An Iowa appeals court rules that the wife of a nursing home resident is liable to the nursing home for her husband’s unpaid balance under a state law charging spouses for reasonable and necessary family expenses. Bethany Lutheran Health Services v. Cumpston (Iowa Ct. App., No. 20-1700, Dec. 15, 2021).
Patricia Cumpston’s husband entered a nursing home and Ms. Cumpston submitted a Medicaid application on his behalf. After the state denied the application due to lack of information, Ms. Cumpston began working with an employee of the nursing home to file more Medicaid applications. The second application was denied due to excess income, so Ms. Cumpston created a Miller trust and submitted another application. When this application was denied due to excess resources, Ms. Cumpston wrote a check to the nursing home to reduce her husband’s resources. Eventually, her fifth application for Medicaid was approved.
After Ms. Cumpston’s husband died, the nursing home sued Ms. Cumpston to recover her husband’s unpaid balance under an Iowa law that provides that “the reasonable and necessary expenses of the family” are chargeable to both a husband and a wife. Ms. Cumpston sued the nursing home for breach of fiduciary duty. The trial court awarded judgment to the nursing home. Ms. Cumpston appealed, arguing that the expenses charged by the nursing home were not reasonable and necessary family expenses because they included charges for things other than medical expenses.
The Iowa Court of Appeals affirms, holding that the nursing home’s charges were reasonable and necessary family expenses and Ms. Cumpston is liable for them. According to the court, while the nursing home expenses included things other than medical expenses, such as room and board, the expenses were necessary for her husband’s medical care. The court also finds that while the nursing home’s advice to Ms. Cumpston when filing her Medicaid applications may have been “irresponsible,” Ms. Cumpston did not show that the nursing home “was in a such a dominant position over” her to create a fiduciary relationship.
For the full text of this decision, go to: https://www.iowacourts.gov/courtcases/14451/embed/CourtAppealsOpinion
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