Lillian Palermo did her best to prepare for end of life care. She arranged for her power of attorney and health care proxy to be her husband, if she ever became incapacitated. Now in her 80’s, her husband Dino, eight years her junior, feeds her home-cooked Italian meals, sings her favorite songs and pays a private aide to be there when he cannot at the Catholic nursing home in Manhattan.
Last summer, after he disputed nursing home bills that had suddenly doubled his wife’s co-pays, and complained about the inexperienced employees who dropped his wife on the floor, Mr. Palmero was shocked to find a six-page legal document lying on her bed. It was a guardianship petition filed by the nursing home, asking the court to give a stranger full legal power over Mrs. Palermo, now 90, and complete control of her money.
Many people are unaware that a nursing home can take such a step. However, interviews with system veterans and a review of the guardianship court data show this practice has become routine, shedding light on the growing power nursing homes have over residents and family members amid changes in the financing of long-term care. At least one judge has ruled this tactic by nursing homes is an abuse of the law, but the petitions, even if they are ultimately unsuccessful, force families into costly legal battles.
Mr. Palermo, 82, was devastated by the petition. A court evaluator eventually reported that Mr. Palermo was the appropriate guardian, but not before his legal expenses reached $10,000. In the end, Medicaid’s recalculation put his wife’s monthly co-pay at $4,558.54, almost $600 less than the nursing home had claimed, but far more than the $2,642 Mr. Palermo had been paying under an earlier Medicaid calculation. As soon as the nursing home cashed his check for the outstanding balance, it withdrew the guardianship petition.
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