Ideas on Overseeing the Care in a Nursing Home When You Can’t Enter the Building
Advocating for our clients in nursing homes during this pandemic has been uniquely difficult, but we continue to utilize whatever tools are at our disposal to help the family members oversee the delivery of care to their loved ones. Many rights are guaranteed, and right now much creativity is needed to protect those rights. Care plan conferences with the treatment team (nursing, dietary,...
Will Medicare ever pay for nursing home care?
Consumers of health care in old age likely consider nursing home care to be part of the continuum of health care that a patient may require. Yet health insurance plans do not pay for nursing home care because it isn’t defined as “treatment.” Instead, it is classified as long-term care rather than “health care,” because the care is maintaining the individual and...
Keep a close eye on your loved one’s care in a nursing home
It almost goes without saying that if your loved one is admitted to a health care facility, somebody outside of the institution needs to immerse themselves in the treatment & care planning process, read the chart on an ongoing basis, know what’s being prescribed, speak with the care providers or treatment team frequently, and demand answers to reasonable questions about What is being...
Don’t count on the Medicaid representative at the County Board to remind you to Spend Down
An application for Medicaid benefits cannot be approved before the applicant (and spouse, if any) has completed the spend-down, because benefits are not payable unless the applicant is financially eligible. It is not uncommon for someone to initiate an application for Medicaid without having any idea whether they are eligible or not. The nursing home may start the process; a nonattorney...
Elective share and Medicaid can lay a trap for the unwary
In New Jersey, a surviving spouse has the right to claim his or her “elective share” of the deceased spouse’s estate if the deceased left him/her an inadequate inheritance. The calculations are made using the step-by-step process of a set of state statutes, N.J.S.A. 3B:8-1. If the individual receives Medicaid benefits and is widowed, failure to claim the “elective...
For Qualified Income Trusts, Not All Bank Accounts Are Created Equal
Medicaid Long Term Services and Supports (MLTSS) in New Jersey pays for nursing home care for people with alzheimers disease, catastrophic disabilities and other serious difficulties with self care. The program requires any applicant with more than $2205 (three times the SSI amount–new for 2017) of gross income to make a Qualified Income Trust. Our office assists applicants with this...
Homemade Powers of Attorney can create expensive legal problems
I ran into a situation recently that I thought I’d share with my readers since it’s the type of thing that happens over and over again. The Elder person is living in New Jersey but owns real estate in another state that needs to be listed or sold because he is applying for Medicaid to pay for his nursing home. The person has Alzheimers Disease and no longer has capacity to sign...
Reduction of Home Care Hours Under Medicaid Can’t be Arbitrary
New Jersey Family Care is the Medicaid a program that provides MLTSS — Medicaid Long-Term Services and Supports. The home care program is called HCBS — Home and Community-Based Services. Once the applicant has been found eligible for Medicaid and is assigned a Medicaid case number, s/he must select a Managed Care Organization (MCO). S/he will then receive a visit from a Case...
Feds announce new Medicaid/Medicare rule banning arbitration clauses in nursing home contracts
Effective in November, 2016, mandatory arbitration clauses in nursing home admissions contracts will be prohibited for all nursing homes which accept federal Medicaid or Medicare dollars. This is a dramatic shift in the landscape which will enable injured parties to decide whether to pursue their negligence claims or other claims through the civil courts or through binding arbitration....
Behavioral Therapy Techniques Show Promise for Alzheimers’ Patients
If you are caring for a person with Alzheimers’ dementia, you are probably seeing a number of behavioral changes that are difficult to understand and challenging to respond to. These are sometimes called “neuropsychiatric symptoms,” and they span the spectrum from apathy and depression to wandering, disinhibition, irritable verbal onslaughts, agitated pacing, and...