Recently, I had a family come in to see me.  Dad was in the nursing home.  Up until just a week before the meeting, Dad had been on skilled care and thus, Medicare was paying for his stay in the skilled nursing facility.  However, Dad had “plateaued” and now the family was on private pay.

Mom is elderly and overwhelmed.  We tried to discuss what needs to occur.  I was able to show her a plan where the property would be divided between Mom and Dad, and then “spending down” Dad’s share to acquire an income stream for Mom so that she would have money for a more adequate lifestyle.  Dad would then immediately become eligible for Medicaid, Mom would not be out any out-of-pocket money, and Mom’s monthly income would go up.  Mom decided that she would wait.  Please understand that the decision to wait is going to cost her $5,000 per month: that is the cost of one month of nursing home care in the facility where her husband located.  Every month that she delays in making a decision, is $5,000 that she can no longer use as an income stream.

What I suspect is going to happen is that she is going to wait until she has almost spent all of the money, come back to see me and then there will be very little that we can do other than to preserve what is left at that time.

 When it comes to long term care, deciding to do nothing is taking the wrong kind of action.

Proposing a change and then implementing that change are two entirely different things. Implementing a change and it passing the muster of both federal and state law is yet another barrier.
I anticipate that there are going to be changes in reimbursement rates to doctors, hospitals and other medical providers. We will also probably also see some reduction in the reimbursement rate for home healthcare and nursing home care.

It will be interesting to see just how long those receiving the reduced benefits can operate in such an economic condition.

I am a strong believer in home healthcare. If the reductions in reimbursement rates shut down the ability to receive home healthcare, such a procedure is counterproductive. Clearly, keeping someone in their home is less expensive than putting them in a nursing home.

Stay tuned for more reports.

Many attorneys that do not specialize in elder law do not understand what Medicaid is or how it works.  According to my client, an attorney told him that this is what he needed to do.

Clearly, I would have been able to protect all of the assets for this family; he would not have had to sell his farm equipment, his personal belongings or his home.

The story is still out on how this is going to work out for this family.  We are scrambling to try to undo what has been done, but it is going to be a challenge.

Please, I urge you – do not try to take action on your own!  Medicaid is very tricky.  You can only rely on a qualified elder law attorney to give you good, solid advice.  Try to find one that is a member of the National Academy of Elder Law Attorneys (NAELA) and even the Kansas Chapter of the National Academy of Elder Law Attorneys.  Find one who has done hundreds of Medicaid cases versus someone who just dabbles.  Ask around.  Please do not sell your home or your property until you talk to someone who can give you good advice.

As I began my search for a new building, it was very important to me that I find something that our elderly and disabled clients could easily get to, that they could park their cars and easily walk into the office.  I needed to be sure that it had good parking and that it was accessible to those who might have difficulty with mobility.  At the same time, I needed to keep in mind that many families who come to us may be located out of state.  The ability to provide communication with them through telephone, internet, telephone or video conferencing was very important.

For over a year, I looked.  I finally discovered an office building at 2604 General Hays Road.  Not only does it have great parking, it is also very accessible.  The building that we will be using doubles our floor space.  Our care coordinators will have their own offices and it will go from one conference room to three.  This is important because many times, our delay in being able to see families was occasioned by this lack of an available conference room.  We will now have three conference rooms and each care coordinator will have an office space in which to meet with the families.

The unusual twist to the location is that it is where I first started practicing when I started my own firm in 1985.  At that time, I had about 20% of the building.  To say it was deja vu when I first walked back into the office to view it as a possible location is an understatement.

It has been fun watching the new office being reconstructed to fit our needs.  New windows were installed throughout and new heating and air conditioning is being put in.  Each office will have not only telephone connections, but also internet and high speed computer setups.  The staff will have more privacy as will our families that come to us.

Working out the logistics of the move has been a challenge for my staff but they have all stepped up to the plate.  Our goal is to move into our office with as little down time and as little interruption to our families as possible.

As I write this blog, our goal is to move in between Christmas and New Years and be operational after the first of the year.  I know that there will be some glitches but that is okay.

I hope that you will stop by the new office at 2604 General Hays Road after the first of the year and see the new offices of Clinkscales Elder Law Practice.

I am Randy Clinkscales and the founder of Clinkscales Elder Law Practice, P.A. I have been practicing for many years at a general practice representing families in various matters. Like most of us, circumstances change the course of our lives. In taking care of my grandmother, I discovered that there was a real need for someone to focus on issues facing the elderly and disabled. As a result, in 2005, I focused my practice on elderly and disability law. It did not take long before I began retooling the entire office. I brought in staff members to focus on specific areas. We have a staff member dedicated solely to various benefit planning, such as Medicare and Medicaid. I also brought in a person whose primary focus is Veterans pension benefits. I also discovered that there was a real need for someone to help my clients achieve one of their principal goals – to stay in their home as long as possible or if they needed to move into assisted living or a nursing home, someone who can be sure that they are getting good care. As a result, I brought in someone who has a lot of experience in healthcare – our care coordinators (we now have three) who are assigned to each family that we are helping with a Life Care Plan.

I have been in my current office at 201 W. 11th Street, Hays, Kansas, since 1987. In 1987, my wife and I bought the office and we painted, remodeled, put down new woodwork, installed new carpet and have called it home for almost 30 years. Now, our staff and our practice has outgrown our office so we are going to be moving to 2604 General Hays Road, Hays, Kansas. In the next blog, we will talk about the move.

Many attorneys that do not specialize in elder law do not understand what Medicaid is or how it works.  According to my client, an attorney told him that this is what he needed to do.

Clearly, I would have been able to protect all of the assets for this family; he would not have had to sell his farm equipment, his personal belongings or his home.

The story is still out on how this is going to work out for this family.  We are scrambling to try to undo what has been done, but it is going to be a challenge.

Please, I urge you – do not try to take action on your own!  Medicaid is very tricky.  You can only rely on a qualified elder law attorney to give you good, solid advice.  Try to find one that is a member of the National Academy of Elder Law Attorneys (NAELA) and even the Kansas Chapter of the National Academy of Elder Law Attorneys.  Find one who has done hundreds of Medicaid cases versus someone who just dabbles.  Ask around.  Please do not sell your home or your property until you talk to someone who can give you good advice.

]]> http://clinkscaleslaw.com/lorem-ipsum6/feed/ 0