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Assisted living is the fastest growing form of residential housing for older Americans.

New York Assisted Living Residences (ALR) are not a hospital, nursing home, continuing care retirement community, mental health facility, independent senior housing, or an adult care facility.

ALRs provide or arrange for housing, on site monitoring, and personal care services and/or home care services (either directly or indirectly), in a home-like setting to five or more adult residents unrelated to the assisted living provider.

Assisted living residents have the right to: Continue Reading 15 Rights of NY Assisted Living Residents

Are you concerned about protecting your assets if you need Medicaid for nursing home care  in New York?

Do you have questions about the Medicaid assets limits and the Medicaid look-back?

“14 Ways to Preserve Your Assets with the New York  Medicaid Laws” seminar will be presented for free  at the Clarence Senior Center, 4600 Thompson Rd, Clarence, NY 14031 on Thursday, April 6, 2017 at 1:30 PM .

Have your Medicaid questions answered by Robert Friedman, Attorney and Jeff Vastola, CLU of M&T Securities who will discuss: Continue Reading Medicaid Planning Seminar

The best nursing homes in Erie County, New York can be found on a website launched today.

Erie County Executive Mark C. Poloncarz issued an Executive Order creating a county website to publicize the ranking of nursing homes in Erie County, New York.

The website provides a searchable list of all nursing homes in Erie County. a list of Medicare- and Medicaid- certified nursing homes in Erie County, along with their overall rating based on health inspection, staffing, and quality measure ratings (1 star being the lowest, 5 being the highest/best). Continue Reading How to Find the Best Nursing Homes

The American Health Care Act Sec. 114 (b) would repeal the authority of states to set a minimum amount of home equity as a countable resource for Medicaid eligibility. This is according to “Considerations on Limitations to Home Equity for Medicaid Eligibility” released by the National Academy of Elder Law Attorneys.

This policy would affect the ability of individuals to remain in their homes and receive their long term care services and supports at home. The result would be an increase in costly institutional care. Continue Reading Medicaid Home Protections Imperiled By AHCA

The End of Three Month Retroactive Coverage Puts Providers and Families At Risk according to the National Academy of Elder Law Attorneys.

Sec. 114(b) of the American Health Care Act would repeal retroactive coverage of Medicaid eligibility. This puts providers at risk of economic loss; strains family finances; and pits providers against family members for recoupment of expenses, potentially through litigation.

Family Caregivers Provide the Bulk of Care, Often until Exhaustion.

Many Americans take pride in caring for their families, including those that need long-term services and supports (LTSS). In economic terms, one study estimates that unpaid caregivers provide close to four times the amount of services than Medicaid LTSS.

Oftentimes, family members place themselves under extreme emotional, physical, and financial strain. Family caregivers often give up working full time to provide care, often foregoing saving for retirement, paying into Social Security, and resulting in economic insecurity over their life-times. Many families turn to public benefits only when they can no longer provide the care their loved one needs.

Current Law Allows for Up to Three Months of Retroactive Coverage.

As a condition of participating in the Medicaid program, states must provide retroactive Medicaid coverage up to three months prior to application, provided the individual with a disability could have qualified for benefits during that time frame. Sec. 114 of the American Health Care Act would end this retroactive coverage except for during the month of application.

Three Month Retroactive Coverage Protects Families and Providers Alike.

Often families hope to support their loved one with a disability as long as possible. They may have personally racked up significant expenses paying for that individual’s health and LTSS needs. Sometimes, admission to a nursing home happens suddenly after hospitalization. The individual may get directly discharged by the hospital to a nursing facility for rehabilitation. Medicaid eligibility rules are complex and the applications onerous.

By the time the adult child of the Medicaid beneficiary makes the application, it may be a month or so after admission to the nursing home. Yet, the nursing facility needs to ensure it gets compensated for providing services to that individual.

The adult child does not want to see his or her parent discharged because the parent lack funds. Retroactive coverage ensures the provider can collect payment for a beneficiary who meets the strict means-tested standards of Medicaid, but has not yet finalized the application process while receiving services.

Repeal of These Provisions Would Put Families at Risk of Lawsuits and Debt Collection.

Without retroactive coverage, from the perspective of the nursing home provider, they now have provided care without compensation. Depending on the contractual obligations of the family caregiver, the nursing facility could sue them by claiming they should have filed the Medicaid application more swiftly, holding them personally liable for payment of services.

This increase in litigation does not serve beneficiaries, their families, nor their providers. In the alternative, a nursing facility may require money paid in advance until Medicaid starts providing coverage.

This could put a tremendous financial strain on the families who may decide to hold off on admission, putting the beneficiary at risk for receiving care at the most appropriate setting.

The soaring cost and prevalence of Alzheimer’s disease has a tremendous impact on our nation’s families and economy. This is according to a disturbing 2017 report released yesterday by the Alzheimer’s Association.

The statistics in the report emphasize the need for estate and Medicaid planning for disability.  390,000 New York residents 65 and older suffered from Alzheimer’s disease last year.

Total annual payments for health care, long-term care and hospice care for people with Alzheimer’s and other dementias exceed  a quarter of a trillion dollars. $175 billion of Continue Reading Devastating Costs of Alzheimer’s Dementia Care

A Buffalo, New York nursing home where an 82-year-old woman  was beaten to death by another resident has been fined the maximum amount of $10,000 by the New York State Health Department.  She mistakenly wandered unsupervised into a male patient’s room in the dementia unit at Emerald South Nursing and Rehabilitation Center.  The man reacted violently believing an intruder was breaking into his house. The woman suffered a broken neck, several broken ribs, a broken nose, facial fractures and a collapsed lung in the attack. She died three days later in the hospital.

An inspection conducted by the New York State Health Department cited four issues that resulted in the $10,000 fine:

  • Residents did not receive adequate supervision to prevent accidents.
  • The nursing home did not notify authorities within 24 hours of the incident.
  • Emerald did not notify the family or legal counsel of the male patient before he was transferred out of the unit for evaluation.
  • There was no documentation of an admission agreement signed by the male resident or a responsible party.

The man was not criminally charged for the death because he lacked the mental capacity to form criminal intent and was not mentally fit to stand trial.

A wrongful death lawsuit by the family claims that the the woman had other physical interactions with residents. In the months prior to her death, she was punched, pushed into a table and had coffee poured on her. The suit also alleges various injuries from  seven falls at Emerald, which was another reason that  she should have been better supervised by the staff.

How to select the the best New York nursing homes will be explained in future blogs.






Are you concerned about losing your assets if you need Medicaid for nursing home care  in New York?

“14 Ways to Preserve Your Assets with the New York  Medicaid Laws” seminar will be presented for free  at the:

Have your Medicaid questions answered by Robert Friedman, Attorney and Jeff Vastola, CLU of M&T Securities who will discuss: Continue Reading 14 Ways to Preserve Your Assets


Mary sold her Buffalo, New York home to her daughter, Donna, in 2015 for $50,000, although it was actually worth $150,780. Mary is in a nursing home now and wants to know if she will qualify for Medicaid since she has no assets. Mary, like many senior citizens, is concerned about the New York  Medicaid Nursing Home “look-back”.
A period of Medicaid (not Medicare) ineligibility or delay in qualification (“penalty period”) is imposed on donors for any transfers of assets for less than fair market value (gifts) for the past five years. Any asset transferred for the purpose of qualifying for Medicaid is considered an impermissible transfer of assets for which a penalty is imposed. Continue Reading 2017 Nursing Home Medicaid Penalty Rates