Appellate Division Reverses Medicaid Denial in Our Client’s Annuity Case
In a precedent-setting decision approved for publication, the Appellate Division of Superior Court has reversed the denial of our client’s application for Medicaid/MLTSS eligibility . Read the case here: C.L. vs DMAHS and Bergen Cnty A-4284-19 Appellate Decision 10-17-2022The case involved the purchase of a certain annuity contract in 2019...
Social Security COLA and QITs for Medicaid recipients
On January 1, 2023 the Social Security Administration will be giving its recipients an 8.7% Cost of Living Increase (COLA). You probably know that if a person on New Jersey MLTSS-Medicaid receives gross fixed monthly income in excess of $2,523 (that’s the 2022 threshold), they must establish a Qualified Income Trust (QIT) to receive the excess income, in order to preserve their Medicaid...
State issues guidance on Right to Privacy in Residential Spaces for Medicaid recipients
The NJ Department of Human Services, Office of Licensing, has just issued an Information Bulletin which outlines the requirements for licensed community residences which participate in the State’s Medicaid Home & Community Based Waiver Programs. These “waiver programs” include a diverse array of settings such as Boarding Homes, Group Homes, Assisted Living, apartment...
Camp LeJeune Justice Act of 2022 Creates Opportunities For Redress
Many of our clients served in the military between 1953 and 1987. Some of them spent time at Camp LeJeune in North Carolina, became very sick, and pursued claims at the Veterans Administration for service-connected compensation over the years. Now there is a new avenue for civil lawsuits to be brought to obtain possible compensation. On August 10, 2022, President Biden signed the Camp...
What’s the Difference between an Assisted Living Facility and a Nursing Home?
An Assisted Living residence (“ALF”) is a facility which is licensed by the Department of Health and Senior Services, and subject to the regulations in N.J.A.C. 8:36, to provide apartment-style housing and congregate dining and to assure that assisted living services are available when needed, to four or more adult persons unrelated to the proprietor. Apartment units offer, at a...
Caution! Watch Out for “Responsible Party” and “Guarantee” Clauses in Nursing Home Contracts
When an individual moves into a nursing home for long-term care, there are an array of admissions documents that get signed. These include everything from personal preferences information to insurance and financial disclosures, medical releases, selection of physicians etc. One of these documents contains the contract for payment for the services being rendered.
Typically, the contract...
Transfer Penalty Traps and NJ Medicaid Applications
Medicaid Long-Term Services and Supports (MLTSS) is the government program that pays for nursing home care and long-term care in other settings for people who meet the stringent financial requirements. The application is filed once the non-excluded resources (assets) are below the specified levels. Along with the application form itself, the applicant must supply numerous documents as proof...
The 2022 “Medicaid Numbers” you need to know in New Jersey
The NJ Division of Medical Assistance and Health Services (DMAHS) has released Medicaid Communication #22-01 which provides the new numbers that are relevant to applications for Medicaid Long Term Services and Supports (MLTSS) benefits. 22-01_Income_and_Resource_Standards_for_Medicaid_Only (1) MLTSS pays for nursing home care (skilled nursing facilities), Assisted Living Facilities and...
Avoiding the Risk of Medicaid Liens
Individuals who receive Medicaid to pay for nursing home care, assisted living or in-home care must meet stringent financial requirements. The non-excluded or inaccessible resources cannot exceed $2,000 at the time of application, and as of the first day of each successive calendar month, must be below that limit in order to maintain eligibility. What resources are “excluded” or...
“Have you Talked to an Elder Law Attorney yet?”
The world can feel like a confusing, tangled mess when a loved one has dementia and needs to be discharged from a hospital with a major care plan in place. There are so many options, and hospital staff are in a huge hurry the minute the doctor signs the order clearing the patient for discharge. Staff speak in “shorthand,” using code words or acronyms that the patient’s family may not...