New York Elder Law

How Medicare and Medicaid Are Addressing Long-Term Care Issues

Published on: March 10, 2022 | by Ettinger Law Firm

Deciding how to receive the medical care that a person needs is a critical part of the elder law process. Unfortunately, the unpredictable nature of aging and medical issues can make it challenging to determine what lies ahead. Various states have also begun to attempt to resolve financing challenges associated with elder care that a growing number of Americans will face in the next couple of decades as a growing portion of the baby boomer generation requires medical care.

The Growing Need for Assistance

Any person can end up needing assistance as they age. This is true regardless of whether a person ends up facing dementia, a significant drop in eyesight, or mobility issues. The degree of assistance and how long a person faces these issues can vary substantially. A person might end up needing assistance with meals, other daily living activities, or total care for the months or years before they pass away. Other times, people end up needing total care for years. The unpredictable nature of a person’s future makes it challenging to plan ahead.

The Future of Elder Care: Senior Villages

Published on: February 12, 2014 | by Ettinger Law Firm

The combined pressures of growing need, rising costs, and altered ideas of the best way to live one’s golden years is leading to a revolution in the look and feel of elder care. To be sure, changes in the way seniors in need receive support are still occurring far too slow for some advocates. But it is undeniable that many seniors now are cared for differently than their parents and the trend will only continue in the coming years and decades.

One common suggestion is that communal living spaces (like nursing homes) are closing and being replaced by a growth in at-home caregivers. While that change is occurring, it oversimplifies the new landscape of seniors care. There are different version of at-home support and even communal living.

Senior Villages

Is There a Future in Outsourcing Elder Care?

Published on: January 28, 2014 | by Ettinger Law Firm

A somewhat bizarre story out of Europe is leading a few elder care experts in the United States to question whether “shipping away” seniors may be part of the future of long-term care for some families.

As reported by the BBC, one adult daughter in Switzerland ignited an ethical debate recently by deciding to send her mother to a long-term care home in Thailand for support. The daughter explained that her decision was based on both her mother’s specific condition and financial realities. The 91-year old mother apparently suffers from severe dementia, and is unable to remember much of anything about the present. In addition, the cost of care in Switzerland was incredibly high–similar to that in New York–while Thai care was far more affordable. The daughter felt that her mother could receive better services in Thailand where she now lives with a group of other Swiss and German seniors.

A Wave of the Future?

Onondaga County Officially Transfers Ownership of Nursing Home to Private Firm

Published on: December 6, 2013 | by Ettinger Law Firm

The changing face of New York nursing home care continued this weekend as another county officially got out of the elder care business. As reported by Syracuse News, the Van Duyn Home and Hospital was transferred by Onondaga County to the “Upstate Services Group” — a private company that owns at least eleven other New York elder care facilities.

This transition was in the works for quite some. The news report explains how the facility has long-been plagued by accusations of poor care on top of acting as a huge financial burden for the county itself. In fact, Van Duyn was under intense scrutiny from federal regulators for its poor caregiving track record. That is on top of more than a dozen private civil lawsuits filed by former residents and their family members against the county alleging negligence.

The financial issue combined with care quality concerns led many to suspect that the 500-bed facility would be shuttered. However, with this transition to private ownership, it appears the the facility is safe–at least for now. Interestingly, one of the main concerns with sales of public facilities to private companies is the risk of a decrease in quality for residents. However, in this case, because of Van Duyn’s poor track record in the past, there were less complaints of that nature.

New Tech Tools Changing Elder Care

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

The look and feel of elder care in the United States is changing. In the distant past, most care was provided by friends and family members at their own homes. Later, larger facilities (nursing homes) were built to provide more consistent care to all seniors, especially those without options for family support. Now, however, care is shifting back to the home. This change is pushed by many factors, including the rising costs of nursing home care and the preferences of individual seniors to avoid institutionalized living.

More Options Than Ever

One interesting driver of the change are advances in technology which offer increasing support options available to seniors living at home. A Huffington Post story explored the different ways that these tools are helping improve elder care. While some of the most advanced systems are still in the works, many simple tech tools are already being pushed out to greatly improve senior services.

Understanding “Specialty” Trusts

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

Many New Yorkers remain unfamiliar with the benefit and flexibility of using trusts to plan for the future and protect assets in the present. Trusts can prove useful for all residents, including most middle class families. In our work with estate planning, we often help set up basic living trusts which help avoid probate and streamline the inheritance process. On the elder law side, Medicaid Asset Protection Trusts are used to protect assets from the “spend down” requirement needed to qualify for Medicaid and secure necessary long-term care.

Beyond those two trusts, however, there are many other options that may prove useful depending on your specific situation. A LifeHealthPro article last week discussed a few “specialty” trusts. A review of the topic is a helpful way to get an idea of the true scope of trusts and the many different ways that they may be used to carry out very specific wishes.

For example, some of the trusts mentioned in the story include:

AARP to Hold Forum on “Modernizing Medicaid”

Published on: October 15, 2013 | by Ettinger Law Firm

Debate and discussion around the ideal setting to care for older individuals has raged for decades. The trends are somewhat cyclical.

In the distant past, virtually all aging took place at homes. “Traditional,” nuclear families were more common, and so seniors who could no longer live on their own almost always moved in with family members. Long-term care facilities were virtually non-existent.

However, seniors who did not have available family caregivers or who needed more support than caregivers could provide were left in dire straits. The growth of various senior housing locations filled the gap. These separate spaces catered exclusively to senior needs, ideally providing better, more efficient care without overburdened family support networks.

Continuing Trend: Private Investor Buys New York Public Nursing Home

Published on: October 10, 2013 | by Ettinger Law Firm

The face of long-term care in New York continues to change. In the past, when seniors were in need of close, around-the-clock care their main option was to move into a skilled nursing home in their community, usually owned by the county itself. These public facilities long acted as the main source of institutional support for ailing seniors.

But things are changing. For one thing, many more seniors are being proactive about their long-term care, creating elder law estate plans that ensure they have more options, including at-home care that allows them to age in place.

On top of that, more and more county owned and operated nursing homes are being sold off to private investors. Finances are at the center of the switch, as tight local budgets are making it very difficult for local policymakers to justify losing significant funds year over year on this care. Recent reports have underscored the situation, noting that virtually all of the county-run nursing homes in New York are operating in the red.

Federal Long-Term Care Commission Set to Issue Report

Published on: September 11, 2013 | by Ettinger Law Firm

Advocating for better long-term care is not just a concern of NY elder law attorneys. Policymakers at all levels and of all political persuasions are also keenly aware of the impact that the growing need for long-term care will have on communities nationwide.

There are few challenges more acute than figuring out how to ensure adequate senior care for all community members. As most know, we are on the cusp of a “gray wave” with demographics changes requiring an increased commitment to skilled care and assistance for seniors. The need extends to all facets of elder care, from ensuring there are enough physical spaces for those in need to coming up with ways to pay for the care.

Federal LTC Commission

Nationwide Nursing Home Report: New York Receives Failing Grade

Published on: August 20, 2013 | by Ettinger Law Firm

A non-profit group called “Families for Better Care” recently released a comprehensive report card that ranks the skilled nursing care in all 50 states. The report, one of the most comprehensive ever, was based on a mountain of data taken from federal reports from 2013. Every state received a letter grade. Sadly, New York grade was far from passing–we received an F. The state was listed in the bottom as one of the worst places for nursing home care in the country.

The report also gave individual state grades on eight different criteria. Those factors included deficiencies identified in state inspections, staffing hours, ombudsman complaints, and more. Those individual grades were then combined to come up with the overall state grade.

The full report can be viewed online here.