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Long-Term Care

Jun 04

How to Qualify for Long-Term Care Medicaid

By Jessica L. Estes

Long-term care Medicaid is a needs-based program that helps qualified individuals pay for long-term care costs.  Long-term care is required when an individual, for a period exceeding thirty days, is unable to perform the basic activities of daily living such as bathing, dressing, eating, toileting, walking, and transferring.  Long term care can include homecare, adult daycare, respite care and assisted living or nursing home services, but long-term care Medicaid will only cover nursing home services.  As such, an individual must be admitted to a nursing home or other long-term care facility in order to apply for long-term care Medicaid.   

Moreover, there are three eligibility criteria that an individual must meet to qualify for long-term care Medicaid: (1) technical; (2) medical; and (3) financial.  In Maryland, to be technically eligible, an individual must be (1) a resident of Maryland; (2) aged 65 or older, blind, or disabled; and (3) a United States citizen or resident alien.  For purposes of Medicaid, an individual is considered a Maryland resident from the moment they are admitted to a nursing home in Maryland, even if their primary residence is located in another state or the District of Columbia.

To be medically eligible, an individual for a period exceeding thirty days, must require skilled nursing care, assistance with at least three activities of daily living, or assistance with at least two activities of daily living if the applicant also needs assistance with an instrumental activity of daily living.  Skilled nursing care is care or treatment that can only be done by doctors or nurses such as complex wound dressings, rehabilitation, or tube feeding.  Instrumental activities of daily living are not necessary for fundamental functioning but are necessary for an individual to live independently in the community.  Instrumental activities of daily living include such things as using a telephone, shopping, preparing meals, housekeeping, or money management.

Most individuals in a nursing home will meet the technical and medical eligibility criteria; however, the financial eligibility requirements are two-fold and most people will not immediately be eligible.  There are two tests an individual must pass to be financially eligible for Medicaid: the income test and the asset test.  The income test is simple.  If a person’s gross monthly income is less than the monthly cost of care at the facility, that person will pass the income test, and because the monthly cost of care at a nursing home is so high, most do.

The asset test, although simple, is not quite so easy to pass.  An individual cannot have more than $2,500 in countable assets as of the first of the month in which he or she applies for benefits.  As such, most people will need to “spend-down” their assets below that $2,500 limit to be eligible for benefits.  But, be careful!  The Medicaid qualification process is very complex and trying to navigate these rules alone, or with the assistance of a non-attorney, likely will result in wasted time, stress and frustration, and an unnecessarily large nursing home bill.  Instead, seek the advice of a competent elder law attorney who will not only obtain Medicaid benefits for his or her client, but preserve some, or all, of the client’s assets as well.

Sep 25

#TuesdayTips: About the Elderly Population in the United States

The older population (persons 65 years or older) numbered 40 million in 2015, representing 13% of the U.S. population, or one in every eight Americans. It is predicted that by 2030, there will be about 72.1 million older persons, more than twice their number in 2000. People 65+ represented 12.4% of the population in the year 2000 but are expected to grow to be 20% of the population by 2030 (U.S. Census Bureau, 2013). How these people will be tended to is an issue of import today. Here are just several of the issues that must be considered.

  • More and more of these elderly adults will need round-the-clock care in full-time residential convalescence facilities.The federal law and regulations regarding nursing home issues are contained in the Nursing Home Reform Act of 1987. Current standards of care can be traced back to the congressionally enacted Omnibus Budget Reconciliation Act of 1987 (OBRA 1987) or NHRA 1987.
  • The legislation set forth certain requirements for quality of care – with regard to nursing homes that receive Medicare and Medicaid funding, but individual states were permitted to pass stricter standards if they chose According to the U.S. Code of Federal Regulations long term care facilities were required to adhere to a list of expectations including (but not limited to) such things as promoting quality of life and maintaining resident dignity, preventing the deterioration of a resident’s physical and communicative needs, ensuring residents receive proper treatment and assistive devices to maintain vision and hearing abilities, and develop a comprehensive care plan for each resident.
  • The purpose of this legislation was to set minimum standards for nursing home care while offering a guarantee of a level of quality to the greatest extent possible. The statute include the incorporation of a Bill of Rights to further support the nursing home resident. The federal government had the ability to intervene because nursing homes rely on the receipt of Medicare and Medicaid programs to continue to function, although this is less true in ‘for profit’ facilities than ‘not for profit’ centers. In either case they must be in compliance with the requirements of the NHRA 1987 unless they have received a waiver.

Do you have an elder family member who currently resides or whom you are considering placing in a nursing home? The legal experts at ERA Law Group in Annapolis will work with you to ensure he or she is receiving proper medical care and support.

Jun 12

WHAT IS ELDER LAW?

By Jessica L. Estes

Ever wonder what “Elder Law” is?  Most people think that if you are 65 or older, it is called Elder Law and if you are younger than 65, it is called Estate Planning.  The real difference, though, is the focus of the representation.

Generally, the focus of estate planning is to make sure you have legal documents in place that provide the following: Read More

Apr 10

#TuesdayTips: Long-Term Care Insurance Policies

By Jessica L. Estes

 Generally, most people do not have sufficient income or assets to fund their long-term care for extended periods of time.  And, most people are not what the government deems “needs-based,” so they would not qualify immediately for any needs-based benefits.  Rather, most individuals are somewhere in the middle.Read More

Feb 27

#TuesdayTips: Utilizing Asset Protection Trusts

By: Jessica L. Estes, Esq.

If you read last week’s #TuesdayTips article, you learned how to protect your stuff in three easy steps: 1) know the rules; 2) know your predators; and 3) know your options.  Easy, right?  But, knowing is only half of the equation.  Now, it is time to: Assess your needs; Create what is missing; and Tie in your plan.  In other words, you must ACT!Read More

Aug 08

#TuesdayTips: Effective Estate Planning

A proper estate plan should provide for the following: (1) the ability to control your property while you are alive and able, (2) planning for you and your loved ones should you become disabled, and (3) after you die, making sure your assets go to the people you love without unnecessary cost or delay.  Moreover, for an estate plan to be effective there needs to be proper asset ownership and control of the process.Read More

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