Posted by: Thomas D. Begley, Jr.
Long-term care is a problem affecting all economic strata. Financing long-term care is uniquely a middle class problem. It is not just a problem for the elderly; it is an inter-generational issue. One-third of all Americans receiving long-term care are under 65. The elderly receiving long-term care are the parents of children of middle age or the grandparents of Generation Xers. The system or delivery of long-term care in the United States is fragmented. We need to develop an integrated system of medical and personal services required by individuals who have lost some capacity for caring for themselves due to [...]
Read the rest of this entry »
Filed under Library, Medicaid Planning, Medicaid Planning.
Tags: Medicaid Planning
No Comments »
Posted by: Thomas D. Begley, Jr.
A state is entitled to recover for Medicaid payments correctly paid on behalf of the individual by use or real or personal property liens and recovery from decedents’ estates. 42 U.S.C. § 1396p(b)(1)(B); HCFA Transmittal 63; N.J.S.A. 30:4D-7.2 et seq.; N.J.A.C. 10:49-1 et seq. The state is required to seek reimbursement from an individual’s estate for the cost of nursing facility services. 42 U.S.C. § 1396p(b)(1)(B). However, no recovery may be made until after the death of the recipient’s surviving spouse, and only when there are no surviving children who are under age 21 or blind or permanently disabled. A. [...]
Read the rest of this entry »
Filed under Medicaid Applications, Medicaid Planning, Medicaid Planning.
Tags: Medicaid Applications, Medicaid Planning
No Comments »
Posted by: Thomas D. Begley, Jr.
Prepared for The Medicaid Long Term CareFunding Advisory Council by Thomas D. Begley, Jr. 1. BACKGROUND The Independence, Dignity and Choice in Long-Term Care Act1 has a stated goal of rebalancing state long-term care programs and budgets so that more older adults and persons with disabilities live in their homes and communities.2 The Act acknowledges that it is easier for adults and persons with disabilities to qualify for Medicaid long-term care coverage if they are admitted to a nursing home than if they seek to obtain services through one of the Medicaid home and community-based long-term care options.3 Many of [...]
Read the rest of this entry »
Filed under Medicaid Planning, Medicaid Planning.
Tags: Long Term Care, Medicaid Planning
No Comments »
Posted by: Thomas D. Begley, Jr.
Effective January 1, 2009 the Department of Health and Senior Services (DHSS) received approval from the US Centers for Medicare and Medicaid Services (CMS) to consolidate three Medicaid-supported home and community base services programs into a single program known as Global Options (GO) for Long-Term Care. Provisions of the GO Program include: Participants will have the option to hire and direct their own service providers. Care managers will have greater flexibility in modifying individual care plans. The program is designed to supplement, not replace, the assistance already being provided by family, friends and neighbors. GO participants work with a care [...]
Read the rest of this entry »
Filed under Medicaid Applications, Medicaid Planning, Medicaid Planning.
Tags: Medicaid Applications, Medicaid Planning
No Comments »
Posted by: Dana E. Bookbinder
Families are understandably apprehensive when selecting a long term care facility for their loved ones. As a firm focusing a large part of its practice on elder law, our attorneys and staff are often called upon for assistance with this important decision. Fortunately, nursing home care has substantially improved over the past generation. Federal regulations that set standards for nursing homes particularly in the area of patient rights have been in place over fifteen years. As our attorneys and many staff members who regularly visit homes in our area can readily attest, nursing homes and assisted living facilities today generally [...]
Read the rest of this entry »
Filed under Medicaid Applications, Medicaid Planning, Medicaid Planning.
Tags: Medicaid Applications, Medicaid Planning
No Comments »
Posted by: Thomas D. Begley, Jr.
1. INTRODUCTION Statistics show that approximately 60 percent of the population age 65 or over will require some form of long-term care. Some will be there for relatively short periods of time. These are usually stroke victims who are doing rehabilitation. A significant percentage will remain in a nursing home for an extended period of time. These are usually Alzheimer’s or Parkinson’s patients. A statistic widely quoted is that the average stay in a nursing home is 2.9 years. This statistic is somewhat misleading, because the persons receiving rehabilitation are often discharged in six months or less. The long-term patients [...]
Read the rest of this entry »
Filed under Medicaid Planning, Medicaid Planning.
Tags: Long Term Care, Medicaid Planning, Nursing Home
No Comments »
Posted by: Thomas D. Begley, Jr.
by Thomas D. Begley, Jr., CELA and Andrew H. Hook, CELA, CFP On February 8, 2006, President Bush signed the Deficit Reduction Act of 2005 (ADRA@). 1 The effect of this legislation has made it more difficult for persons to become eligible for Medicaid. Unfortunately, the federal and state governments save money at the expense of health care for poor and middle-class seniors. Most of the major cutbacks in Medicaid were contained in ” 6011 through 6016. This article will examine each section and attempt to analyze which current Medicaid planning strategies are no longer viable and what other strategies [...]
Read the rest of this entry »
Filed under Medicaid Planning, Medicaid Planning.
Tags: Medicaid Planning, Medicaid Reform
No Comments »
Posted by: Thomas D. Begley, Jr.
1. Medicaid-Qualifying Trusts Trusts established and funded on or before August 10, 1993, are governed by the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) and trusts established and funded after August 10, 1993, are governed by OBRA-93. 42 U.S.C. § 1396a(k) and 1396p. A Medicaid-Qualifying Trust (MQT) was defined under COBRA as a trust or similar legal device that: 1. Was established, other than by will, by an individual or an individual’s spouse; 2. Under which the individual may be the beneficiary of all or part of the payments (principal and income) from the trust; and 3. The distribution [...]
Read the rest of this entry »
Filed under Library, Medicaid Planning, Medicaid Planning.
Tags: Medicaid Trusts, Mediciad Planning
No Comments »
Posted by: Thomas D. Begley, Jr.
The Centers for Medicare and Medicaid Services (CMS) recently completed a rating of nearly 16,000 nursing homes throughout the United States. This was done under the CMS Nursing Home Compare System. Based on these ratings, the Scripps Howard news service did a statistical analysis. Many of the findings were interesting. They included: NON-PROFITS Generally, nursing facilities run by non-profits are better than institutions run by for-profit corporations. This validates observations made by this office over a long period of time. STAFF RATIO Nursing homes with higher nursing staff-per-patient ratios deliver better care than those with lower staff-per-patient ratios. This should [...]
Read the rest of this entry »
Filed under Medicaid Applications, Medicaid Planning, Medicaid Planning.
Tags: Medicaid Applications, Medicaid Planning, Nursing Home
No Comments »
