Families Shun Loved Ones’ Care Tabs, County ‘Stiffed’ for Over $1.2 Million

CREST HAVEN – A sore point for Freeholder Director Gerald Thornton was touched in budget deliberations Jan. 21: bad debt. Those funds owed to Cape May County and are being ignored by debtors.
Worse, of the $1.455 million on the books, about 85 percent is owed by families whose loved ones are being cared for at Crest Haven Nursing and Rehabilitation Center. Thornton told the Herald, $1.223 million of that debt is owed by private-pay patients’ families. They are ones who do not use government funds, such as Medicaid or Medicare, to support their loved ones in the 180-bed long-term care center.
The overall county budget expected to be introduced Jan. 28 at the freeholders’ regular meeting was $139.2 million, which carries a tax levy hike of about half a cent, to .2092 per $100 of assessed value, over the previous year’s .2056 cents.
“If we did not have that bad debt, the tax increase would not be needed,” said Thornton in a Jan. 23 telephone interview.
At the Jan. 21 meeting, Thornton posed the question to County Counsel Barbara Bakley-Marino: “Where are we with bad debt? Just last month you got almost $200,000 in bad debt?”
“Four phone calls today,” replied Bakley-Marino.
For an estimated six years, Thornton has been “really griping about this.” He advocated using a collection agency to recoup delinquent accounts. The idea failed, “They fired us,” quipped Thornton.
Following that episode, a decision was made to take an in-house collection tack utilizing County Counsel Barbara Bakley-Marino. So far, it appears to be working to the county’s advantage.
Freeholder Will Morey theorized getting a letter from the county counsel, and a phone call from someone they likely know, or at least heard of, since this is a small county, results are more concrete than “getting a call from someone in North Dakota.”
Thornton said the county has two cases in Superior Court pressing for payment on the overdue care accounts. If successful, the county could place property liens on assets, he said. Should those cases be won by the county, it’s expected to benefit the bolster coffers by “close to $500,000” said the director.
“A lot of people are beating us who have assets. Family members try to hide the assets,” said Thornton.
Those who are Medicaid or Medicare eligible, and who get Social Security or pension checks are supposed to have those funds diverted to the county to offset the cost of care.
Center residents are allowed to have $2,000 for their personal use.
“What happens here is that relatives keep the pension and Social Security money for themselves,” said Thornton. If that small percentage of people – he estimated 5 to 8 percent of the revenue generated – would pay, the county could realize an additional $193,000 currently owed to it.
“We get stiffed,” said Thornton.
“Here is our biggest problem,” said Thornton, “The only reason we can have somebody sent home from the nursing home is for lack of payment. When we tell the families we will discharge them (loved one) unless we get payment, they do not respond or they said they cannot take them (loved ones) back, or they have no way to care for them. Here is where we get trapped. We cannot discharge a person unless it is a safe discharge, a safe environment,” he continued.
“I would not discharge some poor, elderly person into an environment that they can’t be cared for. We would not do that,” he stressed.
“What I have the biggest criticism is people not willing to pay or care for their loved ones,” Thornton said.
He described $200,000 received last month as a result of Bakley-Marino’s actions, as “good news.”
“I am going to be insistent we get everything we are owed,” he said.
If a person is indigent, “We would take them in the blink of an eye, but right now, all the citizens of Cape May County are paying because someone does not want to be responsible for their loved ones,” he continued.
Of those who are truly in need, he cited a couple in the center who have been there since Superstorm Sandy. “They are still there more than a year after the storm,” he said.
Thornton wanted to allay a concern some voice about admission to Crest Haven Nursing and Rehabilitation Center when a married couple resides in their home. Should one spouse go into the center, the other spouse can remain in their home until their passing. At that time, and only then, does the county take possession of the home to sell and recoup money expended on care of the resident.
Bridgette O’Brien, center director of finance, told freeholders the monthly cost, per person, at the nursing home is about $7,300.
Since many admissions to the center are direct from a hospital, there is little time for pre-planning and financial research. If such planning took place, she said, perhaps assets would be revealed and reassigned in a timely manner.
Application for Medicaid is often lengthy, and can take from three to eight months for acceptance, Thornton said. In the interim, care is provided, but no revenue is realized by the county.
Bakley-Marino said she is attempting to work with Social Services to “get the information back in a shorter time.”
“They hide pension and Social Security money,” said the freeholder director of some families. Soon the bill tallies “hundreds of thousands of dollars. The (County) Prosecutor should prosecute some of them. They are defrauding the County of Cape May.”
“It’s a tricky issue,” admitted Morey. He urged better “front end” research as “the best preventive medicine, no pun intended.”
Because of privacy laws, it is difficult for center staff to even get a yes or no answer from Medicaid whether a family has made application for their loved one, Thornton said.
“Once the loved one is there trying to get the loved one out is hard to do,” Center Administrator Linda Thornton said.
“We can’t get evidence if they filed for Medicaid, then find out they are not eligible, then the family disappears because they don’t want to pay us. They just leave their loved one there and expect us to take care of them for free. It’s a sad situation,” said Morey.
Other bad debt, perhaps $15,000 to $20,000, results from non-payment of bills to the Health Department, such as for family planning visits or septic permits and a fractional amount from County Park.