Elder law refers to the legal framework for dealing with issues related to the elderly, like long term care, nursing home issues, retirement planning and more.
Q: Have you or a loved one been denied Medicare-covered services because you’re “not improving”? A: Many health care providers are still unaware that Medicare is required to cover skilled nursing and home care even if a patient is not showing improvement. If you are denied coverage based on this outdated standard, you have the right to appeal. Q: What is the Medicare “improvement” standard? A: For decades, Medicare applied the so-called “improvement” standard to determine whether residents were entitled to coverage of particular care. The standard, which is not in Medicare law, only permitted coverage if the skilled treatment was deemed to contribute to improving the patient’s condition, which can be difficult to achieve for many ill seniors. Q: Is the Medicare “improvement” standard legal? A: In 2012, the federal Centers for Medicare & Medicaid Services (CMS) agreed to settle a related lawsuit and acknowledged that there was no legal basis for the “improvement” standard and that both inpatient skilled nursing care and outpatient home care and therapy may be covered under Medicare as long as the treatment helps the patient maintain her current status or simply delays or slows her decline. Q: What did the lawsuit ultimately do? A: It doesn’t change the rights Medicare patients have always had, but should make it easier to enforce them. If you or a loved one is denied coverage because the patient is not “improving,” you should appeal. In other words, as long as the patient benefits from the skilled care, which can include nursing care or physical, occupational or speech therapy, then the patient is entitled to coverage. Q: How does Medicare help with care? A: Medicare will cover up to 100 days of care in a skilled nursing facility following an inpatient hospital stay of at least three days and will cover home-based care indefinitely if the patient is homebound.
Q: How have cameras become apart of the nursing home setting? A: Technological advances have made it easier to stay connected with family. That includes the ability to install cameras in a loved one’s nursing home room. Q: How are cameras being used in nursing homes? A: The benefit of the surveillance camera is the ability to monitor your family member’s care. Being able to observe care from afar can give family members peace of mind that their loved one is being well taken care of, and can also serve as evidence if abuse is found. Q: Are there any doubts or legal issues with having cameras in a nursing home? A: These so-called “granny cams” have legal and privacy implications. On the other hand, cameras raise privacy concerns for both residents (including roommates) and caregivers. Residents may not want to be monitored while in a vulnerable state, such as changing or bathing. If the recording device picks up audio, then even the resident’s conversations may no longer be private. Q: Do nursing homes have to permit families to install cameras? A: It varies depending on the facility. Some nursing homes may have language in their admission contracts banning cameras or imposing specific requirements for their use. However, concerns over elder abuse have led some states to pass laws allowing cameras in nursing homes. Q: Which states have passed laws permitting the installation of cameras? A: Illinois, Louisiana, Maryland, New Mexico, Oklahoma, Texas, Virginia and Washington have passed laws permitting families to install a camera in a nursing home if the resident and the resident’s roommate have agreed. Utah permits cameras in assisted living facilities. New Jersey does not have a law specifically permitting cameras, but it has a program that loans surveillance cameras to families who suspect abuse. Q: What steps should I take if I’d like a camera installed in my loved ones nursing home? A: If you are considering installing a camera in a loved one’s nursing home room, you should contact your attorney to discuss the legal and practical considerations.
First thing to look for. Shop around. Prices among funeral homes can vary greatly, so it is a good idea to check with a few different ones before settling on the one you want. The Federal Trade Commission's Funeral Rule requires all funeral homes to supply customers with a general price list that details prices for all possible goods or services. The rule also stipulates what kinds of misrepresentations are prohibited and explains what items consumers cannot be required to purchase, among other things. Choose a reputable funeral home Make sure you have a reputable funeral home. There have been cases of unscrupulous funeral providers taking advantage of customers, so make sure you choose a funeral home with a solid reputation. Is the plan cancelable Read the contract carefully. Before signing, it is important to know what you are agreeing to. Can you cancel the plan and get a refund? Is the plan transferrable if you move to another area? Are you paying just for merchandise or for funeral services as well? If prices for funeral merchandise and services rise, will your estate be responsible for paying additional costs? What happens to the money? Find out where your money goes. The pre-paid plan should provide information on what the funeral home will do with the money you pay them. Some states have protections in place to make sure the money is safeguarded, but other states offer no protections. Is the money put into a trust account? What happens to the interest income? Is there a plan if the funeral home goes out of business? What happens to any money left over? Does the plan effect Medicaid benefits? Make sure the plan won't affect Medicaid benefits. If you are buying the policy as part of Medicaid planning, you must purchase an irrevocable plan, which means you can't cancel or change it once it is bought.
I Move Frequently, Will My Advance Directives Be Valid in Other States? Typically, your health care documents, which include your living will, and health care power of attorney will be valid in other states. If you regularly spend time in more than one state, you should consider whether these documents made in your home state will be valid in the second state as well. For instance, if you have more than one residency in different states (if you live in Florida in the fall/winter time and New York in the spring/summer) it is suggested that you attain distinct information about both states’ policies on advance directives, perhaps by consulting with an estate planning attorney. For the most part, it will be valid, because nearly all states except health care directives from other states so long as the documents are legally valid in the state where they were made. When Your Health Care Documents May Not be accepted In Other States Some states regulate the degree to which they will accept health care directives from other states. Moreover, some states only accept health care documents from other states if they obey their own laws. Other states don’t have specific restrictions or rules about whether or not they will accept advance directives from other states. Should You Make Two Separate Health Care Documents for Each State? Like with any other legal matter, there are benefits and drawbacks to drafting a new set of advance directives for more than one state. If you decide to draft two sets of directives and both are not absolutely identical to each other, signing one could potentially nullify the other if a contradiction is observed. However, if you are moving to another state, it is suggested that you complete a new living will for the state you move to. Even if your original living will is valid in the new state, you can avoid any potential problems simply by completing a new living will that uses terminology and phrases or even a unique structure that may be preferred by the new state. Keep in mind that the new advance directive will nullify the old one. How To Ensure Your Health Care Wishes Are Honored? Most often, it won’t make sense to make different advance directives for each state you reside in, so what should you do? First, start by doing some research in order to find out whether your primary state of residence’s health care documents fully covers you in whichever state you also commonly reside in. You may be able to get all the information you need by talking to a representative at a hospital from the other state(s) you regularly spend time in. Furthermore, be sure that your home state’s specifications for advance directives cover the requirements for the second state as well. If you are not convinced that your health care documents will be valid in both states where you reside, or spend time, consult with an experienced estate planning attorney for advice.
Q: What is causing the increase in nursing home closures across the U.S? A: In what is described as an “epidemic,” rural nursing homes across the U.S. are closing. With staff shortages and low Medicaid reimbursement rates, these long-term care facilities can no longer afford to stay in business. Q: What is the root cause of this epidemic? A: Approximately 63 percent of nursing home patients have their care funded by Medicaid, according to the American Health Care Association. But with reimbursement rates often below the actual cost of care, these facilities can no longer manage operating costs. In some states, Medicaid programs underfund patients anywhere from $30 to $40 per day. Q: How are residents affected by these mass nursing home closures? A: For nursing home residents, the stress of moving is considerable. These facilities may lack the resources to orchestrate a successful closing, meaning residents might not get help to find a suitable home, belongings may be lost in the move and transfer of vital medical records can be delayed. Q: What is “transfer trauma”? A: The stress associated with moving is so real that the industry has a name for it: “transfer trauma.” Common outcomes include depression, agitation, falls, weight loss and new deficits in self-care. Even after making it through relocations, many elders find themselves long distances away from their families. That means fewer visits, greater isolation and increased risk for abuse. Q: How can you properly prepare a loved one for a sudden nursing home closure? A: If your loved one is subject to a nursing home closure, be sure you know their rights. The National Consumer Voice, a nonprofit offering ombudsman support for long-term care, provides information on its website (theconsumervoice.org). The site also has a Nursing Home Closures Kit that can help you understand if the closure is being conducted appropriately. Q: Are there nursing homes more susceptible to closure than others? A: Keep in mind that nursing homes with a higher percentage of private-pay patients are at lower risk of closure. Paying for nursing home care is expensive, but long-term care insurance can help cover those costs. Seniors with the ability to self-pay will have more options for care, making them less susceptible to nursing home closure. Q: Are there measures families can take in order to avoid being affected by these closures? A: Keep tabs on nursing home trends in your area and talk with an estate planner to evaluate whether long-term care insurance would make sense for you or someone you care about. Consider purchasing insurance for yourself and your loved ones. If your parents will not be able to self-pay for their own long-term care, and you want to ensure they have options, long-term care insurance can be a way to protect your own time and resources, while simultaneously caring for your parents.
Divorce When you enter into a marriage you do so with the belief that you and your soon-to-be spouse will be together forever. If that doesn’t come to pass, the marital assets will be divided. If you failed to protect the assets you brought into the marriage, you could lose them in the divorce. Business debts and liabilities People often believe that forming a corporation insulates them from any personal responsibility for the debts and liabilities of the business. In reality, that is not always the case. Creditors may be able to “pierce the corporate veil” and come after your personal assets. Long-term care If you need long-term care during your “Golden Years” the cost of that care could rapidly deplete your assets if you failed to plan ahead given the fact that neither Medicare nor most private health insurance plans will cover LTC expenses. The average annual cost of LTC care nationally is over $80,000. Estate taxes Estates are subject to federal gift and estate taxes at the rate of 40 percent. If the combined value of all lifetime gifts and assets owned at the time of your death exceeds the current lifetime exemption, your estate may lose a significant portion of its value to Uncle Sam if you failed to properly plan. What Can You Do to Protect Your Assets? Acknowledging the myriad and varied potential threats to your assets is only part of the equation. The implementation of asset protection tools and strategies within your comprehensive estate plan are of equal importance. The key to protecting your assets is knowing which strategy works best to protect against a specific threat. This is where an experienced estate planning attorney can help. It may also be beneficial to learn more about some commonly used assets protection tools and strategies, such as: ◦ Pre-nuptial agreements; ◦ Irrevocable trusts; ◦ Forming the right type of business entity, and ◦ Medicaid planning. The best way to ensure your assets are protected, and remain available to provide for loved ones after you are gone, is to work closely with an experienced estate planning attorney to incorporate an asset protection component into your comprehensive estate plan. About Our Law Firm Morrison Law Group, PLC is an estate planning law firm in Metairie, Louisiana. Chip Morrison is Board Certified Specialist in Estate Planning and Administration, as certified by the Louisiana Board of Legal Specialization, and is a member of the American Academy of Estate Planning Attorneys, and offer guidance and advice to our clients in every area of estate planning. We offer comprehensive and personalized estate planning consultations. For more information or to schedule a consultation please contact us at (504) 831-2348 or visit us online at www.morrisonlawplc.com.