Nursing Home

29 Sep NURSING HOME ARBITRATION AGREEMENT HELD ONLY BINDING WHEN THERE IS PROPER AUTHORITY

Posted at 06:53h in Financial Powers of Attorney, Guardianship, Michael Cohen Dallas Elder Lawyer, Nursing Home, Power of Attorney

It is common for nursing home admission agreements to indicate that the patient and nursing home are bound by arbitration – which generally results more favorable decisions for the nursing home (as opposed to litigation). Recently, the son of a patient (his mother) seeking entry...

22 Sep MEDICARE NURSING HOME RATING SYSTEM FLAWED

Posted at 06:43h in Medicaid Application, Medicaid Planning, Medicare, Michael Cohen Dallas Elder Lawyer, Nursing Home

Medicare’s rating system for nursing homes is often misleading. Medicare set up a rating system in 2009 with the hopes that nursing homes would make efforts to increase the star rating (maximum of 5 stars) by improving the quality of care. However, some nursing homes have...

12 Aug Medicare Testing Payment Options that affect Limited Nursing Home Coverage

Posted at 10:04h in Medicaid Planning, Medicare, Michael Cohen Dallas Elder Lawyer, Nursing Home, Short Term Care

Medicare is presently allowing pilot projects across the country to determine if it can reduce costs and improve quality of care pursuant to a provision under the Affordable Care Act. At the present time, Medicare coverage for skilled nursing care is limited to patients who...

01 Aug Texas Department of Insurance Permits 75% Increase in Long-Term Care Insurance Premiums

Posted at 15:36h in Assisted Living, Long Term Care, Michael Cohen Dallas Elder Lawyer, Nursing Home

The Texas Department of Insurance (which regulates increases in insurance premiums) has permitted Allianz Life Insurance Company of North America (”Allianz”) to raise its long-term care insurance premiums by 75% to existing policyholders according to an article on July 25 written by Dave Lieber (the...

16 Jun National Senior Citizens Law Center Publishes Free Guide On Getting Long-Term Services and Support at Home

Posted at 07:15h in Long Term Care, Medicaid Planning, Michael Cohen Dallas Elder Lawyer, Nursing Home

In an effort to allow more seniors and persons with disabilities to live independently at home as opposed to a nursing home or other institutional setting, the National Senior Citizens Law Center (NSCLC) has recently published a free advocate’s guide. The Medicaid laws for payment...

22 Apr GAO STUDY ON MEDICAID ELIGIBILITY DUE TO CONGRESS SOON

Posted at 13:45h in Long Term Care, Medicaid Application, Medicaid Planning, Michael Cohen Dallas Elder Lawyer, Nursing Home

The Government Accountability Office (GAO) is in the final stages of researching and writing a report on financial eligibility for long-term care Medicaid. Senators Richard Burr (R-N.C.) and Tom Coburn (R-OK) and Representatives Trey Gowdy (R-S.C.) and Darrell Issa (R-CA) requested the study. The GAO...

14 Apr SENATE BILL TO CREATE “LOOK-BACK” PERIOD FOR VETERANS BENEFITS FAILS TO PASS

Posted at 22:56h in Assisted Living, Michael Cohen Dallas Elder Lawyer, Nursing Home, Veterans

Due to partisan politics in an election year, Senate Bill 1982 has failed. The bill which was designed to make numerous improvements to services for Veterans but would have also introduced a “look-back” period and penalties for transfers commonly used in planning for Veterans benefits...

23 Mar MEDICAL NEED REQUIREMENTS DIFFER FOR VARIOUS MEDICAID PROGRAMS

Posted at 07:12h in Assisted Living, Disability Benefits, Medicaid Application, Medicaid Planning, Michael Cohen Dallas Elder Lawyer, Nursing Home

Although most first think only of “means-tested” (assets and income) eligibility for various Medicaid programs, one of the other requirements is a “medical necessity”. The standard for nursing home Medicaid, Community Based Alternative (a Medicaid program which provides personal care services at home and in...

09 Mar Agent Under POWER OF ATTORNEY Faces 25 Years After Unsuccessfully Arguing that Transfers to Self Were for Medicaid Planning Purposes

Posted at 23:11h in Beneficiary, Medicaid Application, Medicaid Planning, Michael Cohen Dallas Elder Lawyer, Nursing Home, Power of Attorney

A Texas appeals court has upheld the conviction of an agent under a power of attorney who transferred funds to himself, supposedly to qualify his former grandmother-in-law for Medicaid. In an earlier proceeding, a jury sentenced the agent to 25 years in prison. Natho v....

06 Feb MEDICARE “PROGRESS” STANDARD ELIMINATED

Posted at 16:46h in Beneficiary, Medicaid Planning, Medicare, Michael Cohen Dallas Elder Lawyer, Nursing Home

Although the government agreed to settle a lawsuit (Jimnov v. Sebelius) in early 2013 whereby the government agreed that Medicare has been incorrect in requiring a patient to progress or improve to get skilled nursing services, home health and out-patient therapy covered by Medicare, the...