The dawning of the New Year is good time to reflect on the year past, take stock of all that we have learned, all that we have to be grateful for, and set goals for the year to come.  In my time at Schutjer Bogar, I have learned a great deal from my colleagues, the facilities that we serve, the residents, and their families.  In the spirit of the season, I would like to share with you three important lessons that I will take with me as we embark on 2012:

1. Don’t underestimate the power of good faith.  Time and time again I have seen previously denied Medicaid applications be re-opened and benefits approved because the facility, the resident, and/or their family has made a good-faith effort to provide the information requested by the county.  Diligent efforts to obtain the documentation and keeping the caseworker informed of the status of those efforts will to a long way toward the goal of securing Medicaid benefits.  If you have been trying to obtain those last few bank statements, or a copy of that deed, but just can’t get it, don’t despair!  Tell the caseworker.  Ask for more time.  Or ask for the caseworker to assist with getting the needed information.  The caseworker should accommodate a reasonable request and failure to do so can be grounds for an appeal and, ultimately, lead to the approval of Medicaid benefits.
2. Be kind to your fellow man.  The process of securing Medicaid benefits for a resident can be, as we all know, a lengthy and frustrating process.  Maintaining a cordial and professional relationship with the caseworker, the resident, and their family can go a long way toward securing their assistance and cooperation.  In some cases, the resident and their family may appear hostile or uncooperative simply because they do not understand the process and the need for their cooperation.  Reach out to them.  I have had many cases where a previously uncooperative spouse or child would, once the eligibility process and the importance of securing Medicaid benefits for their family member was explained to them, prove not only cooperative but eager to assist.  There are, of course, unfortunate instances where the unwillingness of the resident and/or their family is evident and appropriate legal action must be taken, but holding firm in your position without sacrificing civility has, in my experience, yielded a far better result under any circumstance.   
3. Communication is key.  Communicating with your residents, their family, and the caseworker is the best way to ensure that an application for Medicaid benefits is timely processed.  Although many counties are backlogged and routinely process applications well beyond the required period, regular and continuous efforts to contact the caseworker to determine the status of an application or inquire whether additional information needed are important.  Even if the caseworker does not respond, the effort that has been made can prove useful in the event that an appeal is necessary.  Keeping a log of attempts to contact the caseworker or, as the case may be, the resident’s family, is also extremely helpful should an appeal or other legal action be necessary to secure Medicaid benefits.

I have no doubt that the New Year will bring challenges, new lessons, and, hopefully, triumphs.  As I go forward, I will take with me the experiences I have had in the hope that they will guide me toward achieving a better outcome for our clients so that they can focus on doing what they do best – caring for their residents.

 Best wishes to all for 2012!

 Erin works in our Washington, DC office with Elizabeth Meadows, Monica O’Connell, Elizabeth Spawn-Stotler and Lucretia Bailey.