Non-Emergency Medical Transportation

Obtaining emergency medical transportation is one of a number of things that Medicaid will cover for eligible parties. Obviously, an emergency is defined as any time medical needs are immediate, like having a heart attack or being severely injured in a car accident. In these situations, you might require being taken to the emergency room via ambulance or medical flight and prior approval is not required to receive this type of transportation.

So, what if it isn’t an emergency?

If you require transportation to a medical appointment, it isn’t considered an emergency by Medicaid, but you may still be able to receive help if and when you need it. One of the other things Medicaid will cover is rides both to and from your doctor, the hospital or any other medical office for the purposes of receiving Medicaid-approved care. This coverage is known as “non-emergency medical transportation,” because it doesn’t involve an emergency situation. They could also provide transportation in case you don’t have a working vehicle of your own or don’t have a license. You could receive help if you have a physical or mental disability or are otherwise unable to travel or wait for a ride alone. Coverage for these services could be different based on individual situations or needs, and you may require prior approval from your state Medicaid agency to qualify.

Who Can Get a Ride?

Federal law mandates that Medicaid beneficiaries can get rides to and from care providers as needed. Each state’s rules regarding when rides are necessary differ from each other, so check rules for your state. Normally, you’ll get instructions as to when rides are necessary and how and when you can schedule one after you enroll in the Medicaid program. You might need to talk with a Medicaid caseworker, a ride service, or some other agency. No matter what, the contact should:

  • Help you decide if you have an immediate need for care;
  • Make sure you are eligible for Medicaid;
  • Verify you have an appointment with a Medicaid provider;
  • Make sure you have no other reasonable way to make it to your appointment; and
  • Decide what type of ride Medicaid can provide for your situation.

Using this information, the contact will then either set up the ride you need or tell you how to do it on your own. A pre-approved person or ride service will then transport you to and from your appointment.

How Do I Get a Ride?

Rides may be by taxi, car, van, public bus or a subway, depending on your state’s rules and your own needs. It could be shared with others. You need to call in advance to set up your ride, and you should also call if you need to cancel. It’s important to remember that the driver is only able to give you or a family member a ride to a medical facility and back home.

Make sure you follow the rules so that Medicaid will approve and pay for the ride. Drivers may only be authorized to pick up riders at a specific time, so it’s important to:

  • Be ready on time for the pick up; and
  • Call the ride service to cancel a ride if you do not need one anymore.

If you or someone you love needs assistance with Elder Care law issues, call 856-281-3131. Let us help ease your stress and give you a plan.

 

Paying a Family Member to Provide Care at Home

While a number of families often desire the services of a professional caregiver to help ease the burden of caring for an elderly loved one, there are still those who wish to keep the care in the family, and that’s okay. You can, in fact, be paid to provide care at home if you are a family member.

Let’s look at how it works:

  • Step 1: First, you’ll need to set aside any awkwardness you may have about discussing things like needs, wages to be earned, when you’ll be paid, any health risks, the schedule you’ll be expected to keep and how respite care or sick days for caregivers will work.
  • Step 2: Next, the creation of the actual contract. Be sure to include things like the hourly wage and any services to be provided.
  • Step 3: Contact an elder care professional, like those at Scott Counsel, to ensure that the contract complies with any tax requirements, covers inheritances, and has been approved by all other potentially interested parties (such as siblings).
  • Step 4: Be aware of the potential need for a session with a family therapist (one whose specialty is elder care). There is a lot of potential for discomfort among family members or disagreement when it comes to the plan you want to enact.
  • Step 5: Both the caregiver and the care recipient must sign the contract.
  • Step 6: Keep professional records of the following:
    • Specify any service(s) performed, the dates they were performed, and the amount paid. Such paperwork is vital should the family member wish to apply for Medicaid later on. A caseworker will examine records for the past five years during the qualification process, so it’s important to keep track.
    • Report any income! It is a caregiver’s responsibility to report any earned wages as taxable income. THIS IS LEGALLY REQUIRED. If taxes have not been paid, this will hurt your loved one’s chances of applying for Medicaid later on, as Medicaid will consider it a gift, not an expense.

If you or someone you love needs assistance with Elder Care law issues, call 856-281-3131. Let us help ease your stress and give you a plan.

Setting Up the Home for Caregiving

When preparing to care for an elderly loved one, either in their home or your own, it is important to make sure that as much of the house as possible is safe for them to move around in (if they can), and safe for them to live in. Let’s take a look at some of the ways to keep the home safe for our elderly loved ones.

First of all—the bathroom. Since we lose the strength in our extremities first as we get older, the fact that bathrooms contain lots of moisture, slick surfaces, and nowhere soft to land if we fall, the bathroom is one of the most dangerous places in a home. Even just trying to get on or off the toilet can be dangerous for an elderly person, let alone trying to get into or out of the shower. Doctors will often recommend an elevated seat with armrests for extra support. However, even models that can be clamped into place won’t work well if the person is overweight. Instead, a better model is one that combines both the seat and armrests with a hydraulic lift that can be used as a bedside toilet.

Grab bars are a must for the tub or shower, and there are even suction grab bars that have armrests that are portable, sturdy, medically safe, and won’t cause holes in your walls. These range in price from $65-$140, which is less than hiring someone to install something for you. Those less than $65 tend to be more dangerous, as they can lose suction, so be cautious!

For the person who has trouble staying in bed, the Standers EZ Adjust Bed Rail might do the trick since it’s quite simple to install and use, and can be adjusted to three different lengths.

The Sonic Boom Alarm Clock series comes in a variety of styles uses a number of features that are specifically for keeping even heavy sleepers from missing their alarm. Such features include a bed-shaker that shakes enough to wake them up, to adjustable alarm volumes ranging from “subtle” all the way to “wake the neighbors,” and most clocks also have battery power backups in case the power goes out.

If you have any questions about these or any other concerns regarding home safety for the elderly, the professionals at Scott Counsel will be happy to assist you in answering them and, most importantly, alleviating your fears.

If you or someone you love needs assistance with Elder Care law issues, call 856-281-3131. Let us help ease your stress and give you a plan.

Understanding a Nursing Home Admission Agreement

One of the biggest lies any one of us ever tells is checking the “I have read the Terms and Conditions” box on literally anything to do with technology or being online. Of course, that’s easy to do, isn’t it? Just hit “Accept” and you’re done. No waiting, no hassle, no nothing. Just done. Unfortunately, real life isn’t at all like that, and when we agree to anything of any kind of importance, there are usually pages upon pages of things we have to read before we can actually agree to it. After all, we want to know that we understand exactly what we can expect from whatever it is. This is most especially true in the realm of health care and caring for our elderly loved ones. Specifically, we’ll be looking at how to understand a nursing home admission agreement.

First, take your time and do not rush through the document. If at all possible, let your attorney see and through the agreement before you sign it. You should do this because some agreements may have illegal or otherwise misleading provisions. Also, DO NOT sign the agreement until after the resident has already decided to move in. Once they move in, you’ll have a lot more leverage to work with. Though, if you have to sign it beforehand, be sure and ask the nursing home to delete any and all illegal or unfair terms from the agreement.

There are a couple of common things in these kinds of agreements you need to watch out for—a requirement that you are liable for the resident’s expenses, and a binding arbitration agreement. Let’s take a closer look at each now:

Responsible Party

There’s a possibility the nursing home might try to get family members to sign the agreement stating that those members are the “responsible part.” DO NOT AGREE TO THIS TERM! Nursing homes are forbidden from requiring any third parties to guarantee payment of any bills, but they might try to get families to voluntarily agree to it anyway.

If they are able to do so, the resident should sign the agreement him- or herself. If this is not possible, you can do it as their family member. However, you should remember to clarify that you are doing so as the resident’s agent. If you sign as a responsible party, you may then be obligated to pay the nursing home if the resident cannot do so on their own. Look over the agreement carefully, looking out for any terms like “responsible party,” “guarantor,” “financial agreement,” or anything similar. Before you sign, you can cross out any terms indicating yourself as the responsible party for payment, and clearly indicate that you’re only agreeing to use income and resources from the resident themselves to pay for care.

Arbitration Provision

Many admission agreements for nursing homes include a provision that states that any and all disputes over the care of the resident will be decided through arbitration.

Let’s quickly look at three other provisions you might run across in this agreement.

Private Pay Requirement

It is illegal for a nursing home to require a Medicare or Medicaid recipient to pay the private rate for a short time. Also, they cannot require a resident to affirm that he or she is not eligible for Medicare or Medicaid if he or she actually is.

Eviction Procedures

By law, the nursing home cannot authorize eviction of any resident for reasons other than the following:

  • The nursing home cannot meet the needs of the resident
  • The health of the resident has improved
  • Other residents are endangering the resident’s presence
  • The resident hasn’t paid
  • The nursing home is closing down

Waiver of Rights

Finally, any provision that waives the nursing home’s liability for any lost or stolen personal items is illegal. It is also illegal for them to waive liability for the resident’s health.

If you or someone you love needs assistance with Elder Care law issues, call 856-281-3131. Let us help ease your stress and give you a plan.

Transferring Assets in Probate

There are many, many aspects of the death process—both things that lead up to and things that come after it. It’s also a time when people have a lot on their mind. If someone’s just trying to get over an emotional loss, they don’t necessarily have time or want to spend time thinking about who’s going to get what and how it’s done, so let’s take a look at that now, so we can be more prepared when the time comes.

In order to transfer something that belonged to someone at the time of their death, their personal representative needs to follow these steps:

  • Acquire the proper affidavits or certificates from the Surrogate
  • File a tax waiver with the New Jersey Inheritance Tax Bureau in Trenton. What this is, is simply something that is given out by the state that will release any property from any inheritance tax claims that the state might issue or assert. (Please note this is only for New Jersey; other states could have different laws on the same situation.)

You may not even need a waiver. If you must determine whether you need one, consider the following assets:

  • Personal Property

If someone passes away but has money in a joint back account in their name and that of their spouse, parent, grandparent, child, stepchild, a child they’ve legally adopted or their issue, the bank can (and will) give out the money to the surviving owner, but only as long as an affidavit of waiver or an L-8 form has been executed. You can get these from the bank and no tax waiver is needed.

If the money is in the name of the deceased only, but will, by will or law, go to any of the people named above, the bank will release the money to a personal representative. To do this, a Surrogate’s certificate and affidavit of waiver or L-8 form are needed, but no tax waiver is required.

If the money in the account is in the name of the deceased only, the bank will freeze the account, but allow the withdrawal of one-half of the total amount in the account. A Surrogate’s certificate is needed by the bank before this can happen, and the balance may only be released when the appropriate tax waiver has been received by the bank.

To get a tax waiver, all inheritance taxes to the state must be paid. Even if taxes are not due, there could still be a necessary form needing to be filled out to show the Inheritance Tax Bureau that the property listed is exempt.

When this happens, the bureau will issue a tax waiver, and the bank will release any potential frozen funds.

  • Real Property

The transfer of real property is the simplest that we will talk about. If the property is in the name of the deceased only, it will be passed on according to what’s in the will. If there is no will, it will be passed on according to intestacy laws.

If jointly owned with rights of survivorship, the property passes to the surviving owner.

If the

property is owned as tenants by husband and wife in entirety, the property passes to the surviving spouse automatically by operation of law.

  • Motor Vehicles

The title of a vehicle that is jointly in the name of the deceased and his or her spouse will automatically become the sole property of the surviving owner when the other spouse passes. The title may then be changed by the survivor when they appear at a Motor Vehicle office and execute a proper affidavit.

If the title is in the name of the decedent alone, or jointly with another person other than themselves, a personal representative or co-owner must then show either a Surrogate’s certificate or Affidavit, along with the original title, registration and insurance I.D. card.

  • Stocks, Bonds and other Securities

For the transfer of stocks, an examination of the stock certificate must be done first in order to determine the registered or transfer agent. Then that person must be contacted to find out the necessary steps to transfer the stock.

Normally, these requirements include the following: a transfer agent’s transmittal form, an affidavit of domicile, a certified copy of the death certificate, a Surrogate’s certificate, and the original stock certificates, and, in New Jersey, a tax waiver or an affidavit of waiver.

If it is

owned by the deceased and someone else, that stock might have the same requirements listed above in order to have it transferred to the surviving owner.

  • Clearing Title and Transferring Property

Any unpaid inheritance taxes on real estate and shares of stocks of corporations and financial institutions are considered a lien under New Jersey law.

Waivers from the New Jersey Inheritance Tax Bureau are sent out, and these are needed to clear titles to land, and also the transfer of bank account ownership or securities. If a tax is needed, a bill is then submitted and waivers are sent out when the tax is paid.

To clear any real property, a tax waiver has to be filed with a County Clerk in the county where the property (that is, land) is located. If married, any land held by a husband and wife as tenants in its entirety does not have to be reported and is able to be transferred without a waiver.

In order to transfer any stocks, shares and securities of financial institutions and New Jersey corporations, the personal representative needs to obtain waivers. They can then be sent by the Tax Bureau to t

he bank, institution or individual.

If you or someone you love needs assistance with Elder Care law issues, call 856-281-3131. Let us help ease your stress and give you a plan.

What to Do About Wandering

That feeling of dread that parents experience when they lose their child at the grocery store can happen to us again as adults, especially if our elderly parents have Alzheimer’s and are prone to wandering. So, what can you do if the unthinkable should happen?

The fact of the matter is that 6 out of 10 Alzheimer’s patients (over half!) will often move around aimlessly or try to leave the immediate area, causing more confusion thanks to memory loss and other physical disabilities associated with Alzheimer’s. If this happens to your loved one, here are some things you can do to help bring them back safely:

  • Use Technology:

There are a lot of great technologies that can help both you and law enforcement in locating your loved one. Such things include Medical ID bracelets that can help Good Samaritans to better help your family member or friend, phone alert technology that alerts those in a community about a missing person, as well as track systems that make use of satellite or cell technology to locate a missing person.

  • Begin search and rescue efforts at once:

Around 94% of people that have wandered off are often found close to their homes or wherever they went missing from, so focus any early search efforts in that particular area.

  • Have identifying information:

Be sure to keep a recent photo and medical information on-hand in order to give to law enforcement or other volunteer searchers.

  • Ask neighbors and friends for help:

People with Alzheimer’s often struggle in identifying themselves, so it’s important to have as many people as possible to help in the search who know what your loved one looks like and can identify him or her.

  • Find familiar places:

A loved one might go to the places they know, like old homes, favorite restaurants, or places of worship. If any such places are close by the area, they’re likely a good place to look first or to talk about with police and law enforcement.

  • Follow the hand:

Those

with Alzheimer’s often head off in the direction of their dominant hand, so it’s a good idea to start looking in that particular direction first.

While it can be and is often a frightening time when a loved one has wandered off, following these steps can better help you to be able to organize searches and know what to do in case just such a scenario should happen. And while it can be easier said than done, it is important, also, to remain calm. Keeping a level head will help you to concentrate and remember, it’s often made more difficult to search for a lost loved one if we ourselves are breaking down because of it.

If you or someone you love needs assistance with Elder Care law issues, call 856-281-3131. Let us help ease your stress and give you a plan.

 

When Loved Ones Reject Care

Not a one of us wants too lose that image that we have of those we love—strong, vibrant, full of life and energetic. But, it happens. Suddenly, those we thought were unstoppable somehow can’t even complete the simplest of tasks. We want to help them, but sometimes they reject help or simply refuse to even ask for or receive it. What can you do if you find yourself in that situation? Here are some tips:

  1. Start Early

The best-case scenario when it comes to receiving care later in life is one where families have had the conversation of potentially receiving care in the future. Make sure that the conversation is relaxed and not forced. If the opportunity arises, you could ask something like “Where do you see yourself getting older?” or “What would you think of hiring a housekeeper or driver so you could stay at home?” The earlier you can peaceably discuss the situation and the possibilities in brings, the easier it can be to bring them around to the idea when the time finally arrives.

  1. Be Patient

When discussing the topic, be sure to remember and ask open-ended questions and be patient. Give your loved one time to think and answer on their own. However, it could take a while to get to the root issue, with many stops at off-topic discussions along the way. But don’t give up. If you can find out the cause of why they’ve fired several aides—perhaps because they did not vacuum or dust a specific spot—you may be better able to figure out how to help them best.

  1. Probe Deeply

Your loved one may have what is, in their mind, a perfectly legitimate reason for refusing to get help when they need it. Again, if you can ask questions and figure out why that is, then you can come up with a proper solution to the issue. However, it’s important to remember that you should try to build trust with them; listen and try to see things from their perspective rather than cutting them down and invalidating their feelings in the process.

  1. Offer Options

If you’re in the process of preparing interviews for potential help, try to include your parents in the interviewing process or the setting of schedules, if possible. You could let them set the days or the times during those days that they have an aide present. Be sure to highlight the positives of having an aide around: companionship for walks, concerts, museum visits, and lots of other favorite activities.

  1. Recruit Outsiders Early

It can sometimes be a lot easier for parents to talk with someone from the outside rather than another family member. Don’t be afraid to ask a social worker, a doctor or nurse, a priest or minister, or even an old friend, to bring up the idea to them.

  1. Prioritize Problems

One thing that might help is to make two lists: one for the problems and one for the steps you’ve already taken, and where you can go to get more help. If you don’t prioritize the issues, caregiving can turn into an even bigger problem than perhaps you’re already facing. By categorizing them, that can help remove some of the stress.

  1. Use Indirect Approaches

If your loved one suffers from a mental health issue such as dementia, sometimes giving them less information can prove more helpful. You don’t have to go into every minute detail of what the aide can help with before they even have the ability to form a relationship with the caregiver. This might take away some of the anxiety they may be feeling.

  1. Take it Slow

Incorporate a new aide slowly. You could start with short, simple home visits or meet together for coffee, then take the aide to the doctor later on. Having some pretext to leave earlier and allowing the aide to accompany the loved one home will help to establish the relationship and make them more comfortable.

  1. Accept Your Limits

Remember that you aren’t Superman or Wonder Woman; you can’t do everything, and sometimes bad things happen that we can’t stop. However, if your loved ones aren’t a danger to themselves or others, let them make their own decisions. It’s important to accept your limits, know what you can and can’t do, and not feel guilty about it.

If you or someone you love needs assistance with Elder Care law issues, call 856-281-3131. Let us help ease your stress and give you a plan.

Titling Your House: Who Should Be On It?

A lot of people don’t think much about how they’re going to title their home, but it’s not really something that should be brushed off. So, with this in mind, let’s take a look at how you should title the home.

In fact, there are multiple ways that you can hold the title to your home. You may do so solely as yourself, in joint tenancy or as tenants in common. Sole ownership is pretty self-explanatory. The title is in your name only, even if you own the property along with others.

Joint tenancy is a way to hold the title in a way that includes more than one person. For example, if you and I own a home together, and one of us passes away, joint tenancy means that the home automatically passes to the other person without having to go through the probate process.

Tenancy in common means that you and I would hold the property together, but if one of us dies, interest is then distributed according to the will or state law (if there is no will).

When deciding how to title your home, you need to decide who you want to end up with your interest in the property. If you are married, joint tenancy might be the best choice. However, if your spouse has credit issues, you’re probably not going to want anyone with credit issues on the title.

Also, you’re going to want to be very careful when adding someone other than your spouse to the title as a joint tenant. You should speak with a tax adviser before doing anything because any adult children could lose potential tax benefits. For example, if you have a son listed as joint tenant, any creditors he has could come after your property. If there are siblings he doesn’t get along with, he can file an affidavit of survivorship and the property can be put solely in his name, even if that’s not what you wanted.

If you or someone you love needs assistance with Elder Care law issues, call 856-281-3131. Let us help ease your stress and give you a plan.

Setting Boundaries as the Caregiver

When we’re young, we learn about boundaries—where they are and how not to cross them. As we grow, oftentimes there are no issues respecting these invisible, unspoken boundaries that have been dictated to us by both our society at large and on a more personal level by our family units. When caring for our older family members, however, it can be much more difficult to distinguish the lines between those boundaries—for both them and ourselves. Sometimes, we so desire to be of assistance that we don’t realize that we, in fact, might be overstepping. This is why it is crucial to set boundaries for caregiving and make sure they’re well established at the beginning of the journey.

One of the more common complaints is that a caregiver may feel that his or her loved one has been taking advantage of them—perhaps not physically, of course, but simply in the way that they may ask the caregiver to do things. The caregiver may feel run ragged, may see no chance of relief in sight, and hear no thanks given by their charge.

If this is the case for you, then it is absolutely important to make sure some boundaries are set. After all, you want to be sure and be there for them inasmuch as you can be, but you also need to be sure and take time for yourself too. Remember that it’s okay to speak up! You are as deserving to have your feelings known and your voice heard as your loved one is. You matter just as much as they do.

It can be difficult for caregivers though, since we don’t want to make anyone feel like they’re imposing on us, no matter if they sometimes unintentionally do. Simply let your charge know what boundaries you’ve set for yourself and make sure they understand and will abide by those boundaries. It can also be important to reassure them if you need some time for yourself that you’ve ensured they will be taken care of by someone you both trust while you’re away.

It can’t be overstated—you have got to take care of yourself first before you can begin to even think of looking after someone else. Take care of yourself physically, mentally and emotionally. This includes seeing that the boundaries you’ve set are known and respected.

If you or someone you love needs assistance with Elder Care law issues, call 856-281-3131. Let us help ease your stress and give you a plan.

Ownership and Beneficiaries

If you’ve been preparing for having to care for a loved one or deal with their passing, chances are good that you’ve at least heard the terms “ownership” and “beneficiary.” Perhaps, though, this is your first foray into the world of elder law and all the fancy terms it includes, so let’s quickly go over each of those things right now.

Beneficiaries are those people or other entities whom you leave things to in your will. In talking about life insurance, they are the ones who inherit any proceeds from that life insurance policy. Most generally, someone will say that their spouse, if possible, should be the beneficiary, or their children if the spouse is deceased.

You should be aware that any proceeds you leave to your spouse at the time of your death have potential to be lost (at the time of their death) or the subject of claims by any creditors, or they may even go to the surviving spouse’s new spouse if they get remarried.

Any children will be subject to the exact same circumstances as a spouse. However, a guardian may gain access to the funds if the children are minors. If you want to designate your estate as the beneficiary, you can. Although you need to be aware that this will cause any proceeds to go through the probate process. The proceeds could also potentially be subject to claims via creditors along with increasing the taxable estate for estate tax purposes.

If you or someone you love needs assistance with Elder Care law issues, call 856-281-3131. Let us help ease your stress and give you a plan.