Tuesday, October 25, 2016
New Federal Regulations on Medi-Cal and Nursing Homes by Kevin Staker
Revised Federal Regulations on Medi-Cal and Nursing Homes
The Centers for Medicare & Medicaid Services ("CMS"), part of the United States Department of Health and Human Services has issued a final rule on long term care facilities.
This rule revises the requirements that Long-Term Care facilities must meet to participate in the Medicare and Medicaid programs. These changes reflect the substantial advances that have been made over the past several years in the theory and practice of service delivery and safety. These revisions are also an integral part of their our efforts to broadly improve both the quality of health care furnished through federal
programs, and patient safety. However, they also attempt to reduce the procedural burdens on long term care providers.
One important rule is a prohibition of arbitration clauses in pre-admission agreements.
These regulations are effective on November 28, 2016. They revise 42 Code of Federal Regulations Parts 405, 431, 447, 482, 483, 485, 488, and 489.
By Kevin Staker
Tuesday, October 4, 2016
2016 Medi-Cal Amounts by Kevin Staker
2016 Medi-Cal Amounts for Long Term Care by Kevin Staker
The Community Spouse Resource Allowance ("CSRA") for 2016, the amount at home spouse can have in countable assets is $119,220 in assets.
The maximum amount of income the at home spouse is guaranteed to receive is $2,981. This amount is called the Minimum Monthly Maintenance Needs Allowance ("MMMNA"). The MMMNA can be increased by going to Court and requesting additional support for the at home spouse from the income of the ill spouse.
For 2016 the Average Private Pay Rate ("APPR") for nursing homes for 2016 is $8,189. The APPR is used in calculating the term of ineligibility if an individual gives non-exempt assets to other individuals.
By Kevin Staker
The Community Spouse Resource Allowance ("CSRA") for 2016, the amount at home spouse can have in countable assets is $119,220 in assets.
The maximum amount of income the at home spouse is guaranteed to receive is $2,981. This amount is called the Minimum Monthly Maintenance Needs Allowance ("MMMNA"). The MMMNA can be increased by going to Court and requesting additional support for the at home spouse from the income of the ill spouse.
For 2016 the Average Private Pay Rate ("APPR") for nursing homes for 2016 is $8,189. The APPR is used in calculating the term of ineligibility if an individual gives non-exempt assets to other individuals.
By Kevin Staker
Monday, October 3, 2016
Medi-Cal Recovery Only Against Probate Estate for Long Term Care Costs by Kevin Staker
Medi-Cal Recovery Only Against Probate Estate for Long Term Care Costs by Kevin Staker
We have had some time now to digest the 2016 California State Budget Act and its limitations on recovery by the California Department of Health Care Services ("DHCS") arising out of services from Medi-Cal.
The key point that surfaces is that DHCS can only recover against a probate estate. Futher, tt can only recover for nursing home facility and long term care services provided after age 55 or any age if the person was “permanently institutionalized”.
Hence, a living trust of a decedent avoids recovery. This is another clear advantage of living trusts for estate planning.
Joint tenancies will also escape recovery; but they can be very crude in their disposal on assets. Especially because a co-tenants creditors can go after their share of the asset. A living trust avoids that.
Please note these changes are effective for individuals who die on or after January 1, 2017..
For an explanation further in depth, go to the site of the California Advocates for Nursing Home Reform at http://www.canhr.org/factsheets/medi-cal_fs/html/fs_medcal_recovery_FAQ.htm.
By Kevin Staker
We have had some time now to digest the 2016 California State Budget Act and its limitations on recovery by the California Department of Health Care Services ("DHCS") arising out of services from Medi-Cal.
The key point that surfaces is that DHCS can only recover against a probate estate. Futher, tt can only recover for nursing home facility and long term care services provided after age 55 or any age if the person was “permanently institutionalized”.
Hence, a living trust of a decedent avoids recovery. This is another clear advantage of living trusts for estate planning.
Joint tenancies will also escape recovery; but they can be very crude in their disposal on assets. Especially because a co-tenants creditors can go after their share of the asset. A living trust avoids that.
Please note these changes are effective for individuals who die on or after January 1, 2017..
For an explanation further in depth, go to the site of the California Advocates for Nursing Home Reform at http://www.canhr.org/factsheets/medi-cal_fs/html/fs_medcal_recovery_FAQ.htm.
By Kevin Staker
Tuesday, July 5, 2016
Medi-Cal Recovery for Nursing Home Costs Limited by 2016 California State Budget Act (by Kevin Staker)
New Limits on Medi-Cal Recovery for Long Term Care
The 2016 California State Budget Act incorporates the limitations on recovery by the California Department of Health Care Services ("DHCS") arising out of services from Medi-Cal. The changes were originally proposed in Senate Bill 33.
The changes include:
The changes will dramatically decrease the effort needed to escape recovery for Medi-Cal expenses for long term care in a nursing home.
By Kevin Staker
The 2016 California State Budget Act incorporates the limitations on recovery by the California Department of Health Care Services ("DHCS") arising out of services from Medi-Cal. The changes were originally proposed in Senate Bill 33.
The changes include:
- No recovery against the estate of a surviving spouse;
- Recovery limited to the federal law requirements, in other words, only for nursing home facility and long term care services provided after age 55 or any age if the person was “permanently institutionalized”;
- No recovery against homes of modest value;
- Recover only against a probate estate, and so living trusts and joint tenancies will escape recovery; and
- A limit on the interest on Medi-Cal liens.
The changes will dramatically decrease the effort needed to escape recovery for Medi-Cal expenses for long term care in a nursing home.
By Kevin Staker
Monday, March 7, 2016
Staggered Gifting by Kevin Staker
"Staggered gifting" is still allowed under California Medi-Cal law. This state of the law allows an individual to give assets to family member or friends and not cause a period of ineligibility for Medi-Cal to pay for long term care in a nursing home.
The key is the "average private pay rate" in a nursing home in California. Divided the gift by the APPR and that gives you the period Presently one rounds down. Hence a gift of under the APPR in 2015 of under $8,092 causes a fraction under one. Rounded down gets us to zero. Hence, no period of ineligibility under California law.
The APPR for 2016 should come out in late March 2016. Go to canhr.org to discover it. Found at http://www.canhr.org/factsheets/medi-cal_fs/html/fs_medcal_limits.htm
By Kevin Staker
The key is the "average private pay rate" in a nursing home in California. Divided the gift by the APPR and that gives you the period Presently one rounds down. Hence a gift of under the APPR in 2015 of under $8,092 causes a fraction under one. Rounded down gets us to zero. Hence, no period of ineligibility under California law.
The APPR for 2016 should come out in late March 2016. Go to canhr.org to discover it. Found at http://www.canhr.org/factsheets/medi-cal_fs/html/fs_medcal_limits.htm
By Kevin Staker
Saturday, January 16, 2016
Kevin Staker Elected President of Ventura County Legal Aid, Inc. for 2016
Ventura, California
Kevin Staker, a living trust and estate planning attorney with StakerLaw Tax and Estate Planning Law Corporation in Camarillo, California, has been elected President by the Board of Directors of Ventura County Legal Aid, Inc. ("VCLA") for 2016. VCLA dedicates its work to assist lower income individuals in Ventura County, California, with legal issues they cannot otherwise afford to pay for.
VCLA provides services two ways: first, VCLA finds an attorney to work pro bono to handle the case of an individual, second at its legal clinic at the Ventura County Law Library from 4 pm to 7 pm on the first and third Tuesdays of each month.
VCLA is the public service affiliate of the Ventura County Bar Association. Charmaine Buehner, President of the Ventura County Bar made the following nice comments about Kevin Staker's appointment:
Source: http://www.vcba.org/2015/12/presidents-column-the-butterfly-effect-by-charmaine-h-buehner/
Kevin Staker, a living trust and estate planning attorney with StakerLaw Tax and Estate Planning Law Corporation in Camarillo, California, has been elected President by the Board of Directors of Ventura County Legal Aid, Inc. ("VCLA") for 2016. VCLA dedicates its work to assist lower income individuals in Ventura County, California, with legal issues they cannot otherwise afford to pay for.
VCLA provides services two ways: first, VCLA finds an attorney to work pro bono to handle the case of an individual, second at its legal clinic at the Ventura County Law Library from 4 pm to 7 pm on the first and third Tuesdays of each month.
VCLA is the public service affiliate of the Ventura County Bar Association. Charmaine Buehner, President of the Ventura County Bar made the following nice comments about Kevin Staker's appointment:
Camarillo-based tax-and-estate planning attorney Kevin Staker has
graciously agreed, after unanimous vote of the board, to serve as the
president of Ventura County Legal Aid in 2016. Together with the VCLA
Board and Emeritus attorneys, Kevin will continue the important work of
Legal Aid’s direct representation program. Second, Legal Aid will see
the launch of a new free legal clinic in Ventura at the County Law
Library beginning on Feb. 2, continuing on the first and third Tuesday of the month from 4 to 7 p.m. Check out our plans for the clinic, sign up to volunteer or donate at www.vclegalaid.org, or contact me or the co-chair of the clinic committee, Mark Kirwin.
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