New Quality Measures from CMS

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The Centers for Medicare & Medicaid Services this week added new quality measures to its websites that allow patients to compare data on long-term care and inpatient rehabilitation facilities. The updates center on vaccination and infection rates. Long-Term Care Hospital Compare and Inpatient Rehabilition Facility Compare both now offer data on the percentage of employees at these facilities who were vaccinated for the flu, and will offer infection rates for two dangerous hospital-acquired infections: methicillin-resistant Staphylococcus aureus and Clostridium difficile. Some of the country’s most touted healthcare systems fail to prevent potentially-deadly C. diff infections, according to a recent analysis. C. diff infections can increase patient length of stay by more than 55% and may increase the cost of…

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Nursing Homes Are Pushing Out Poor and Disabled Patients

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Complaints are rising in California and other states about improper evictions and discharges. Advocates say some patients end up in cheap hotels, homeless, or back in the hospital. Kaiser Health News By Jocelyn Wiener/California Healthline Anita Willis says the social worker offered her a painful choice: She could either leave the San Jose, Calif., nursing home where she’d spent a month recovering from a stroke—or come up with $336 a day to stay on. She had until midnight to decide. Willis’ Medicaid managed-care plan had told the home that it was cutting off payment because she no longer qualified for…

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Why Big Medicare and Medicaid Cuts Are Likely

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Tax reform will lead to ‘entitlement reform,’ this expert says By Bob Blancato Elder AdvocateDecember 12, 2017 Part of the Transforming Life as We Age Special Report The tax reform bill will almost undoubtedly cause significant harm to Medicare. And provocative statements by President Trump and House Speaker Paul Ryan declaring that “entitlement reform” will be next threatens Medicaid. Put these two together and, I think, one thing is clear: big Medicare and Medicaid cuts are coming. “We’re going to have to get back next year at entitlement reform, which is how you tackle the debt and the deficit, Ryan…

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Key Elder Law Numbers for 2018: Our Annual Roundup

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Medicaid Spousal Impoverishment Figures for 2018 The new minimum community spouse resource allowance (CSRA) is $24,720 and the maximum CSRA is $123,600. The maximum monthly maintenance needs allowance is $3,090. The minimum monthly maintenance needs allowance remains $2,030 ($2,536.25 for Alaska and $2,333.75 for Hawaii) until July 1, 2018. Medicaid Home Equity Limits Minimum: $572,000 Maximum: $858,000 For CMS’s complete chart of the 2018 SSI and Spousal Impoverishment Standards, click here. Income Cap The income cap for 2018 applicable in “income cap” states is $2,250 a month. Gift and estate tax figures Federal estate tax exemption: $11.18 million (estimate) for…

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Retirement Savings Program for Lower-Income Earners Is Ending

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The Trump administration is ending an Obama program that was designed to be a starter retirement savings account for low- and middle-income workers. The Trump administration’s Treasury Department determined that the program, known as myRA, was not cost effective. Similar to a Roth IRA, the myRA accounts allowed workers to invest money after tax and withdraw the money in retirement tax-free. Unlike a Roth IRA, however, the savings were backed up by U.S. Treasury bonds, so investors would never lose their principal investments. The accounts were available to married couples with modified adjusted gross incomes up to $191,000 and to…

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Be Aware of the Kiddie Tax Before Leaving an IRA to Children

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Grandparents may be tempted to leave an IRA to a grandchild because children have a low tax rate, but the “kiddie tax” could make doing this less beneficial. An IRA can be a great gift for a grandchild. A young person who inherits an IRA has to take minimum distributions, but because the distributions are based on the beneficiary’s life expectancy, grandchildren’s distributions will be small and allow the IRA to continue to grow. In addition, children are taxed at a lower rate than adults—usually 10 percent. However, the lower tax rate does not apply to all unearned income. Enacted to prevent…

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HUD Makes Reverse Mortgages a Little Less Attractive

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The Department of Housing and Urban Development (HUD) has announced changes to the federal reverse mortgage program. Citing the need to put the program on better financial footing, HUD will raise reverse mortgage fees for some borrowers and lower the amount homeowners can borrow. A reverse mortgage allows a homeowner who is at least 62 years old to use the equity in his or her home to obtain a loan that does not have to be repaid until the homeowner moves, sells, or dies. In a reverse mortgage, the homeowner receives a sum of money from the lender, usually a bank,…

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Social Security Beneficiaries Will Receive a 2 Percent Increase in 2018

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In 2018, Social Security recipients will get their largest cost of living increase in benefits since 2012, but the additional income will likely be largely eaten up by higher Medicare Part B premiums. Cost of living increases are tied to the consumer price index, and an upturn in inflation rates and gas prices means recipients get a small boost in 2018, amounting to $27 a month for the typical retiree. The 2 percent increase is higher than last year’s .3 percent rise and the lack of any increase at all in 2016. The cost of living change also affects the maximum amount of…

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What Can We Do About Our Parents’ Credit Card Debts?

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Q: My wife and I have just become agents under a power of attorney for her parents. They are both in their late sixties, and her mother has just been diagnosed with terminal cancer. We moved them into a retirement home so her mother can get the extra help she needs. After gaining access to their finances, we’ve discovered that her father has accumulated over $100,000 in credit card debt spread among several cards. We purchased their home, and they recently sold some land that was in a trust. Her mother just transferred to my wife a 25 percent interest…

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Use Your Will to Dictate How to Pay Your Debts

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The main purpose of a will is to direct where your assets will go after you die, but it can also be used to instruct your heirs how to pay your debts. While generally heirs cannot inherit debt, debt can reduce what they receive. Spelling out how debt should be paid can help your heirs. If someone dies with outstanding debt, the executor is responsible for making sure those debts are paid. This may require selling assets that you would like to leave to specific heirs. There are two types of debts you might leave behind: Secured debt is debt…

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