Planning for Life

Brookline Nursing Home Subject to 93A Claim

Posted by Harry S. Margolis on April 24, 2018

By Harry S. Margolis

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The U.S. District Court for Boston has ruled that the estate of a deceased resident of the Brookline Health Care Center (BHCC) can pursue its claim that the facility violated the Consumer Protection Act, often referred to by its statutory reference, 93A.

Sarah Theresa Libby died after choking at BHCC on May 7, 2014. This occurred "when she was left unsupervised to eat in the dayroom of the nursing home in which she resided." Mrs. Libby's estate brought suit for wrongful death in Estate of Sarah Theresa Libby v. Park Marion and Vernon Streets Operating Company (U.S. Dist. Ct. Boston, C.A. No. 17-10843-JGD) for negligence and violation of the Consumer Protection Act. The 93A claim carries with it the threat of treble damages and the facility being responsible for the plaintiff's legal fees.

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Topics: assisted living, nursing homes

Reminder: There is No Such Thing as a Medicare "Improvement" Standard

Posted by Anthony Bushu on March 8, 2017

By Harry S. Margolis

hospital-discharge-protections-medicare-legal-guide.pngFor decades Medicare, skilled nursing facilities and visiting nurse associations have applied the so-called "improvement" standard in determining whether residents were entitled to Medicare coverage of the care. The standard, which can be found nowhere in Medicare law, only permitted coverage if the skilled treatment was deemed to contribute to improving the patient's condition, which can be difficult to achieve for many ill seniors.

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Topics: Medicare, nursing homes

MassHealth Seeking to Limit Use of Pooled Trusts

Posted by Anthony Bushu on January 11, 2017

By Harry S. Margolis

MassHealth has proposed massive changes to its regulations governing long-term care, both in the community and in nursing homes. Many of these are complicated, but could adversely affect many seniors in the state. One that's not so complicated is a proposal to limit transfers to pooled disability trusts.

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Topics: MassHealth, nursing homes, long-term care planning

US Agency Strengthens Protections for Nursing Home Residents

Posted by Elizabeth Stepakoff on October 28, 2016

By Rebecca J. Benson

The Center for Medicare and Medicaid Services (CMS) has announced its first comprehensiveAgingWaiver-resized-600.jpg overhaul of nursing home rules in over 20 years. CMS first promulgated nursing home regulations in 1989 and 1991 to implement the landmark Nursing Home Reform Law of 1987. CMS stated that the new regulations were necessary to reflect innovations in resident care and quality assessment practices, and to address the fact that the population of long-term care facilities has become more diverse and more clinically complex.

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Topics: long-term care planning, nursing homes

11 Nursing Homes to Avoid?

Posted by Harry S. Margolis on December 25, 2015

By Harry S. Margolis

The Boston Globe has reported on a New York father and son who have been buying up nursing homes in Massachusetts and then, apparently, cutting costs to such an extent that patient care has suffered. According to an article, "Owners profited as complaints grew." Larry Lipschutz owned a development in Belleville, New Jersey, Branch Brook Gardens, that he ran into the ground with about 1,400 code violations in a March 2004 inspection. His failure to respond to the violations ultimately led to his criminal conviction and fines.

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Topics: nursing homes

Trust Reformation Causes MassHealth Penalty

Posted by Harry S. Margolis on November 3, 2015

By Harry S. Margolis

The Massachusetts Court of Appeals in Needham v. Director of the Office of Medicaid (Mass. App. Ct. 14-P-182, October 20, 2015) rules that the reformation of a trust causes a period of ineligibility for MassHealth coverage of nursing home care.

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Topics: trusts, long-term care planning, nursing homes, MassHealth

How Much Does MassHealth Pay Nursing Homes?

Posted by Harry S. Margolis on January 20, 2015

By Harry S. Margolis

Families of nursing home residents often want to know what MassHealth is paying for the care of their loved ones. This can be difficult to determine because the rates are different for each facility and for each patient, depending on his or her level of care. But it's important because MassHealth often has a right to recover its expenses at the death of the nursing home resident in the form of a claim for estate recovery against a home, as the beneficiary of an annuity, or under the terms of a (d)(4)(A) or (d)(4)(C) trust.It helps to know what to expect.

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Topics: MassHealth, nursing homes, long-term care planning

Why is Long-Term Care Planning So Complicated?

Posted by Harry S. Margolis on December 23, 2014

By Harry S. Margolis

I've been thinking about why long-term care planning is so complicated. The reason is that the future can take so many paths, from no need for care to a long-term nursing home placement, with one or more stops in between. The difficulty of predicting how we will fare is compounded when considering planning for a couple rather than for a single individual.

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Topics: long-term care planning, nursing homes

New Study Reports Decreased Nursing Home Risk

Posted by Harry S. Margolis on December 16, 2014

By Harry S. Margolis

The Boston College Center for Retirement Research has released the results of a new analysis which reports a higher than previously-reported likelihood that Americans over age 65 will need long-term care, but a lower likelihood that they will spend a long time in a nursing home. The study, Long-Term Care: How Big a Risk?, compares recent data to a 1999 report and finds that:

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Topics: nursing homes

Health Care Agents Cannot Bind Nursing Home Residents to Arbitration

Posted by Rebecca J Benson on September 9, 2014

The Massachusetts Appeals Court has ruled that an agent named in a health care proxy lacks authority to agree to arbitration on behalf of a nursing home resident in a wrongful death case. Barrow v. Dartmouth Nursing Home (Mass App. Court No. 13P-1375, August 18, 2014). The Court noted that the Supreme Judicial Court had recently defined the standards for authorizing arbitration agreements and distinguished them from other forms of agency authority, including those governing health care proxies and the signing of ordinary nursing home admission agreements. Johnson v. Kindred Health Care (Mass., No. SJC-11335, Jan. 13, 2014); and Licata v. GGNSC Malden Dexter LLC (Mass., No. SJC-11336, Jan 13, 2014) (Click here to learn more about the agreements).

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Topics: nursing homes, Estate Planning, long-term care planning

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