You may be able to fight a nursing home discharge

Sometimes a nursing home wants to get rid of a particular resident. It might think the resident (or the resident’s family) is “difficult.” The resident might require more expensive or demanding care than others. Or the resident might be a Medicaid recipient, and the nursing home could make more money by replacing him or her with a private-pay individual.

The usual way that nursing homes get rid of residents is to transfer them to a hospital, then refuse to let them back in. This can obviously be very traumatic for the resident. However, it’s sometimes possible for residents to fight back and challenge such discharges legally.

According to federal law, a nursing home can discharge a resident only for the following reasons:

• The resident’s health has improved. 
• The nursing home can’t meet the resident’s needs. 
• The resident hasn’t paid (after receiving adequate notice). 
• The resident is endangering the health and safety of others. 
• The nursing home is going out of business.

A nursing home can transfer a resident to a hospital, if this is required for the person’s care. However, if it does so, most states require the nursing home to hold the person’s bed open for them for a certain number of days (usually about a week). Before transferring a resident, the home must tell the person about its “bed-hold” policy.

A nursing home can require a resident to pay a fee to hold the bed open. If the person receives Medicaid, Medicaid will pay this fee. Also, if a Medicaid recipient is in the hospital longer than the “bed-hold” period, then when he or she leaves the hospital, the nursing home must readmit the person to the first available bed.

In general, a nursing home can’t discharge someone unless it provides 30 days’ notice (although shorter notice is allowed in an emergency), and unless it provides certain specific information and a discharge plan. A discharge plan must ensure the resident has a safe place to go, preferably near family, and outline the care the resident will receive after the discharge.

If you think you or someone you know was discharged improperly, you can appeal or file a complaint with the state. You should contact us quickly, because your chances of success are much better if you appeal as soon as possible.

Average cost of nursing home private rooms is now $80,000 a year

Inflation may be low and the economy may be struggling, but the cost of elder care is continuing to increase, according to a new Metlife survey.

The average cost of a private room in a nursing home rose 3.3 percent in 2009 to $79,935 a year - or $219 a day. The average cost of an assisted living facility also climbed 3.3 percent, to $37,572 a year or $3,131 a month.

Home health care aides now cost an average of $21 an hour, a 5 percent jump, and adult day care services now average $67 a day, a 4.7 percent increase over 2008.

The cost of a semi-private room in a nursing home increased 4 percent to $198 a day, or $72,270 a year. The cost of a semi-private room in an Alzheimer’s wing averages $75,920 annually, and the cost for a private room is $85,045.

The rates for a private nursing home room ranged from a low of $132 a day in rural Louisiana to a high of $584 a day in Alaska. Assisted living rates ranged from $2,014 a month in North Dakota to $5,219 a month in Wilmington, Delaware.

The cost of home health care aide services was lowest in Shreveport, Louisiana, where it averaged $13 an hour, and highest in Rochester, Minnesota, where the average hourly rate was $30.

The rates for adult day care services ranged from $27 a day in Montgomery, Alabama to $150 a day in Vermont.

Nationwide, the nursing home population is 68% female, with a median age of 83.2.

Larger tax deductions for long-term care insurance

The amount you can deduct on your taxes as a result of buying long-term care insurance has been increased by the IRS for 2010.

Generally, you can deduct part of your premiums if the premiums, together with your other unreimbursed medical expenses, amount to more than 7.5 percent of your adjusted gross income.

The maximum amount of premiums you can deduct each year depends on your age at the end of the year: 

 
For policies issued in 1997 or later, the premiums are deductible so long as the policies meet certain requirements. For instance, they must give you the option of “inflation protection” and “non-forfeiture protection.” (You don’t have to choose these options, but the policy has to offer them.)

For policies issued before 1997, the premiums are deductible if the policies were approved by the state insurance commissioner.

The rules for deductibility are different if you’re self-employed. In that case, you can generally take the deduction as long as you made a net profit, even if your medical expenses don’t exceed 7.5 percent of your income.

High-profile Astor case could lead to more prosecutions of financial elder abuse

The criminal conviction this past October of the son of New York society matron Brooke Astor on charges of taking advantage of her while she suffered from Alzheimer’s disease could lead to more prosecutions for financial abuse of the elderly…and this includes ordinary families, not just wealthy socialites.

As many as a million older people are taken advantage of financially each year, according to a study by MetLife. In most cases, the culprits are family members or caregivers.

Often, family members begin by “borrowing” small amounts of money, and may fully intend to pay it back. But over time it becomes a bad habit. Although the amount at issue is usually much smaller than the millions of dollars involved in the Astor case, these actions can still amount to criminal theft or fraud.

In the past, law enforcement officials have often been reluctant to prosecute such crimes, because they consider them too difficult to prove in court and too complex for juries to understand. But the high-profile conviction in the Astor case is likely to make prosecutors focus more attention on this type of wrongdoing.

Brooke Astor died at age 105 and left an estate worth about $180 million. Her son, Anthony Marshall, was accused of manipulating her after she became mentally incompetent due to Alzheimer’s, in order to increase his share of her estate and to pay himself inordinately large sums of money for acting as her manager.

Marshall was convicted on 14 counts, including a charge of grand larceny after he used his power of attorney to give himself a $1 million retroactive raise for acting as his mother’s financial advisor.

Under New York law, Marshall’s crimes are subject to a sentence of up to 25 years in jail.

529 plans can pay for computers and Internet service

Tax-free college savings plans and prepaid tuition programs - known as “529 plans” - can be used to buy computer equipment and Internet services for students during 2010. This change was part of the stimulus bill enacted by Congress last year.

Many grandparents and other relatives set up 529 plans (named for section 529 of the federal tax code) to help young people with college expenses. Family members can contribute up to $13,000 a year to these plans ($26,000 for a couple) without incurring gift tax. The money can then grow in the account tax-free. Family members who want to quickly get money out of their estate for tax reasons can “front-load” their contributions and give $65,000 right away (or $130,000 for a couple), as long as they don’t make any other contributions for five years.

The money in the account can be used to pay for college tuition, room and board, or other expenses. In 2010, these expenses include computer equipment and Internet access. (However, the money can’t be used to buy software for sports, games or hobbies, unless it is predominantly educational in nature.)