NMS Healthcare

This is NMS Healthcare of Hyattsville's (“NMS") response to *** ***'s (“**") complaint involving former NMS resident and **'s mother *** *** ("Resident")As an attorney for NMS, I have been actively involved in this matter since November The Resident is not capable of
making her own decisions and, therefore, ** has been our point of contact for all matters involving the Resident.In October 2016, the Resident was admitted to NMSShortly after admission, NMS staff approached ** to discuss the Resident's participation in the Medicaid program in order to ensure that the Resident's long term care medical needs and expenses be covered.In November 2016, NMS staff told me that ** was unwilling to provide bank statements required by the Medicaid program and that, without them, the Medicaid application would be denied, potentially leaving over $30,a month uncoveredAt that time, I filed a document in court to compel ** to cooperate with us, given that the deadline to submit all documents was December 31, 2016.** did not turn over all requested documents to us; instead, she worked directly with a third partyThe Medicaid application was denied because the Resident's assets were above the limit allowed by Medicaid.On January 19, 2017, the Resident had to be sent to a local hospital, as we could not manage her needs(The Resident is still at this hospital.)On February 3, 2017, I spoke with ** and she said that the Resident's assets had been spent down to comply with the Medicaid asset limit** said that she had spent this money (over $8,000) on medical bills due to other healthcare facilities, and paid $to NMSI asked her to provide copies of the bills and receipts related to other facilities, as this is normally required in a Medicaid appealI never received these documentsOn February 9, 2017, I called ** to follow up on the requested documentationI was unable to get in touch with her, so I left a voicemailShortly after, ** was served with legal documents I filed in November 2016.On February 14, 2017, ** left me a hostile voicemail full of profane languageAmong other things, she called me a "***" and a "son of a ***," and said that I would "rot in ***," and that her mother's Medicaid application was none of my '*** businessOn that same day, she called another NMS employee, Craig N***, and left another offensive VoicemailI m happy to give you a copy of the transcripts.Throughout the Resident's stay at the hospital, NMS hospital liason Telisa S*** has been in touch with ** and the hospital's case manager to find a solution to this disputeTo this day, ** has not turned over any documentation that proves that she spent her mother's money on medical billsThat documentation is crucial to a Medicaid appeal.Additionally, it is my understanding that ** communicated to hospital staff that her mother's Medicaid application had been approvedThe hospital and MsS*** asked for proof, but ** never provided any**'s unwillingness to show proof that she actually spent her mother's money on medical bills may be indicative of fraud and/or abuseAt this time, NMS is considering reporting ** to Adult Protective Services and the Attorney General's Office for violating Health General Article s: 9344.I Additionally, NMS is considering other legal avenues to pursue Medicaid.Should you have any questions, please do not hesitate to contact me.Best regards,Juan A***Associate General Counsel

From: Kyle A[redacted]<[redacted]@nmshealthcare.com>Date: Thu, Mar 9, 2017 at 3:55 PMSubject: Re: Case ID [redacted]The latest update we have on this case is as follows:The issues underlying the complaint that was made against NMS Healthcare of Springbrook can only be resolved through one of our...

outside billers. We emailed the billing company on  March 9, 2017, to request the status of this account, so we can determine what happened.Regarding MD Medicare and DC Medicare: as far as we know, when the services are rendered at the Springbrook facility, the billing goes with DC [redacted]Please advise, with respect to the 10 day window and the possible consequences of not providing a sufficient written response. Thanks, Kyle A[redacted] Esq. | Associate General CounselNMS Healthcare