Sunday, April 29, 2012 The VA's Income Test for Aid and Attendance
The United States Department of Veterans Affairs (VA) Aid and Attendance program can be an excellent option for older wartime veterans and their widows. Among other requirements, there are four tests to qualify for Aid and Attendance, including military service, medical status, asset level, income level, and then documentation and proof of these requirements. The topic of this post will be the income requirement. Read more . . .Friday, March 30, 2012 Turmoil in the Long-term Care Insurance Market
Long-term care is expensive. Nursing homes in Michigan cost, an average, $227 per day or $6,816 per month for a semi-private room. Assisted living in the metro-Detroit area cost, an average, $114 per day or $3,425 per month. Home health aides cost, an average, $19 per hour. Read more . . .Sunday, March 25, 2012 Can Adult Children be Paid by their Parents to Provide Care?
As an elder care attorney, I frequently meet with the adult children of a senior who has been hospitalized and is about to be discharged to a nursing home or has recently moved into a nursing home. In these meetings, a common situation I see is that one of the adult children, frequently a daughter, has been providing care to her mother or father for quite some time. Read more . . .Wednesday, March 07, 2012 Mary and Don Plan Ahead
In my last post, I wrote about what you do with the home of a nursing home resident in a crisis Medicaid plan. A crisis Medicaid plan is planning that is done when an older person’s move to a nursing home is imminent or after they have already moved to a nursing home. While I, as an elder care attorney, can help save money in a crisis situation, since it is often better and less stressful to avoid a crisis, in this post I will discuss the options and benefits of planning ahead for long-term care. Read more . . .Sunday, March 04, 2012 What Do You Do with the Home of a Nursing Home Resident?
Many people are aware that an older person who is a nursing home resident can continue to own a home and qualify for Medicaid nursing home benefits. Nevertheless, in assisting people in my elder care practice with paying for nursing home care, I have seen that the home is often the major asset at risk or that is lost, despite the protection provided to the home under Michigan’s Medicaid laws. Read more . . .Wednesday, February 29, 2012 Applying for Aid and Attendance is Not a Do-It-Yourself Project
The VA Aid and Attendance benefit is one of the best options for older wartime veterans or their widows who need elder care assistance.
Long term care is expensive, and the receipt of these veterans services can help avoid the high costs of nursing home care, assisted living, or home care in depleting an older person’s assets. That’s important because, once an older person is out of money, their only care option is to apply for Medicaid. Read more . . .Saturday, February 25, 2012 Applying for Medicaid is Not a Do-It-Yourself Project
As an elder law attorney who assists seniors and their families with Medicaid eligibility, I am frequently called on to review Medicaid nursing home applications that have been denied. Since most people who need to move to a nursing home and apply for Medicaid are the frail elderly, often age 80 and over, these Medicaid applications were usually prepared by someone else for the nursing home resident, be it their spouse, who also may be quite elderly, or an adult child of the nursing home resident. Read more . . .Tuesday, December 06, 2011 Aid and Attendance benefits to Increase in 2012
There is good news for older veterans and their surviving spouses who rely upon Aid and Attendance to pay for their home care, assisted living, and nursing home costs. The amounts veterans and their surviving spouses receive in Aid and Attendance will increase in January 2012.
The U.S. Department of Veterans Affairs has indicated that single veterans receiving Aid and Attendance will receive $1,703.00 per month. Married veterans receiving Aid and Attendance will receive $2,019.00 per month. Surviving spouses of veterans receiving Aid and Attendance will receive $1,094.00 per month.
These are the first increases in the VA’s Aid and Attendance program since 2008.
Thursday, November 03, 2011 What’s the difference between a nursing home and assisted living facility?
As an elder law attorney practicing in Oakland County, I am often asked “what’s the difference between a nursing home and assisted living facility?” The difference in the appearance between the two types of facilities can be dramatic, because nursing homes tend to be more hospital like.
A nursing home provides residents with a room, personal care, nursing care, medical services, and meals. As to the room, it is often semi-private, meaning the resident has a roommate. Residents of nursing homes tend to have chronic conditions requiring long-term care and need assistance with multiple activities of daily living, such as bathing, dressing, eating, toileting, transferring in and out of beds or chairs, and help with continence issues. Moreover, residents of nursing homes often have cognitive and memory problems due to various forms of dementia, such as Alzheimer’s disease. Medicare does not pay for this long-term custodial care in a nursing home, but Medicaid will pay for nursing home care provided that the asset, income, and medical criteria are met.
Nursing homes also provide care for patients needing shorter-term recovery after a hospitalization. Medicare may pay for up to 100 days of this type of skilled nursing care per spell of illness, which tends to be physical therapy and rehabilitation services after a stroke or broken bone.
The average cost of a nursing home in Michigan in 2011 is $220 per day, $6,692 per month, or $80,300 per year.
Assisted living residences provide services for people who are not able to live independently, but who do not require the level of care provided in a nursing home. For instance, assisted living facilities provide housing for those who need help with day-to-day living, but who do not need the 24-hour level of care found in nursing homes. Residents of assisted living may need help with personal care, assistance with meal preparation, some assistance with some of the activities of daily living, and housekeeping services. Residents of assisted living facilities tend to have their own private living space, which can range from just a bedroom with a private bathroom, to a small apartment with a living room, bedroom, bathroom, and small kitchen area. Assisted living facilities tend to have many activities for their residents. Sometimes they seem like a nice resort with good staff and lots of activities.
Many assisted living facilities have special “memory units” for older people with Alzheimer’s and other forms of dementia who need a great deal of supervision.
The average cost for assisted living in Michigan is $3,425 per month or $41,100 per year. However, costs can easily exceed $5,000 a month for assisted living residents living in memory units. Assisted living facilities in Michigan do not accept Medicare or Medicaid as a payment source for the cost of room and board.
In conclusion, nursing homes tend to be more institutional and hospital like. They accept Medicaid as a payment source. Some of the residents tend to be very frail, many others have dementia, and some residents of nursing homes are there because they have inadequate financial resources to live in assisted living or elsewhere. Assisted living facilities are more home-like, though they can provide a similar level of care as a nursing home. Assisted living facilities are strictly private pay, meaning the resident or family has to pay the bill out of their own funds or with long-term care insurance or the veteran’s Aid and Attendance benefit.
Wednesday, November 02, 2011 Nursing Home Costs Rise Again
A recent report finds what many of us working with older people and their families already know, which is the cost of nursing home care continues to rise. MetLife’s Mature Market Institute’s 2011 survey determined that the statewide average cost of a semi-private room in a Michigan nursing home is $220 per day or $6,600 per month. Many of our clients in nursing homes in northern Oakland County are paying more than that at about $230 to $240 per day.
The MetLife study also cites interesting U.S. Census Bureau statistics that the median age of U.S. nursing home residents is 82.7 years. Often, people who have not dealt with long-term care in their family think of nursing homes as being places for people in their 90’s or older. Moreover, many also erroneously think of nursing homes as places people move to when they are quite incapacitated and about to pass away in a few weeks or a month or so. The survey makes clear that nursing home residents are made up of people ranging in age from their 60’s to their 90’s and older. While some stays are short term, average stays in a nursing home are about 2 years.
As such, given the high costs and high chance of living in such a facility for a long time, it is important to plan ahead about how to pay for long-term care. Long-term care insurance should be considered, but many seniors wait too long to obtain such policies and then feel they cannot afford the $3,000 to $5,000 annual premiums or they may not pass the health underwriting standards for the insurance. Estate and longevity trusts or Medicaid Asset Protection Trusts should be considered, either alone or in conjunction with long-term care insurance policies.
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