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Guildnet Closes Its Doors

On August 21, 2018, Guildnet CEO, Alan R. Morse, notified employees that the company will be closing its doors as of December 1, 2018, leaving New Yorkers in need of managed long-term care (MLTC) services at a disadvantage. The Guildnet program was designed to offer therapeutic/medical care, home healthcare services, case management, and medical equipment to those who qualify and will be in need of the provided services for a minimum of 120 days. Guildnet announced that by January 1st of 2019, all medical services to their 8,211 managed long-term care members will be terminated. United Healthcare, who until recently offered a partial MLTC plan, will also be pulling out of several counties in up-state New York by February of 2019, affecting nearly 1,500 enrollees who are said to be notified of these changes by November.

Guildnet’s managed long-term care members will be given a 90-day grace period to enroll in a new plan. Members who fail to switch care programs before the deadline will be automatically assigned to a care plan.  After enrolling in a new plan, Guildnet members will be able to switch their plan within 120 days should their new plan be deemed insufficient. The new care plan must honor the same service plan that the former Guildnet member received in the past and allow members to be seen by the same providers unless otherwise agreed to. The new care plan must perform a comprehensive care evaluation.

The void left by Guildnet and other MLTC providers leaving can bring about uncertainty about the continuity of home care services. If you or a loved one has been affected by the closing of Guildnet or the disruption of service from another MLTC association, it is imperative that you contact an experienced New York Medicaid and elder law attorney, who can guide you through the process. The attorneys at Hobson-Williams, P.C. are dedicated to representing clients with diligence and compassion. For an initial consultation, contact the New York Medicaid attorneys at Hobson-Williams, P.C. by calling 866-825-1LAW.

 

Nursing Home Concerns: Identifying Elder Abuse

Many wonder about the overall safety and well-being of their loved ones after admittance to a long-term care facility. This puts added pressure on the family should the facility be found insufficient. To better understand the risk factors involved with assisted living and nursing facilities, the care experts at HelpGuide.org have categorized elder abuse in the following ways:

  • Sexual Abuse;
  • Physical Abuse;
  • Financial Exploitation;
  • Elder Neglect; and
  • Emotional Abuse.

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Importance of Advanced Directives

As the seasons begin to turn, it is important to stress the need to have your advanced directives in place. Advanced directives include:

  • A health care proxy;
  • Health Insurance Portability and Accountability Act (HIPAA) release form;
  • A living will; and
  • Power of attorney.

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Fair Hearings – Medicaid

Applying for Medicaid or any other government benefits can be challenging. If an application for Medicaid or other government benefits is denied, it is important to understand that you have the right to appeal the denial to the State in an administrative proceeding called a Fair Hearing. (NOTE_- You must also request an internal appeal of an adverse decision with your healthcare provider in addition to requesting a NYS Fair Hearing)
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Ensuring Maximum Hours with MLTC Evaluations

Individuals receiving home care services through a Managed Long Term Care (MLTC) company may find that the agency did not award their family member or loved one with a sufficient amount of hours of home care services after they’ve conducted an evaluation.

The evaluation process by an MLTC can be complex. A person approved for Medicaid Home Care services will eventually have to enroll with an MLTC. The MLTC provider will send an evaluator to assess the recipient’s condition in order to create a care plan that will suit the individual’s daily needs. The evaluator will determine the number of hours per day that the recipient is entitled to receive to assist with their personal care needs. Continue reading “Ensuring Maximum Hours with MLTC Evaluations”

Expect to Pay More for Home Health and Assisted Living Costs

According to the most recent data from the U.S. Census Bureau, there were 2,797,589 people in New York who were aged 65 and over in 2016 which is 14.6% of the state’s population. Compare that number to 2015, when 2,724,135 seniors lived in New York State (14.3% of the population), and 2014 (2,655,913 people ages 65 and over, 14.0% of the population). Continue reading “Expect to Pay More for Home Health and Assisted Living Costs”

Revocable Living Trust

A revocable living trust allows assets within the trust as well as income generated by those assets to be managed and distributed by the trustee. The trust income and property are then distributed in accordance with the terms and conditions of the trust. This type of trust is referred to as a living trust because it is established during the life of the creator.

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Health Care Proxies and Power of Attorney

A Health Care Proxy is a document that designates an agent to make health care decisions on an individual’s behalf in the event that he or she is unable to do so. Federal regulations, such as the Health Insurance Portability and Accountability Act (HIPAA), protect the confidentiality of an individual’s medical information as well as their ability to make health care decisions. The establishment of a Health Care Proxy and the HIPAA release form are the best means of carrying out health care decisions on behalf of loved ones.
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Tracking down a Retirement Account

Many individuals have worked for different companies throughout the years and may have had a 401(k) plan worth a small amount of money when they left.  Some people lose track of these accounts over the years or find that their plan was transferred to another administrator. Sometimes, in such a case, the administrator may not be able to locate the plan.  Unfortunately, there is no central repository for missing 401(k) funds to date.

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Nursing Home Contracts

Before a senior gets admitted to a nursing home, he or she will need to sign a contract or other admission’s agreement. A contract is a legally binding document that defines the conditions under which the senior is admitted. It is important for seniors and caregivers alike to review and understand the contract in its entirety to ensure optimal care, protection and provisions. Some of the most important terms of a nursing home contract define the circumstances under which a resident can be admitted, transferred or discharged and how they will pay for the services provided.

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