The spouse of a nursing home resident learned that he had needlessly spent down his assets in order to qualify his wife for Medicaid because the nursing home had misinformed him about his insurance coverage. A Pennsylvania court dismisses his suit, ruling that the statute of limitations began running when the mistake was first discovered. Donison v. HCR Manor Care (Pa. C. Cumberland County, No. 05-5626, Nov. 6, 2008).
After being told by his wife's nursing home that his insurance company, Tricare, would not cover his wife's care, Duane Donison spent down some $30,000 in assets so that his wife could qualify for Medicaid. In July 2001, a county caseworker informed Mr. Donison that the facility should have been billing Tricare, which provides civilian health benefits for military personnel, for his wife's care and that there was no need for him to have spent down the funds. In December 2003, after correspondence from Mr. Donison, Tricare confirmed that his wife was indeed covered for nursing home care. Mr. Donison sued the nursing home for negligence and detrimental reliance in October 2005.
The nursing home argued that Mr. Donison's claims were barred by the relevant statutes of limitations, which are two years for negligence and four years for detrimental reliance. Mr. Donison countered that the statutes should be tolled according to the "discovery rule," which prevents a statute of limitations from running against a claim until the injured party has sufficient knowledge that a harm has occurred. He argued that he did not have sufficient knowledge until December 2003, when Tricare confirmed his wife's coverage in writing. The nursing home claimed that Mr. Donison learned of the injury after his conversation with the case worker in 2001.
The Court of Common Pleas of Pennsylvania, Cumberland County, grants the nursing home's motion for summary judgment, finding Mr. Donison's claim barred by the statutes of limitations. The court cites Mr. Donison's deposition, in which he described the conversation with the caseworker, as proof of his knowledge of the injury at that time.
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