Nursing Homes Must Protect Their Residents

Family members of a disabled woman have filed a lawsuit against a nursing home in Aurora, Illinois. Their family member, a disabled woman, was sexually assaulted while a resident of the Fox River Nursing Home.

The lawsuit alleges that Sylvester Grays was a patient at the nursing home. Mr. Grays, age 39, sexually assaulted a senior woman who suffers from dementia. The assault left her “in a bruised, battered, and bloody condition” according to the lawsuit.

Mr. Grays is now awaiting trial on eight counts of aggravated criminal sexual assault and battery. He has previously served prison terms for burglary and retail theft in Rook County, Illinois.

Nursing homes have a responsibility to protect their patients. When they know that a dangerous individual is in their facility, he should be closely monitored or restricted.

The nursing home industry is a growing industry in the United States. They are profit driven and this sometimes leads to their being lax in their responsibilities. Should you, a member of your family, a friend or loved one suffer from inappropriate conduct, abuse, or negligence related to a stay in a nursing home call us at 1-800-344-6431 or contact us by email. We can help you protect seniors for inappropriate practices or conduct.

Paying for Nursing Home Care

It is impossible to predict whether a family member will require long term nursing home care but one thing is certain. Medicare will not pay the cost of long term nursing home care.

Alternative methods of paying for nursing home care may involve long term care insurance, paying out of your pocket, or qualifying for Medicaid.

In the event you seek to purchase long term care insurance, it is important you get the following benefits:

1. Home care coverage.

2. An inflation rider.

3. Make sure to obtain at least 3 years of coverage.

If you seek to qualify for Medicaid, you should take the following into consideration:

1. You can only have about $2,000 in assets.

2. Your home doesn’t count in qualifying for Medicaid but Medicaid can place a lien on your home to cover its expenses.

3. If you have a spouse, he or she is entitled to retain up to about $95,000 in assets.

4. The individual in the nursing home has to give up all income except for $60 per month for a personal allowance, the cost of health insurance premiums and an allowance for minor children or his or her spouse.　

5. Under certain circumstances the stay at home spouse is entitled to a share of the nursing home spouse’s income.

6. The state can go after the Medicaid recipients estate upon his or her death.

7. The Medicaid application process is difficult, complicated and time consuming.

In the event that you need assistance with Medicaid planning to help preserve your assets in the event of a future Medicaid application or with an actual Medicaid application, you can e-mail us or call at 800-344-6431

Long Term Care Hospitals – A Capitalist Solution

During the past quarter of a century there have been over 400 long term care hospitals built in the United States. These hospitals do not provide acute care for specific illnesses. They are, generally speaking, holding facilities for individuals who are too sick for nursing homes but not sick enough for regular hospitals.

Patients often stay for many weeks or months in these facilities. Many of these patients are senior citizens. Long term care hospitals have a much higher rate of bed sores and infections among their patients than regular hospitals. They are also more profitable than regular hospitals. They generally do not do surgery in the long term care facilities or handle medical emergencies. Patients needing these services are transferred to general hospitals. 

A large portion of the bills paid for the treatment at long term care hospitals are paid by Medicare. For profit, long term care hospitals often spend less money on patients and have higher profit margins than regular hospitals.

Inspections in the past 3 years in long term care hospitals have found increasing levels of violations of healthcare standards. Many long term care hospitals do not maintain staff physicians on a 24 hour basis. If you have a friend or loved one in along term care facility, you should monitor their treatment to see to it that they are provided with an appropriate level of medical care.

Should you have any problems regarding a hospital stay or a stay at a long term care facility, feel free to contact the Law Office of Elliot S. Schlissel at 1-800-344-6431 or email us at schlissel.law@att.net.

–Elliot Schlissel, Esq.

Picture courtesy of life123.com.

More Options For Medicaid Planning

On Tuesday, this blog featured an article about what seniors can do to qualify for Medicaid if they forsee the need for nursing home services in the future, but do not yet need to go that route. But what if you or a loved one has already had to enter a nursing home? Now, you are faced with a situation where the senior’s life savings will soon be depleted by nursing home bills that can run as much as $10,000 to $12,000 per month. Is there any way to preserve the person’s assets, or at least a portion thereof?

Attorneys have used various strategies to allow seniors to preserve their savings for their children while still “spending down” their estate legally for the purpose of qualifying for Medicaid. One of those, which is not playing out as the most effective method, is the use of “personal service contracts” in conjunction with a lump-sum up-front payments to caregivers.

A better method is emerging for those who need “crisis planning,” i.e., trying to preserve assets after a senior has already entered a nursing home. This is the use of gifts along with promissory notes.

This method consists of retaining an attorney’s assistance to gift  half of his or her assets to another while simultaneously loaning the other half of the assets (minus the $13,900 [in 2009]) to another with a promissory note for repayment. The promissory note must not last longer than the life expectancy of the lender, it must require that  equal payments are made during the loan period without deferred or balloon payments, the note is not terminated by the death of the lender, and the note must be non-negotiable.

The attorney will assist the client in then applying for Medicaid, receiving a denial indicating that the person is “otherwise eligible” but for the uncompensated transfer of the gift. The applicant can then use the payments on the promissory note to pay the nursing home bills till the Medicaid “penalty amount” is paid, and then reapplying for Medicaid at which time the application should be accepted.

At that time, the person will have at least preserved half of her assets from the “spend down” requirement.

Maximum protection can be afforded to seniors’ assets by starting the Medicaid planning process several years before the expected need for nursing home services, as discussed earlier. But the promissory note/gift method, among others, is still available to seniors even if the time has already come to enter a nursing home.

For help with short term or long term Medicaid planning, e-mail or call us at 800-344-6431.

Picture courtesy of the Ombudsman Program.