New Nursing Home Regulation
Contained in the 2010 Law
• Requires Nursing Homes to:
disclose their owners,
operators, suppliers, financers,
and others accountable for residents' care, and
reduce criminal and civil violations
• Establishes a
Quality Assurance and Performance Improvement Program
to improve quality assurance standards.
• Requires a government system to collect
and report information about
how well nursing homes are staffed,
including accurate information about
hours of nursing care residents receive;
staff turnover rates;
and
how much facilities spend on wages and benefits.
• Requires nursing homes to file cost reports
to show expenditures by category:
nursing, therapy, capital assets, and
administrative services.
• Requires civil monetary penalties (fines) to be
held in escrow pending appeals
rather than allowing nursing homes
to delay payment indefinitely while they file appeals.
• pilot program to improve federal government
oversight of nursing home chains
that have quality of care problems.
• Provides training to workers
who care for residents with dementia
and to prevent abuse.
Click for Medicaid Average
Nursing Home Cost
in Massachusetts
Nursing Home Cost
in Massachusetts
Currently since May 1, 2009
$274 per day or 8,220/month
May 1, 2008 - April 30, 2009
$267 per day or 8,010/month
March 1, 2007 - April, 2008:
$256 per day or
$7,680/month
Nov. 1, 2006 - March, 2007:
$246 per day or
$7,380/month
Feb.1, 2005 - Nov. 1, 2006:
$232 per day or
$7,192/month
These are rates estimated
by the
Division of Medical Assistance.
Privately paid nursing home rates
may be higher.
Information on
What to Look for in a
Nursing Home:
Massachusetts
Long Term Care Guide
Choosing a Nursing Facility
Nursing Facility Checklist
Nursing Home Ombudsman
You have worked a lifetime to provide for yourself and for your family. Without a plan for care, your life savings could be consumed if admission to a nursing home becomes unavoidable.
Our step - by step planning services will coordinate all of the resources that are available in your unique situation. We work with you, your family members and your financial advisors to prepare strategies can include:
- Trusts that protect you home and other assets from being counted by Medicaid during your lifetime, and then transfer those assets to your children upon death, without the need for probate proceedings. Medicaid Trusts can be designed so that you have the use and income from these assets during your lifetime.
- Trusts that build a bridge over the 5 year ineligibility period imposed on asset transfers by the Medicaid long term care rules
- Annuities that provide benefits to your spouse or loved ones
- At home care resources, including services paid for by Veterans benefits and other sources
- Real estate deeds that protect the equity of your home or income producing property
- Long term care insurance that protects your home equity and provides flexibility for care at home
- Caregiver contracts that protect family relationships and preserve assets.
If a nursing home admission is needed immediately, we provide objective information on how these resources can work together, and how you can get benefits NOW.
The need for independent elder law advice was illustrated in January, 2010, when a Springfield widow agreed to pay thousands of dollars to settle a collections lawsuit that had been filed against her by a local nursin
g home.
Her decision to pay the nursing home an undisclosed amount of cash came two months after a Hampden County Superior Court judge decided that Massachusetts law makes spouses jointly liable for services like nursing home care. Read Summary Judgment Decision.
According to pre-trial facts that were filed just before Christmas, 2009, the elderly defendant had hired a company to assist her in handling Medicaid and Medicare issues for her husband, who is now deceased. Read Widow's Statement of Evidence. There was evidence that her capacity to cope with the situation was failing when she hired the company, and that Medicaid would have paid her husband's nursing home bill if the situation had been handled differently!
The company she hired offers to prepare Medicaid long term care applications for a flat fee, and they give discounts to nursing homes who refer residents to their company.
But the elderly defendant never obtained the counsel of an independent elder law attorney to manage the difficult situation involving her husband's care needs. Medicaid eligibility that would have paid the nursing home bill was never obtained for her husband. According to the attorney who was called in 2008 to defend her from the nursing home lawsuit, the elderly defendant had only $24,000 in excess assets over the Community Spouse Resource Allowance when her husband was admitted to the nursing home in 2006!
The widow now resides in assisted living, and the nursing home settlement took thousands of dollars that could have been used to pay her assisted living rent. Read interview with nursing home attorney in Mass Lawyers Weekly Article.
An independent elder law attorney can explain how you can avoid these bad consequences, and protect your future. It's possible for most married couples to keep their assets, AND obtain Medicaid coverage when only one spouse needs the nursing home care. Additional Medicaid regulations protect people in many other difficult situations.
Compare the private pay nursing homes costs with the Medicaid average daily costs of nursing home care listed in the drop-down box on the right side of this page. The Medicaid rates are lower. So, nursing homes often have no incentive to transition a private pay patient to Medicaid. For professional planning advice and Medicaid eligibility, call us at 567-5600 for a long term care planning appointment.
The cost of nursing home care can be a shock to families that are suddenly confronted with the need to place a loved one in institutional care. Feelings of fright and helplessness can be compounded by the stack of papers that the nursing home hands you upon admission to the care facility. Among the papers that people are often asked to sign include a statement of who is a "responsible party."
You can bring the feelings of uncertainty about these paper forms under control, even if you are in the midst of the crisis planning. Remember, we have laws and regulations that protect you and your loved one. Federal and state laws say that nursing homes can not require family members to guarantee payment for care. Only the assets of the person who is receiving care are subject to private payment requirements.
Federal laws say that a nursing home cannot “require a third party guarantee of payment to the facility as a condition of admission (or expedited admission) to, or continued stay in, the facility.” 42 USC §1396r(c)(5)(ii).
Massachusetts regulations also protect you and your family. The Long Term Care Facilities Regulations from the Massachusetts Attorney General say that it is unfair and deceptive for a nursing home: “to require a resident or a prospective resident, his/her legal representative or next of kin, as a condition of admission, expedited admission, or continued stay in the facility, to provide a third party guarantee of payment to the facility.” 940 CMR 4.40(1).
To bring a difficult crisis situation under control, please me call for help for you and your family.
Download our Long Term Care Planning Organizer in WORD or PDF.
42 USC 1395i says that each resident has the right to: choose a personal attending physician (so residents may chose a doctor other than the medical director of the nursing home, who might have a responsibility to the nursing home on questions of discharge and transfer)
be fully informed in advance about care and treatment
be fully informed in advance of any changes in care or treatment that may affect the resident's well-being
participate in planning care and treatment or changes in care and treatment
be free from physical or mental abuse, corporal punishment, involuntary seclusion, and any physical or chemical restraints imposed for purposes of discipline or convenience and not required to treat the resident's medical symptoms
reside and receive services with reasonable accommodation of individual needs and preferences, except where the health or safety of the individual or other residents would be endangered
participate in social,religious, and community activities that do not interfere with the rights of other residents in the facility
voice grievances with respect to treatment or care
receive notice before the room or roommate is changed
