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Nursing homes have been substantially impacted by the COVID-19 due to its outbreaks leading to high mortality rates among the elderly. Understandably, aggressive attempts were made to restrict the risk of Covid-19 exposure as much as possible. 

In March 2020, the Centers for Medicare and Medicaid Services issued a memorandum guiding restricting visitation of all visitors and non-essential healthcare workers. Several months later, in May 2020, the Centers for Medicare and Medicaid Services released its reopening recommendation for nursing homes which provided additional guidance in dealing with Covid-19 and reopening. 

The Center notes that physical separation from loved ones has taken a substantial physical and emotional toll on nursing home residents as well as their loved ones. The Center for Medicaid Services appreciates that nursing home residents find value in the support they receive from visitations by their loved ones. Consequently, the Center recently revised its guidance addressing visitation in nursing homes during the pandemic. 

A possible palliative care demonstration care model recently got substantial support from the House Ways and Mean Committee. Ten members of the committee wrote a letter to the Centers for Medicare and Medicaid Service Administrator requesting either a new community-based palliative care demonstration model or building on the Medicare Care Choices Model, which permits beneficiaries who are eligible for both Medicare and Medicaid to receive supportive care services that are often utilized hospice in the midst of receiving curative services. 

The National Hospice and Palliative Care Organization President who had been fighting to secure a demonstration model for years expressed encouragement from the committee’s support. 

The President also commented that through continued advocacy, the organization is starting to see Members of Congress coalesce around the need for a community-based palliative care model to make care access fairer, lower prices, deliver better services, and improve life quality for patients. 

A Los Angeles judge recently ruled that Britney Spears’ father should have his position as her conservator suspended. This change will set Britney Spears on the road to freedom. Spears’ father filed to end his position after Spears filed to replace him with a professional conservator. 

The famous singer has described the conservatorship as abusive and stated that it prevented her from achieving many of her life objectives including getting married and having children.

The Los Angeles County Superior Court Judge who heard the case had several options including terminating the conservatorship, keeping the conservatorship in place and replacing the conservator, changing nothing, or delaying a ruling and requesting more evidence.

Frustration is growing for medical professionals including those who work at hospices as they wait for President Biden to reveal details about how federal regulations for COVID-19 will be enforced.

This frustration is in part driven by uncertainty about aspects like permissible exemptions, testing costs, and the number of worker counts that will be utilized. Until the regulation is published, the country will not be certain about the exact impact on home care organizations by COVID-19 regulations. 

The National Hospice and Palliative Care Organization President and CEO have reported that there is widespread concern and that the country continues to collect input about COVID-19 to inform its discussions with the administration to make sure that the requirement is executed in the best possible manner.

Many people write off falls as a normal danger associated with the aging process. In reality, this could not be any further from the truth. While September was Fall Prevention Month, it’s important for the elderly and their loved ones to remain up to date about the various dangers associated with falls as well as what can be done to stop them.

Factors that Can Lead to Falls

Falls are the second most common factor for older individuals needing long-term care. Dementia is the most common factor. To prevent as well as treat the injuries and other damage caused by falls, it’s a good idea for patients as well as caregivers to inform themselves about what causes falls.

In 1990, the United States Supreme Court acknowledged the constitutional right of a patient to decline medical treatment. Over the last couple of decades, New York state has slowly recognized that traditional health care advance directives do not sufficiently deal with mental health issues. Consequently, a large number of states have issued legislation permitting mental health care advance directives. 

New York Law and Psychiatric Advance Directives

A person can utilize New York’s Health Care Agents and Proxies law to nominate an agent to make decisions for them if that individual cannot do so. Additionally, a person might decide to write a living will containing instructions for the mental health care that person would like to receive. 

A family with a disabled child faces countless obstacles. For many years, one of the best estate planning tools for parents in such a situation was a special needs trust. These trusts provide resources to care for disabled children while making sure that the child remains eligible for means-tested government benefits. 

Many people lately have realized that Achieving a Better Life Experience (ABLE) Accounts can also be helpful. Signed into law in 2014, ABLE Accounts were created by Internal Revenue Code Section 529A which authorizes the state to offer tax-advantaged savings accounts for blind and disabled individuals.

How ABLE Accounts Are Structured

When people in the United States qualify for Medicare on reaching the age of 65, they often notice a substantial decline in medical costs paid out-of-pocket.

A new study recently discovered that reducing the eligibility age would save even more for people. The study’s lead author, an assistant professor of cardiac surgery at the University of Michigan’s Medical School, found that these savings would be most profoundly felt by those who most need financial protection.

The study examined out-of-pocket health care costs including co-pays and deductibles for individuals in their late 50s to early 70s. The average out-of-pocket cost declined 27% between the ages of 64 to 66 even though income remained the same. Meanwhile, average health costs paid by individuals and insurance increased 5%. Meanwhile, the percent of older individuals lacking health insurance decreased from 5% to almost 0% from ages 64 to 66. The study made note of older individuals whose health care costs consumed 40% of their income after food and housing. This category included 9% of uninsured 64-year-olds but dropped by 35% for 66 year olds. Not having medicare benefits likely contributed to the fact that approximately 6% of 66-years-old spent more than 40% of their disposable income on health care costs. 

The Center for Medicaid Services recently issued a notable statement requesting that parties conform with the duties and obligation of third-parties found in existing law. The Center recently reviewed each state’s Medicaid plan to make sure that states complied with recent statute changes. The Center for Medicaid decided that many states are yet to revise their guidelines to meet regulations found in the Bipartisan Budget Act as well as the Medicaid Services Investment and Accountability Act. Regulations found in the Bipartisan Act include statements that impact regulations connected to the treatment of some kinds of care. 

The Background of These Changes

Medicaid often disperses funds only as a “last resort”, which means that Medicaid issues payment for treatment and services only when it is assessed that no other payment sources exist. The Social Security Act’s Section 1902 requires all 50 states to take measures deemed reasonable when deciding on third-party payer liability.  The Act also specifies what the term “third-party payer” means. The definition of “third-party payer” encompasses various entities including health insurers, qualified health plans, and any other entity that are classified as legally responsible for certain medical treatment. The Bipartisan Act revised section 1902 to require all 50 states to utilize standard cost avoidance methods rather than paying the total amount allowed under the appropriate payment schedule then seeking third-party reimbursement. 

Disputes involving conservatorship and guardianship fall under the purview of probate litigation, while trust and will debates also fall under this category. The best approach to not mitigating the risk of probate litigation is to plan. Your plans may very well include comprehensive estate plans as well as measures to resolve incapacity issues and documentary evidence that supports gifts. 

The Creation of Wills and Trusts

Creating a will before a person passes away allows the creator the chance to both control and communicate their wishes for how their assets should be handled. The creator of a will is also able to nominate either their personal representative or the person charged with administering their estate. By creating a will, your estate plan will not be subject to the control of New York’s intestacy law. Individuals who create wills are instead permitted to have the terms of their will dictate the distribution of their estates and resolve their affairs. A nominated personal representative has the capacity to act in such a position. Without this appointment, surviving loved ones are often left to fight over how an estate is administered. Without the will’s creator appointing such a person, loved ones often fight over who is suited for the job. Additionally, the terms of a will must be clear and inarguable to anyone who reads them to reduce the risk of future litigation. 

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