Navigating the Elder Care Universe
For some families, the golden years are turning nightmarish, thanks to state laws that some nursing homes are using to try to gain guardianship – and financial control – of their older patients. For more details, go to my blog: Nursing Homes Use Gardianship as Tool to Profit.
“Across the USA, solitude has become a deadly threat for hundreds of thousands of senior citizens living at home.” This article was in the November 28, 2018 edition of USA Today. You may find it to be of interest.
Click here to be directed to article ———-> https://www.usatoday.com/story/news/nation/2018/11/27/elderly-abuse-neglect-federal-government-statistics/2113361002/
Best Regards,
Perry A. Shulman, CPA
Chair – Orion Elder Abuse Committee
Starting February 5, financial brokers will have two new tools to try to stop elder financial
abuse. On that day, Finra is enacting rules to make it easier for brokers to bring an outside party into a situation where financial abuse or exploitation of an elderly person is suspected, and to allow brokers to delay payments from an account if something seems suspicious. Read more…
Finra Fights Elder Fraud
Financial Advisor Magazine
DECEMBER 12, 2017 • KAREN DEMASTERS
SUBMITTED BY:
Perry A. Shulman, CPA, Chair – Orion Resource Group Elder Abuse Advocacy Committee
NY Managed Long Term Care Companies (MLTC) Are Killing Elders By Refusing Mandated Services. – My Elder Advocate, LLC
The New York Legal Assistance Group has filed a federal class action lawsuit in the Eastern District of New York to challenge threatened and actual reductions in Medicaid-funded home care services. Named Plaintiffs and the class they seek to represent are people with disabling conditions who need home care services to remain safely in their homes and communities.
WHAT IS HOSPITAL “OUTPATIENT” OBSERVATION STATUS?
A hospital billing classification that can make Medicare patients pay for the cost of their:
Hospital stay
Hospital prescriptions
Nursing Home Care
Patients must be classified as inpatients for 3 days in the hospital in order for Medicare to pay for subsequent nursing home care.
OBSERVATION STATUS…
May be called “outpatient,” but it has NOTHING TO DO with where a patient receives care or the kind of care received.
IS A BILLING CODE. Hospitals use it to protect from overzealous auditors and Medicare readmission penalties. May just seem like semantics, but for Medicare beneficiaries,
IT CAN RUIN LIVES. Saddles patients with increased out-of-pocket expenses. Patients who don’t have Medicare Part B are responsible for the FULL COST of the hospitalization.
WHY DOES OBSERVATION STATUS MATTER?
Observation Status can be devastating. It can result in thousands of dollars in hospital bills and thousands more in nursing home bills after a hospital stay.
In 2012 an average hospital stay in the U.S. cost $10,400, and the median monthly cost for a nursing home in the U.S. was almost $8,000.
The use of “outpatient” Observation Status isn’t just wrong, it can be DANGEROUS. Many patients CAN’T AFFORD their care if Medicare won’t pay. If post-hospital care in a nursing home won’t be covered by Medicare, many people GO WITHOUT that care altogether, rather than face the enormous bills. The problem is growing: the number of patients cared for under Observation Status DOUBLED from 2006 to 2014.
Take action at the BEGINNING of a hospital stay to try to stop Observation before it starts.
Ask the hospital doctor to “admit the individual as an INPATIENT” based on needed care, tests and treatments.
Ask the patient’s regular physician to CONTACT THE HOSPITAL DOCTOR to support this request.
FILE AN APPEAL with Medicare, if the patient’s nursing home coverage is denied.
FILE A COMPLAINT with the patient’s state health department, if he/she did not get a notice about “outpatient” Observation Status.
GET AN ELDER ADVOCATE!!!!!!!