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Long-Term Care

Sarasota is Part of Medicaid Experiment

By Long-Term Care, Medicaid PlanningNo Comments

Thousands of caregivers in Sarasota and Charlotte counties are receiving letters this month from the state, telling them they have 30 days to enroll their loved ones in Florida’s new Medicaid Long-term Care program.

The two counties are part of a sweeping experiment in managed long-term care that begins here on Sept. 1, affecting 5,596 Medicaid recipients in a seven-county area.

The goal: To cut Medicaid costs by gradually diverting more frail Floridians from nursing homes or assisted-living facilities and into home care.

To achieve this, private contractors will take over the state’s work of supervising cases and paying providers.

For the first year, contractors’ bonuses are linked to a modest 2 percent reduction in their share of the nursing home population, who receive 24-hour highly skilled care. The expectation is that these companies can move more Medicaid patients over time to less costly assisted-living facilities — or even back to their own homes, the cheapest option.

Click here to read the whole Herald Tribune article.

July 9, 2013
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10 Ways to be a Healthier Caregiver

By Health, Long-Term CareNo Comments

It is so important to remember to take care of ourselves while providing care to a loved one. Here are tips to help focus on you while caring for another.

1. Understand what is happening with the disease and diagnosis as early as possible.

2. Know what community resources are available to help.

3. Become an educated caregiver. Take advantage of workshops and training resources available to you.

4. Get help for yourself through friends and family.

5. Stay healthy with your diet, exercise and sleep.

6. Manage your stress level with relaxation techniques that work for you or the help of your physician.

7. Accept changes as they occur.

8. Make legal and financial plans. If possible, involve your ill loved one in the decision making process so their voice is heard.

9. Give yourself credit, not guilt. Caregiving is a difficult job.

10. Visit your doctor for regular check-ups.

There are many organizations with support groups in Sarasota including Senior Friendship Center, Alzheimer’s Association, Jewish Family Services, Neuro Challenge Wellness Center and more.

If you need legal advice for estate planning, Medicaid planning, or VA planning, please contact our office at (941) 906-1231 for an initial consultation.

January 3, 2013
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Common Symptoms of Caregiver Stress

By Health, Long-Term CareNo Comments

While it is important to so many people to care for their loved ones in a time when they need assistance, it is also important to remember to take care of ourselves. Here are 10 signs that a caregiver is experiencing stress.

1. Denial about the disease and its effect on the person who’s been diagnosed

2. Anger at the ill loved one, at the disease or the fact that other’s don’t understand the changes happening

3. Social withdrawal from activities, friends and family.

4. Anxiety about providing care and the future.

5. Depression that breaks your spirit.

6. Exhaustion that makes it difficult to complete daily tasks.

7. Sleeplessness due to concerns for the ill loved one.

8. Irritability towards your ill loved one and other family members or friends.

9. Lack of concentration that makes it difficult to perform your day to day tasks.

10. Health problems that begin to take a physical and mental toll on the caregiver’s well being.

If you or a caregiver you know experience any of these signs of stress on a regular basis, it is important to make time to speak with a physician.

If you need legal advice for estate planning, Medicaid planning, or VA planning, please contact our office at (941) 906-1231 for an initial consultation.

January 2, 2013
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Landmark Decision for Medicare Recipients Increasing Medicare Coverage for Home Care and Skilled Nursing Rehabilitation

By Elder Law, Government Benefits, Long-Term Care, MedicareNo Comments

Historically well informed Elder Law advocates have challenged the denial of Medicare coverage for a full 100 days in skilled care after a three night hospital stay under the premise that this common practice is not consistent with federal law.  Finally this denial of coverage may end thanks to a landmark class action settlement.

            Those receiving rehabilitation in skilled care or Medicare home care have historically been told that coverage will end when the patient is no longer showing signs of improvement.  However, neither Medicare law nor any Medicare regulations require the patient show a likelihood of improvement.  But this became “the” accepted practice due to provisions of the Medicare manual and guidelines use by Medicare contractors which suggested that coverage should be denied or terminated when a patient reaches a plateau or is not improving or is stable.

            This settlement should result in increased Medicare coverage for rehabilitation in skilled care and home care if the services are needed to “maintain the patient’s current condition or prevent or slow further deterioration.”

            Under a proposed settlement expected to be approved by a Federal Judge this week,  Federal officials will rewrite the Medicare manual to make it clear that Medicare coverage of nursing and therapy services does not turn on the presence or absence of an individual’s potential for improvement but is based on the patient’s need for care.

            While this may increase the Medicare budget it is an honest reflection of what the law is currently.  Is it an honest correction of a misapplication of regulations interpreting the law.

Many beneficiaries may now be able to continue Medicare home care and thereby avoid skilled care.  In these cases, Medicare costs may actually be reduced by keeping the patient at home.  Many more patients should be able to receive the full 100 days of skilled nursing services, so long as the care is required to maintain the patient’s current condition.

If you need legal advice for estate planning, Medicaid planning & Medicare, or VA planning, please contact our office at (941) 906-1231 for an initial consultation.

October 26, 2012
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Long-Term Care Expenses Can Be Tax Deductible

By Long-Term Care, Tax LawNo Comments

Long-term care expenses quickly add up, but it is good to know that many long-term care expenses can be deducted from your taxes. Under the tax code, expenses for medical care may be claimed as an itemized deduction if they exceed 10 percent of adjusted gross income. The definition of medical expenses includes the cost of long-term care if a doctor has determined you are chronically ill. “Chronically ill” means you need help with activities like eating, going to the bathroom, bathing, and dressing, or you require substantial supervision due to a severe cognitive impairment.

For more information on your tax return, visit www.irs.gov.  Please contact our office for an initial consultation if you need legal advice at (941) 906-1231.

September 12, 2012
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New Face to Face Meeting Requirements for patients receiving Medicare, Home Care or Hospice

By Long-Term Care, MedicareNo Comments

New Face to Face Meeting Requirements for patients receiving Medicare, Home Care or Hospice

By Babette B. Bach Esquire, Sarasota, FL

A requirement that health care providers have a face-to-face meeting with patients was added as a Medicare payment requirement for home health and hospice care by the Affordable Care Act (ACA). Implementation of the requirement was effective April 1st 2011.The Face-to-Face requirement is intended to be a tool for reducing fraud and abuse by assuring that physicians or other healthcare providers have actually met with potential home health patients to determine their specific care needs.

The specifics of the Face-to-Face requirement for home health care are included in CMS regulations that were issued on November 17, 2010.  The regulations establish that a face-to-face encounter must have “occurred no more than 90 days prior to the home health start of care date or within 30 days of the start of the home health care by including the date of the encounter.” The certification of the need for home health care must include an explanation as to why the physician’s clinical findings support the need for home health care, including that the patient is homebound and the need for either intermittent skilled nursing services or therapy. Regulations provide that a face-to-face encounter can be by tele-health as provided in the Social Security Act.

If the face-to-face encounter occurred within 90 days of the start of care, but was not related to the primary reason that the patient requires home health services, or if the patient has not seen the certifying practitioner within the 90 days, the practitioner must have a face-to-face encounter with the patient within 30 days of the start of the home health care.

If you need legal advice for estate planning, Medicaid planning, or VA planning, please contact our office for an initial consultation.

 

Babette B. Bach, Esquire, Board Certified Elder Law

Bach & Jacobs, P.A.

240 S. Pineapple Avenue, Suite 700

Sarasota, FL 34236

941-906-1231

941-954-1185 facsimile

www.bachjacobs.com

 

June 11, 2012
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