Alternatives to Nursing Homes as Nursing Home Populations Swell With Younger Patients – Conclusion

Our current health care reform has several provisions to incentivize states to expand at home care, but there is still a strong “institutional bias” that requires states to fund nursing homes, but makes the payment of nurses for at home care optional.   Despite the savings, participation in  a new Federal pilot program that promotes at home health care is optional for states.

Another trend that has been found is that the population in nursing homes is changing to those who are either sicker, or more economically disadvantaged.   Those with the ability to pay, are moving to assisted living facilities.  Those who do not have as great a medical need (i.e. Healthier, but still in need of assistance) are also better served in more independent living facilities.  This new movement creates a nursing home population that is more disadvantaged both from a medical and a financial perspective.

NPR reports that “By federal law, people who face going into a nursing home must be told about alternatives. But in Miller's study in one state, nearly 30 percent of younger people in nursing homes said they weren't told about options. Often doctors and other health care providers just don't know what's available — and recommend a nursing home instead.”

Many times, when younger people chose to not to into a nursing home, it is at the expense of family members.  These family members provide care at no cost to the state.  While the state gets a free pass, the care giver family members can bear a huge burden in terms of  health, time and stress.

There are alternatives for many younger people to nursing home care.  With an experienced legal advocate by your side, you can also consider independent living facilities.  Many severely disabled people still live full and rich lives, not even in a facility, but with at home care.  It will frequently take an experienced attorney to protect your rights, and to help you determine what care is most appropriate for your situation.

 

We welcome hearing from you if you or a family member has special needs, and is looking for alternatives to nursing homes, or looking for ways to protect your family financially from the costs of long term care.

Call one of elder law attorneys at Cohen & Oalican, LLP Boston, Andover and Raynham.

Preview of the Proposed New Tax Relief Act of 2010–Conclusion

 

 

Changes to Regulated Investment company (RIC). 
Do you have investments in an offshore owed Regulated Investment company (RIC).  Here’s what changes you might be able to expect if the current bill is extended.

 

Estate tax look-through of certain Regulated Investment Company (RIC) stock held by nonresidents. Although stock issued by a domestic corporation generally is treated as property within the United States, stock of a RIC that was owned by a nonresident non-citizen is not deemed property within the United States in the proportion that, at the end of the quarter of the RIC’s taxable year immediately before a decedent’s date of death, the assets held by the RIC are debt obligations, deposits, or other property that would be treated as situated outside the United States if held directly by the estate (the “estate tax look-through rule for RIC stock”). The proposal permits the look-through rule for RIC stock to apply to estates of decedents dying before January 1, 2012.

 

By the time you read this, much may have been changed.  What we know for sure is that there will be change and it will impact our elder and special needs clients.  Please consult with us, or with an appropriate elder law attorney as you make decisions that will impact your taxable situation for the coming years.

 

Your friends at…

 

Cohen & Oalican

Boston Elder Law Attorneys
Raynham Elder Law Attorneys
Andover Elder Law Attorneys

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 2

The need was for all researchers and experts to come together to work and evolve a standard data set. But how was this possible? It would entail an incredible collaboration as no one company or researcher could manage to do this alone. The project would involve 800 subjects with varying degrees of memory impairment; some normal, some with a little impairment, some with Alzheimer’s and all had to be tested for the biomarkers and then followed up for several years to judge whether the markers heralded the progression of the degenerative disease. It did seem an impossible project and one that was way beyond anybody’s implementation.

But in the car, Dr. Potter had an intuitive flash when he felt that this project due to its seriousness of objective and aim of ending untold suffering may well propel people to work together in a way that had never been attempted before. The concept was to make the National Institutes of Health the go-between or broker between the world of academia and the pharmaceutical industry. Very soon afterward the director of the National Institute on Aging Dr. Richard J. Hodes talked about this to the former scientific director at the National Institute of Mental Health, Dr. Steven M. Paul and the latter agreed to consult the drug companies to find ways of getting funding for the research. Soon it became clear that all these companies were ready to assist as the development of diagnostic methods was a gigantic task that no one could manage on their own. Collaboration was the need of the hour. Congress established the Foundation for the National Institutes of Health to find ways and means to garner private funds for the institutes. Dr. Steven M. Paul was appointed to the board of the foundation.

Ultimately, $ 41 million was given by the National Institute on Aging, $2.4 million was contributed by some other institutes, 2 non-profit associations and 20 organizations together managed $27 million and this became the initial seed money to get the project started and keep it going for the first 6 years. The National Institute of Aging advanced another $24 million last year and on the basis of further federal and private funding the foundation made plans for the project to continue for another 5 years.

In the beginning, the unique parameters of the project had many scientists worried as they wondered whether giving up ownership and sharing valuable data with all and sundry would result in anything positive at all. There could be misinterpretation, misuse and wrong information being disseminated that could do more harm than good. But despite the misgivings, all realized that there was no alternative to this collaborative endeavor. Even the drug companies, who were usually looked upon with suspicion, were roped in and everyone had to overcome this mental block, according to Dr. John Karlawash an Alzheimer’s researcher at the University of Pennsylvania.

Dr. Karlawash stresses the need to combine resources and work together. The need to find these valid biomarkers for Alzheimer’s was urgent and the entire process demanded such huge funding and massive research that it was impossible for any one company or academic institution to even think of embarking on the project. It had to be a collaborative exercise and now all concerned are making use of the data. The huge data set has been downloaded at least 3200 times and the data sets comprising images of brain scans have been downloaded almost a million times.

The positive outcome of the project has delighted Dr. Buckholtz who says that he is quite “pleasantly surprised” by the way it has turned out. No one was sure how this innovative concept of sharing everything in the public domain in a research project would evolve, but they were confident that ultimately there would be some good coming out of the hard work and combined research. That is how it has turned out to be and it has kindled new hope for the conquest of these diseases.

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.

PROTECTING YOUR HOUSE FROM THE COST OF NURSING HOME CARE Part 6 Bring on The Medicaid Lien

Cohen & Oalican, LLP discuss: PROTECTING YOUR HOUSE FROM THE COST OF NURSING HOME CARE Part 6 of 7



Bring on the Medicaid Lien


In certain situations, it may make more sense to apply for Medicaid and let the Medicaid lien accrue against the house. Let’s consider a client who has $100,000 and a house worth $400,000. They spend down their funds in a year or so after entering a nursing home. At that point they have two choices. First, they could sell the house and pay privately for their care until the funds are spent down. If the nursing home costs $10,000 a month this will take about three years or so. Another option would be to apply for Medicaid once the funds are spent down. Remember, Medicaid will not count your house as an asset in determining eligibility if you indicate on your application that you intend to return home. Once the application is accepted, Medicaid will place a lien against the house and when the individual dies, the family will have to pay back Medicaid for benefits provided during that person’s life. You may be wondering where is the benefit in this strategy? The benefit lies in the fact that when you repay Medicaid you are paying them based on what Medicaid pays the nursing home which is typically between 60 and 60 percent of the private pay rate. In other words, if you let the lien accrue you would pay back Medicaid at a rate of $7,000 a month compared with the $10,000 a month that you would have paid privately if you sold the house. Of course, if you receive Medicaid benefits over many years, the lien may exceed the value of the house and there would be no benefit to the family. (It’s important to note that regardless of the size of the lien, Medicaid is only entitled to the value of the house.) One other drawback to this strategy is that the Medicaid applicant cannot use their own income to pay for the house expenses (taxes and insurance). The only way to cover this cost is either to rent the house or for other family members to pay the bills.

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

This has been Part 6 in a series of 7, brought to you by Cohen & Oalican LLP, Elder Law Attorneys Boston, Raynham, Andover