A version of this article appeared in print on July 22, 2017, Section B, Page 1 of the New York edition with the headline: The Ethics of Trying to Qualify for Medicaid. The numbers quoted, and some facts have changed since 2017. I am publishing this edited article because I have had a number of people / clients ask if Medicaid planning is legal. The answer is YES. However, you have a choice to pay privately or go on Medicaid. But what happens if you need dentures, hearing aids, even cable tv for your room and you have no money!…
Last November, in what the U.S. Department of Justice called “one of the largest health care fraud settlements in U.S. history,” Johnson & Johnson and its subsidiaries were fined more than $2.2 billion to resolve criminal and civil charges because of their aggressive marketing of drugs, including antipsychotics, to nursing homes, when they knew the drugs had not been approved by the U.S. Food and Drug Administration (FDA) as safe and effective for a general elderly population. The corporation also allegedly paid kickbacks to physicians, as well as to Omnicare, the nation’s largest long-term-care pharmacy provider. Omnicare pharmacists were recommending Johnson…
Medicare beneficiaries who are admitted to a hospital and then discharged to a nursing home have been getting charged for care they thought Medicare would cover. A new self-help packet from the Center for Medicare Advocacy explains how beneficiaries can fight for the coverage they need. The problem arises if a hospital places you in “observation status” instead of formally admitting you. Observation status triggers Medicare Part B, a part of the Medicare law that does not pay for post-hospital care. Medicare covers nursing home stays entirely for the first 20 days, but only if the patient was first admitted…
At the turn of the 20th Century, the average life expectancy was about 47 years. Now in the 21st Century, life expectancy has doubled that. As a result, we face more challenges and decisions in our life than those who came before us. One of the major transitions people face is the change from independent living in their own home or apartment to living in a long-term care facility or nursing home. There are many reasons for this while the transition is so difficult. One is the loss of home; a home where the person lived for many years with…
Long-term care recipients can be of any age. Conditions that may lead to the need for long-term care include disability, mental decline or illness, AIDS, stroke, and simple frailty. The need for long-term care is primarily measured by assessing limitations in performing or managing tasks of daily living, including self-care and household tasks. Obviously, the likelihood of needing long-term care assistance increases with age. The aging of Americans will only increase the need for quality long-term care options. The growth in demand will be driven by increases in the numbers of elderly as a result of the aging of…
The Illinois Department of Public Health conducted an investigation concerning an automobile accident involving a 79-year-old female resident who was under the care Community Living Options, Inc., an intermediate-care facility for the developmentally disabled. The resident was diagnosed with mental retardation, cerebral palsy, speech and hearing impairment, and dementia. Defendant's employee was driving a facility van with the subject resident and two other residents. A truck braked in front of the van and the employee braked to avoid the truck. The resident came forward and hit the dash with her head. She was transported to a hospital and died the…
A KVUE Defenders investigation uncovered cases of nursing home neglect on the rise across Texas. The investigation also discovered that facilities repeatedly cited for violations rarely see their contracts terminated with the state, despite getting millions in taxpayer dollars. According to the Department of Aging and Disability Services (DADS), deficiencies involving Texas nursing homes jumped from 14,215 in 2011 to 15,113 in 2012. The most severe violations, which put patients in immediate danger, increased by 35 percent. "This is crisis mode right now for Texas," said Brian Lee, Executive Director for Families for Better Care. Earlier this year, the nonprofit…
The month of October is a time to recognize residents across all long-term care settings. The theme for 2013 by the National Consumer Voice for Quality Long-Term Care is “Speak Out Against Elder Abuse.” The Consumer Voice hopes to empower and educate residents around the issue of elder abuse. Learn more about the events for Residents’ Rights Month.
Older lesbian, gay, bisexual, and transgender (LGBT) people, including those among the first to come out as a political and social force, are increasingly apprehensive about encountering discrimination as they grow older and more dependent on strangers for care. An estimated 2 million Americans 50 or older identify as LGBT, with that number expected to double by 2030, according to the Institute for Multigenerational Health at the University of Washington. About 15,000 are estimated to live in the Washington metropolitan region. Those over 65 grew up in what their younger counterparts now see as a dark age, when doctors viewed…
The Arc of Northwest Indiana is closing all 22 of its group homes where it houses people with developmental disabilities, laying off 120 employees. The decision was made by the Northwest Chapter after the state Family and Social Services Administration said they had concerns about the health and safety of the 90 people living in the homes. Dickerson says this was mainly due to a nursing shortage. "There is specifically a shortage of nurses working with people with developmental disabilities," said Dickerson. The 90 residents have been moved to what have been described as "temporary" homes, some as far away…
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