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Diversity case where RLI sued PIIL and USF to recover part of what RLI paid to settle a nursing home case. The nursing home and all three insurance companies settled the underlying claim in 2003 for $3.9 million. The issue on summary judgment was allocation of the settlement amount among the insurers. Applying Texas law, […]

Forfeiture action by the government where it was alleged that cocaine was sold at a nursing home. One witness “observed the Isleys supply people living in the home with cocaine and alcohol in exchange for the endorsement of their monthly government check to the Isleys.” The government filed a motion for summary judgment under the […]

Plaintiff brought wrongful death action against assisted living facility. During the admission process, resident’s daughter signed admission papers without a power of attorney and without discussing it with the resident. After suit was filed, the facility filed a motion to compel arbitration. The matter was referred to the magistrate. The court found no evidence that […]

At admission to assisted living facility, daughter who was completing documents indicated she wanted to have residency agreement reviewed by an attorney. The facility employee said that would be “pointless” because the facility would not accept any changes and resident would not be allowed to move in without a signed agreement. The agreement provided for […]

Plaintiff brought a claim under 42 U.S.C. § 1395y(b)(3)(A) to recover funds for the Medicare program attributable to cigarette smoking. The trial court dismissed the claim. On appeal, the court found that “[u]ntil Defendants’ responsibility to pay for a Medicare beneficiary’s expenses has been demonstrated (for example, by a judgment), Defendants’ obligation to reimburse Medicare does […]

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 […]

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 […]

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