Medicaid Planning

Tax Time Tip – Declaring a Parent as a Dependent

Published on: March 19, 2014 | by Ettinger Law Firm

Late March is best known for many as the time of year that they fervently fill out their “March Madness” college basketball bracket in hopes of winning the office pool or family competition. For others, however, this marks the time when the procrastination ends and you finally get around to filing your taxes. With less than a month left before the classic April 15th deadline, if you have not done so already, it is time to start gathering paperwork and getting the task out of the way.

Elder Care & Taxes

Tax issues are notoriously complex and confusing. And considering the thousands of pages that make up the Tax Code, New York residents can be forgiven for not committing the details to memory or spending their free-time analyzing the issues. Yet, one general tip that most are aware of is the need to claim all possible deductions in order to lower your overall tax burden.In that regard it is important not to forget the way that elder care intersects with your taxes.

Do Even “High Ranking” New York Nursing Home Neglect Residents?

Published on: March 11, 2014 | by Ettinger Law Firm

Nursing home horror stories abound, and everyone has likely heard some tale of seniors suffering neglect at a New York long-term care facility. It is for that reason that elder care advocates always suggest doing your homework before making a final decision about where to receive skilled nursing care.

One of the most well-regarding nursing home ranking system is the federal “Nursing Home Compare” website. The site lists most nursing homes and gives them a star rating, from one to five. The rating is based on health inspections, staffing levels, and various quality measures. As a general guide, browsing the rankings of all local New York homes is a very helpful way to get an idea of home performance.

However, can the star system be relied upon exclusively? Is admission to a home with four or five stars a guarantee that the care provided will be proper?

Privately-Run Managed Elder Care – Advocates Worry About Neglect

Published on: March 7, 2014 | by Ettinger Law Firm

The elder care “problem” with which many policymakers in New York and federally are grappling is rooted around one issue: finances. In other words, there are many great models for providing high-quality care to seniors, but there is far less understanding of how to pay for that care. As a result, a balancing act is being performed within the New York Medicaid system as administrators determine what model provides the best care based on the amount of funds that the public can provide.

Is Managed Care the Answer?

The most popular recent trend nationwide, including in New York, involves using “managed care” programs for elder care. The idea is relatively simple: pay private companies to provide senior care at a set-price, with the compensation not tied explicitly to the exact services rendered. The pay-for-service model is often plagued with fraud and perverse incentives.

Billions on the Line with New York Medicaid “Adjustments” from Federal Government

Published on: February 27, 2014 | by Ettinger Law Firm

New York State has the largest Medicaid system in the country. As most know, Medicaid is a joint state-federal program that provides healthcare to low-income residents. Unlike Medicare (which is a program exclusively for seniors based on their age), Medicaid is for all those who do not have enough assets to pay for the insurance they need out-of-pocket.

Medicaid provides general health care to residents of all ages. In addition it acts as the primary public provider of support for seniors in need of a nursing home stays or other elder care. Considering that each kind of support comes from the same pool of Medicaid money, it is useful for those reliant on the Medicaid system to keep up with all matters that affect the overall budget. In other words, any NY Medicaid budget issues may eventually affect elder care and support options.

Federal Government Adjustment

New York Nursing Home Costs & Medicaid “Lookback” Period

Published on: February 24, 2014 | by Ettinger Law Firm

Any family who has gone through the process of helping a loved one into a New York nursing home understands the initial “sticker shock.” New York remains one of the most expensive states in the country for long-term care.

As outlined in the latest Genworth Cost of Care study (from 2013), the median cost of a private room in a long-term care facility in the state is $125,732 per year. Not only that, but the rate is expected to jump by five percent over the next few years. Notably, the average cost nationwide is only $83,950. This means that our state is near the very top of the list when it comes to caregiving costs for seniors.

Do not forget, however, that these studies only report on averages or the median rate. In certain locations, the costs can even run higher. For example, last week Newsday published a story which found that within New York, Nassau and Suffolk counties average the highest in the state. In those counties, the average stay costs over $145,000 per year.

New York Medicaid Program Recovers Record $851 Million in 2013

Published on: February 5, 2014 | by Ettinger Law Firm

Earlier this week new figures were released by the Medicaid Inspector General’s office which highlight the expanding crackdown on misuse of New York Medicaid funds.

As discussed in a NY Daily News story, last year state investigators recouped $851 million in allegedly misspent Medicaid funds. This marks nearly double the previous record, from 2012, of $468 million in savings. However, the sizeable figure for 2013 is due in large part to the recovery of nearly $496 million as part of a settlement with federal officials regarding billing for home health services.

These tallies represent a commitment by a growing number of state officials and lawmakers to ensure billing practices with Medicaid are above board and every taxpayer dollar is spent as efficiently as possible. Even with this “record setting” year, some officials, particularly fiscal conservatives, argue that more needs to be done to root out fraud and lower overall Medicaid spending.

County Run Nursing Home in New York Studying Future of Long-Term Care

Published on: February 4, 2014 | by Ettinger Law Firm

The future of providing necessary care and support for New York seniors is a hotly debated topic. The analysis is taking place everywhere, including at the local level. As frequently discussed, one of the primary battlegrounds is that of county-run nursing homes. Long a bastion of care for residents, these facilities are being shuttered by some and transferred to private owners.

But not all New York communities are giving up on the idea of publicly-owned long-term care facilities. One area taking a cautious approach is Genesee County which recently commissioned a committee to study various aspects of long-term care in the community to determine the best course of action with regard to the current county nursing home.

NY Elder Care – A Closer Look

The Truth About Medicaid “Estate Recovery” Concerns

Published on: January 29, 2014 | by Ettinger Law Firm

The New York Medicaid system is the primary source of funding for many seniors in need of long-term care at nursing homes. Medicare does not cover these extensive stays, and the out-of-pocket costs are tremendous. As a result, many seniors enroll in the program to pay for their care.

Payments for long-term care make up a sizeable part of the entire Medicaid budget. As a result, policymakers are often looking at ways of cutting expenses or funnelling more money into the program to pay for those in need. One way that Medicaid law has accounted for ths is via a Medicaid estate recovery program. The basic idea is that the state can re-coup portions of the funds spent on an individual under Medicaid after that person’s passing. This takes the form of the state receiving a portion of the decedent’s assets.

The laws regarding Medicaid estate recovery are quite complex, with exceptions depending on surviving spouses, dependent children and similar details. But, under current rules,recovery may be made on “assets passing under the terms of a valid will or by intestacy, and any other real and personal property and other assets in which the decedent had any legal title or interest at the time of death…”

AARP Comment on Upcoming State of the State Address

Published on: January 8, 2014 | by Ettinger Law Firm

Today, New York Governor Andrew Cuomo will deliver his 2014 “State of the State” address. Just like the more well-known “State of the Union” address that President Obama will deliver later this month,the purpose of the event is for the Governor to lay out his vision for the upcoming year. It is intended to be a starting point in policymaking, usually outlining the issues that the Governor will attempt to advance within the state legislature in the upcoming session.

Earlier this week, the New York State AARP Director, Beth Finkel released a statement sharing information about what the advocacy organization hoped to hear included within the address. In particular, the statement discusses the policy issues that are likely to affect older New Yorkers. Considering the critical role that state policy has on so many elder law issues, from New York Medicaid to nursing home quality, the issues to be addressed her should be on the radar of most New York families.

Relevant New York Policy Issues

Don’t Let Qualifying for Medicaid Force You Into Poverty

Published on: December 26, 2013 | by Ettinger Law Firm

If a New York senior is in immediate need of close, skilled, long-term care and lacks the resources to pay the (quite high) fees for such care are out of pocket, then the only recourse is usually the New York Medicaid system.

But far too many residents fail to appreciate the basic details of this system until they are confronted with the reality head-on. Most notably, Medicaid, unlike Medicare, is based on need–not age. Therefore, the only way to qualify is to have a set asset level that falls below a certain threshold. Many families who have spent a lifetime saving and investing in their home have assets above that threshold. Therefore they are forced to spend down their resources in order to qualify for needed Medicaid support.

A New York Times story from last month discussed how many elderly couples in the past were essentially forced into poverty in order to receive Medicaid help. One story from the 1980s is shared involving a couple who were married for 45 years before divorcing in the mid-1980s. The divorce was not pursued because the couple had fallen out of love, but because it was the only way to avoid the healthier partner from being forced into poverty to ensure the couple qualified for Medicaid.