Legal experts focusing on Wills, Trusts, Medicaid, Guardianships, and Asset Protection for Seniors and Veterans.
Our elder law attorney in Kansas City has more than 25 years focusing solely on issues common to seniors and their families. This includes planning for the inevitable with Wills & Trusts, or planning for the unforeseen with Powers of Attorney, Guardianships, and Medicaid or VA benefits.
Our caring staff listens to your situation and concerns, then explains your options with a timeline for completion. Our goal is to provide each client with security in legally planning for the inevitable and unforeseen regarding their passing and long-term care needs.
Mission & Values
To provide excellent legal and client services to Missouri seniors and their families as they navigate planning for their later years and preserving their assets.
We value being elder law experts working with our clients as a team efficiently and reliably.
The Centers for Medicare & Medicaid (CMS) recently unveiled its final rule for the fiscal year (FY) 2024, bringing substantial changes and updates to payment rates for skilled nursing facilities (SNFs).
Centers for Medicare & Medicaid is mandated to establish a market basket index reflecting changes in the prices of goods and services covered by skilled nursing facilities services. If you’re interested in the specifics, forecasting adjustments led to a 3% SNF market basket update. Additional adjustments, including a 3.6% forecast error increase, a 0.2% productivity adjustment decrease, and a 2.3% decrease for the Patient Driven Payment Model parity adjustment, resulted in a net increase of 4%. This amounts to approximately $1.4 billion increase in Medicare Part A payments for the fiscal year 2024.
Value-Based Purchasing Updates
The final rule also introduces an expansion of the SNF Value-Based Purchasing Program. CMS is set to adopt four new quality measures, replace one existing measure, and implement various policy changes. Noteworthy additions include the Nursing Staff Turnover and Discharge Function Score measures, aiming to enhance the evaluation of SNF performance.
Health Equity Adjustment
To recognize and reward skilled nursing facilities providing excellent care to underserved populations, CMS has introduced a Health Equity Adjustment. This adjustment will benefit SNFs with a resident population of at least 20% with dual eligibility status. The payback percentage policy under the program is also increased from 60% to 66% for 2027, facilitating bonuses for high-performing SNFs without adversely affecting others.
Quality Reporting Program Updates
The SNF Quality Reporting Program has seen adjustments as well. Centers for Medicare & Medicaid is increasing the threshold for data completion for the Minimum Data Set items, requiring SNFs to report 100% of the required quality measure data on at least 90% of the assessments submitted. Failure to meet this requirement may result in a 2% reduction in the annual payment update starting from fiscal year 2026.
Notable changes in quality measures include the adoption of the Discharge Function Score measure and the COVID-19 Vaccine: Percent of Patients/Residents Who Are Up-To-Date measure. Three measures have been removed, and one measure has been modified, reflecting CMS’s commitment to refining the evaluation of SNF performance.
Civil Money Penalties
In an effort to streamline administrative procedures, Centers for Medicare & Medicaid has introduced a constructive waiver process. Facilities will be considered to have waived their hearing if CMS does not receive a request within the specified timeframe. While the current 35% penalty reduction remains unchanged, CMS will continue to review this policy and penalty reduction in the future.
The fiscal year 2024 final rule from Centers for Medicare & Medicaid brings significant changes, including payment increases, value-based purchasing updates, quality reporting program modifications, and a streamlined civil money penalties process. Skilled nursing facilities should stay informed about these updates to ensure compliance and make the most of the opportunities presented by these changes.
Reach out to us at Paths Law to help you navigate the changes for Medicare and Medicaid and skilled nursing facilities.
For many Americans, long term care isn’t something they think about until they or a loved one needs it. When that time comes, the confusion can be overwhelming. With so many terms thrown around, like “skilled nursing,” “memory care,” and “assisted living,” it’s no wonder seniors and their families get lost in the maze of options.
Unraveling the Jargon: Skilled Nursing vs. Long Term Care
One of the most confusing terms you’ll encounter is “skilled nursing.” It simply refers to a type of medical care provided by trained professionals, like nurses and therapists. But just because your doctor recommends skilled nursing doesn’t mean you have to move to a long term care facility.
Skilled Nursing Care: What It Is and Where You Can Get It
Skilled nursing care is a higher level of medical attention that’s often needed after an illness or injury. It can be provided in short bursts for rehab, or on an ongoing basis for those with chronic conditions. The good news is, you don’t always have to leave home to get it.
In many cases, Medicare, private insurance, VA benefits, and long term care insurance policies cover short-term skilled nursing care at home. This is a great option for seniors who want to stay in their familiar surroundings while receiving the care they need.
Long Term Care: When Extra Support is Needed
For seniors who require more than just occasional skilled nursing, long term care facilities offer a variety of living options and support services. Assisted living communities are a popular choice for those who want to maintain some independence but need help with daily activities like bathing, dressing, and medication management.
Long term care facilities come in all shapes and sizes, with different levels of care available. Most have on-site medical staff who create and monitor personalized care plans for each resident. They also provide security and 24-hour access to nurses. However, it’s important to remember that long term care may be assisted living or the more attentive skilled nursing.
Finding the Right Fit: It’s a Team Effort
Choosing the right long term care option is a big decision, and it’s best not to go it alone. Talk to your doctor, family, and friends for recommendations. Visit different facilities and ask lots of questions. There’s no one-size-fits-all answer. The best option for you or your loved one will depend on individual needs and preferences. Just like realtors, there are some placement agencies that help find the right long term care facility for you. Typically there is no cost to you as the facilities will pay the fee. We do not recommend such agencies that are primarily online as those services are always inferior to those living and working in the community.
With careful planning and a little guidance, you can navigate the maze of long term care options and find the perfect fit for a happy and healthy future.
Additional Tips for Choosing Long Term Care:
- Start planning early. The sooner you start thinking about long term care, the more options you’ll have.
- Consider your loved one’s needs and preferences. What level of care do they need? Do they want to stay independent or have more assistance?
- Tour different facilities. Get a feel for the atmosphere and see if it’s a good fit for your loved one.
- Talk to the staff. Ask about their qualifications and experience.
- Get everything in writing. This includes the care plan, costs, and policies.
Remember, you’re not alone in this journey. There are many resources available to help you make the best decisions for your loved one. Contact us at Paths Law Firm today to learn more!
Children experiencing disabilities, whether already diagnosed or not yet identified, frequently encounter distinctive challenges that might restrict their chances for personal growth. Inheritance holds the potential to provide financial assistance to children with disabilities, empowering them to embark on novel paths of growth and development.
Unveiling Hidden Potentials
Many children with disabilities possess untapped potentials that, due to financial constraints, may have remained dormant. Recognizing and nurturing these capabilities is crucial for their overall well-being and future success. Whether the disability is visible, such as a physical impairment, or less apparent, like certain propensities, adequate financial support can be a game-changer.
Breaking Financial Barriers
Inheritance can provide the much-needed financial boost to unlock opportunities for children with disabilities. Most parents or grandparents enrich other persons who they plan will share with the disabled child, however this is fraught with potential problems. A disabled child’s newfound financial support can be channeled into various avenues, including education, healthcare, and therapeutic interventions. For instance, specialized educational programs, tailored to their unique needs, can be funded to enhance their learning experience and skill development through more secure methods.
Addressing Stigmas and Misconceptions
It’s essential to address the stigma associated with disabilities, including societal biases towards certain propensities or behavioral tendencies. Inheriting funds can empower these children to access resources that challenge negative perceptions and encourage a more inclusive environment. By promoting awareness and understanding, society can foster an atmosphere that values diversity and individual strengths.
Education and Skill Development
Inheriting funds can significantly impact the educational journey of children with disabilities. Whether it’s pursuing higher education, vocational training, or skill development programs, financial support can open doors to a myriad of opportunities. This, in turn, enables them to contribute meaningfully to society and lead fulfilling lives.
Balancing Autonomy and Guidance
While financial support is essential, it is equally crucial to strike a balance between providing autonomy to children and offering necessary guidance. Inheritance should be managed responsibly to ensure it aligns with the best interests and well-being of the child. Collaborating with financial advisors and professionals can assist families in creating a sustainable plan that addresses both immediate needs and long-term goals.
Building a Supportive Ecosystem
Inheritance not only benefits individual children but also contributes to creating a supportive ecosystem. Families, communities, and organizations can work together to establish programs and initiatives that cater to the diverse needs of children with disabilities. This collaborative effort fosters a sense of belonging and ensures that inherited funds are utilized for the greater good.
Empower your child’s future with Paths Law. Our experts are here to ensure a secure and supportive financial foundation for children with disabilities. Take the first step toward peace of mind – plan with Paths Law today.
Understanding the factors influencing nursing home costs is crucial for individuals and families preparing for long-term care. Beyond geographical location, the level of care required significantly impacts expenses. Higher levels of care, such as assistance with daily activities, come with a higher price tag. Additionally, the type of facility is also a factor; assisted living facilities generally have lower family costs than the traditional nursing homes or skilled nursing facilities.
Comparing Costs: Nursing Homes vs. In-Home Care
For those opting to age at home, if paying out-of-pocket and the caretakers are available, in-home care can be a viable economical choice. The median monthly cost for in-home care ranges from $4,957 to $5,148, making it a potentially more affordable alternative. However, even if the economics are more favorable, there are other factors that require serious consideration.
Financial Options for Nursing Home Care
The monthly average cost for a private room in a nursing home is around $9,000. Fortunately, several financial options exist to alleviate the burden, including:
- Savings and Investments: Utilizing personal savings or investments can be an option. However, it’s crucial to consider tax implications and seek professional guidance.
- Long-Term Care Insurance: Planning ahead with long-term care insurance is a proactive way to offset nursing home costs. Despite higher premiums, it provides a safety net for individuals who may not qualify for Medicaid.
- Veterans Affairs Aid and Attendance:Veterans may be eligible for the Aid and Attendance pension, providing a dependable monthly sum to cover long-term care expenses.
- Medicare: While Medicare covers short-term stays for skilled nursing care, it does not provide comprehensive coverage for extended nursing home care.
- Medicaid: State-administered Medicaid programs are mandated to cover nursing home care for low-income individuals. We’ll explore Medicaid in-depth, addressing eligibility criteria and financial considerations.
Medicaid: Navigating Eligibility and Considerations
If an individual lacks sufficient savings to cover nursing home expenses or if an extended stay depletes their assets, they may qualify for assistance from Medicaid, a state-administered health insurance program designed for individuals with low income or insufficient assets. Federal law mandates that state Medicaid programs cover nursing home care costs for qualifying individuals.
To be eligible for these services, individuals must meet their state’s level of care criteria and satisfy financial eligibility requirements. Medicaid eligibility is intricate, with multiple pathways allowing individuals to qualify. Some options are at the discretion of the state (sometimes referred to as a “waiver program), while others are mandatory. Depending on the qualification method for nursing home care with Medicaid, the state may require the beneficiary to contribute to the cost of their care.
Seniors who own homes should consider the fate of their property before applying for Medicaid. While federal law exempts homes from income and savings limits, that same protection stops when the owner passes away. Each state has an “estate recovery” program the purpose of which is to collect from estates of those who received Medicaid nursing home benefits. The government can put liens on the house while the person is still living and can collect reimbursement from the house after they die. Families seeking to preserve a cherished home may opt to bypass Medicaid, especially if the applicant’s life expectancy is short, and relatives can cover anticipated costs out of pocket.
Alternatively, a senior can retain their home within the family by a variety of methods, some must be done before applying for Medicaid, such as establishing an asset-protection trust. Other avenues exist even though the senior is already in the nursing home. An asset protection trust, typically one type of irrevocable trust, allows the transfer of property, such as a home or cash-like assets, to a trustee for management and benefit.
Navigating the complexities of Medicaid and nursing home care requires legal assistance. Finding a qualified Medicaid lawyer can be achieved by contacting the local bar association and identifying attorneys who teach seminars on Medicaid planning. Reach out to us at Paths Law today for more information!
In estate planning, the significance of a well-crafted strategy cannot be overstated. Enter the world of “Mastering Your Legacy: The Comprehensive Guide to Revocable Living Trust Packages,” a roadmap designed to empower you in safeguarding your assets and ensuring a seamless estate transition.
Overview of Revocable Living Trust Packages
At the heart of this guide is the exploration of revocable living trust packages. These packages serve as a comprehensive solution for individuals seeking a robust end-of-life care plan. Unlike traditional estate planning, revocable living trust packages provide a dynamic framework that adapts to your changing needs.
What a Revocable Living Package Entails
A revocable living trust package encompasses a suite of essential documents tailored to meet the unique needs of individuals, couples, and families. The core components include a revocable living trust, pour-over will, a general (financial) durable power of attorney, and advance healthcare directive, including a healthcare durable power of attorney. These documents work in tandem to create a holistic strategy that goes beyond the basics of a will.
Key Components and Documents
- Revocable Living Trust: Establishes a flexible framework for managing and distributing assets during and after your lifetime.
- Pour-over Will: Acts as a safety net, ensuring that any assets not explicitly placed in the trust are seamlessly transferred.
- General Durable Power of Attorney: Enables another to care for another’s financial affairs when they cannot, such as health insurance issues, utilities, or legal matters.
- Advance Healthcare Directive: Empowers you to make decisions about your medical care, providing peace of mind for you and your loved ones.
Advantages and Flexibility of Revocable Living Trust Packages
- Asset Management and Protection During Incapacity:
- Safeguard your assets by designating a trusted individual to manage them in case of incapacity.
- Probate Avoidance and Streamlined Estate Distribution:
- Bypass the time-consuming and costly probate process, ensuring a smooth distribution of assets to your heirs.
- Flexibility in Modifying Trust Terms:
- Enjoy the unique advantage of modifying the terms of the trust during your lifetime, accommodating changes in circumstances or financial goals.
Securing your legacy demands a sophisticated approach. “Mastering Your Legacy” demystifies the complexities of estate planning. At Paths Law, we offer a tailored strategy that speaks directly to the needs of individuals in the Kansas City area. Take control of your legacy with a revocable living trust package — your key to a seamless, flexible, and protected estate.