Sunday, July 15, 2018

Another Look at What Can Happen to Refundable Fees In Troubled CCRCs

Over the weekend, a reader asked about the ultimate outcome of a Chapter 11 Bankruptcy reorganization, involving Sears Methodist Retirement System's CCRC properties in Texas, that we reported on back in 2014.  The specific question was "what happened to the refundable entrance fees?"

The bankruptcy court approved escrow and repayment terms of refundable fees for "certain" residents as part of a proposed reorganization plan, with the purchaser(s) of one or all of the 8 involved CCRCs having the option of "assuming" or reaffirming resident agreements; but I need to research more to find out the ultimate outcome, once the dust settled.   I've reached out to a few folks to see if there was a final accounting. 

In picking up the research on the Sears Methodist case, that reminded me I had not reported in this blog on another CCRC bankruptcy court proceeding, filed as a reorganization under Chapter 11 in late 2015 involving what was then known as Westchester Meadows CCRC in New York.

The August 23, 2016 opinion for In re HHH Choices Health Plan, LLC  is interesting, thoughtful, and remarkably accessible for nonlawyers.  The issues addressed carefully include:

  • Where the debtor in the Chapter 11 proceeding is a nonprofit organization, what rules apply for possible for-profit and nonprofit bidders?   For example, could state law governing and limiting transfers of assets of a nonprofit organization apply?  The Court concludes that although a new operator would need to comply with state laws (such as the Department of Health's licensing rules), the Bankruptcy Code controls bidding and sale of a bankrupt debtor's assets.
  • What standards apply if one bidder, for a lower price, would continue operations as a nonprofit, while the other bidder, for a higher price (and thus more attractive to unsecured creditors), would convert to for-profit operations?  Here, the Court observes that New York state law makes it "clear that price alone is not determinative, and that fulfilling the corporate mission can be decisive if creditors are all being paid in full."   However, that rule was "clear" only if all the debtor's creditors would be fully paid, which would not be the outcome here.  After careful consideration of case precedent, the Court concludes it can confirm a lower-priced sale of the assets, where the buyer satisfies certain standards and is better aligned with the charitable mission of the operation, including in this instance protection of the interests older residents.

The Court's concludes:  

Continue reading

July 15, 2018 in Consumer Information, Current Affairs, Estates and Trusts, Ethical Issues, Federal Cases, Federal Statutes/Regulations, Health Care/Long Term Care, Housing, State Cases, State Statutes/Regulations | Permalink | Comments (0)

Thursday, July 12, 2018

Consumer Credit Security Freezes for Free on September 21, 2018.

The National Center for Law & Elder Rights (NCLER) has released a fact sheet explaining a new law that allows consumers to place freezes on their credit info for free, starting on September 21, 2018. New Law Provides Free Security Freezes and Increased Fraud Alert Protection explains that "[o]n May 24, 2018, the President signed Public Law 115-174 into law. Section 301 of Public Law 115-174 amends the Fair Credit Reporting Act, to establish a new federal right for consumers to implement a security freeze of their credit file." (citations omitted).

The legislation establishes standards for the creation, temporary lifting or “thaw,” and permanent removal of security freezes from the nationwide consumer reporting agencies. The security freezes are essentially limited to parties seeking the consumer’s information for credit purposes. The freeze does not apply to parties who seek the report for employment, insurance, or tenant-screening purposes. It also does not apply to existing creditors or their agents or assignees conducting an account review, collecting on a financial obligation owed them, or seeking to extend a “firm offer of credit” (i.e.,prescreening).
 

In addition, the new law preempts state credit freeze laws and expands the length of  fraud alerts from 3 months to a full year!  Further, "[t]he legislation’s preemption extends to any state requirement or prohibition with respect to subject matter regulated by the statute’s provisions relating to security freezes. For example, some state statutes are stronger than the new federal standards by allowing consumers to freeze access to credit reports for employment or insurance purposes." There is also a provision covering when a fiduciary needs to secure a freeze for an individual who is incapacitated.

PS-if you haven't checked your credit reports this year, what are you waiting for?
 

July 12, 2018 in Consumer Information, Crimes, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Federal Statutes/Regulations, Property Management, State Statutes/Regulations | Permalink | Comments (0)

Thursday, June 28, 2018

When Complexity in the Law Is the Biggest Barrier to Home Care

Karen Vaughn, a woman living with quadriplegia in her own apartment for some 4o years, was held against her will in a care facility after hospitalization for a temporary illness. She wanted to go home. The state argued it could no longer find a home care agency that could provide the level of services Ms. Vaughn needed following a tracheostomy  in 2012. 

Ms. Vaughn's case gave a federal district judge in Indiana the opportunity to revisit the Supreme Court's landmark Olmstead decision from 1999. In ruling on cross motions for summary judgment, the court rejected the state's arguments as based on complexity in reimbursement rates, not availability of appropriate care providers.  Judge Jane Magnus-Stinson observed,  in ruling in favor of Ms. Vaughn, that

The undisputed medical evidence establishes that at or near the time of the filing of this Complaint, Ms. Vaughn’s physicians believed that she could and should be cared for at home—both because home healthcare is medically safer and socially preferable for her, and because Ms. Vaughn desires to be at home. . . . That support has continued throughout the pendency of this litigation, through at least April of 2018 when Dr. Trambaugh was deposed. Based on the evidence before this Court, it concludes as a matter of law that Ms. Vaughn has established that treatment professionals have determined that the treatment she requests—home healthcare—is appropriate.
The court traced, and criticized, the Byzantine nature of Medicaid waiver programs that fund portions of home care:
[State] Defendants' own administrative choices—namely, the restrictions they have imposed on Ms. Vaughn’s home healthcare provision pursuant to their Medicaid Policy Manual—have resulted in their inability to find a caregiver, or combination of caregivers, who can provide Ms. Vaughn’s care in a home-based setting. It may be the case that other factors, such as the nursing shortage or inadequate reimbursement rates, contribute to or exacerbate the difficulty in finding a provider. But, at a minimum, Ms. Vaughn has established that Defendants' administrative choices, in addition to their denials of her reasonable accommodation requests, have resulted in her remaining institutionalized.
 
For the full opinion, with the judge admitting frustrations in finding a solution, see Vaughn v. Wernert, USDC, Southern District of Indiana, June 1, 2018.  The judge recognized that the court cannot simply order "return home" as an appropriate remedy, and instead set a "remedy hearing" for July 30 to explore all proposals, while also urging the parties to meet prior to that hearing in hopes of finding a mutually agreeable plan.  If any of our readers hear the result, please do share! Best wishes to Ms. Vaughn.
 

June 28, 2018 in Current Affairs, Discrimination, Ethical Issues, Federal Cases, Federal Statutes/Regulations, Health Care/Long Term Care, Housing, Medicaid, Medicare, Social Security | Permalink | Comments (0)

Wednesday, June 27, 2018

Free Webinar-Financial Exploitation & Medicare Fraud

Mark your calendars for a free webinar on Financial Exploitation and Medicare Fraud. The National Center on Law & Elder Rights will be offering this webinar on Wednesday, July 18, 2018 from 2-3 edt. Here's info about the webinar

Medicare fraud hurts individuals and is harmful to the Medicare Trust Fund. The Medicare Trust fund loses between $60 and $90 billion dollars every year to fraud, waste and abuse. Individuals can lose access to Medicare services because their identity has been misappropriated by someone else. Law and aging advocates play an important role in helping older adults prevent, detect, and report Medicare fraud and abuse.

In this free webinar, Financial Exploitation and Medicare Fraud, California’s Senior Medicare Patrol will teach advocates how to identify potential Medicare scams and report fraud and abuse to the Senior Medicare Patrol. Justice in Aging will highlight potential exploitive Medicare practices and outlines strategies to help prevent exploitation. 

To register, click here

 

 

June 27, 2018 in Consumer Information, Crimes, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Federal Cases, Federal Statutes/Regulations, Health Care/Long Term Care, Medicare, Webinars | Permalink | Comments (0)

Friday, June 22, 2018

VA Posts "Annual" Comparative Ratings for Veterans Nursing Homes (but, is that enough?)

A recent press release from Department of Veterans Affairs announced the VA's  decision to release "annual" ratings for its nursing homes.  From the opening words, the language in the notice is, shall we say, interesting.

Today [June 12, 2018] the U.S. Department of Veterans Affairs (VA) extended its unprecedented 18-month record of transparency disclosures by making public for the first time its annual nursing home ratings. View the ratings here.

 

The data show that, overall, VA’s nursing home system – composed of more than 130 community living centers – compares closely with private sector nursing homes, even though the department on average cares for sicker patients in its nursing homes than do private facilities.

 

In fact, the overall star rating for VA’s nursing homes compared to the 15,487 private sector nursing homes rated by the Centers for Medicare and Medicaid Services (CMS) shows that VA has a significantly lower percentage (34.1 percent lower) of one-star, or lowest rated, facilities than the rest of the nation.

    

Of note, 60 of VA’s nursing homes improved their quality score from last year to this year (2nd Quarter FY17 to 2ndQuarter FY18).  Only one facility had a meaningful decline in that metric, and that facility was already rated with four stars.

 

Extending President Trump’s Commitment to VA Transparency, Quality Improvement

 

For years, the Obama administration had resisted making certain VA quality data public. But under President Trump’s leadership, transparency and accountability have become hallmarks of VA.... 

In addition to the press release, interested readers will want to follow USA TODAY and Boston Globe articles analyzing statistical reports from the VA, including Secret VA Nursing Home Ratings Hide Poor Quality Care From the Public (June 17, 2018); Lawmakers Demand Secrete NVA Nursing Home Data Be Released After USA TODAY, Boston Globe Report (June 19, 2018).   

On June 20, 2018, USA Today followed up its series of articles with an editorial, pointing to incomplete information released by the VA:

Veterans can now go online to see comparative data for VA hospitals and outpatient clinics and choose private alternatives if VA care is wanting. But Veterans Affairs evidently hasn't yet learned that lesson for its operation of nursing homes. Though it released limited appraisal information after reporters inquired, the agency continues to withhold underlying quality data such as infection and injury rates at its elderly care facilities.

 

This information needs to be made public, not just when reporters ask for it but for any veteran or family of a veteran considering care at a VA nursing home. Private nursing homes are required by federal law to make this information available, and so should taxpayer-financed VA facilities. 

June 22, 2018 in Consumer Information, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Ethical Issues, Federal Statutes/Regulations, Veterans | Permalink | Comments (0)

Thursday, June 21, 2018

Boomerang Hospital Admissions and Medicare

Kaiser Health News recently reported on efforts by CMS to crack down on what KHN calls "boomerang" hospital admissions. Medicare Takes Aim At Boomerang Hospitalizations Of Nursing Home Patients focuses on the situation where nursing home residents have multiple hospitalizations.

With hospitals pushing patients out the door earlier, nursing homes are deluged with increasingly frail patients. But many homes, with their sometimes-skeletal medical staffing, often fail to handle post-hospital complications — or create new problems by not heeding or receiving accurate hospital and physician instructions.

Patients, caught in the middle, may suffer. One in 5 Medicare patients sent from the hospital to a nursing home boomerang back within 30 days, often for potentially preventable conditions such as dehydration, infections and medication errors, federal records show. Such rehospitalizations occur 27 percent more frequently than for the Medicare population at large.

One solution implemented by CMS, the story explains, has been to penalize hospitals when the resident is readmitted, "in an attempt to curtail premature discharges and to encourage hospitals to refer patients to nursing homes with good track records."  In the next few months, CMS will now initiate a program with incentives for nursing homes: "giving nursing homes bonuses or penalties based on their Medicare rehospitalization rates. The goal is to accelerate early signs of progress: The rate of potentially avoidable readmissions dropped to 10.8 percent in 2016 from 12.4 percent in 2011, according to Congress’ Medicare Payment Advisory Commission."

Of course, this doesn't mean that a resident will never be hospitalized but hopefully this will make the process and the care better for residents.  The article looks at reasons for the frequent admission problems, noting the causes include ineffective communication between the nursing home and the treating doctors.

This issue is a common one.

Out of the nation’s 15,630 nursing homes, one-fifth send 25 percent or more of their patients back to the hospital, according to a Kaiser Health News analysis of data on Medicare’s Nursing Home Compare website. On the other end of the spectrum, the fifth of homes with the lowest readmission rates return fewer than 17 percent of residents to the hospital.

Stay tuned.

June 21, 2018 in Consumer Information, Current Affairs, Federal Cases, Federal Statutes/Regulations, Health Care/Long Term Care, Medicare | Permalink | Comments (0)

Wednesday, June 20, 2018

New Rules Governing Nursing Facility Care Trigger New Approaches to Advocacy

Eric Carlson, Nancy Stone and Lori Smetanka have joined forces to write an important new guideline for advocacy under the revisions issued by CMS in 2016 for nursing facility care, with an eye towards additional changes likely to occur under the Trump administration.   

After surveying the most important reforms, they advise:

The revised regulations contain both positives and negatives for nursing facility residents and their advocates. The positives include expanded requirements for person-centered care, care planning, and resident choice and participation in health care services. The revised regulations also strengthen the NHRA’s prohibitions against facilities requiring a third-party guarantee of payment or a waiver of legal rights, and protections for residents from improper transfer/discharge. In addition, the regulations have added requirements for a facility grievance official and procedures.

 

It is disappointing, however, that the revised regulations do not require a registered nurse around the clock or a minimum staffing standard. Even though unnecessary restraints are included in the definition of “abuse” and the requirements for drug regimen reviews and reporting of unnecessary drugs were expanded, the revised regulations compromise the focus on ending the misuse of antipsychotic medications.

 

In addition, the Trump administration has proposed a repeal of the ban on predispute arbitration agreements and delayed enforcement remedies for certain Phase 2 requirements. The administration is also considering the repeal or further modification of other revised regulations (e.g., regulations on grievance procedures, quality assurance, and ombudsman discharge notices).

The authors explain the importance of advocacy in this time of change:

Even though CMS and the states are responsible for implementing these regulations, regulation implementation, if left solely to government agencies and providers, is usually scattershot and inadequate. For the revised regulations to truly become the national standard of care, nursing facility residents and their advocates must be prepared to assert resident rights over and over again. Another unfortunate reality is that nursing facilities may be hostile or apathetic toward the revised regulations and the survey agencies can only do so much, given that federal law requires surveys only once a year. For these reasons, it is up to residents, families, and advocates to be knowledgeable about the federal law and make nursing facilities accountable when they fall short.

For the full picture, read Advocating for Nursing Facility Residents Under the Revised Federal Requirements,  published April 2018 in the NAELA Journal, and available online as a PDF.

 

June 20, 2018 in Consumer Information, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Ethical Issues, Federal Statutes/Regulations, Health Care/Long Term Care, Medicaid, Medicare | Permalink | Comments (0)

Thursday, June 14, 2018

The Evolution of Email Scammers: Moving from Granny, to Granny's Lawyers and Financial Companies as Their Targets

In my Elder Protection Clinic days, I met with family members of older adults victimized by off-shore scammers.  In one notable case, the older mother,  normally a savvy woman about her personal finances, had succumbed to the flattery of someone posing as a  financial advisor, who offered her various new "investments."  He knew just how to work her, appealing to her "business acumen," using internet maps to learn about her neighborhood and thus to make it seem his office was in a building near her bank in a suburb of Pittsburgh.   Even after her daughter, with the help of a legitimate financial advisor who caught the unusual activity on the mother's accounts, shut down any easy means of access to her mom, the mother continued to believe the perpetrator was just bad at financial advice, and not totally corrupt.   

The elderly mother's  judgment on who to trust was impaired, but the impairment was specific and hard to recognize because she otherwise functioned fairly well.  The combination of the perpetrator's flattery, his appeal to her once-strong financial skills, and the fact that she was lonely, trapped in her house as her physical strength was waning, all contributed to the success of the scam.  It all began with a single email.

A recent announcement by the FBI of a coordinated law enforcement effort to disrupt international scammers reveals how the scamming industry has evolved. The FBI explains:

Operation WireWire—which also included the Department of Homeland Security, the Department of the Treasury, and the U.S. Postal Inspection Service—involved a six-month sweep that culminated in over two weeks of intensified law enforcement activity resulting in 74 arrests in the U.S. and overseas, including 42 in the U.S., 29 in Nigeria, and three in Canada, Mauritius, and Poland. The operation also resulted in the seizure of nearly $2.4 million and the disruption and recovery of approximately $14 million in fraudulent wire transfers.

 

A number of cases charged in this operation involved international criminal organizations that defrauded small- to large-sized businesses, while others involved individual victims who transferred high-dollar amounts or sensitive records in the course of business. The devastating impacts these cases have on victims and victim companies affect not only the individual business but also the global economy. Since the Internet Crime Complaint Center (IC3) began formally keeping track of BEC [business e-mail compromise] and its variant, e-mail account compromise (EAC), there has been a loss of over $3.7 billion reported to the IC3.

 

BEC, also known as cyber-enabled financial fraud, is a sophisticated scam that often targets employees with access to company finances and trick them—using a variety of methods like social engineering and computer intrusions—into making wire transfers to bank accounts thought to belong to trusted partners but instead belong to accounts controlled by the criminals themselves. And these same criminal organizations that perpetrate BEC schemes also exploit individual victims—often real estate purchasers, the elderly, and others—by convincing them to make wire transfers to bank accounts controlled by the criminals.

 

Foreign citizens perpetrate many of these schemes, which originated in Nigeria but have spread throughout the world.

Law firms were among the most frequent targets of the scammers, who posed as clients to access funds held in the law firms' trust accounts.  For more on the industry, read "It's Time to Stop Laughing at Nigerian Scammers -- Because They're Stealing Billions of Dollars,"  from the Washington Post.    

June 14, 2018 in Cognitive Impairment, Consumer Information, Crimes, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Ethical Issues, Federal Cases, Federal Statutes/Regulations, International, Property Management | Permalink | Comments (0)

Tuesday, June 12, 2018

Medicare Trustees Release Bleak News on Trust Fund

The Medicare Trustees have released their 2018 annual report, which is chock-full of empirical data.  Reporting on this, the New York Times puts things in perspective with their story:Medicare’s Trust Fund Is Set to Run Out in 8 Years. Social Security, 16. This is less time than was reported  last year, as the story explains:

The Medicare trust fund will be depleted in 2026, the administration said. By contrast, the government said last year that the trust fund would be exhausted in 2029.

In a companion report, federal officials said the Social Security Trust Funds for old-age benefits and disability insurance, taken together, could be depleted in 2034, the same year projected in last year’s report. The fund that helps tens of millions of retirees is expected to be depleted a year earlier than projected last year, while the outlook for the disability trust fund is more favorable.

A good economy doesn't seem to be enough to extend the programs' solvency, according to the article:

The report said the less favorable outlook for Medicare’s hospital trust fund resulted from “adverse changes” in program income and costs. Income to the Medicare fund is expected to be lower than estimated last year because of “lower payroll taxes attributable to lowered wages in 2017 and lower levels of projected gross domestic product,” the Treasury said in a “fact sheet” accompanying the report.

At the same time, it said, outlays from Medicare’s hospital trust fund “are expected to be higher than last year’s estimates due to higher-than-anticipated spending in 2017, legislation that increases hospital spending” and higher payments to private Medicare Advantage plans.

The Trustees report explains why the trust fund's time line has sped up:

The estimated depletion date for the HI trust fund is 2026, 3 years earlier than in last year’s report. As in past years, the Trustees have determined that the fund is not adequately financed over the next 10 years HI income is projected to be lower than last year’s estimates due to (i) lower payroll taxes attributable to lowered wages for 2017 and lower levels of projected GDP and (ii) lower income from the taxation of Social Security benefits as a result of legislation. HI expenditures are projected to be slightly high er than last year’s estimates, mostly due to higher than expected spending in 2017, legislation that increased hospital spending, and higher Medicare Advantage payments .

The full Trustees' report is available here.

June 12, 2018 in Consumer Information, Current Affairs, Federal Statutes/Regulations, Health Care/Long Term Care, Medicare, Social Security | Permalink | Comments (1)

Monday, June 11, 2018

Aging: "The One Shark We Cannot Escape"

My good friend and colleague, Pennsylvania Elder Law Attorney Linda Anderson, has a thoughtful essay about her personal journey in elder law in a recent issue of  GPSolo,  the ABA journal for solo, small firm, and general practitioners.  Her closing paragraphs address several core issues, comparing her elder law focus with traditional tax and estate planning concerns.  I enjoyed her use of classic lines from the movie Jaws.  

My early work with elder clients or their adult children across a variety of asset levels certainly involved tax and estate planning. But it became clear that serving and protecting these clients demanded more than just good lawyering, that good planning needed “a bigger boat.” It entailed comprehensive knowledge of the Social Security, Medicaid, and VA benefits bureaucracies, close engagement with insurance providers, geriatric care managers, social workers, and other professionals, as well as close monitoring of state and federal regulatory and policy changes and housing and age discrimination laws, among others. The eventual next step for me was completing the requirements to become a certified elder law attorney (CELA).
 
 
Solo or general practice attorneys do not have to become dedicated elder law experts when taking on clients seeking long-term care and funding planning. Take those clients, but be prepared to augment tax and estate planning expertise with a deep dive into areas of elder and special needs law and funding mechanisms. All this is doable, of course, but the biggest difference is in mindset. Attorneys often approach estate and long-term care planning as transactional or episodic--needs arise, documents are drafted or revised, and we and the clients move on. But the nature of the legal work I've touched on above demands a continuing, flexible outlook and a lot of homework. When in doubt, consult with or refer your client to a CELA-qualified attorney. These attorneys are listed in the website for the National Elder Law Foundation (NELF, nelf.org). Another resource for lawyers (who may or may not be CELA-qualified) is the National Academy of Elder Law Attorneys (NAELA, naela.org). Both organizations are excellent sources for information and referrals.
 
 
Finally, as we all learn in time, everything that we've covered here will become very personal for each of us. This may first happen through our parents or siblings as they transition and age, but it's necessarily part of our own futures as well. That's true whether you're a Baby Boomer looking at 70, a Gen Xer thinking that 40 is “old,” or any age in between.
 
 
Aging is the one shark we cannot escape. But as attorneys, we know how to plan and can build our clients' (and our own) “boats” to manage aging as well as possible.
 
The full article is currently behind a paywall on the ABA website. For more of Linda's wise words, it is worth tracking down a copy of An Elder Care Lawyer's Story.  It is in Volume Issue No. 2 (March/April, 2018) of GPSolo.  It is also available on Westlaw, although, of course, that's another paywall.   

 

June 11, 2018 in Consumer Information, Current Affairs, Dementia/Alzheimer’s, Estates and Trusts, Ethical Issues, Federal Cases, Federal Statutes/Regulations, Health Care/Long Term Care, Legal Practice/Practice Management, Medicaid, Medicare, Property Management, State Cases, State Statutes/Regulations, Statistics | Permalink | Comments (0)

Thursday, June 7, 2018

Michigan Bar Journal Issue Explores the Intersection of Elder Law and Disability Law

A recent issue of the Michigan Bar Journal offers interesting practitioner perspectives on disability law and elder law issues.  The January 2018 issue includes:  

Introducing the theme of the issue, attorney Christine Caswell writes: 

While there may be a perception that the section focuses on helping clients qualify for public benefits, its mission is actually much broader. Elders and those with  disabilities have many of the same issues as the rest of the population— divorce, consumer problems, bankruptcy, business ownership, and litigation—but these issues are magnified when questions arise concerning competency, the need for ongoing care, and discrimination. Moreover, these different legal areas may conflict when determining what is in the best long-term interests of these clients.

June 7, 2018 in Consumer Information, Current Affairs, Dementia/Alzheimer’s, Estates and Trusts, Ethical Issues, Federal Cases, Federal Statutes/Regulations, Health Care/Long Term Care, Legal Practice/Practice Management, Medicaid, Medicare, Social Security, State Cases, State Statutes/Regulations | Permalink | Comments (0)

Wednesday, May 30, 2018

Details Emerge on the Federal Senior $afe Act

I promised more information about the consumer protection measures signed into law by President Trump on May 24, 2018.  Here's the more detailed update I wrote for WealthManagement.com:  The New Senior $afe Act Encourages Reporting Senior Financial Abuse. 

May 30, 2018 in Consumer Information, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Estates and Trusts, Ethical Issues, Federal Statutes/Regulations, Property Management | Permalink | Comments (0)

Tuesday, May 29, 2018

Register Now: Free Webinar on Helping Elders Post-Disaster

With hurricane season looming (it starts June 1), this notice about an upcoming webinar is particulary timely. The National Center on Law & Elder Rights has scheduled a free webinar for June 20, 2018 at 2 p.m. edt, Assisting Older Homeowners After a Natural Disaster. The announcement explains this about the webinar

Older adults face unique challenges and exhibit different vulnerabilities during and after a natural disaster. Older homeowners, for example, may need additional assistance securing their homes and moving out of a storm's path. Recovering from the disaster may also be a challenge for older adults on fixed or limited income. This free webcast will address both the practical challenges and resources available to aid older homeowners after a disaster. The discussion will highlight the loss mitigation and other options available to prevent mortgage foreclosure, and housing and other related assistance from FEMA. Closed captioning will be available on this webcast. A link with access to the captions will be shared through GoToWebinar’s chat box shortly before the webcast start time. Presenters: • Odette Williamson, Staff Attorney, National Consumer Law Center • Sapna Aiyer, Managing Attorney, Housing & Consumer Unit, Lone Star Legal Aid

May 29, 2018 in Consumer Information, Current Affairs, Federal Cases, Federal Statutes/Regulations, Housing, Other | Permalink | Comments (0)

Thursday, May 24, 2018

Banking Industry and the New Senior Safe Act

The "Senior Safe Act," part of a federal banking reform law that will modify Dodd-Frank, has been passed by both houses of Congress with bi-partisan support.  Note the sometimes clever spelling for "Safe" as "$afe," used by proponents.  From a McKnight's Senior Living report on  May 23, 2018:

A bipartisan bill intended to help protect older adults from financial exploitation and fraud is on its way to the president's desk to be signed into law.

 

The Senior $afe Act, authored by U.S. Sens. Susan Collins (R-ME) and Claire McCaskill (D-MO), passed in the House of Representatives on Tuesday as part of a bipartisan banking reform package after previously being passed by the Senate in March. President Trump tweeted on Wednesday that he plans to sign the legislation into law.

 

Collins and McCaskill had introduced the Senior $afe Act in 2017 when they were chairman and ranking member, respectively, of the Senate Special Committee on Aging. Collins still leads the committee, and McCaskill remains a member.

 

The legislation protects banks, credit unions, investment advisers, broker-dealers, insurance companies and insurance agencies from being sued for reporting suspected exploitation or fraud as long as they have trained their employees about how to identify the warning signs of common scams and make reports in good faith to the proper authorities.

 

“The Senior $afe Act, based on Maine's innovative program, will empower and encourage our financial service representatives to identify warning signs of common scams and help prevent seniors from becoming victims,” Collins said in a statement.

 I'll report more once I have a close look at the language, as enacted.  

May 24, 2018 in Consumer Information, Crimes, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Estates and Trusts, Ethical Issues, Federal Statutes/Regulations, Statistics | Permalink | Comments (0)

Wednesday, May 23, 2018

Myths & Mistakes About New Medicare Cards: AARP Research Survey

As we all know, CMS has been rolling out the new Medicare cards without SSN on them.  AARP Research conducted a survey about the new cards, and the results are quite interesting.  2018 AARP Survey: Experience and Knowledge of Medicare Card Scams explains:

n March 2018, AARP engaged Alan Newman Research to conduct a national research study among U.S. adults ages 65 and older about their experience and knowledge around the new Medicare cards being issued in April 2018 and potential vulnerability to scams related to the new card and benefits. 

Key findings include the following:

  • Most (76%) U.S. adults ages 65 and older indicate they have not seen, read, or heard much or anything at all about the new Medicare cards (or are not sure).
  • Three in four (75%) Medicare beneficiaries are not sure or are incorrect about the key change with the new cards being new identification number.
  • Nearly two-thirds (63%) of Medicare beneficiaries are unsure or are incorrect in believing that Medicare will charge new beneficiaries a $25 processing fee for the new card. 
  • Over half (56%) are not sure or are wrong in thinking that Medicare will call them to verify their Social Security number before they can receive their new card.
  • At least one in three are extremely/very concerned about being a target of Medicare scam (33%) or victim of identity theft (40%).

A pdf of the survey results is available here.

 

May 23, 2018 in Consumer Information, Current Affairs, Federal Statutes/Regulations, Health Care/Long Term Care, Medicare, Statistics | Permalink | Comments (0)

Tuesday, May 22, 2018

Congrats to NAELA

NAELA celebrated its 30th year with its annual conference in New Orleans, LA on May 17-19, 2018. The conference consisted of three tracks: legal tech, advocacy and public benefits.  The well-attended conference packed in a great amount of programming in two and a half days. Speakers included leaders from the field of elder law, consultants, cyber security experts, researchers and more.  NAELA members unable to attend may check the NAELA website for more information.

In addition, Michael Amoruso was sworn in as the next NAELA president by outgoing president Hy Darling.  Congrats NAELA!

(In the interest of full disclosure, I'm a former president of NAELA and co-chair of the planning committee for this conference.)

 

May 22, 2018 in Consumer Information, Current Affairs, Federal Statutes/Regulations, Health Care/Long Term Care, Legal Practice/Practice Management, Medicaid, Medicare, Programs/CLEs, Property Management, Social Security, State Cases, State Statutes/Regulations | Permalink | Comments (0)

Wednesday, May 16, 2018

National Senior Fraud Awareness Day

Yesterday, May 15, 2018, was designated by the U.S. Senate as "National Senior Fraud Awareness Day." The reason for the day, according to the Congressional Record is "To Raise Awareness About the Increasing Number of Fraudulent Schemes Targeted At Older People of The United States, To Encourage The Implementation of Policies to Prevent These Scams From Happening, and to Improve Protections From These Scams For Seniors."

Senator Collins for herself and 4 other Senators, and introduced the resolution, S. Res. 506.

Here it is in its entirety:

Whereas, in 2017, there were more than 47,800,000 individuals age 65 or older in the United States (referred to  in this preamble as ``seniors''), and seniors accounted for  14.9 percent of the total population of the United States;

Whereas senior fraud is a growing concern as millions of older people of the United States are targeted by scams each year, including the Internal Revenue Service impersonation scams, sweepstakes and lottery scams, grandparent scams, computer tech support scams, romance scams, work-at-home scams, charity scams, home improvement scams, fraudulent investment schemes, and identity theft; Whereas other types of fraud perpetrated against seniors include health care fraud, health insurance fraud,  counterfeit prescription drug fraud, funeral and cemetery  fraud, ``anti-aging'' product fraud, telemarketing fraud, and internet fraud;
Whereas the Government Accountability Office has estimated that seniors lose a staggering $2,900,000,000 each year to an ever-growing array of financial exploitation schemes and scams;
Whereas, since 2013, the fraud hotline of the Special Committee on Aging of the Senate has received more than 7,200 complaints reporting possible scams from individuals in all 50 States, the District of Columbia, and the Commonwealth of Puerto Rico;
Whereas the ease with which criminals contact seniors through the internet and telephone increases as more creative schemes emerge;
Whereas, according to the Consumer Sentinel Network Data Book 2017, released by the Federal Trade Commission, people age 60 years and older were defrauded of $249,000,000 in 2017, with the median loss to defrauded victims age 80 and older averaging $1,092 per person, more than double the average amount lost by those victims between the ages 50 and 59 years old;
Whereas senior fraud is underreported by victims due to embarrassment and lack of information about where to report fraud; and
Whereas May 15, 2018, is an appropriate day to establish as ``National Senior Fraud Awareness Day'': Now, therefore, be it
Resolved, That the Senate--
(1) supports the designation of May 15, 2018, as ``National Senior Fraud Awareness Day'';
(2) recognizes ``National Senior Fraud Awareness Day'' as  an opportunity to raise awareness about the barrage of scams  that individuals age 65 or older in the United States  (referred to in this resolving clause as ``seniors'') face in person, by mail, on the phone, and online;
(3) recognizes that law enforcement, consumer protection groups, area agencies on aging, and financial institutions all play vital roles in preventing scams targeting seniors and educating seniors about those scams;
(4) encourages implementation of policies to prevent these scams and to improve measures to protect seniors from scams targeting seniors; and
(5) honors the commitment and dedication of the individuals and organizations who work tirelessly to fight against scams targeting seniors.

  

 

May 16, 2018 in Consumer Information, Crimes, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Federal Cases, Federal Statutes/Regulations, Other, State Cases, State Statutes/Regulations | Permalink | Comments (0)

Sunday, May 13, 2018

New Article: Primer on Disability Law for Land Use & Zoning

The intersection of land use and zoning laws and regs with a person's ability to live at home is so important. I wanted to let you know about a new article on the topic: A Primer on Disability for Land Use and Zoning Law  posted recently on SSRN.  The article is published in Volume 4 of  the Journal of Law, Property, and Society at 1 (March 2018). Here is the abstract

Approximately 20-30 percent of American families have a family member with a disability, many with a mobility impairment. Many people need access to disability services and programs. They need the availability of group homes, senior housing, drug rehabilitation centers, medical marijuana dispensaries, and counseling clinics. This leads to land use disputes.

This Primer is designed for people familiar with property law and land regulation (planning and zoning), and with little experience with disability law. The goal is to present an introduction that facilitates understanding of the intersections between land use law and disability. In general, the legal requirements of primary concern are limited, such that only a few parts of our expansive disability law are most relevant to the vast majority of planning and zoning matters. This Primer will guide the reader through these key provisions. The Acts discussed in this Primer include the Americans with Disabilities Act (ADA), the Rehabilitation Act (RHA), and the Fair Housing Act (FHA).

The 45 page article is available for download as a pdf from the Journal's website, here.

May 13, 2018 in Consumer Information, Current Affairs, Federal Statutes/Regulations, Housing, Other, State Statutes/Regulations | Permalink | Comments (0)

Thursday, May 10, 2018

Why Can't Medicare Beneficiaries use Drug Discount Coupons?

Because Medicare says so, that's why. Actually that's a bit of a glib answer. Instead, as Kaiser Health News explains it in the article, Medicare Beneficiaries Feel The Pinch When They Can’t Use Drug Coupons it's about impartiality.

Under the federal anti-kickback law, it’s illegal for drug manufacturers to offer people any type of payment that might persuade them to purchase something that federal health care programs like Medicare and Medicaid might pay for. The coupons can lead to unnecessary Medicare spending by inducing beneficiaries to choose drugs that are expensive.

“The law was intended to prevent fraud, but in this case it also has the effect of prohibiting Part D enrollees from using manufacturer copay coupons … because using the coupon would be steering Medicare’s business toward a particular entity,” said Juliette Cubanski, associate director of the Program on Medicare Policy at the Kaiser Family Foundation.

The story digs down deeper into the issue regarding coupons and discusses the ramifications of such use, including higher costs, dismissal of less-expensive alternatives and annual ceililngs on the cards.

Now we know.

May 10, 2018 in Consumer Information, Current Affairs, Federal Statutes/Regulations, Health Care/Long Term Care, Medicare | Permalink | Comments (0)

Monday, May 7, 2018

Wisconsin Study Reports 20% of Long-Term Care Jobs Are Unfilled

From Wisconsin Public Radio on the Long-Term Care Workforce Crisis Report of 2018:  

A coalition of Wisconsin health care organizations is warning that the state's shortage of long-term care providers continues to grow.

 

The study, put together by several groups across the state, says 1 in 5 direct caregiver positions in the state is going unfilled. That's up from 1 in 7 positions in 2016.

 

Starting wages in the profession are so low that many potential workers never apply, according to the report. The median hourly starting wage for personal caregivers is $10.75 an hour, according to the study, while other positions outside health care start at $12 an hour.

 

The report found Wisconsin's low rate of Medicaid reimbursement is a key factor keeping provider wages low.

 

Sarah Bass of the Wisconsin Assisted Living Association said with so many unfilled positions, many facilities are cutting back, even though demand for long-term care continues to grow.

 

"Assisted living providers are closing their doors, or shutting down areas of their assisted living facilities, because they don't have the staff to safely take care of the residents," she said. "They're reducing their admissions."

These problems exist despite some increases in state funding for skilled care and family care workers in the latest budget.  

May 7, 2018 in Consumer Information, Current Affairs, Ethical Issues, Federal Statutes/Regulations, Health Care/Long Term Care, Medicaid, State Statutes/Regulations, Statistics | Permalink | Comments (0)