New York Elder Law Attorney Blog

Senior Forced to Spend $100,000 to Prove Competence

Tue, 21 May 2013 10:06:22 -0500

The Austin American Statesman reported on a troubling elder competence case that is leading many to call for legal reforms. The story is a reminder of the heartache that may arise when feuding arises within families and relatives engage in costly legal battles.

The 91-year old's struggles began when two adult daughters told a local judge that they believed their mother was not mentally sound. They worried that she was being financially exploited and was unable to care for her own health. While perhaps rooted in good intentions, the process is an example of how senior guardianships proceedings can go awry when not done carefully.

The senior in this case lived alone until 2009. That year she broke her leg and was required to move into a senior living community. The woman was happy at the facility, and eventually one of her three daughters began helping managing her financial affairs.

Delegating the financial duties to only one daughter caused disagreement between the siblings. They eventually made allegations of abuse, neglect, and exploitation. As required, area senior protective service groups investigated the situation--appointing a guardian ad litem to look out for the senior's best interest.

The protective services investigation eventually determined that the senior was not being financially exploited and that her health was not at risk. Yet, this was not reached until after a very long back-and-forth between the parties that lasted month, came with mounting legal bills, and caused immense stress for all parties. Ultimately, mediation was required to end the matter. But it was not before the senior had to $30,000 to a court-appointed lawyer as well as $70,000 for her own private attorney. ANother $40,000 was spent by the others involved in the matter.

All of this is leading some familiar with the case to change the law so that adult guardianship cases are handled more efficiently. One advocate explained, "Before we remove somebody's civil rights, we need to make sure they are, in fact, at risk, that they are being exploited and that they are incapable of making decisions/."

The lesson: Always act as early as possible to put long-term plans in place. If outside parties truly want to make an issue out of competence, they will have more ammo to drag out a process unfairly if they can point to factors like age or illness. Even if those reasons are baseless, the appearance of some questions can cause a senior problems. The prudent step is always to act now. Make a call to an estate planning lawyer today to bring security and peace of mind.

National Nursing Home Week 2013: Team Care

Fri, 17 May 2013 06:00:07 -0500

The American Health Care Association (AHCA) is leading the effort this year as part of the official "National Nursing Home Week" which was designated as May 12th through the 18th. More information on the event can be found here.

The purpose of the Week is to raise awareness of various needs of the long-term care community. In addition, it is used by many local facilities to better connect senior residents with their neighbors. Unfortunately, there remains somewhat of a barrier between nursing home residents and others--the seniors in these facilities are often viewed as "others." Instead, many elder care advocates urge a more holistic outlook, where the skills of seniors are valued and they are viewed as an integral part of any neighborhood.

The official theme of these year's National Nursing Home Week is "Team Care." According to the AHCA this theme, "recognizes residents and patients in long term and post-acute care settings, the dedicated staff who care for them, and the value of care planning where everyone 'pitches in' for optimal outcomes."

It is encouraging that "care planning" is incorporated into this year's effort. This planning takes many forms, beginning with efforts to prepare for possible long-term care long before the actual care is needed. As elder law attorneys, we have seen many seniors who are forced to chose between two unwanted options when illness or injury befalls them and they do not have plans in place to provide ideal are.

Lack of Planning & Mistreatment
Unfortunately, there is often a connection to a lack of planning and receiving less than quality services. Of course abuse and neglect can occur anywhere, and so all seniors and their families need to be vigilant about standards anytime that one is receiving aid at a nursing home, assisted living facility, or at-home services.

For example, an elder abuse forum was recently held in Saratoga Springs where advocates from the Weinberg Center for Elder Abuse Prevention discussed how elder abuse remains overlooked far more often than it is caught. The advocate explained how elder abuse is much more than broken bones or pressure sores. Instead, a wide range of physical, financial, and emotional damage can strike seniors with their caregivers do not provide proper treatment.

In honor of National Nursing Home Week, hopefully all New Yorkers take an extra moment to check on the seniors in their lives to ensure they are receiving the basic aid they need to thrive in their golden years.

Stolen Home: Elderly Mother Claims Deed Conveyed to Son Via Fraud

Wed, 15 May 2013 06:00:41 -0500

Most discussions of elder financial exploitation include accusations of unique scams targeted at trusting seniors. As we discussed last week, many wrongdoers try to swindle the elderly community via insurance frauds, home repair schemes, and similar techniques. These are very real dangers that must be guarded against. However, it is a mistake to assume that all scams are committed by random strangers.

The sad reality is that many act of elderly financial exploitation are perpetrated by family members. Because of a senior's propensity to trust their relatives and/or not wish to come forward with suspicions against loved ones, financial crimes committed by friends and family are particularly hard to identify. Experts working on these affairs point out that the vast majority of these situations never result in liability. In other words--wrongdoers often get away with it. The "success" rate of this exploitation is one reason why it continues to be perpetrated time and again. That makes it incumbent on all of us to do everything in our power to check on vulnerable friends and relatives and put plans in minimize the risk of harm.

Fraudulent Deed
Prevention is far better than dealing with exploitation after it has occurred. For example, Courthouse News recently reported on one case where an 80-year old woman was forced to file a civil lawsuit in an attempt to get her house back. According to the documents filed with the court, the senior attempted to pay her 2012 property taxes on the home when, to her surprise, she was told that she was no longer the owner of the property.

Apparently, her adult son was the new owner. The woman does not remember knowingly signing over the deed to the home, but the son claims she did just that over a year ago. The son admits that he did not pay anything for the property. However, he claims that it was given in "compensation" for the fact that two vehicles that he owned were "lost" to his other siblings. It is unclear from the report exactly how the other sibling's potential debt may have been involved in this scheme.

Sadly, many seniors find themselves in somewhat similar circumstances, losing control over assets to unscrupulous relatives. When professionals are not around to provide oversight to these sorts of transactions and identify problems early on, then complications like this develop. Ideally, this would have been caught before the deed was signed, eliminating the need for a prolonged legal battle just to fix the fraud.

For help ensuring you or a loved one has that professional oversight, throughout New York please get in touch with our elder law attorneys.

Massive Elder Scam Cost Seniors Nearly $6 Million

Mon, 13 May 2013 10:38:35 -0500

On the whole, studies continue to show that seniors citizens are more "trusting" than younger demographics. Sadly, that trust is often exploited by those seeking to scam seniors out of significant sums of money, including retirement savings. These scams take many forms, and each are a reminder for families to be vigilant about the financial well-being of elderly loved ones.

Recently, headlines were made when authorities arrested a couple who are alleged to have bilked seniors out of nearly $6 million in a far-reaching insurance fraud scheme. The pair tricked many different families into purchasing long-term care insurance to provide in-home care to seniors. They collected a mountain of premiums, but refused to provide any of the actual services needed when participants sought use of their claims.

According to various reports, more than 230 seniors purchased insurance policies from the couple. They paid monthly premiums as high as $4,000 for what they thought would ensure them "unlimited in-home, non-medical services." In reality, it bought them nothing.

The plan worked by having the seniors pay for in-home services out-of-pocket, like cooking, cleaning, and other basic chores. The seniors then expected to submit a claim order, and those costs would be reimbursed. But the couple never intended to reimburse anything. They simply took the monthly funds and refused to honor the claim requests.

The husband in the scheme is a former insurance salesman, and so he was familiar with the appropriate ins and out of the industry and ways to put on a convincing front. The pair ran the business under several different names. Authorities believe that the total haul of nearly $6 million was perpetrated in at least six states over a ten year period.

As the daughter of one of the victim's explained, ""It takes a really special narcissism and cruelty to live an opulent lifestyle at the expense of vulnerable, trusting, often physically or mentally fragile senior citizens,"

Trusted Help
What makes this case so tragic is that the seniors hurt usually only discovered the fraud at the exact moment when they needed help the most--usually after a health decline or serious medical event requiring at-home aid.

It is critical for families to rely on the help of trusted professionals experienced in all facets of elder law issues, including procuring secure and reliable long-term care insurance. The attorneys at our firm are available to help families throughout New York on various issues, from estate planning, securing private insurance, and joining the Medicare program.

New York State Commissioner of Health On NY Medicaid Reform

Fri, 10 May 2013 06:30:16 -0500

This week Dr. Nirav R. Shah--the Commissioner of Health for the state--issued a press release summarizing the positive impact of each of the Medicaid reform efforts that have taken place over the last few years. As many are aware, Governor Andrew Cuomo has been aggressive in his efforts to streamline the system, mostly motivated by financial concerns.

The Commissioner used the occasion to paint a positive picture of the New York Medicaid's current situation. He noted how costs for the program are down while quality indicators are receiving good marks. Amazingly, all of this is coming at a time when actual enrollment in Medicaid is increasing. Lowering costs even with steady enrollment is difficult, and so do so while adding to the program is a real achievement. The press release points out that, all told, over $3.2 billion has been saved in New York City alone. That is not a trivial amount, particularly considering trends had been moving in the opposite direction for years.

Interestingly, the Commissioner noted that it was long-term care services which, in the past, were the main drivers of increased Medicaid spending. But the Medicaid Redesign Team has been able to "bend the cost curve," mostly by shifting resources into less expensive but helpful programs--like at-home care.

The Commissioner's press release also discussed the "Managed Long-Term Care" (MLTC) Program. This slate of projects applied to those on Medicaid who are concurrently enrolled in Medicare (the senior health insurance program). The purpose of MLTC is to provide more cost-effective long-term care. Some worry about the quality of care provided via the MLTC, but Commissioner Shah argues that quality indicators thus far are encouraging, with the vast majority of seniors showing no problems following a switch into the MLTC program as compared to the old system.

This is important considering changing demographics demonstrate that many more New York seniors will likely need expensive nursing home care in the coming years. This will result in more seniors relying on Medicaid for assistance. Our NY elder law attorneys work with families on just that issue.

All of these indicators are good news for New York residents. Efficient but quality public healthcare services are of vital importance to communities throughout the state. Medicaid will only grow in importance in the next few decades. For aid understanding how the qualifications process works, whether assets can be saved from being "spent down," and more, please get in touch without our NY senior care lawyers.

Is New York Ready For Boom in Old Age?

Wed, 08 May 2013 09:24:57 -0500

The Post-Star recently published a story with the provocative headline: "Old Age is Coming, and We Are Not Ready."

The article touches on some practical issues in New York state that have often been discussed in the wake of the national demographic shift that is already underway. As most know, the population is aging. But far fewer give serious consideration to what these means for those seniors (and society as a whole). The coming of old age has two main questions: (1) Do we have the appropriate quantity of services to provide the care necessary for all seniors in need in future years? (2) If not, how are we going to come up with the resources to acquire those services?

Minimal Senior Care Services
The story notes that about ten thousand Baby Boomers turn 65 and reach the traditional retirement age each and every day. In the New York state counties of Washington and Warren, those over 65 account for about one-third of the entire population. The trends are similar throughout the state and country.

Many of those seniors will eventually need extra care for daily tasks, perhaps including nursing home stays. But do we have enough beds in nursing facilities to account for the change? Right now, most experts on the issue do not believe that there is anywhere near sufficient supply to meet the coming demand. This is fueling a burst in private investment in elder care resources (like nursing homes) in New York. Nationwide the long-term care industry grew by 31% over the last five years--the trend is expected to continue in the next five.

But many worry that there still may be problems in the future. That is because not only is the Baby Boomer generation far larger than the generations before and after it, but with advances in medicine, that generation is living longer. In the not-too-distant past, retiring at age 65 often only came with a few years of retirement, on average. But today, both men and women live over 75 years on average, with many living much longer. While longevity is a good thing, it comes with clear concerns about supply of care for seniors and finances to pay for that care.

The bottom line: It remains unclear how public bodies will respond to the looming senior care challenges. That makes it in every individual's best interest to take matters into their own hands and ensure plans are in place to provide for their own well-being no matter what the future holds. That may include contacting an elder law attorney and ensuring access to NY Medicaid services.

Landmark Medicaid Study on Effect of Program Expansion

Mon, 06 May 2013 11:04:51 -0500

The results of a comprehensive new research effort on Medicaid's effects on low-income residents was just published in the New England Journal of Medicine. The full summary of the article can be found online here.

As discussed in the New York Times late last week, the project compared individuals who received Medicaid support over a period of two years with those in similar income brackets who were not enrolled in Medicaid. The idea was to compare these groups on a wide range of indicators--financial well-being, physical health, mental health, and more. As such, it provides the most comprehensive understanding yet of how wide-ranging Medicaid changes may impact various community members.

Counterintuitive Results?
Interestingly, some of the finding are a bit surprising. For one thing, over the two-year period of the study, those on Medicaid did not showed marked differences in physical health on factors like blood pressure and blood sugar levels. However, observers are quick to point out that this may be because of the relatively short-time frame of the effort. Looking at health outcome five or ten years out may be a better indicator of how access affects various basic health indicators.

And that is not to say that there were not clear benefits to program expansion. The study found that those on Medicaid were clearly better off financially as a result of the support--significant sums of their income were saved that otherwise would have been lost to out-of-pocket medical bills.

In addition, mental health indicators showed those with Medicaid support were better off than their non-Medicaid counterparts. Depression levels were lower among the covered group, up to 30% lower.

Medicaid & Seniors
While the Medicaid study is drawing a lot of attention for its comprehensive scope, it is important to put it into context for New York seniors who are on (or may join) the program. While some seniors were included in the study groups, the majority of program participants in this research effort were low-income children and adults. The needs of this group are slightly different than those of seniors for basic care.

In other words, while this research may offer mixed-results regarding to merit of Medicaid expansion, there is obvious benefit for seniors who need close care and who are unable to pay the staggering costs on their own. It is one thing to understand system-wide trends, it is another to have a senior loved one who has a medical emergency and suddenly needs around-the-clock care. In the latter case, qualifying for Medicaid is obviously essential, regardless of the national trends.

Every family is different. That is why it is important to receive individual advice about qualifying for Medicaid and understanding what benefits the program can provide in your specific case. For help throughout New York on these issues, please get in touch with our team of NY elder law attorneys.

New York Nursing Home Evacuation Plans

Fri, 03 May 2013 06:02:22 -0500

The reverberations of Hurricane Sandy's impact on the city are far from finished. We will be cleaning up and adapting for many months--likely years--into the future. Considering the predictions of some, we may even have to deal with large storms of this magnitude on a far more consistent basis. It affects all areas of life--including things like senior care and nursing home operations.

Many New Yorkers were shocked to learn of the goings-on at some long-term care facilities hit hardest by Sandy. Stories have been told of seniors stuck in upper levels of flooded facilities for days without power. Many questions have been raised about the management of the long-term care facilities and confusion over why the senior residents were not evacuated. In fact, in large part because of the struggle with NYC nursing home evacuations during Sandy, the Center for Medicare and Medicaid Services (CMS) will release new disaster planning for all nursing homes in the coming year.

Looking to the future, local residents are advised to understand evacuation plans for long-term care facilities where loved ones reside--or to ask about such plans when making nursing home choices. An AARP story recently profiled nursing home evacuation plans, pointing out the critical issues that facility caregivers need to consider. It is worth browsing the list to get an idea of the questions that owners and operators in New York need to be asked to ensure that seniors are protected in case any manner of natural or man-made disaster strikes requiring quick action.

As the post pithily explains: "You may not be able to control an explosion, earthquake, hurricane, power outage, terrorist attack or other catastrophic natural or human-created events. But, you can make sure you know what will happen to your parent or someone else dear to you should there be one."

There are no one-size fits-all evacuation plans. In fact, some plans need to be adapted on a per-resident basis, because needs vary considerably. For some seniors, it is not a difficult matter to load onto a vehicle and move to a safe location in a timely manner. For others, transportation and alternative living arrangement come with their own inherent dangers that need to be considered. For these residents, "sheltering in place" may be the most prudent choice. But no matter what, it is important that operators have a specific play in place to deal with all of these contingencies.

For help understanding the many different issues connected to finding the appropriate nursing homes for a loved one and paying for their care, consider contacting our New York elder law attorneys today.

More Oversight Needed to Improve Nursing Home Quality?

Thu, 02 May 2013 06:05:50 -0500

The Herald Tribune recently reported on troubling case of nursing home neglect and Medicaid fraud that is causing many to worry about a lack of industry oversight.

At the heart of the problem are questions about why a nursing home closed in 2011 for repeated quality of care problems was allowed to open at all. The facility was opened in 2006 by two family members (a brother and brother-in-law). Somehow, when screening the pair's application to open the facility, officials did not register that the two men were both sentenced to three years in prison in the late 1970s for New York Medicaid fraud.

Obviously the owners' past record of criminally violating Medicaid rules should have raised huge red flags as they tried to again operate a business where they would receive Medicaid funding. But, none of that mattered; the two men made it through the screening and received a license to practice.

They had not learned the error of their ways.

Sadly, it was not just the taxpayers providing Medicaid support that suffered from this problem. Many seniors residents apparently spent years in the facility receiving substandard care. It wasn't until a resident death at the home caused widespread outrage that investigators looked closely at the facility. They discovered a laundry list of standard problems, resulting in the home's official closure.

The case has become a rallying point for advocates across the country who are hoping to explain how a lack of government oversight can lead to severe suffering and Medicaid fraud. Most nursing home regulation issues are decided at the state level, and each is able to craft its only rules about how much (or little) oversight to provide.

What does this mean for you?

This "administrative oversight" is another reminder that local residents cannot simply assume a facility is of high quality because it is currently operational. State officials are unable to monitor detailed quality of care indicators on a consistent basis. This means that even poor homes can remain open for years--harming countless New York seniors in the process.

Our elder law attorneys advise families to do as much research as possible before making a final nursing home selection. Resources like the "Nursing Home Compare" website from the Centers for Medicare and Medicaid Services as well as the "Nursing Home Rankings" from U.S. News are good places to start.

For tailored advice on how to apply for Medicaid, secure long-term care insurance, or otherwise deal with the realities of growing older, please feel free to reach out to our legal professionals today.

NY Medicaid Supported Adult Day Care Suspended Following Fraud Concerns

Tue, 30 Apr 2013 17:10:57 -0500

Last week we shared information about the revelations in the New York Times that efforts to curb New York Medicaid costs have been less than successful--mostly because of expanded enrollment in certain programs, like senior day care centers. These assistance centers are locations where frail and sometimes vulnerable elderly community members can stay during the day, while other caregivers--usually adult children--are at work. The facilities offer a way for seniors to avoid being forced to move into a long-term care home.

While useful, concerns have mounted regarding the tactics used by the operators of these facilities to increase enrollment. Owners of the adult care facilities are paid based on the number of eligible New York Medicaid recipients who attend. Therefore, it is in the best interest of the operators financially to increase enrollment--and that is exactly what they have been doing. The increase has been so stark, that some worry that the cost-savings intended (by averting expensive nursing home stays) may be illusory.

Temporary Suspension
In fact, some suggest that outright fraud is being committed in an attempt to attract seniors into the programs. According to a New York Times story, those fears prompted a sudden suspension of the program last week by state officials. The Times notes that the adult day care project is "New York's largest managed long-term care plan for frail elderly and disabled people."

The root of the concern was the tactics used by some centers to entice seniors to enroll. Accusations include giving away free fast food, visits to casinos, and even cash payouts. These seniors were convinced to join adult day care centers and then referred to other managed care companies for other services, like at-home nursing aides. State officials have suggested that this referral network abused the system, increased costs, and led to unnecessary services.

The officials are planning on auditing the most recent referrals from many of the largest providers to ensure only qualifying seniors are participating. According to the story, "People are eligible to enroll if they need at least 120 days of help a year with tasks like walking, cooking or taking medication." Abuse of those guidelines would lead to excessive Medicaid payments. State officials plan on pursuing reimbursements for all money spent unnecessarily.

While it is important to root out fraud in the system all elder care attorneys understand that there are many seniors in New York with very real ailments that rely on Medicaid. Hopefully, this particular situation gets worked out soon so that no eligible residents is delayed support they critically need.

Managed-Care Medicaid in New York

Fri, 26 Apr 2013 06:47:47 -0500

A New York Times article this week took a look at the consequences of a Medicaid change engineered by Governor Cuomo in the hopes of saving money: switching to "managed-care" for NY Medicaid programs.

The basic idea is straightforward: switch from paying providers a "fee for service" and instead make a specific payment to provide proper care--whatever that care might be. The logic goes that when medical care providers receive a fee for specific actions performed, they are incentivized to provide more services, even if they aren't needed. By switching to a set payment amount, those providers will be incentivized to simply provide the most efficient care possible. They will also be more competitive, trying to increase quality of care to attract more Medicaid participants.

The Reality
That argument has intuitive sense, and many policymakers have touted the benefits of managed care both in New York and throughout the country. But, as observers found here, the reality is far more complex. That is because medical care providers discovered that with the managed-care program they can increase profits merely by signing up more seniors in need of care--not necessarily changing past practices.

In other words, instead of focusing on cost-effectiveness, many providers have focused on attracting new low-income seniors for various programs. This all has resulted in an increase in Medicaid participants, increasing the overall costs of the program.

As a Slate article on the situation explained, "[I]t is a total failure from the standpoint of Cuomo's fiscal policy objective."

But that is not to say that signing up under-served seniors in the state is necessarily a bad thing. There are many good reasons why it is helpful for these individuals to receive certain assistance or participate in programs that they otherwise did not know about. For one thing, providing access to these helpful tools early-on is one way to stave off the development of more serious accidents or deterioration in health that require more extensive care or moves into New York nursing homes.

What Does This Mean for the Future of the NY Medicaid System?

Discussion about the perverse effects of the switch to managed-care is simply one more part of the larger issue of financial management of the NY Medicaid system. It will provide more ammunition for those hoping to change eligibility rules or otherwise alter how New Yorkers sign up for the program while preserving assets. It remains important to follow along with state lawmakers to see if any real legal changes are on the horizon.

Be Aware of Senior Financial Scams with Roll Out of Health Care Law

Tue, 23 Apr 2013 09:03:56 -0500

From suspicious claims in an email to unsolicited letters, most of us assume we are not naive enough to fall victim to a financial scammer. This is a mistake. It takes only a moment of confusion or a lapse in judgement to provide a fraudster with the the tools they need to steal.

Financial scammers thrive in confusion and unfamiliarity. There is a reason that seniors are targeting more often than others--the elderly may be less familiar with certain aspects of modern technology or culture. As such, scammers are able to poke at their uncertainty in order to gain trust and ultimately take advantage.

These frauds are often connected to current events. Disgustingly, it was only hours after the Boston bombings that some fake charities were set up in an attempt to dupe well-intentioned community members into donating money that would end up in the pockets of criminals. Along the same lines, fraudsters are trying to exploit unfamiliarity and confusion about the high-profile national health care law. Many aspects of the law are set to take effect this year, and most community members are unfamiliar with the details of those changes. Scam artists are stepping into the void, working to use the complexity of the law to solicit funds from unsuspecting community members. Senior citizens are the most likely to be hurt.

Health Care Law Scams
New York Now discussed those health care scams in a story this week. The tricks are usually quite simple. For example, one New York senior explained how she was called by an unknown number. The caller claimed that as part of the new healthcare law, they were verifying information for Medicare. He then proceeded to confirm basic details, like name, phone number, and address. The senior did not become suspicious until the man asked to confirm her bank routing number. The woman hesitated before hanging up.

Afterward, she did the right thing: calling Medicare to report a possible scam. In so doing she became one of a shocking 80,000 people who report similar scam attempts each and every year. The numbers are on the rise, with a 12% jump last year from the previous one.

Officials note that anyone can be affected, but seniors are far and away the prime targets. This is a product of their tendency to answer the phone, retirement savings, and trusting nature.

It is important to be vigilant about these risks, both for yourself and senior loved ones. Occasionally asking about these issues or related financial matters is a simple way to broach the topic and ensure a family members is not exploited. Also, discussing some planning and protection matters with an elder law attorney may be a good step to provide real security.

NAELA Journal Article on Future of Medicaid

Thu, 18 Apr 2013 15:47:01 -0500

It can can a confusing, scary, and stressful time for all New Yorkers who use the Medicaid system for necessary health care or for those who suspect they may need it down the road. Not a day goes by that news does not break at either the state or national level regarding payment cuts, service trimming, changes to qualifications, and more.

Considering the complex political dynamics involved in any major decision regarding the New York Medicaid system, it is next to impossible to make predictions with certainty. But many experts in the field are more than eager to share their ideas about what the program might look like in the future.

For example, some may be interested in a recent article a the journal published by the National Association of Elder Law Attorneys (NAELA). Entitled "Whither Medicaid," the comprehensive article takes a look at all of the major notions about how Medicaid might disappear in coming years and how it may be saved via different alternative arrangements. The article can be read for free online in it's entirety here.

The author summarizes what the national long-term care scene might be like in the event that the Medicaid program as we know it disappears. He discusses how almost all agree that financial concerns will force some changes to the program in the coming decades. While some are adamant that nothing can ultimately be done to preserve the system, many others suggest that alterations and cost saving measures are possible.

Those possible changes are then discussed in significant detail. They include the use of "block grant" programs (as proposed by Governor Romney is the last election), "managed care" options, and extension of the "look back" period for qualification purposes. The third of those options has obvious direct bearing on estate planning matters. As it now stands, residents who act prudently can use tools like a Medicaid Asset Protection Trust to protect items like a family home from being lost while trying to spend down assets to qualify for Medicaid.

Act Prudently
While talk of a world without Medicaid is understandably alarming to local residents, it is important not to overreact to certain political claims. At the end of the day, policymakers respond (usually) to the demands of their constituents. While various financial changes may be needed, it is hard to imagine such a vital tool will be pulled out from under those who rely on it.

For help understanding how to qualify for Medicaid in New York or protect assets in the event that you or a loved one needs support down the road, please contact our elder law attorneys today.

NY Senator Facing Allegations of Conflict of Interest In Nursing Home Legislation

Tue, 16 Apr 2013 08:51:48 -0500

New conflict of interest claims are being made against a powerful New York State Senate leader related to nursing home legislation and operation. The situation presents troubling issues of undue influence, and it is also a good example of the complex relationships in the state which ultimately dictate rules and regulations regarding NY long-term care.

The Allegations
The New York Daily News reported on concerns that state Senator Jeffrey Klein may have acted improperly when he involved himself in issues affecting New York nursing home care in Albany while at the same time sitting on the Board of Directors for a Bronx nursing home. The BOD position was not paid, but the Senator did receive over $71,000 in campaign contributions from the nursing home industry. Troublingly, Klein did not disclose his relationship with the Bronx nursing home, Morningside House, on required disclosure forms.

Also concerning is the fact that Morningside has faced nearly two dozen elder neglect lawsuits over the past several years. About $1.4 million have been paid out toward those claims over the past eight years.

For his part, Klein claims that he erected a "firewall" between his fundraising activities and his duties as a representative of the people. He called the Morningstar position "honorary" and does not believe that his position or actions were unduly influenced by his connection to the private long-term care business. Klein also denied knowledge of Morningstar's spotty quality of care record.

Long-Term Care Law in NY
It is impossible to separate long-term care issues in New York from state lawmakers. That is because statehouse decision makers create a wide range of rules that impact how local families plan for this care. On one hand, state lawmakers control most NY Medicaid issues, determining who qualifies, what services are covered, and what steps need to be taken to enroll in the program. In addition, those same lawmakers craft policies that affect planning, from issuing regulations about the use of certain trusts, taxes on nursing home payments (i.e. the so-called "granny tax"), and more.

For example, State Senator Klein led a bill through the chamber in 2009 that allowed seniors to tap into expected life insurance benefits to pay for nursing home care. This move was initially opposed by life insurance companies, but the nursing home industry was supportive as it opened up a new pool of money that they could ultimately secure from private citizens.

New Survey on Cost of New York Nursing Home Stays

Thu, 11 Apr 2013 09:57:35 -0500

All medical care is expensive. Many people are shocked when they get a medical bill covering costs for even minor incidents, emergency room visits, or very short hospital stays. Consider then what the costs must be for care that occurs every day for month or years--it is staggering. That is the prism through which nursing home costs should be examined. While the traditional skilled nursing home does not necessarily provide the same comprehensive care as an actual hospital, the costs of ensuring around-the-clock access to certain medical treatments is incredibly expensive.

NY Nursing Home Study
The shocking nature of those expenses were recently verified in a new study. The NY Daily News reported this week on the findings. The results of Genworth's annual "Cost of Care" survey were revealed, confirming that there is almost nowhere more expensive to receive long-term care than New York. For example, according to the study, on average, a single room in an elder care facility in Manhattan costs a mind-boggling $180,000 per year. And this cost is not some anomaly for that borough. The average yearly cost for a senior in Queens is about $140,000, and a Long Island resident should expect to pay $160,000 each year.

Industry officials point out that high property costs are part of the issue in our area. On top of that there are maintenance and staffing payments that are far higher here than elsewhere. All of this has led to about 5% price increases each and every year in the recent past.

Keep in mind that these are averages. The more comprehensive facilities with certain amenities or location advantages can be considerably higher. Nationwide the average annual cost for a single room is $84,000--still not a small sum. But New Yorkers must be aware that costs here are higher, requiring prudent planning to ensure adequate resources are available when and if the time comes.

Also, remember that the average nursing home stay is two and half years--though some stay far longer. This means that all families, including middle class families, must come up with ways to find incredibly large sums of money when this care is needed.

For help learning about your options to prepare for these costs or secure them if a nursing home stay is immediately necessary, please contact our elder law attorneys today. We can explain issues related to long-term care insurance, New York Medicaid eligibility, and more.