Alternatives to Nursing Homes as Nursing Home Populations Swell With Younger Patients - Part 2

 

One of the main reasons cited for this movement of younger people into nursing homes are the budget cuts most states face in Medicare and Medicaid.  In the long term, it is more cost efficient to care for a younger person in their home with part time caretakers.  However, in the short term, this is a more expensive way of treating patients, as the caregivers need to be hired and trained.  In the budget crunch most states are experiencing, short term funding takes priority over long term spending.   Younger people are being moved into nursing homes earlier, as in the short term, this is a more economically viable way of treating them.

According to a study by the AARP Public Policy Institute, the cost of at home care is about a third the cost of providing care in a nursing home or institution.  Many states, however, simply do not have the funding for at home care in their Medicaid programs.

One of the most telling quotes about the movement of younger people to nursing homes is:

“Over the past 20 years, federal laws and policies have established a civil right to get long-term care at home. But NPR's investigation found that is only sporadically enforced.

More than 60 percent of what states spend on long-term care for the elderly and disabled goes to pay for people — like Michelle Fridley — to live in a nursing home. The amount spent on home-based care has grown steadily, but not nearly enough to meet the need. Nationwide, there are some 400,000 people on state waiting lists for home-based care, double the number 10 years ago.”

Frequently attorney’s like our firm, that specialize in caring for the elderly, and those that have long term care needs, must be engaged to support a patient’s right to at home care.  In 1999, the right to at home care was clearly established in the Supreme Court, in the “Olmstead Case”.   In that decision, the Supreme Court stated that the unnecessary institutionalization of people with disabilities is  a form of discrimination.

 

To be continued…

Preview of the Proposed New Tax Relief Act of 2010 - Part 1

 

 

There’s a lot of talk about the New Tax Relief Act of 2010. 

At the time of this writing, it isn’t law, and with our current political logjam, there is likely to be a fair bit of change between now and then. 

We thought, however, that our clients would like to hear some of the elements that are of most direct interest to their welfare, and to the health of their estate.

Once again.. this is a preview of what is currently under discussion.  It is NOT law, and should not be looked at as political, legal, or financial advice.  This is only  a brief look at some of the currently debated act, as it impacts our senior clientele.

Reductions in Individual Income Tax Rates

Under contemplation is to temporarily extend the 10% bracket. The 10% individual income tax bracket expires at the end of 2010, and this impacts a great deal of our elder law clients. If nothing happens, the lowest tax rate will be 15%. This proposal extends the 10% individual income tax bracket for an additional two years, through 2012.

 

Part 2 will look at the proposed changes to Capital Gains and Dividends as well as The Dependant Care Credit.

 

Your friends at…

Cohen & Oalican, LLP

Boston ElderLaw Attorneys
Raynham ElderLaw Attorneys
Andover ElderLaw Attorneys

Scams and our elderly clients

• Unlicensed contractors offering home repairs: "Hey, we just finished a job for the smiths two streets over, and there's leftover tile, would you like a great deal on....."  If it sounds too good to be true, it probably is.  Beware of home repair scams.   Look out for transient work crews, strangers claiming to have extra material, free inspections in your home.. All of these should be red flags.  You should look to licensed bonded and insured professionals.  It may feel more expensive at the outset than these street contractors that show up.. but nothing is more expensive than a botched job, or worse, paying and never seeing your money or the work again.  Shop around for a certified contractor insist on a detailed contract on the work to be done, estimated cost and timetable.

• The state of Massachusetts Executive Office of Elder Affairs should be notified of any scam, or scam attempt by calling 1-800-243-4636.

If you have been victimized, keeping quiet will not help the next victim in line.  Just last month (October 20/2010) in Ipswitch an elderly citizen was approached by someone saying that they were the recipient of funds from the federal government, and asked to provide personal information in order to claim his windfall.  The man intelligently informed local police, and the scammer was investigated and arrested.  We applaud this anonymous individual.  Our elders cannot be a doormat waiting for the next scam artist to come knocking. 

If you are subjected to a scam, contact local authorities, and your elder law attorney.

 

At Cohen & Olican we take pride in protecting our clients.

Scams and our elderly clients–Fake Charities

Fake Charities:  

Scam artists create fake charities, often sounding like a real charity... they can spend a few dollars at a local copy store to dummy up credible looking ID, and they go on the prowl.  These ruthless con men (and women) not only steal from the vulnerable, but they also make it harder and harder for legitimate charities to do the worthy work that they are chartered to do.  We recommend that you make a conscious decision and a real plan for your charitable giving and philanthropy.  Check out the organizations that you intend to support, and support them for the good works that they do.  Do not be moved by the compelling story of a young woman knocking on your doorstep.  Legitimate charities are registered with the state of Massachusetts.  Here's a website to go to to validate whether or not a charity is registered with the state. 

At Cohen and Olican we take pride in protecting our clients.

Scams and our elderly clients: Some common swindles–ID Theft

 

 

ID theft: With the growing of the internet and all the different ways con artists work to get ahold of your private information, you must be incredibly careful with Identity theft.   Place outgoing mail in a secure collection box and remove incoming mail from your mailbox promptly. Get a shredder.. nothing that is in your trash should be considered safe.  Any personal information should be shredded before it is trashed.   Question any website that asks you for your passwords or bank account numbers.  Websites can be built to look like they are your real bank website - but in truth - they are there to take your information.  If it doesn't feel right..ask the question.. has my bank ever before asked me to go to a website just to confirm my password... We assure you - they haven't.  If in doubt.. call your bank, or whomever it is that is asking for your information.   To cut down on credit offers, call 888-567-8688 or go to http://www.optoutprescreen.com to opt out of mail credit offers. You will need to provide your Social Security number so they can match your request with your file - this is a legitimate request for your private information.

 

At Cohen Olican we take pride in protecting our clients. 

Sharing of Data Leads to Progress on Alzheimer’s Disease - Part 1

A project was initiated in the year 2003 when the National Institutes of Health, the Food and Drug Administration, the drug and medical-imaging industries, universities and nonprofit groups joined hands in a joint endeavor to find the biomarkers that reveal the progress and evolution of Alzheimer’s disease in the human brain. It was a unique project in the annals of medical research and it is yielding results now, which are evident in a deluge of research papers on the subject.

Early diagnosis of Alzheimer’s is being done with PET scans and spinal fluid analysis and more than 100 drug studies are in progress to find formulations that might slow down or even cure the disease. This remarkable collaborative effort is showing the way for more such projects and a similar one has begun for Parkinson’s disease. The Michael J. Fox Foundation has sponsored a $40 million study to find the biological markers for Parkinson’s disease that will enlist 600 subjects in Europe and the USA.

The project has generated great excitement among the research fraternity as the agreement to share all data and make all findings public was something unheard of in the scientific world. Anybody with a computer anywhere can access all the data and go through the findings of all the research studies on the subject. The objective was not just to raise funds, or do research but share all the facts and figures and everything going on in the project on a global scale. There would be no ownership or patent of the data or the research finding and everything would be in the public domain. Private pharmaceutical companies would of course benefit in the long run from the drug formulations or imaging tests that were being developed during the project.

Dr. John Q. Trojanowski, an Alzheimer’s researcher at the University of Pennsylvania is stunned by the amazing scope of the project. It is a project that is unique and path-breaking in scientific research, according to him. But it is the only way to do it, as unless we kept aside our egos and intellectual property issues, the task of finding the biomarkers for these diseases would be an impossible one, he says. It does not mean that a person having the biomarkers would definitely get the disease, but that is also part of the project. The study aims to find those biomarkers that herald the onset of the degenerative disease.

The Alzheimer ’s disease Neuro-imaging Initiative or ADNI came about during a normal conversation about 10 years ago. Neil S. Buckholtz, chief of the Dementias of Aging Branch at the National Institute on Aging was being driven to the airport in Indianapolis by Dr. William Potter who was himself a neuroscientist at Eli Lilly. Dr. Potter was seriously thinking about the ways to hasten the progress of the drug research on Alzheimer’s. He wanted to come out of the typical drug development syndrome of the 19^th century, where a drug was administered and then everyone waited around for it to work. He felt that there must be some other method, where one could view the brain as Alzheimer’s developed and then formulate drugs to halt that development. There were efforts to locate biomarkers, but there was not much progress as different scientists in many different parts of the world were doing their own studies in their universities and with their own patients. They were obviously coming up with different results due to this.

Could someone you love have Alzheimer’s? Do you have a long term plan to deal with the Medicaid issues surrounding this? Call Cohen & Oalican, LLP to draw up a plan.

Medicare coverage for Nursing Treatment, Long-Term Treatment and Expert Nursing Care

What is the amount of coverage that the current Medicare plans offer for nursing home treatment, long-term treatment and expert nursing care?

Normally, Medicare does not offer any help for long-term treatment and care. Treatment on a long-term basis is referred to as “custodial care,” as it can be carried out in various forms and locations. Long-term treatment and care can be rendered at a nursing home, another location in the community and even at home.

Personalized care, which cannot be categorized as skilled care, includes supportive service for daily activities like bathing, eating and other general support which does not fall under the category of skilled medical treatment. Therefore, Medicare will not pay for this type of care.

Medicare offers monetary help only for treatment, classified as vital and proficient medical or nursing care. If you are ill and need constant care under the eye of trained medical personnel who will have the responsibility for your remedial care, you would fall into this category.

Trained medical personnel like doctors and nurses managing your treatment differ from the long-term care given at home or elsewhere by your family members or care-givers. Medicare will only pay for treatment given at a medical facility by qualified and experienced staff.

To make sure you will be protected, call Cohen & Oalican, LLP to discuss your long-term care and Medicaid Plan.

PROTECTING YOUR HOUSE FROM THE COST OF NURSING HOME CARE Part 7 Conclusion

Cohen & Oalican, LLP : PROTECTING YOUR HOUSE FROM THE COST OF NURSING HOME CARE Part 7 of 7




Conclusion

Our clients worked extremely hard their entire lives saving for their retirement and to pass along a little something for their children. Often, their home is their “nest egg” representing a life time of hard work and savings. The best way to protect your home is to plan ahead. Given the State’s tightening budget, it has become even more difficult to obtain Medicaid eligibility and protect your home. For your own peace of mind, it’s more important than ever to hire an experienced Elder Law Attorney to create a comprehensive Asset Protection Plan to preserve all that you have worked for.

Consult with one of the attorneys at the offices of Cohen & Oalican, LLP for more information on Medicaid and Estate Planning.

This series has been brought to you by Cohen & Oalican LLP, Elder Law Attorneys Boston, Raynham, Andover

PROTECTING YOUR HOUSE FROM THE COST OF NURSING HOME CARE Part 2

Cohen & Oalican, LLP discuss:


PROTECTING YOUR HOUSE FROM THE COST OF NURSING HOME CARE

Part 2 of 7

Noncountable does not mean Protected

A home with equity of less than $750,000 is considered a noncountable asset. Without proper planning, at death the State will have a lien against your house and Medicaid will seek reimbursement for benefits provided. On the other hand, there are steps you can take to avoid a Medicaid lien and protect your home, saving hundreds of thousands of dollars.

Although the risk of a Medicaid lien is very real, the good news is that Medicaid will not force you to sell your house if you enter a nursing home. As long as a Medicaid applicant indicates on their application that they intend to return home, Medicaid will not force the sale of the house. This is a subjective question and it does not matter whether there is any realistic chance that the person actually will be able to return home.

Many people think the best way to protect their home is to give it outright to their children. Although this may sound like the simplest solution -- it may be the worst choice. Transferring a home outright to children can result in large capital gains taxes. Secondly, things can happen to children that can place the house at risk. What happens if a child gets divorced, is sued or has creditor problems? Seniors have been literally forced out of their own home as a result of ‘gifting’ their house to their children. There are several strategies available which will protect the house from Medicaid but also protect your right to live in the house. However, before you consider transferring your house, you have to understand the Medicaid transfer rules.

Be sure to consult with one of the attorneys at the offices of Cohen Oalican, LLP to create your Medicaid plan

This has been Part 2 in a series of 7, brought to you by Cohen & Oalican LLP, Elder Law Attorneys Boston, Raynham, Andover

Protecting your house from the cost of nursing home care - Part 1

Cohen & Oalican discuss Part 1 of 7

PROTECTING YOUR HOUSE FROM THE COST OF NURSING HOME CARE



Introduction

For must of us, our home is our most valuable asset. “Value” refers both to how much money you would receive if you sold your house but perhaps more importantly, value describes the emotional attachments we hold for the place we live and raise our families. When we first meet with our clients we typically ask what they are most worried about. The overwhelming majority tell us that they want to protect their home. “I don’t want to lose my house, if I go to a nursing home” is an often repeated refrain.

There is a great deal of confusion regarding what will happen to your house if you enter a nursing home. Some people have the good fortune of being wealthy enough to pay privately for their care. Although when nursing homes typically cost $100,000 a year, most of us are not that lucky. Others had the foresight to buy long-term care insurance. However, most of our clients are not wealthy enough to pay for their care and they either cannot afford insurance, or are not qualified. The remaining choice is Medicaid.

The first basic rule of nursing home Medicaid eligibility is that an applicant, whether single or married, may have no more than $2,000 in "countable" assets in his or her name. "Countable" assets generally include everything you own, except for your home (if it is located in Massachusetts and it has equity less than $750,000). Everything else,(second homes, retirement savings, life insurance) is counted and may have to be spent down before you can obtain eligibility. Although Medicaid will consider your home to be a noncountable asset it is important to understand that does not mean your home is protected.

This has been Part 1 in a series of 7, brought to you by Cohen & Oalican LLP, Elder Law Attorneys Boston, Raynham, Andover