Importance of a Social Worker

Oftentimes when we think of social workers, images of those who work to get children out of unsafe or less than ideal conditions may pop into our heads. But it isn’t only children that social workers assist. No, in fact, there are social workers who specialize in the field of the elderly population as well.

The field of geriatric social work has indeed grown right alongside the aging population. In a report by the Administration on Aging, those people 65 or older made up about 12.4% of the population in 2000, and that number is expected to rise to 19% by 2030. That accounts for a total of 72.1 million people.

Because of this, those whose calling is in elderly social work focus on helping those individuals and their families, and the communities too. A geriatric social worker isn’t what it might sound like at first. Instead, a geriatric social worker specializes in dealing with those people 65 or older, like we mentioned above. They also often have graduate-level education and field experience in the areas of geriatrics, gerontology, aging or social work with older people.

They work to take care of a number of issues that older adults and their families have to put up with, and also the many social and environmental changes that go along with getting older. Let’s take a look at what that includes right now:

They can help you get through the mountains of paperwork and confusion that come from health care or other social services. In particular, they can help with clinical interventions for someone who is lonely or who suffers from depression or anxiety. They also serve as a link between clients and the numerous programs—both public and private—that may be available to them. They are a source of advocacy, and can give clients an Advanced Directive form and show them how to complete it, and geriatric social workers are often a first line of defense against elder abuse.

Those families in a caregiving situation right now can be greatly helped by geriatric social workers too, since they offer direct assistance to families through things like family-support services, suggesting useful technologies, and coordinating medical care. They can also provide counseling services dealing with end-of-life issues, bereavement, or any other concerns that seniors or their families could have. They are a go-between for elders and their families and the health care staff, and work to keep families apprised of their loved one’s conditions.

They can also help in a home care setting as well. Social workers specializing in geriatric care will often coordinate discharge planning from the hospital to home, and will work to conduct home visits to ensure that their client is safe, happy, healthy and living in an environment in which they can thrive. They can also let families know when home care might be inappropriate for an elder, and help with finding assistance or transportation services, or recommend specialized technology for use with in-home care.

Geriatric care managers are trained to be aware of and recognize any abnormal patterns in aging and can suggest when a doctor visit may be appropriate. They can also arrange the appointment or visit. When making use of a geriatric social worker, some elders can live in their own home when, otherwise, they would be put in a nursing home facility.

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.

Last Instructions: An Answer to What and Why

The period of time right before and right after someone passes away is one of the most chaotic times someone might personally experience. Making matters worse is the fact that no one’s business is ever in perfect order. Add to that the fact that those left behind often have to handle the fallout without having all the necessary information and it becomes a perfect storm of unfortunately normal and never easy.

Justin Scott, of Scott Counsel, recommends a letter of last instruction. “Outside of having a will, it will allow you to make your wishes known on how you want things to be handled.”

So, what can be included in your letter of last instruction? Let’s take a look!

  • Names and addresses of those who should be notified upon your death
  • Names of your family members and their relationships
  • The location of your will
  • Instructions on funeral and burial arrangements
  • The location of any and all important papers (like marriage/divorce papers, automobile title, discharge from the military, etc.)
  • Cemetery plot information
  • Safe deposit box location
  • A list and location of insurance policies
  • A list and location of any and all bank accounts (including checking and savings)
  • Information on pensions, trusts, etc.
  • A list and location of all stocks, bonds, securities, etc.
  • A statement of any and all real property with locations of mortgages, deeds etc.
  • Location of all income tax returns for the previous five years
  • Current bills, debts and cancelled checks for five years

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.

Does Medicaid Pay for Adult Day Care?

In most all cases, Medicare Part B DOES NOT cover any type of adult day care. It will, however, cover some of the services the adult day care provides, though normally in limited circumstances. Medicare Part B covers mental health treatments that have been prescribed by a physician and provided by an outpatient mental health facility. If that place also happens to be an adult day care center, the patient will have the added benefit of those types of services while also receiving mental health treatments. You should be aware that Medicare will only cover care if said care involves actual medical treatment—like administration and monitoring of medication, treatment to recover from a medical crisis, or either individual or group psychotherapy.

Medicare Part C Medicare Advantage plans cover everything that’s included in Parts A and B. Though, sometimes a part C plan will cover more than that, with any extra services or an expanded amount of coverage. Co-payments for Part C plans may also be different from those for Part A or B. Contact your plan directly to see if your plan provides this extra coverage or requires different co-payments.

If Medicare Part B covers some adult day care as a part of mental health care, it only covers around 50% of the approved amount that they have allotted to perform the service. In some states, Medicare partners up with Medicaid to sponsor what’s known as the PACE program, or the Program of All-Inclusive Care for the Elderly. This program provides comprehensive in-home and community care—including adult day care—for any elders who may otherwise need to be put into nursing home care. In those states that have the PACE program, only those with low income and few assets, who are also eligible for both Medicare and Medicaid can participate in the program.

No matter the rules regarding any specific type of care, in order for any Medicare plans to provide coverage (whether Parts A, B, or C), the care has to meet the following requirements:

  • The care has to be “medically necessary.” This means that it must be ordered or prescribed by a licensed physician or other authorized medical provider, and that Medicare (or Medicare Part C) agrees that it is both necessary and proper.
  • The care must be performed or delivered by a healthcare provider that participates in Medicare.

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.

Aging in Place

If you have done any research into elder care at all, you have probably run across the term “aging in place.” While it might be confusing at first, it’s actually pretty straightforward. All it means is that someone lives in his or her own residence as long as possible as they get older. Specifically, it means that an elder is at a time in life when he or she can have the things they need in life while still keeping the same quality of daily life. That distinction is vital, since many seniors might be mistaken thinking that aging in place will fix things that cannot be fixed simply by staying home.

If you have a loved one that has chosen to stay at home and age in place, your primary goal should be to either maintain or improve on the current quality of life. You can do this by having a solid plan in place that covers the elder, the home, finances, and other things as soon as possible. Then, simply maintain this plan for as long as you can (or as long as is realistic for their situation).

Aging in place is, in fact, a choice, and it means choosing how you want to spend your retirement years, how you want your home set up, and what healthcare choices you’ll have, which types of help are right for you, and finally, what your wishes are for major life events—like sickness, housing transitions, or financial decisions. There are a number of other things to think about too when considering aging in place, and it’s a topic best discussed with family members or other trusted friends that can help you and/or your loved one to come to the best possible decision.

In making these choices, it can provide a sense of control over things like independence, quality of life, and dignity. Chief among everything, though, is that aging in place doesn’t mean that your loved one doesn’t have to do everything on their own—hence making that plan we talked about earlier. Then, when that time comes, you or your loved one can decide how their needs are met, who will meet them, and when.

It’s important to also remember that aging in place is not the right decision for everyone. It’s for those who want to ensure for themselves a quality of life and live it in dignity, responsibly, without placing a burden on family or community.

Those who are currently taking care of an elderly parent can benefit from it too. The best way to help is to work with the elder to make sure his or her needs are being met properly and consistently, and that their wishes are being respected as much as possible.

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 Medicaid

Many people all over the country take advantage of the benefits that Medicaid provides for them. However, those same people may not even fully understand all of the benefits they are receiving or can receive, exactly what Medicaid covers, or they may lack a general understanding of Medicaid overall.

So, what is Medicaid? Simply put, Medicaid began in 1965 after it was signed into law as a joint state and federal program. The point of Medicaid was to provide health insurance to both low-income families as well as individuals. And while it began its life as a way to provide coverage to those recipients of government welfare, its reach has extended beyond simply low-income individuals and families to certain sections of the country’s elderly and disabled population. Today, there are approximately 60 million people on the receiving end of Medicaid benefits and CHIP benefits (Children’s Health Insurance Program), and is the largest health insurance program in the nation, costing upwards of $400 billion per year.

Eligibility for benefits is determined at state level and is based on income, so each individual and family should check the Medicaid site to find the policy for their state. Those adults without children, who are between 18 and 65, are eligible to receive coverage thanks to the Medicaid expansion in the Affordable Care Act, but there are some states that may not provide coverage to those individuals.

Those who live in states implementing the expansion will qualify for benefits if they earn up to 149% of the federal poverty level. Children, pregnant women, parents, seniors and those with disabilities will qualify so long as they meet both residency and immigration requirements and are documented citizens of the United States.

Benefits

All enrollees are entitled to receive the following mandatory benefits:

  • Inpatient hospital services
  • Outpatient hospital services
  • EPSDT: Early and Periodic Screening, Diagnostic, and Treatment Services
  • Nursing Facility Services
  • Home health services
  • Physician services
  • Rural health clinic services
  • Federally qualified health center services
  • Laboratory and X-ray services
  • Family planning services
  • Nurse Midwife services
  • Certified Pediatric and Family Nurse Practitioner services
  • Freestanding Birth Center services (when licensed or otherwise recognized by the state)
  • Transportation to medical care
  • Tobacco cessation counseling for pregnant women

Some states also provide the following optional benefits as well:

  • Prescription drugs
  • Clinic services
  • Physical therapy
  • Occupational therapy
  • Speech, hearing and language disorder services
  • Respiratory care services
  • Other diagnostic, screening, preventative and rehabilitative services
  • Podiatry services
  • Optometry services
  • Dental services
  • Dentures
  • Prosthetics
  • Eyeglasses
  • Chiropractic services
  • Other practitioner services
  • Private duty nursing services
  • Personal care
  • Hospice
  • Case management
  • Services in an intermediate care facility for the mentally retarded
  • Self-directed personal assistance services
  • TB Related Services
  • Inpatient psychiatric services for those under 21
  • Other services approved by the Secretary

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 are Medicaid Beds?

Despite the name, a Medicaid bed isn’t an actual bed. Instead, it refers to what is known as a bed-hold policy. This means that certain residents of nursing homes can return to their beds if they are temporarily absent from the facility.

The Nursing Home Reform Act allows those who qualify for Medicaid benefits to take advantage of “Bed-Hold and Readmission rights. These rights are not available to Medicare beneficiaries, so what this means is that those who get Medicaid and who are required to leave the facility for hospitalization or therapeutic reasons, they have the right to return, and the nursing home must hold the bed for them for a certain period of time. Although, if the absence should go beyond the bed-hold period, and if the person still requires skilled or intermediate nursing care, he or she will then be entitled to the first bed available in a semi-private room at the facility.

There are both federal and state laws in place, along with regulations, that require nursing facilities to give out written information to the elder and his or her family members that goes into detail regarding the bed-hold policy as outlined in the State Medicaid plan. However, this isn’t normal procedure for those who get reimbursed by Medicare for their care. Those individuals might be required to pay any bed-hold fees that have been instituted by the facility.

This means that people insured by Medicare aren’t protected by the above rules and regulations. However, those who aren’t protected aren’t completely left out in the cold. They have the option too either pay the daily rate in order to keep the bed or take the chance that a bed will be available elsewhere once the elder is covered by Medicaid—though this is understandably more difficult.

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 is a Buy-In at a Continuing Care Retirement Community?

A Continuing Care Retirement Community is a type of retirement community in the U.S. where a variety of care needs can be met within the community—from independent living, assisted living, or even skilled nursing care. While there are many benefits to living in such a community, one of the downsides is the rather great financial cost. An individual could expect to pay anywhere in the range of $20,000 up to $500,000 just in entrance fees—though the exact figure depends on whether you actually purchase the unit.

There are other fees to be aware of, and one of them, the Buy-In Fee, is the focus of this article. While this fee might initially be confusing, it’s really not. All it is, is the cost you pay to buy your unit, though sometimes this isn’t even an option in some communities. Conversely, it’s required in others, as it is in the case of newer models, which often operate quite similarly to condos (which you actually purchase).

In many cases where a Continuing Care Retirement Community involves a buy-in fee, you’ll actually own your accommodations. However, in these situations, things like health care or any other services will be a separate expense.

The exact amount you’ll pay will vary depending on a number of things, such as the location and type of community, the size of the residential unit, etc., but often the cost of the unit will be comparable to any type of non-senior living facilities in the area.

When considering moving to a Continuing Care Retirement Community, there are a lot of T’s to cross and I’s to dot, so:

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.

Annual Exclusion Gifts and Medicaid

At Scott Counsel, we pride ourselves on our extensive knowledge of difficult subjects, such as Medicaid, for example. It can be incredibly mind-boggling to try and understand when you already have so much on your mind as it is. So, we want you to know that what you think you know about Medicaid exclusion gifts and how they relate to the Medicaid look back period could be wrong.

To illustrate, many people often are under the mistaken belief that by gifting (or giving away) an amount of money that is equal to the annual gift tax exclusion ($15,000 as of 2018), that gift will then be excluded from Medicaid’s look back period, thus phasing out a waiting period prior to receiving Medicaid benefits.

Unfortunately, this is not true.

What you need to know about the gift tax is that it is a rule imposed by the IRS. This means that anyone who gifts an amount of $15,000 or less doesn’t need to report it to the IRS. They do, however, have to file a gift tax return if any amount above that number is given to anyone other than a spouse. Keep in mind, though, that you won’t necessarily pay a gift tax, and you’ll only need to do that if your total lifetime exemption is $5.49 million.

It is also important to note that this rule from the IRS is not related in any way to the asset transfer rules imposed by Medicaid. So, while the $15,000 that you can gift to a grandchild or someone else will be exempt from a gift tax, it will still be counted as a transfer by Medicaid, and this could create an ineligibility period for you when it comes to receiving benefits—though only if you apply within the next five years.

As we said, this can be a very confusing topic, but you don’t have to worry.

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.

Leaving a Legacy

We all want to be remembered. It is an innate desire in each and every one of us. When our time comes, we would like to think we will have left behind something of value. We want to leave a positive mark on society and give our family and friends a legacy to remember us by. One of the ways we can do that is through outlining our final wishes in a will or through estate planning and leaving specific things to specific people. At Scott Counsel, we value legacies. We are a law firm committed to helping you and your family preserve all of the good things—material and immaterial—that are left behind.

At the end of the day, the things that are most important to us are not things at all, but people. People matter, and getting to help individuals and families navigate through one of the toughest times in their lives is one of the most rewarding experiences we can have. We want our legacy as a firm to be the fact that we walk in and out of the office each day knowing that we’ve done our best to give our best to the people who need us the most.

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.

Good Facilities vs. Bad Ones

It’s never easy when it comes to making decisions about elder care. This includes the decision to move into a long-term care facility as well. Numerous things have to be considered, even prior to beginning your research, let alone actually making the move into the facility itself. Even the preparatory time can be (and is) a lot of work. Though, our focus isn’t on that part of the process. Instead, we want to focus on what comes next—what comes when you’ve actually chosen a place to move. What makes a long-term care facility good or bad? Let’s find out.

First of all, when visiting the facility, what’s the first thing you notice upon entering? Are there any weird smells emanating from any of the residents’ rooms or any other common areas? If there is, warning bells should be going off, and red flags should be raised if the overall cleanliness of the facility itself doesn’t match the standards you would set for your own home, take caution. If you wouldn’t let yourself be cared for here, it probably isn’t the best place for your loved one either.

Pay attention to the other residents too. Are they happy and smiling, or do they seem lethargic and listless? Is the facility lively or lifeless? If there are no residents you can see, speak up and ask where they are or what they may be doing. Keep an eye out for the employees as well. Are they eager to assist and have a pep in their step? Are they actively trying to help residents participate in activities? Beware of stationary employees or those who act more like a drill sergeant barking orders instead of gently coaxing people into participation. Let’s now look at some questions you should ask:

  • Can the facility meet your explicit needs? Don’t be afraid to be detailed in explaining what they are.
  • What is the cost each month? Are there any added costs for extra help with things like medications or incontinence? Even little things can cost quite a bit extra.
  • Is there a community fee for moving someone in and refurbishing a room? Is it refundable if they don’t want to stay?
  • What kinds of activities does the facility offer?
  • Are religious services held on or offsite?
  • What’s the ratio of caregivers to residents. There should be no less than 1 to 15 for assisted living and 1 to 8 for memory care.
  • What conditions would cause a resident to move to another care level?
  • Are there regular visits by physicians?
  • What sort of Alzheimer’s or dementia care training do staff members receive?
  • Is the facility licensed for dementia care, and do they have a special unit for those patients?
  • Do dementia patients have a daily routine? THEY SHOULD.
  • Question the residents about life at the facility and whether they enjoy living there. You can ask any friends or family who may be visiting as well. However, it’s important to trust your gut. If something seems off, it likely really is.

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.