There’s no “income cap” anymore for Medicaid long term benefits
When I first started filing Medicaid applications for my clients back in 1995, a person who needed long-term care services in the home or assisted living but had run out of money could not even apply for Medicaid if their gross monthly income was higher than the “income cap.” Of course, the income cap was well below the amount that was needed to pay for care, which meant that a lot...
Feeding the Patient is Part of the Plan of Care
What can you do if your loved one can’t feed himself but the nursing home staff just keep leaving the tray on his table? The Nursing Home Reform Act Residents’ Rights 42 CFR Ä 483 requires that provision of adequate nutrition be part of the services provided to all nursing home residents. The facility must provide adequate services to “attain or maintain the highest...
Don’t count on the Medicaid representative at the County Board to remind you to Spend Down
An application for Medicaid benefits cannot be approved before the applicant (and spouse, if any) has completed the spend-down, because benefits are not payable unless the applicant is financially eligible. It is not uncommon for someone to initiate an application for Medicaid without having any idea whether they are eligible or not. The nursing home may start the process; a nonattorney...
Watch out for Transfer Inheritance Tax when you do your estate planning
Most of the publicity in the news concerning changes to New Jersey’s “death tax” has focused on its raising of the estate tax thresholds. Now, if a person dies and has less than two million dollars in his or her estate, there will be no estate tax regardless of who is receiving that bounty. Not so for the Transfer Inheritance tax, which is based on the relationship of the...
The Landscape has changed for Guardianship in New Jersey
Procedures for filing for Guardianship are changing in New Jersey as a result of amendments to the Court rules that were effective 9-1-2016. The Rules are at N.J.R. 4:86-1 to 4:86-10. Guardianship petitions now must be initiated using a specific set of forms that have been prepared by the Administrative Office of the Courts. A Guardianship Monitoring Program is being established in each...
VA Secretary Announces Plan to Upgrade the VHA Electronic Health System
On June 5, 2017, DVA secretary David Shulkin announced that the Department of Veterans Affairs would adopt the same electronic health records management system as the Department of Defense, called MHS GENESIS (https://health.mil/mhsgenesis). The primary motivation is to permit the Veterans Health Administration (VHA) to communicate and exchange information between the DVA and DoD health...
Find your parents’ Long-Term Care Policies so you can help them plan
There is plenty of debate about the benefits and drawbacks of buying long-term care insurance. The premiums are expensive for a person in their 70’s who is first considering a purchase. Potential buyers worry that they will pay premiums for years and never have to use the policy. The industry has been in flux and there aren’t too many carriers around. What I do know is that over...
Garn-St. Germaine Act protects families against certain mortgage acceleration
Home mortgages typically have a mortgage acceleration clause, called a “due on sale” clause. This is a clause that says that the mortgage becomes due and payable if the property is sold or transferred to another individual without the lender’s prior written consent. There is a federal law that prevents lenders from applying that clause when the homeowner transfers their...
New SEC rule could protect vulnerable adults from exploitation
There is a fine line to tread when a concerned person observes what appears to be financial exploitation of a person with cognitive impairment. Under the law, an adult is presumed to be “competent” unless and until a Court has entered an Order declaring him or her to be incapacitated. As dementia develops, there can be a long distance between the onset of impaired judgment with...
What to do when you think it’s time to refuse further treatment
If you are the Guardian of the Person or the designated Health Care Representative for a person who is extremely mentally incapacitated, there may come a time that you may face that most dreadful of decisions. You may wonder whether to treat all new medical crises. The person you are responsible for may have advanced Alzheimers or other dementia, may be incapable of expressing themselves, or...