreement. This case includes a detailed discussion of the administrative process through which civil monetary penalties are imposed and […]
Blog
A community spouse purchased an actuarially sound single-premium irrevocable annuity for $250,000 for the purpose of spending down excess assets so her husband, a nursing home resident, would qualify for Medicaid. Pennsylvania denied eligibility, contending that the annuity was an available asset and that Medicaid eligibility could not be established until that asset was spent […]
The district court granted insurer’s motion to defense where insurer claimed it had no duty to defend case where the only potential claims are by putative class members until the class is certified. The district court was reversed on appeal. Applying Florida law, the Court held that the duty to defend is determined from the […]
A physician brought a qui tam action against two other physicians and several health care providers after a nurse showed him a progress note in a nursing home chart allegedly documenting a physician’s (Lachman’s) review of the chart. The problem was that the resident had died several weeks earlier. After seeing that record, the relator […]
The court identifies this litigation as a “grudge match.” When counsel spent the first 30 pages of a deposition reviewing Gerstein’s criminal history, the questions got under his skin. After he began answering with “that’s none of your business” counsel began instructing him not to answer. Counsel gave no reason for the instruction other than […]
This is not a nursing home case. Justice Scalia, writing for the Court, framed the issue as whether a court or an arbitrator should consider a claim that a contract containing an arbitration agreement is void for illegality. Customers of a check cashing company had signed agreements including an arbitration clause. A class of customers […]
In Arkansas Dept. Health and Human Services v. Ahlborn, 547 U.S. 268 (2006), Heidi Ahlborn suffered severe and permanent injuries at age 19 as a result of an automobile accident. She was left partially brain damaged and unable to complete her education. Medicaid determined she was eligible for benefits and paid providers $215,645.30 on her behalf. Later, […]
Suit was filed after a CNA failed to check the water temperature before bathing resident; resident was burned and died 3 days later. Suit was settled for $1.5 million. One of Defendant’s insurers paid $200,000; Defendant paid the balance of $1.3 million because its other insurer was in liquidation. Defendant then sought indemnification from the […]
“Plaintiff presented expert medical testimony that the cause of Mr. Alston’s death was septicemia, or an infection which entered into his bloodstream. Plaintiff argued the cause of the infection was the pressure sores which defendant negligently failed to prevent. Defendant presented conflicting expert medical testimony that the cause of death was Alzheimer’s dementia, a terminal […]
Plaintiff’s suit against the nursing home was dismissed for failing to comply with the pre-suit notice requirement in W. Va. Code § 55-7B-1, et seq. The decision was affirmed. Any possible error was harmless because the dismissal was without prejudice and Plaintiff has the right o refilled after compliance with the statute.
