GDGC is proud of our many successes and especially so when we hear from our clients how pleased (and often surprised) they are with our results. Our clients expect a lot from us and we expect a lot of ourselves, especially as we strive to maintain and exceed an almost 90% success rate.
Below are just a few of our most recent accomplishments on behalf of our clients.
"Nassau County" Center for Nursing and Rehabilitation v. A.C.**
This matter turned on the potential sale of real property to satisfy the facility's balance of $33,927.44. To complicate matters, though, was the fact that Ms. A.C. still resided in the facility and thus, her balance due increased daily. We learned from Ms. A.C.'s attorney that he intended to apply "rule of halves" planning after closing on the real property sale. Armed with the knowledge that funds would be available to Ms. A.C. to privately pay the facility until the expiration of the penalty period, we negotiated payment in advance to cover the entire penalty period so as not to rely on the resident or her family for continuity of payment before Medicaid assumed primary responsibility.
Principal balance due: $33,927.44; Amount collected: $243,764.81 (through 2008).
"Bronx County" Extended Care Center v. C.D.**
Mr. C.D. failed to remit private payment to the facility so the facility filed a Medicaid application on his behalf to limit their exposure. However, the application was denied. GDGC worked with Mr. C.D.'s family to secure documentation to file a Reconsideration Application. The Reconsideration Application was approved but with a pick-up date almost two (2) years later than that requested. GDGC worked with the Medicaid case worker to prove the original Medicaid application submission date and the original Reconsideration Application date and ultimately secured the pick-up date dating back more than two (2) years. GDGC then worked with the facility and the Department of Health to secure Medicaid reimbursement and collected the entire NAMI balance due from the resident's spouse.
Principal balance due: $288,000; Amount collected: $288,000 and continuing Medicaid reimbursement.
"Nassau County" Extended Care v. R.C.**
Mrs. C. hired a company to prepare and file an application for Medicaid benefits for her husband. When Mr. C. expired, the company contacted the Department of Social Services and erroneously withdrew the application, resulting in a private pay balance due to the facility of $43,860. GDGC filed suit again Mrs. C. as spouse of the debtor and thereafter obtained a judgment for the full balance due plus interest and attorneys' fees.
Principal balance due: $43,860; Amount collected: $71,017.
In the Matter of J.J. (Guardianship proceedings on behalf of "Nassau County" Center for Nursing and Rehabilitation)**
Mr. J., an under-65 year old male with a history of alcoholism, was a resident of the facility but was not making payment arrangements and was not eligible for Medicaid benefits. GDGC successfully petitioned for the appointment of a guardian and thereafter secured Social Security Disability benefits and qualified Mr. J. for Medicaid benefits. GDGC prepared and filed both the disability application and the application for Medicaid benefits and collected $46,251.46 in private pay and NAMI balances and secured Medicaid reimbursement for all future benefits incurred at the facility.
Principal balance due: $46,251.46; Amount collected: $46,251.46 and continuing Medicaid reimbursement.
"Queens County" Nursing Home v. A D. and C.D.**
Pursuant to the admission agreement and the applicable chronic care budget, Mr. D. was to pay to the facility his wife's Net Available Monthly Income ("NAMI"). In failing to comply with his contractual and legal obligation, GDGC brought suit against Mr. D. and obtained a judgment against him for the full principal balance of $25,842.80, plus interest, costs and attorneys' fees. Post-Judgment Discovery Subpoenas revealed banking relationships in Mr. D.'s name, although held jointly with another individual. GDGC filed a petition for a special turnover proceeding to freeze Mr. D.'s assets and direct the turnover of funds from his financial institution.
Principal balance due: $25,842.80; Amount collected: $40,859.30.
"Nassau County" Care v. S. L.**
The application for Medicaid benefits submitted by Ms. L.'s son on her behalf was denied for failure to produce certain documentary evidence. GDGC requested a Fair Hearing and persuaded the Department of Social Services to reconsider the application while maintaining the original application date and thus the original pick-up date. GDGC navigated through and adequately explained to the Department of Social Services numerous family trusts and trust tax returns, ultimately securing Medicaid benefits with the original pick-up date of May 1, 2004.
Principal balance due: $150,000; Amount collected: $150,000 and continuing Medicaid reimbursement.
"Nassau County" Center for Nursing and Rehabilitation v. A.G.**
Mr. A.G. maintained no assets other than a home and had no source of income to satisfy a significant private pay balance. GDGC worked with Mr. A.G.'s counsel and his brother to secure an agreement to sell the home and satisfy the facility's outstanding invoice. GDGC played an integral role in expediting the sale and in the sale itself. The house was quickly sold and GDGC collected $88,562.72 within three (3) months for the facility, representing the full balance due.
Principal balance due: $88,562.72; Amount collected: $88,562.72.
"Suffolk County" Care v. B.G.**
Mr. G.'s application for Medicaid benefits was denied for failure to provide certain documentation. Mr. G. refused to cooperate with GDGC and would not provide the requested information. GDGC filed suit against Mr. G. for the private pay balance. In the meantime, GDGC gathered all the required documentation and filed a Reconsideration Application. While the Reconsideration Application was pending, GDGC pursued the lawsuit against Mr. G. in case the Reconsideration Application was denied or there was a Medicaid pick-up date problem. The Reconsideration Application was ultimately approved with the original requested pick-up date.
Principal balance due: $296,000; Amount collected: $296,000 and continuing Medicaid reimbursement.
"Nassau County" Center for Nursing and Rehabilitation v. G.C.**
Mrs. G.C.'s family was not complying with the Department of Social Services' requests for production of documents in order to process the submitted application for Medicaid benefits and the facility was justly concerned that the application would be denied. GDGC worked with the family to provide all documentary requests to the Department. In September 2004, GDGC received an approval for Medicaid benefits with the requested pick-up date of October 1, 2002, securing hundreds of thousands of dollars for the facility.
Principal balance due: $192,000; Amount collected: $192,000 and continuing Medicaid reimbursement.
"Nassau County" Center for Nursing and Rehabilitation v. McG.**
Mr. McG. incurred a combined private pay and NAMI balance of $41,972.33. GDGC brought suit against Mr. McG. and quickly settled the matter with opposing counsel for $40,000 - without protracted litigation.
Principal balance due: $41,972.33; Amount collected: $40,000.00.
In the Matter of A.L. (Guardianship proceedings on behalf of "Nassau County Center for Nursing and Rehabilitation")**
A.L.'s guardian failed to properly prepare and support her submission of a Medicaid application on behalf of her ward. The result was a late pick-up date by seven (7) months, potentially costing the facility more than $50,000. GDGC requested a Fair Hearing and, in the meantime, successfully convinced the Hearing Officer to review the matter taking into consideration new evidence obtained by GDGC. The result was a revised budget with the earlier pick-up date, providing seven (7) additional months of Medicaid payments.
Principal balance due: $56,000; Amount collected: $56,000 and continuing Medicaid reimbursement.
M.B., an attorney and the brother of resident K.B., was power of attorney for the resident and together, they held numerous joint bank accounts. K.B. owed a private pay balance to the facility in excess of $38,000. Upon GDGC’s investigation on behalf of the facility, we learned that funds from these accounts were being drained off. Considering funds were available to satisfy K.B.’s private pay balance and M.B. maintained complete control over these funds as joint owner of the accounts and as power of attorney for K.B., we initiated a lawsuit against both alleging breach of contract and fraudulent conveyances resulting in a settlement for the full outstanding balance due the facility.
Principal balance due: $38,807.13; Amount collected: $38,807.13.
W.E., spouse of nursing home resident, signed the facility’s admission agreement as Designated Representative and thereby acknowledging her responsibility to assure all NAMI payments directly to the facility. W.E., failed to fulfill her obligations under the contract. GDGC commenced suit on behalf of the facility and, after W.E. retained her second set of attorneys to stave off a default, she agreed to obtain a home equity loan to satisfy the outstanding NAMI debt owed to the facility.
Principal balance due: $18,257.09; Amount collected: $18,257.09.
S.M.’s mother was a resident of the facility pending Medicaid approval. During a brief portion of the pending period, S.M., as Designated Representative, turned over his mother’s NAMI in anticipation of Medicaid’s approval, but stopped payments without reason or notice. Medicaid was ultimately approved, but S.M.’s prior payments satisfied a small fraction of the actual NAMI balance, ultimately in excess of $50,000. GDGC commenced suit on behalf of the facility and negotiated full payment from S.M.’s counsel.
Principal balance due: $54,101.99; Amount collected: $54,101.99.
* * Facility names are withheld for privacy purposes.
* Prior results cannot and do not guarantee or predict a similar outcome with respect to any future matter, including yours, in which a lawyer or law firm may be retained.