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COOK COUNTY RECORD

Tuesday, June 18, 2024

Nursing home accuses estate over unpaid fees amid Medicaid dispute

State Court
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A legal battle over unpaid nursing home fees has taken a new turn as the Illinois Appellate Court reversed a lower court's summary judgment in favor of a healthcare facility. The Council for Jewish Elderly, doing business as Lieberman Center for Health and Rehabilitation, filed the complaint on June 5, 2024, in the Circuit Court of Cook County against Julia Kurtz, both individually and as an independent administrator of Frank Kurtz's estate.

The case revolves around Frank Kurtz, who resided at Lieberman from September 2013 until his death in September 2018. Lieberman alleged that it had not been paid for services provided to Frank after November 1, 2014. The trial court initially granted partial summary judgment in favor of Lieberman regarding liability, leading to a jury awarding $496,861 in damages. However, after deductions from other payor sources during a prove-up hearing, the final judgment was set at $306,923.84.

Julia contended that the trial court erred on multiple fronts: granting summary judgment on liability, making certain evidentiary rulings, and determining the damages award. She argued that Frank had been approved for Medicaid retroactively from September 1, 2014, which should have covered his long-term care costs. Julia appealed both the spenddown requirement and penalty provisions imposed by the Illinois Department of Human Services (DHS), ultimately winning her appeal against DHS's imposition of a penalty period.

Lieberman issued a notice of involuntary transfer and discharge to Frank due to nonpayment shortly before Julia commenced the Medicaid application process. Despite this notice and subsequent administrative decisions permitting involuntary transfer due to nonpayment issues related to Medicaid coverage were ongoing. Julia argued that there was an agreement between HFS (Healthcare and Family Services) and Lieberman preventing the latter from seeking payment from Frank or his estate once he was deemed eligible for Medicaid.

Lieberman's motion for summary judgment claimed no genuine issues of material fact existed regarding its claims for breach of contract, quantum meruit (reasonable value of services), unjust enrichment, and liability under the Rights of Married Persons Act (Family Expense Act). They argued that Frank never satisfied his spenddown requirement nor met his penalty period; thus he remained responsible for paying for his care.

Julia countered with evidence suggesting she had submitted proof of medical expenses totaling $349,000 to DHS and HFS which should have reduced or eliminated Frank’s spenddown requirement. Furthermore, she claimed Lieberman failed to file timely Medicaid claims necessary for reimbursement.

The appellate court found merit in Julia’s arguments noting discrepancies between Lieberman's assertions about unpaid spenddowns and existing DHS documentation indicating otherwise. It concluded there were genuine issues of material fact regarding Frank’s Medicaid eligibility during relevant periods rendering summary judgment inappropriate.

As such it reversed the trial court’s decision granting summary judgment on liability remanding case back for further proceedings including potential new trials on both liability damages aspects considering unresolved factual disputes around scope extent coverage under Medicaid program during Frank’s stay at Lieberman facility

Attorneys involved include Leon Zelechowski representing appellants while Meredith A Duncan from Polsinelli PC represented appellee Honorable Jeffrey Warnick presided over original case Circuit Court Cook County Case ID No 2016 L8894

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