Laws created during the Obama administration to give nursing home residents more control of their care are gradually going into effect. The rules give residents more options regarding meals and visitation as well as making changes to discharge and grievance procedures.
The federal Centers for Medicare and Medicaid finalized the rules in November 2016. These rules are the first comprehensive update to nursing home regulations since 1991. The first group of new rules took effect in November. The rest will be phased in over the next two years.
Some of the new rules include:
Continue Reading New Protections for Nursing Home Residents
Want to live in a private nursing home room? Expect to pay more.
That’s according to Genworth’s 2017 Cost of Care survey of U.S. nursing homes, conducted by the insurer each year, which found that the median cost for a private room rose 5.5 percent between 2016 and 2017.
Genworth says the median cost of a private room is $97,455, while a semi-private room in a nursing home is $85,775, up 4.44 percent from 2016. This price increase is substantially larger than the 1.24 percent and 2.27 percent gains, respectively, in 2016.
Continue Reading Nursing Home Costs Rise Sharply in 2017
All hospitals must now give Medicare recipients notice when they are in the hospital under “observation.” The notice requirement is part of a law enacted in 2015 that just took effect.
Signed by President Barack Obama in August 2015, the law was intended to prevent surprises after a Medicare beneficiary spends days in a hospital under “observation” and is then admitted to a nursing home. This is important because Medicare covers nursing home stays entirely for the first 20 days, but only if the patient was first admitted to a hospital as an inpatient for at least three days. Many beneficiaries are being transferred to nursing homes only to find that because they were only under observation and were therefore hospital outpatients all along, they must pick up the tab for the subsequent nursing home stay — Medicare will pay none of it.
Continue Reading Hospitals Now Must Provide Notice About Observation Status
Moving your spouse into a nursing home can be a weighty decision, emotionally and financially.
If you don’t take the right steps, there is a chance that transitioning to a nursing home will drain your spouse’s finances, and possibly even your own.
In this blog post, we’ll look at some common mistakes to avoid before your spouse transitions to a nursing home.
Continue Reading Costly Mistakes to Avoid When a Spouse Enters a Nursing Home
When you are planning for Medicaid coverage in a nursing home, it’s important to take any IRAs you own into account.
Medicaid applicants can keep only a small amount of resources (usually $2,400) in order to be eligible for benefits. Certain resources may be exempt from this rule. Whether your IRA is exempt often depends on whether it is in “payout status.”
Continue Reading Your IRA Can Affect Your Medicaid Eligibility
In Pennsylvania, if you give your home to your children (or to someone else) and then apply for Medicaid coverage in a nursing home, you may be ineligible for Medicaid for a period of time. You are required to spend down your resources on your own care before applying for Medicaid, rather than give them away.
However, there is an important exception that allows you to give your home to your child in certain circumstances.
Continue Reading Medicaid Helps Children Who Live With Aging Parents
Recently, the United States Court of Appeals for the Third Circuit ruled that short term annuities are a viable Medicaid planning tool for nursing home residents attempting to protect a portion of their resources and qualify for Medicaid benefits.
Many people believe that in order to qualify for Medicaid in a nursing home, you must deplete all of your resources. This is not correct. Medicaid annuities permit you and or/ your spouse to protect a significant portion of your resources.
Continue Reading Short Term Medicaid Annuities Approved by Court
The Pennsylvania Filial Support Act, which is contained in Chapter 46 of Title 23 of the Pennsylvania Consolidated Statutes, permits an indigent person or any agency involved in the care of the indigent person, such as a nursing home, to make a claim against you for their care and for financial assistance if you are the spouse, the child, or the parent of the indigent person.
The amount of your liability to your indigent relative will be determined by the court in the judicial district in which the indigent person lives. If the court determines, after reviewing evidence of your assets and income, that you do not have sufficient financial ability to support the indigent person, then the Filial Support Act will not apply to you. Also, a child will not be liable for the support of their parent if the child was abandoned by the parent, and the abandonment lasted for at least a period of ten years during the child’s minority.
Continue Reading Filial Support Act Alive in PA!
Many people are surprised to discover that Medicare actually provides very limited coverage for nursing homes.
In theory, Medicare Part A covers up to 100 days of care in a skilled nursing facility for each spell of illness. However, this is true only if the nursing-home care follows at least a three-day admission to a hospital. Further, after 20 days, you must pay a copayment of $157 a day (although this may be covered by Medigap insurance).
In addition, the definition of “skilled nursing” and the other conditions for obtaining this coverage are quite stringent. As a result, very few nursing home residents actually receive the full 100 days of coverage. In fact, Medicare pays for less than a quarter of long-term care costs in the U.S.
Continue Reading A Quick Look at Medicare, Medicaid, and Nursing Homes