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Law Educator, Esq.
Law Educator, Esq., Attorney
Category: Legal
Satisfied Customers: 118060
Experience:  JA Mentor -Attorney Labor/employment, corporate, sports law, admiralty/maritime and civil rights law
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My father is 89 years old, legally blind, a WWII Veterans

Customer Question

My father is 89 years old, legally blind, a WWII Veterans and is incontinent. I felt it was time to put him in an assisted living facility. While researching facilities, we found out there was a Veterans Assisted Living Benefit that was available. We were told that all that was required that he serve during war time. We found Elmcroft of West Knoxville to be the facility that best met our needs. They had several veterans and they told us that they knew how to fill out all the paperwork and they made us feel confident that there would not be any problems in him getting the benefit which would be $1788.00 per month. We told them up front and specifically that he could NOT afford to stay there if he did not receive this benefit. They told us it would take 6-9 months before we heard anything from the VA and we would get back pay. They did not mention that he would need at least 2 ADL's in order to qualify. They filled out the paperwork and no ADL's were checked on the paper. They should have let us know at that time (which was during the first month of his stay) that he was not receiving any ADL's and that he possibly would not qualify for the benefit. After 10 months of him staying at Elmcroft, we received a denial letter from the VA stating that he did not qualify. We paid Elmcroft $23,000 during the 10 months and we would have received $10,788.00 from the VA. I reported Elmcroft to the Better Business Bureau for not informing us in the beginning that he would not qualify for the benefit. We would have discharged my father from Elmcroft the next month after giving them a 30 day notice. We requested a refund from Elmcroft for the amount of $10,788.00. They have failed to respond to the complaint that was filed to the BBB. When we first took the denial letter to the director at Elmcroft, she said that yes, he needed to have at least 2 ADL's checked in order to qualify for the VA benefit. We did not even know what an ADL was until this time. They knew that he did not need assistance in dressing, not assistance in bathing. This was a complete failure to notify us after they completed their paperwork on my father. We need to know if Elmcroft is legally responsible for not notifying the family that he would not be receiving the VA benefit, and are they legally responsible for paying the refund?
Submitted: 2 years ago.
Category: Legal
Expert:  Law Educator, Esq. replied 2 years ago.
Thank you for your question. I look forward to working with you to provide you the information you are seeking for educational purposes only.
If the facility told you he would qualify and was negligent in processing the application and also was negligent in validating he met the qualifications, yet represented to you he would meet the qualifications, they can indeed be liable to you BOTH under breach of contract and detrimental reliance on their representations AND ALSO for unfair and deceptive business practices. Since they were supposed to be an expert on these matters and applying for benefits, you would have been reasonable to rely upon their representations to you and as such you relied upon those representations to your detriment. Furthermore, if you can show, which you can by the subsequent statements they made to you, that they knew all along he needed to meet the ADL requirements and did not disclose that to you, that would be an unfair and deceptive business practice that could entitle you to up to triple damages plus attorney's fees for their conduct.
I would urge you to get a local elder law or consumer protection law attorney to seek to pursue them in court.