Elder Law

Back to the Basics: Understanding Medicaid Asset Protection Trusts in New York

Published on: July 18, 2013 | by Ettinger Law Firm

The tremendous benefit of planning ahead for possible long-term care needs cannot be explained enough. The typical New York family is understandably most concerned about paying monthly bills, attending birthday parties, fixing up the house, and the thousand other activities that fill the day. Taking the time to think about serious illness, death, and inheritance often falls quite low on the priority list.

The motto, “I’ll cross that bridge when I get there” may work well for issues that cannot be dealt with ahead of time, but that is certainly not the case when it comes to long-term care and similar elder issues. Planning makes all the difference, not just for the senior, but also their family. That is why it is critical to fight the inertia and be prudent about planning.

The MAPT

Comptroller Claims New York Medicaid Still Rife with Waste

Published on: July 16, 2013 | by Ettinger Law Firm

News about potential fraud and waste within the New York Medicaid system keeps on coming. It seems as if every week there is a new allegations of practices which unnecessarily cost the state money in unnecessary Medicaid payments. With Governor Cuomo’s continued focus on rooting out problems with the system, we can likely expect even more information to come out regarding these issues in the next few months.

In fact, just last week the Capitol Confidential published a story discussing how the New York Comptroller, Tom DiNapoli, recently released two new audits which suggest widespread waste in the system.

One of those audits suggests that the NY Department of Health paid out more money for certain procedures than is allowed under current Medicaid rules. The administrative rules for Medicaid set specific maximum rates for certain procedures. Care providers—from nursing homes to hospitals–know those set rates. Those facilities do not necessarily get to set their own price.

Long-Term Care Insurance — Essential for New York Women?

Published on: July 8, 2013 | by Ettinger Law Firm

Our NY estate planning lawyers frequently advise local residents that in virtually all cases the single best way to prepare for possible senior care needs is by purchasing long-term care insurance (LTCI). Unfortunately, the biggest barrier for most families in securing LTCI is cost. Depending on one’s age when purchasing the product, the premiums can be prohibitive. Gender also plays a role, as women may have higher rates because of their longer life expectancy. We reported last month on one large LTCI insurer, Genworth, making the decision to institute “differential pricing” to charge women more. Reports suggest there could anywhere from a 25% to 40% gender price gap.

Of course the trajectory of these insurance costs mirror the actual costs for nursing home stays or at-home caregivers. As the price of that care rises, so does the cost of LTCI insurance.

Act Now and Act Smart

Elder Financial Exploitation from Jail — Anything Can Happen

Published on: July 1, 2013 | by Ettinger Law Firm

Elder financial exploitation is often one of those problems that community members believe only happens to “other people.” When reading stories about seniors falling for scams or being exploited by caregivers it is easy to view them as one-of-a-kind examples. But the truth is the exact opposite: elder financial exploitation is referred to by observers as an epidemic. It is prudent for all New York families to take preventative steps to minimize the chance of a loved one falling victim.

Misplaced Trust

One story that made headlines last week is a reminder of how scammers eager to take advantage of seniors can cause harm from anywhere. According to a report from NBC, the scam artist began by knocking on the senior’s door in a panic. The man pretended to be distraught, and was in tears while falsely claiming that his own parents were just killed in an automobile accident.

Battles Continue Over New Medicaid Eligibility for NY Home Health Programs

Published on: June 25, 2013 | by Ettinger Law Firm

In an effort to more efficiently use state funds, over the past few years the New York Medicaid program has been closely analyzed by state groups looking to root out fraud. Those investigations have returned hundreds of millions of dollars back into the programs following problematic practices at New York nursing homes, senior day care facilities, and many other settings.

While rooting out excess and fraud is a net positive, one must not forget the real lives that are affected any time that changes are demanded by program officials. Many New York seniors are in delicate situations, and any time that a nursing home, at-home provider, or other entity is no longer able to operate as a result of bad practices, many seniors struggle to deal with caregiving changes.

Finding Good Elderly Home Care in New York

Be Careful With “Pop Up” Senior Centers in New York

Published on: June 21, 2013 | by Ettinger Law Firm

Long-term care is big business. For many years now, companies that work in these fields have grown in size, scope, and influence, emerging as powerful entities making significant profits. There is nothing inherently good or bad about the changing nature of the industry so long quality, affordable options exist for seniors and their families.

Yet, in recent years observers have noticed that the increase in need for senior care services creates a natural business opportunity which are leading to some questionable practices. Take, for example, the growth of “pop up” senior centers in New York. The Brooklyn Eagle recently reported on these facilities and the scrutiny that is being directed their way.

City Council Questioning

NY Nursing Home Kickback Settlement – Reminder of Need to Make Careful Nursing Home Choices

Published on: June 19, 2013 | by Ettinger Law Firm

The New York Medicaid program has been making many headlines in recent months. Implementation of the Affordable Care Act and efforts to control state spending all have significant implications for the program. Interestingly, these developments have opposing outcomes. As the Affordable Care Act provisions are unrolled the program will be expanded, offering services to more New Yorkers. Conversely, the state’s push to control costs and root out fraud limits services in a few ways, sometimes impacting local seniors and their families.

Fraud Repayment From Estate

On the fraud issue, the NY Daily News reported last week on a settlement reached between the Attorney General and the estate of a former nursing home owner.

Beefing Up New York Long-Term Care Ombudsman Programs

Published on: June 17, 2013 | by Ettinger Law Firm

Over the last few years elder care advocates have issued a steady drumbeat of concern: mistreatment of seniors is on the rise. The rates of neglect and abuse are not necessarily rising, but the total number of seniors affected are–a product of the changing demographics. The problem is only expected to get worse in the coming years.

It is important to keep in mind that research consistently shows that even “minor” forms of neglect can prove deadly. The U.S. Department of Human Services’ Administration for Community Living points out the stark difference in morbidity rates for abused versus non-abused seniors. Even when split only between those who received adequate care and those who received “modest forms of abuse” there is a 300% increase in the death rate for the mistreated seniors.

In other words, even small difference between the quality of long-term care facilities–both nursing homes and less-intensive assisted living facilities–can have life or death consequences. All of this makes the process of choosing a proper facility a critical task for seniors and their families.

“Financial Caregiving” for Ailing Senior Parents

Published on: June 14, 2013 | by Ettinger Law Firm

One overlooked aspect of elder caregiving is the difficulty of the transition time itself. While some seniors may suffer serious medical events (stroke, heart attack, etc.) which require adult children to manage affairs overnight, in many cases the need for support happens only gradually. This presents a challenge as children must delicately broach the topic with parents who may be uninterested in change. At the same time, sibling rivalry, hurt feelings, misunderstood intentions, lack of information about savings, and many other details are thrown into the mix.

Put another way, before even deciding the best way to provide “financial caregiving” for an elderly parent, one must first figure out when to begin and how to get the parent to concede that help is needed.

A CNBC article last week examined this sensitive subject. The article provides reasonable advice while noting that “the shift [to financial caregiving by adult children] can be less stressful if everyone takes it slow, seeks advice and remembers that helping to maintain a loved one’s well-being is the primary goal.

Queens Nursing Home Facility Director Faces Criminal Neglect Charges

Published on: June 12, 2013 | by Ettinger Law Firm

It is no secret that most New Yorkers would prefer to “age in place” instead of moving into a nursing home. For one thing, having access to the comforts of one’s own home and the freedom to live as independently as possible is a natural goal. On top of that, however, are the myriad of horror stories that continue to pop up regarding mistreatment, neglect, and outright abuse that is sometime perpetrated at skilled nursing facilities. If you read enough of those harrowing accounts, it is easy to get the impression that these homes are no place to thrive in your golden years.

A new story coming out of Queens offers little relief. As reported this weekend in the NY Daily News, a former director of nursing at a Queens facility is now facing criminal charges for her conduct following a resident’s wandering from the facility.

Authorities explain how two weeks ago a 74-year old resident of the facility went missing. He was apparently not properly supervised and wandered out of the home without notice of the caregivers. The man has dementia, and obviously is at risk of serious harm while alone in the community. The senior has still not been found.