ElderLaw News — The Estate Planning & Elder Law Firm, P.C. — MD, VA, DC
ElderLaw News

ElderLaw News is a weekly e-newsletter that brings you reports of legal developments and other trends of vital interest to seniors and their advocates. This newsletter is brought to you by The Estate Planning & Elder Law Firm, P.C., William S. Fralin, Esq., President.

Hospice v. Skilled Nursing Facility

No one wants to be faced with the choice at the end of life, either for themselves or their loved ones, of choosing between hospice care or care in a skilled nursing facility (S.N.F.) and sometimes referred to as the ‘sniff’ benefit. (Paula Span, “Forced to Choose: Exploring Other Options,” NY Times, Dec. 3, 2012)

But that is what is happening right now to most Medicare recipients. Medicare will only cover both services if the patient has both a terminal condition and another illness occurring concurrently, for example, when a patient with Alzheimer’s also breaks a leg. According to the Journal of American Geriatrics Society, in a 2006 study it was found that of 4,300 patients with advanced dementia who were receiving care in a S.N.F., only one fourth were also receiving hospice care. (NY Times, Dec. 3, 2012)

So given the option of one service or the other, most choose S.N.F. coverage. As with most things, no choice is perfect. What they miss about hospice care is the tender loving care which is provided by social workers, nurses, and other health aides. Also, those in a S.N.F. received very aggressive care which included the use of feeding tubes, injections, and in some cases, physical therapy, even when the patient was bedridden. In many cases, this aggressive care was inappropriate for someone in the final stage of life.

Hopefully, in the future, families will not face this either/or proposition. As part of the Affordable Care Act, there will be a demonstration project allowing for ‘concurrent care’. The project will last for 3 years and will allow those in the project to receive both hospice and S.N.F. at the same time. 15 hospice programs across the United States will be permitted to enroll patients. The project will then be evaluated to analyze the pros and cons of patients receiving both services. Perhaps there will even be a cost savings as a result. We won’t know for sure until the project is carried out. The only glitch is the law didn’t set a specific date for the project to be undertaken. Stay tuned. We hope to have good news in the future. (All information taken from the NYT article cited in paragraph 1)

In the meantime, The Estate Planning & Elder Law Firm can help you with the Long-Term Care Planning for your loved ones. The Estate Planning & Elder Law Firm has specialists which can help you maximize your access to the benefits you qualify for and to which you are entitled.


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The Estate Planning & Elder Law Firm, P.C.

The Estate Planning & Elder Law Firm, P.C. is an elder law firm. We represent older persons, disabled persons, their families, and their advocates. The practice of elder law includes estate planning, estate and trust administration, powers of attorney, advance medical directives, titling of assets and designations of beneficiaries, guardianships, conservatorships, and public entitlements such as Medicaid, Medicare, Social Security, and SSI, disability planning, income tax planning and preparation, care management, and fiduciary services. For more information about The Estate Planning & Elder Law Firm, P.C., please visit our website at http://www.chroniccareadvocacy.com.

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