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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.

 

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”

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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Voluntary Administration Proceedings for Small Estates

When a parent dies without a Will and leaves behind money (example $10,000) in a sole checking account, a proceeding would be governed by the small estate process. Not all estates require a full probate or an administration proceeding. If the deceased passed away after January 1, 2009 and has $30,000 or less in personal property, they are entitled to a voluntary administration proceeding, which is a simplified Surrogate’s Court procedure.

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How Joint Accounts and Gifting Affect Medicaid Eligibility

As individuals begin to age, long-term care services and how to finance them become major concerns. Many turn to Medicaid to pay for their long-term care needs. Medicaid is a joint Federal and State funded program that provides medical insurance and long-term care payments on behalf of middle- to low-income individuals, including those who are elderly and disabled. However, since Medicaid eligibility is determined by the combined value of income and assets, gifting money and joint accounts may impede a person’s ability to secure Medicaid benefits.

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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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Nursing Home Discharges: Can You Appeal?

There are many reasons why elderly persons wind up in nursing homes, including voluntary admittance to obtain assistance with rehabilitation after a hospital stay or problematic behaviors associated with various mental conditions such as dementia. In order to afford nursing home costs, many of these adults rely on Medicaid and Medicare. A nursing home may choose to discharge a person for various reasons, including their coverage is running out or they feel the patient is ready for release.  However, if a resident is being discharged, the discharge can be challenged.

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Judge Decides Not to Dismiss Case Against Nursing Home

Eladia Ciprian, an 80-year-old patient at St. Barnabas Rehabilitation and Continuing Care Center, will not have her case dismissed for the center’s failure to correctly diagnose and treat a hematoma in her right bicep. A Bronx County Supreme Court judge decided not to dismiss the case after the center claimed she made no proof of the nursing home’s neglect or deprivation of her rights.
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Changes to the ABLE Act

The federal government passed the Achieving a Better Life Experience (ABLE) Act in December 2014. The ABLE Act allows the family of a disabled person to create a federal income-tax-free account to be used for the medical expenses of the disabled individual. This law was created under the same provisions of the tax code as 529 plans for college savings. According to Autism Speaks, the National Disability Institute estimates that there are 58 million individuals in the United States who have a qualified disability.

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Antibiotic Usage in Nursing Homes Linked to Serious Health Problems

According to the Center for Disease Control (CDC), up to 70% of nursing home residents are prescribed antibiotics during the course of any given year, ranging in cost between $38 million to $137 million per year. Recently, the Journal of American Medical Association (JAMA) released the results of a study that linked the high usage of antibiotics in nursing homes to many health problems such as gastroenteritis, clostridium difficile, and resistance to superbugs, drug-resistant germs.

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