A good estate plan doesn’t end with the signing of your documents. there are many post-signing tasks that need to be completed and are often overlooked. Mr. Di Costanzo will share valuable tidbits that are necessary to complete your estate planning.

Thursday, August 27th, 2020, I continued discussing Governor Cuomo’s State Budget implementing a new 2 1/2 year look-back period for Medicaid home care services. As discussed in my blog, this is a drastic change for those seeking Medicaid eligibility to cover the cost of an aide at home. It also presents an immediate planning opportunity that should not be dismissed!

Sal discusses Governor Cuomo’s State Budget implementing a new 2 1/2 year look-back period for Medicaid home care services.

As discussed in my blog, this is a drastic change for those seeking Medicaid eligibility to cover the cost of an aide at home. It also presents an immediate planning opportunity that should not be dismissed!

Raising the minimum wage by as little as 10 percent would significantly improve the safety and health of nursing home residents, according to new research.

Most direct care in nursing homes is provided by nursing assistants, who make up about 40 percent of the nursing home workforce and are among the lowest-paid workers in the U.S. economy. Nursing assistants help residents with activities of daily living like eating, bathing and dressing, and and work with certified nurses and elder care teams to monitor patients’ conditions.

Due in part of their low wages, nursing assistants frequently change jobs for better pay or working conditions.  “Between 60 percent and 85 percent of nursing assistants leave their employers each year, most often to go work in other nursing homes,” writes Krista Ruffini, a visiting scholar at the Minneapolis Federal Reserve. Nursing homes frequently report difficulty in recruiting and retaining staff, she says.

Ruffini recently looked at the impact increasing the minimum wage has on nursing home staff turnover and quality.  She compared facilities in hundreds of U.S. counties that had increased their minimum wage with those that hadn’t between 1990 to 2017.

In findings based on her preliminary data published in a working paper, Ruffini found that “increasing the minimum wage by 10 percent would reduce the number of health inspection violations by 1 percent to 2 percent, the number of residents with moderate to severe pressure ulcers [bed sores] by about 1.7 percent, and the number of deaths by 3 percent.”  The 3 percent reduction in deaths, she notes, translates to 15,000 fewer deaths in nursing homes each year.

Ruffini found that raising the minimum wage reduced turnover and increased tenure among nursing assistants.  This greater continuity of care, she says, translated into improved health and safety conditions for the patients.  At the same time, nursing home profits held steady because the extra costs were passed on in the form of higher fees.

Ruffini notes that her findings have particular relevance in a time when the coronavirus pandemic is overwhelming nursing homes.  Comparing a facility’s number of COVID-19 deaths with its quality-of-care performance, she concluded: “The data provide some suggestive evidence that higher service quality is associated with fewer deaths from COVID-19 in nursing homes.”

For Ruffini’s paper, click here.  For an article she wrote about her findings, click here.

For a New York Times article on Ruffini’s research and another minimum wage study, click here.

 

With the coronavirus pandemic responsible for more than a hundred thousand deaths and disrupting life across the United States, the only way for the country to return to normal is an effective vaccine. When a vaccine is available, Medicare will cover the cost. 

Medicare covers vaccines in a variety of ways, depending on the vaccine.  It may be through Medicare Part B, Medicare Part D, or a Medicare Advantage plan if you are enrolled in one. Part B covers vaccines only for certain illnesses: flu, pneumonia, and Hepatitis B (if you are at medium or high risk). Medicare covers 100 percent of the cost of these vaccines if you go to an approved provider, and you do not have to pay a deductible or coinsurance. Medicare Advantage is also required to provide these vaccines at no additional costs. 

Part B also covers vaccines if you are exposed to a dangerous virus or disease, such as rabies or tetanus. In those cases, you will have to pay a deductible and a 20 percent coinsurance. 

Part D covers all other doctor-recommended vaccines, such as the shingles vaccine and the Tdap (tetanus, diphtheria, pertussis) vaccine. How much the vaccine costs will depend on whether you go to a provider who is in-network for your Part D plan. If you get the vaccine in-network, you will have to pay the co-pay amount. If you get the vaccine out-of-network, you may have to pay for the entire vaccine and bill Medicare. Medicare will only pay for the approved cost, which may be less than what you paid. If you have a Medicare Advantage plan that covers prescription drugs, it may cover these vaccines. The cost to you will vary, depending on the plan.  

With regard to COVID-19, the CARES Act provides that if a vaccine becomes available, Medicare is required to cover this vaccine under Part B with no cost sharing. Medicare Advantage plans are required to include the basic coverage offered by Medicare Parts A and B, so this coverage also applies to beneficiaries in Medicare Advantage plans. 

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The information presented at this site should not be construed to be formal legal advice nor the formation of an attorney/client relationship.

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