Elder Law

S2016tatistics show that New Year’s resolutions are maintained continuously by most Americans for only one or two weeks. Here are 5 resolutions that you can keep and that will help protect you and your family:

  1. Make sure that my family knows what I want if I become ill or incapacitated and provide them the tools to get things done for me.
  2. Give a trusted person the authority to take care of my health and my financial affairs should I become incapacitated.
  3. Make sure that my assets (the things I own) will be distributed the way I want by the person I have chosen to handle my affairs.
  4. Make sure that I have arranged my affairs to minimize taxes, and have helped provide a secure financial future for my spouse, children and other heirs.
  5. Make sure that I have anticipated long term care expenses, so I can preserve assets for myself and my heirs.

You can accomplish these resolutions by putting together a proper estate and long term care plan.  An estate and long term care plan prepared by a knowledgeable estate planning attorney will address these resolutions through the proper use of Wills, Trusts, Powers of Attorney, Health Care Directives, and proper beneficiary designations, and life and long term care insurance.

To make 2016 the year you keep your resolutions – call  experienced Estate Planning Attorney, Elga A Goodman today at 973-841-5111 to assist you in creating an estate plan that will implement your 5 New Year’s resolutions.

{ 0 comments }

The National Academy of Elder Law Attorneys (NAELA) has designated May National Elder Law Month.  Below is a recent article that appeared in the NAELA: Eye on Elder and Special Needs Issues newsletter.  It addresses disturbing new hospital practices that may severely impact medicare patients.

May 2014


Observation Stays in the Hospital: The Impact on Medicare Beneficiaries

By Judith Stein, Esq.

In December 2013, Ms. M., 99, was found on the floor in her assisted-living apartment. She was sent to the hospital and treated for a broken shoulder. She stayed at the hospital for three nights, but instead of being deemed an “inpatient,” she was considered to be under “observation.” As a result, she had to pay $300 a day for subsequent skilled nursing facility care that otherwise would have been covered by Medicare.

The Problem
Under the Medicare statute, an individual must have an inpatient stay in the hospital of at least three consecutive days, not counting the day of discharge, in order to meet Medicare criteria for coverage of post-acute care in a skilled nursing facility (SNF). Unfortunately, like Ms. M., many Medicare beneficiaries are being denied access to Medicare coverage of SNF stays because of the growing use of “observation status” in the hospital setting. Pursuant to this practice, hospitals classify patients as “outpatients” receiving observation services rather than admitting them as inpatients.i

Care received by patients in observation status is often indistinguishable from care received by inpatients. But the designation of a patient as an outpatient (covered under Part B of Medicare) vs. an inpatient (covered under Part A) can result in beneficiaries being charged for some services received in the hospital that would otherwise be covered, including their prescription medications. Further, the most vulnerable patients will be responsible for their entire subsequent SNF stay, having not satisfied the statutory three-day inpatient hospital stay requirement.

Use of “Observation Status” Is on the Rise
Hospitals’ use of observation status and the amount of time patients spend in observation status have both increased significantly in the last few years. The Center for Medicare Advocacy (CMA) regularly hears about beneficiaries throughout the country whose entire stay in a hospital, including stays in excess of 14 days, is classified by the hospital as outpatient observation.

The primary motivation for hospitals’ increased use of observation status is the threat of punitive action by Recovery Auditors. These Medicare contractors review claims. If they reject a hospital’s admission of a patient as an inpatient, the hospital loses reimbursement for almost all related services. Penalties imposed on hospitals that readmit patients who return to the hospital shortly after discharge from a prior inpatient admission also foster the use of observation status.

The Centers for Medicare & Medicaid Services (CMS) has issued various payment rules in an attempt to address certain problems posed by the use of observation status, but these rules do not solve the problem for beneficiaries.ii

Take Action
CMA and the National Academy of Elder Law Attorneys (NAELA) have brought together a broad coalition of organizations representing consumers, nursing homes, physicians, and other stakeholders supporting a bipartisan, common-sense approach to help Medicare beneficiaries who are hospitalized in observation status.iii The Improving Access to Medicare Coverage Act of 2013 (H.R. 1179) introduced by Reps. Joe Courtney (D-CT) and Tom Latham (R-IA) would require that time spent in observation in the hospital be counted towards meeting the three-day prior inpatient hospitalization requirement for Medicare coverage of SNF care. A companion bill has been introduced in the Senate, S. 569, co-sponsored by Sens. Sherrod Brown (D-OH) and Susan Collins (R-ME). We urge you to ask your Members of Congress to support these bills. Find out more about Observation Status on NAELA’s website.

For individuals who find themselves affected by observation status, see the Self-Help Packet for Observation Status problems on CMA’s website.


iSee, generally, the Center for Medicare Advocacy website.
iiSee, e.g., the Center’s Weekly Alert “New Study: CMS’ New 2-Midnight Rule Increases Use of Observation Status” (February 20, 2014).
iiiSee NAELA’s webpage devoted to observation status. Also see a flyer supporting this legislation by the observation status coalition, including a list of members.


About the Author
Judith Stein, Esq. is the founder and executive director of the Center for Medicare Advocacy and a past president of the National Academy of Elder Law Attorneys.


{ 0 comments }

The National Academy of Elder Law Attorneys (NAELA) has designated May “Elder Law Month.”   NAELA members are attorneys who are experienced and trained in working with the legal problems of aging Americans and individuals of all ages with disabilities.  Given the growing aging population in the United States, elder law awareness is more important than ever.

Elder Law attorneys deal with such matters as

  • Health and personal care planning, including Living Wills and Powers of Attorney; lifetime planning.
  • Financial planning; housing opportunities and financing; income, estate, and gift tax matters.
  • Asset protection; planning for a well spouse when the other spouse requires long term care; public benefits such as Medicaid and insurance; Veterans’ benefits.
  • Guardianship and guardianship avoidance.
  • Resident rights in long term care facilities; nursing home claims.

 Given the broad scope of issues, Elder Law attorneys may specialize in specific subsets of Elder Law categories.  Elder law attorneys are important resources for clients because they understand that clients’ needs may extend beyond basic legal services and they stay informed about and connected to the local networks of professionals who serve the elder population.

Elder Law Events in May

NAELA attorneys will be hosting a variety of Elder Law events throughout New Jersey in May.  Come hear Elder Law Attorney, and NAELA member, Elga A Goodman, speak about Life Planning: Legal Tools to Enhance your Golden Years at the Washington Township Library on Monday, May 19th, at 12 p.m. and at the Summit Public Library on Tuesday, May 20th, at 7:30 p.m.  Please RSVP at 973-841-5111.

 

{ 0 comments }

There comes a time for many older people when, for various reasons, they must leave their homes.  For some, moving in with children or other close family members is the solution.  For others, a different solution is needed.  This post describes two alternative living arrangements that have gained prominence: 1. Continuing Care Retirement Communities (CCRCs) and 2. Assisted Living.

Continuing Care Retirement Communities (CCRCs)

CCRCs are usually restricted to individuals aged 55 or older.  Different levels of care are available to an individual as his/her needs change over time.  It’s a sort of one-stop shopping arrangement.  No need to worry about leaving the community to find a suitable new living arrangement when the time comes.  It’s all available within the CCRC.

– A person may start off living independently in a house, apartment, or condo.  Various social activities and recreational facilities are often available.  Depending on the community, on-site swimming pools, tennis courts, beauty salons, dances, card games, and off-site trips may all be part of the CCRC experience.

– As the person ages and requires assistance with daily living, such services are provided, including nursing home care if needed.

– CCRCs typically charge a high one-time admission fee in addition to a monthly occupancy fee that rises only modestly (if at all) over time.

Assisted Living

Assisted Living  is a housing arrangement for older people who need some assistance, but not to the extent provided by a nursing home.  Assisted living aims to help people live as independently as possible, providing some modest individualized support services along with limited health care services.

– An individual typically has his own room, furnished with his own things.   There are communal areas, including a dining hall where meals are served, and a variety of social and recreational activities are available.

– Occupancy fees are paid on a monthly basis.

It’s All In The Details

Whether opting for  a CCRC or Assisted Living, it is critical to carefully read the contract.  Marketing brochures and other sources of information won’t necessarily tell you everything you need to know.  For example, if a one-time admission fee is required, check the contract to see if you will receive a refund of some of that money if you decide to leave.  Also make sure you understand exactly what your basic monthly fee will get you.  There may be additional fees for a variety of things such as administering medication or emergency ambulance services, and, if you assume these are included in your monthly fee, you may be unpleasantly surprised.  Such separate fees can significantly increase your monthly costs.   So, to the buyer beware!  It’s all about the details; and they’re in the contract.

Getting Legal Help

Experienced Estate Planning and Elder Care Attorney, Elga A. Goodman, can help you explore elder care options and determine what meets your needs.  Contact us today at 973-841-5111.

{ 0 comments }

Is a New York Health Care Proxy the same as a Living Will?

November 15, 2011

Health Care Proxy   A health care proxy assigns the power of making health care decisions to someone else. A person must be careful to choose someone he trusts completely for his health care proxy because the person will be entrusted to make potentially life-saving decisions. The health care proxy can also provide specific details […]

Read the full article →

Elder Law Attorneys Help People of all Ages

November 10, 2011

The name “elder law attorney” is a bit of a misnomer because elder law attorneys work with people of all ages. It is fairly common for younger clients with disabilities, or parents of children with disabilities, to need help managing finances and long term care.  There are complicated laws in regard to social security disability […]

Read the full article →

Protecting Loved Ones from Fraud

October 19, 2011

Last month a man from Sarasota Florida was arrested for swindling $600,000.00 from an elderly woman who had taken him in as her roommate years earlier. Anita Seidel met the man and trusted him to live with her. She even signed a power of attorney form granting him the authority to write checks from her […]

Read the full article →

Elder Financial Abuse is on the Rise

October 17, 2011

According to the 2011 MetLife Study of Elder Financial Abuse, victims lose an estimated $2.9 billion dollars annually, up 12% from $2.6 billion in 2008. While strangers are responsible for 51% of the crimes, 34% are committed by family members, friends and neighbors. The study also showed women are twice as likely as men to […]

Read the full article →

Consult an Elder Law Attorney for Peace of Mind

October 12, 2011

An Elder Law Attorney can help a family plan for medical expenses, minimize tax liabilities and preserve wealth by drafting necessary legal documents including a power of attorney, a living will or health care directive, and a last will and testament. An Elder Law Attorney can also help complete complex Medicaid  and Medical Assistance applications. […]

Read the full article →

Creditors Must be Paid from the Estate

June 6, 2011

Satisfying Creditors Bills from credit cards, utility companies, and mortgage companies will continue to be sent until the creditors are informed of the debtor’s death.  Once creditors are informed of the death of a debtor, they must make a claim to the estate in order to be paid. Some creditors may not bother if the […]

Read the full article →