Tips on Residents’ Rights in Nursing Homes: Individualized Plan of Care Required
Once a person has moved into a nursing home, they are situated in a health care facility and receiving patient care, but they are also living there, and are therefore referred to as a “resident” rather than as a “patient.” The critical laws governing Residents’ Rights are the federal Nursing Home Reform Act, 42 USCS ‘ 1395i-3(b) and 42 CFR ‘ 483.10,...
Tips on Residents’ Rights in Nursing Homes: Bed Holds
The Federal Nursing Home Reform Act and New Jersey Nursing Home Residents Bill of Rights along with their regulations create numerous enforceable rights and protections for nursing home residents. Among these are the obligations to keep the bed available for certain amounts of time if a resident is temporarily out of the facility.
There are times that a resident must be transferred to a...
Tips on the nursing home admissions process
The need to place a beloved family member in a nursing home may be one of the most harrowing and heartbreaking decisions a person has to make. Not only is there a terrible sense of guilt and failure, but the sheer cost of a single month in a nursing home is staggering, and leaves the family with a bleak view of their future security. They feel vulnerable, because they are at the mercy of...
Wyoming Supreme Court holds that Agent under Power of Attorney had authority to consent to arbitration in nursing home admission contract
It is not uncommon for nursing home admissions contracts to include provisions requiring the resident to consent to binding arbitration of any dispute. In this recent case in Wyoming, the question was the enforceability of an optional arbitration clause. The nursing home admission contract for Aletha Boyd was signed by her Agent under a General Durable Power of Attorney (DPOA) which...
Section 8 housing eligibility terminated due to Intentional falsification of income data
Tenants who reside in Section 8 housing must certify to their household income every year, because the rent is based on the income. A recent case addressed a termination of eligibility for Section 8 due to willful misrepresentation on the application, coupled with the defense that the misrepresentation was due to the tenant’s severe depression and thus required an accommodation under the...
NJ 2017-18 Budget Adds Funding for Medicaid Long-Term Care
After the Governor and the Assembly leader resolved their Fourth of July Weekend Budget Kerfuffle, some positivity came out of it for Medicaid long-term care providers and beneficiaries.
Nursing home reimbursements would be increased by $10.5 million, shifting funds from Managed Long-Term Services and Supports (MLTSS). This would be $5.25 million of state funds with an identical federal match....
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...
Block Grants Could Throw Elder Care into Chaos
Since the election, there have been serious plans put out there to radically alter the Medicaid program . Right now, while it can be hard to get Medicaid without guidance and assistance, if you meet the eligibility criteria you are entitled to receive certain statutory benefits under federal law. The benefits provided to every person on Medicaid are paid for through a combination of state...