Nursing Home Costs Rise Sharply in 2017

The median cost of a private nursing home room in the United States has increased to $97,455 a year, up 5.5 percent from 2016, according to Genworth's 2017 Cost of Care survey, which the insurer conducts annually. Genworth reports that the median cost of a semi-private room in a nursing home is $85,775, up 4.44 percent from 2016. The rise in prices is much larger than the 1.24 percent and 2.27 percent gains, respectively, in 2016.

The price rise was slightly less for assisted living facilities, where the median rate rose 3.36 percent, to $3,750 a month. The national median rate for the services of a home health aide was $22 an hour, up from $20 in 2016, and the cost of adult day care, which provides support services in a protective setting during part of the day, rose from $68 to $70 a day.

Alaska continues to be the costliest state for nursing home care, with the median annual cost of a private nursing home room totaling $292,000. Oklahoma again was found to be the most affordable state, with a median annual cost of a private room of $63,510.

The 2017 survey was based on responses from more than 15,000 nursing homes, assisted living facilities, adult day health facilities and home care providers. The survey was conducted by phone during May and June of 2017.

As the survey indicates, nursing home care is growing ever more expensive. Contact your elder law attorney to learn how you can protect some or all of your family's assets.

How to Reverse Medicare Surcharges When Your Income Changes

What happens if you are a high-income Medicare beneficiary who is paying a surcharge on your premiums and then your income changes? If your circumstances change, you can reverse those surcharges.

Higher-income Medicare beneficiaries (individuals who earn more than $85,000) pay higher Part B and prescription drug benefit premiums than lower-income Medicare beneficiaries. The extra amount the beneficiary owes increases as the beneficiary's income increases. The Social Security Administration uses income reported two years ago to determine a beneficiary's premiums. So the income reported on a beneficiary's 2015 tax return is used to determine whether the beneficiary must pay a higher monthly premium in 2017.

A lot can happen in two years. If your income decreases significantly due to certain circumstances, you can request that the Social Security Administration recalculate your benefits. For example, if you earned $90,000 in 2015 but your income dropped to $50,000 in 2016, you can request an income review and your premium surcharges for 2017 could be eliminated. Income is calculated by taking a beneficiary's adjusted gross income and adding back in some normally excluded income, such as tax-exempt interest, U.S. savings bond interest used to pay tuition, and certain income from foreign sources.

You can request a review of your income if any of the following circumstances occurred:

• You married, divorced, or became widowed
• You or your spouse stopped working or reduced your work hours
• You or your spouse lost income-producing property because of a disaster or other event beyond your control
• You or your spouse experienced a scheduled cessation, termination, or reorganization of an employer's pension plan
• You or your spouse received a settlement from an employer or former employer because of the employer's closure, bankruptcy, or reorganization

If your income changes due to any of the above reasons, you can submit documentation verifying the change in income -- including tax documents, letter from employer, or death certificate -- to the Social Security Administration. If the change is approved, it will be retroactive to January of the year you made the request.

Florida Nursing Home Tragedy Causes Rethinking of Disaster Preparedness

The recent tragedy in which 12 Florida nursing home residents died when the facility lost power during Hurricane Irma is causing government officials to rethink disaster planning.

In response to the deaths, Florida Governor Rick Scott announced a new emergency rule, requiring nursing homes and assisted living facilities in the state to have generators capable of maintaining comfortable temperatures for four days after a loss of power. Fire marshals must inspect the generators within 15 days after installation. The rule goes into effect immediately and lasts 90 days, after which it needs to be renewed. Florida already required nursing homes to ensure power, food, water, staffing, and 72 hours of supplies. The governor hopes to make the emergency rule a permanent part of Florida law.

The incident is also shining light on a new federal rule that is scheduled to take effect in November. The rule, enacted in response to 215 people dying in hospitals and nursing homes in Louisiana following Hurricane Katrina, requires that nursing homes have an alternative source of energy to maintain temperatures. However, the rule does not specify that the nursing home must have a generator or the ability to power air conditioning. It also provides no funding to nursing homes to assist in purchasing the type of generator required to power an air conditioning unit.

Officials at the Hollywood, Florida, nursing home where the recent deaths occurred – which is across the street from a hospital that was fully functioning at the time -- is facing serious consequences. To start, the facility has lost its Medicaid funding and its license to operate has been suspended. In addition, the Hollywood police department has opened a criminal investigation into the deaths that could lead to manslaughter charges. Lawsuits by patients' families have already begun. The nursing home had a two-star rating (out of five) from the Centers for Medicare & Medicaid Services, based on the fact that the state had cited it for 11 health deficiencies in its most recent inspection.

If you have a loved one in a nursing home or assisted living facility, or you are trying to choose a facility, you may want to ask to see the institution's emergency management plan, especially if the area is a vulnerable one like Florida, according to The New York Times. You may also want to ask whether the plan includes a backup generator to power the air conditioning system. Many facilities do not even have air conditioning anywhere except common areas, however. No doubt, given recent events, you will not be alone in inquiring about emergency preparedness.

It remains to be seen what lessons can be learned from the Florida tragedy.  According to a Kaiser Health News investigation, nursing homes have been caught unprepared for far more mundane emergencies than hurricanes and rarely face serious consequences for their lapses.

Using a Prepaid Funeral Contract to Spend Down Assets for Medicaid

No one wants to think about his or her death, but a little preparation in the form of a prepaid funeral contract can be useful. In addition to helping your family after your death, a prepaid funeral contract can be a good way to spend down assets in order to qualify for Medicaid.

A prepaid or pre-need funeral contract allows you to purchase funeral goods and services before you die. The contract can be entered into with a funeral home or cemetery. Prepaid funeral contracts can include payments for: embalming and restoration, room for the funeral service, casket, vault or grave liner, cremation, transportation, permits, headstones, death certificates, and obituaries, among other things.

One benefit of a prepaid funeral contract is that you are paying now for a service that may increase in price—possibly saving your family money. You are also saving your family from having to make arrangements after you die, which can be difficult and time-consuming. And, if you are planning on applying for Medicaid, a prepaid funeral contract can be a way to spend down your assets.

Medicaid applicants must spend down their available assets until they reach the qualifying level (usually around $2,000, depending on the state). By purchasing a prepaid funeral contract, you can turn available assets into an exempt asset that won't affect your eligibility. In order for a prepaid funeral contract to be exempt from Medicaid asset rules, the contract must be irrevocable. That means you can't change it or cancel it once it is signed.

Before purchasing a contract, you should shop around and compare prices to make sure it is the right contract for you. Buyers need to be careful that they are buying from a reputable company and need to ask for a price list to make sure they are not overpaying.