A New Jersey appeals court held that a Medicaid application was properly denied when the applicant did not submit all the financial information and documents requested by the Medicaid agency. P.N. v. Division of Medical Assistance and Health Services (N.J. Super. Ct., App. Div., No. A-2025-15T2, July 28, 2017). P.N. resided in an assisted-living facility. Based.. read more →

The federal Nursing Home Reform Law was enacted in 1987, and became effective in October 1990. The Reform Law governs any nursing facility that accepts reimbursement from Medicare or Medicaid, and applies to all residents in any such facility, regardless of the individual resident’s payment source. In other words, the law applies whether the resident’s.. read more →

The New York State Bar Association has issued a brochure to help consumers understand the benefits of utilizing an elder law attorney to assist (1) in the preparation of Medicaid applications and (2) in planning for yourself or a loved one to protect assets when seeking eligibility for public benefits based upon financial need. The.. read more →

Nancy Gimenez-Watson was a resident of Brighton Gardens of Edison, an assisted living facility (ALF) operated by Sunrise Senior Living and its parent company. Mrs. Watson was in the “Reminiscence Plus” program for residents diagnosed with Alzheimer’s disease or dementia. In April 2008, Mrs. Watson choked on her food. After a Brighton Gardens nurse administered.. read more →

In Singer v. Emeritus Senior Living Center, following a series of falls and the later death of Elizabeth Singer, her family sued the Emeritus Senior Living Residence, claiming that the last of those falls led to Mrs. Singer’s cognitive decline and hastened her death. Plaintiff’s expert was a board certified psychiatrist. At the conclusion of.. read more →

To be eligible for Medicaid, applicants must meet two requirements: financial requirements and medical requirements. I’ve posted many articles on this blog over the years discussing the financial requirements of the Medicaid program in New Jersey, and offering various strategies to accelerate financial eligibility for the program. However, I have surprising few posts discussing Medicaid’s.. read more →

As discussed in a prior blog post, a major overhaul of Medicaid will be introduced in New Jersey in the coming months. The new Medicaid program is called Managed Long Term Services and Supports (MLTSS). The MLTSS implementation date has been repeatedly adjourned, and the next date scheduled to put the new program into effect.. read more →

The Medicaid programs in New Jersey which help residents pay long-term care costs are about to get a major overhaul. Currently, there are three (3) Medicaid programs in New Jersey that pay for long-term care costs. The Medicaid-Only Medicaid program pays the costs of caring for nursing home residents. A companion program, Global Options for.. read more →

The Affordable Care Act (ACA) is an historic effort by the government to extend medical insurance coverage to all Americans, increase the quality of care, increase accountability, and reduce cost. It’s been said that the ACA changes the relationship between government, health care providers and all who receive health care in the U.S. However, at.. read more →

In a recent opinion, Hon. Robert B. Kugler, United States District Judge for the District of New Jersey, denied a motion filed by the State of New Jersey seeking the dismissal of a pending class action lawsuit which my co-counsel, Alan Sklarsky, Esq., and I filed in federal court seeking an injunction barring the State.. read more →

The cost for care in an assisted living facility (ALF) varies widely throughout the United States. You may have expected some states listed below to be expensive, but there are others with high costs which may surprise you. Is your state on the top 10  list for the most expensive yearly cost? 10. New Hampshire.. read more →

Soon after the passage of the Deficit Reduction Act of 2005 (DRA), New Jersey’s Division of Medical Assistance and Health Services, the State Medicaid agency, took the position that the penalty period, or period of ineligibility for Medicaid, resulting from transfers made during the look-back period by applicants for home or community – based services.. read more →

Lately, I have seen a deceptive business practice beginning in New Jersey and the Northeastern states which, until recently, was largely confined to California and other western states. That is, the practice by certain companies of presenting themselves as non-profit organizations dedicated to assisting veterans by offering to prepare a veteran’s application for Aid and.. read more →

Like most other states, New Jersey’s system of regulating assisted living facilities provides little meaningful protection to residents facing involuntary discharge. Federal and state laws give powerful protections to nursing home residents, but not to residents of assisted living facilities, even though New Jersey’s Medicaid program pays for care in assisted-living facilities. As a result,.. read more →

A national assisted living company broke its promises to elderly New Jersey residents by throwing them out after allowing them to believe they could convert to Medicaid when their life savings were depleted, a report by the state’s Public Advocate has determined. The report concludes that regulations in New Jersey and around the country are.. read more →

The costs of nursing home care can be deducted on federal individual income tax returns as medical expenses under Internal Revenue Code (IRC) § 7702B because they are considered “qualified long-term care costs”.  However, the status of assisted living facility (ALF) costs has not been as clear. To assist readers, below we have summarized an.. read more →

This year, the Guardianship Association of New Jersey, Inc. (GANJI) held its 13th Annual Conference on Guardianship on October 30th at the New Jersey Law Center in New Brunswick, NJ. The conference was entitled “Surrogate Decision-Making: A Holistic Approach.” The Program Schedule is attached here – 13th-annual-conference-on-guardianship-10-31-08. As can be seen, there was a wide.. read more →

The Center for Medicare and Medicaid Services (“CMS”) states that the Deficit Reduction Act of 2005 (Pub. L. No. 109-171, 120 Stat. 4, 151) (“DRA”) does not permit a person to receive benefits under a Medicaid waiver program (including assisted living facility Medicaid) if there has been a transfer of assets within sixty months of the.. read more →

(The following is based upon a real discussion that recently took place on an elder law listserv for attorneys. It illustrates the misinformation that is often inadvertently provided to consumers by government agency personnel concerning the availability of and eligibility criteria for needs-based public benefits.) Question: I recently contacted the Veterans Administration (VA) about applying.. read more →

Federal law allows nursing homes to evict residents for six reasons: they are healthy enough to return home; they require care not offered at the nursing home; they risk the health of other residents or staff; they endanger the safety of other residents or staff; they do not pay their bills; or the nursing home.. read more →

According to a recent article in The Philadelphia Inquirer, the New Jersey Office of the Public Advocate is investigating allegations that a company operating eight assisted living facilities in South Jersey improperly discharged residents when their savings ran out. Public Advocate Ronald K. Chen is scheduled to appear in Court in early June 2008 to.. read more →

I recently read two interesting articles and a study on the ever-increasing costs of long-term care, both in the nation and New Jersey. The articles are found in the Houston-Chronicle and the Star-Ledger, while the study, in which researchers examined data from more than 10,000 nursing homes, assisted living facilities and in-home care providers nationwide… read more →

An administrative law judge has concluded that an individual who is trying to avoid nursing home care by applying for home- or community-based coverage under a Medicaid waiver program, but who has made a transfer during the look-back period, must have the penalty period begin on the date on which the applicant would otherwise be.. read more →