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How to Create a Long-Term Care Plan, for New York Residents

Posted on July 3, 2023

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As elder law practitioners, we are aware that nothing is less pleasant than contemplating a day when you may be too disabled to make decisions for yourself. Yet putting together a formal plan now, while everything is going well, comes with a variety of benefits. Speak with an experienced Long Island elder law attorney before making significant decisions. 

At Schlessel Law, PLLC, our attorneys are dedicated to providing compassionate and comprehensive legal guidance to elders and their families. Whether you need assistance with estate planning, Medicaid retroactive coverage, or guardianship matters, our team is here to guide you every step of the way. Give us a call at (516) 574-9630 to schedule a consultation and start planning for your future today.

Over half of the elderly population will eventually require paid long-term care.

Here’s everything you need to know about putting together a long-term care plan.

The Benefits of a Long-Term Care Plan

A plan helps you communicate your wishes and needs to your loved ones.

If your spouse is healthy, then putting a plan in place can help your spouse maintain control if you prefer that to giving your adult children control.

This also gives you the opportunity to pre-vet care facilities and services. You can provide your loved ones with a list of care providers you trust so they can choose from your list of pre-approved caregivers when the time comes.

Long-Term Care Options for Long Island Residents

Long-term care plan attorney in New York

The first option is a nursing home. Nursing homes are rarely an ideal option. They’re the most expensive and often generate the worst outcomes. 

On average Long Island nursing homes cost between $96,360 per year and $142,350 per year. Any good plan will account for the number of years you might need care. The average for nursing homes is 2.5 years.

In-home care tends to be the preferred option. This could include bringing in the help of a professional caregiver or using a service like adult day care to lift some of the burden from family members and friends who are serving as caregivers. The average cost of this care is $23,400 for an in-home caregiver and $19,500 for an adult day care. Seniors using this form of care typically need it for three to five years. Note this only covers care costs, not the costs of housing, food, or utilities.

Medicaid will cover all three types of care, but there are strict income limits associated with relying on Medicaid alone. A Medicare lawyer can help you protect as many of your assets as possible if you need to rely on Medicare. 

Having an informal caregiver such as a friend or family member is an option, but it is often one that takes an extensive financial and physical toll on the caregiver. It is rarely an ideal option. 

Long-Term Care Option Description
Nursing Home Expensive option with potential for poor outcomes.
In-Home Care Preferred option, including professional caregiver or adult day care services.
Informal Caregiver Option involving a friend or family member, but can be financially and physically demanding for the caregiver.

Planning for Nursing Home

Long-term care options in New York, including nursing homes, assisted living facilities, and home health care, can place a significant financial burden on individuals.The annual cost of nursing home care in New York is higher than $150,000 on average. Unfortunately, private health insurance policies and Medicare typically do not cover long-term care, and only a small percentage of individuals invest in private long-term care insurance.

For New Yorkers in need of long-term care, Medicaid is the primary source of funding. Over 70% of nursing home residents in New York depend on Medicaid to cover their care expenses. Seniors aged 65 or older, individuals with disabilities, and those who are blind may be eligible for Medicaid coverage for nursing home stays if they meet certain income and asset criteria and require skilled nursing care. It’s important to note that New York’s Medicaid regulations mandate nursing home residents to contribute nearly all of their monthly income towards the cost of their care, allowing only a particular amount per month for personal expenses.

If you are considering long-term care in a nursing home, the staff will gather your health information and assess your health condition to develop a personalized care plan. If you have the ability, you or your family, with your consent, or a designated representative, have the right to actively engage in care planning with the nursing home staff. The fundamental care plan includes the following components: 

  • Health assessment: Comprehensive review of your health condition conducted upon admission and must be completed within 14 days.
  • Subsequent health assessments: Health assessments must be conducted at least every 90 days following the initial review, and more frequently if your medical status changes.
  • Ongoing assessments: Regular evaluations of your health status to identify any changes, with corresponding adjustments to your care plan as necessary.

Nursing homes are obligated to report this information to the federal government, which is then utilized for quality assessments, nursing home payment evaluations, and state inspections. Depending on your specific needs, your care plan may include the following:

  • Personal and healthcare services required.
  • Appropriate staff members responsible for providing these services.
  • Frequency of service provision.
  • Necessary equipment or supplies, such as wheelchairs or feeding tubes.
  • Dietary requirements, including any special diets and preferences.
  • How the care plan will aid in achieving your goals.
  • Information regarding the possibility of returning to the community, along with a plan to support that objective.

Actively participating in the care planning process can help you ensure that your individual needs and preferences are considered, leading to a more effective and personalized care experience during your nursing home stay. At Schlessel Law, PLLC, our Long Island elder law attorneys can guide you through the care planning process, offering legal guidance advocating for your rights. Schedule a consultation with us to provide compassionate and knowledgeable legal representation for all your elder law needs.

Long-term Care Payment Options in New York

When planning for long-term care, payment is an important consideration. Long-term care planning can be daunting,  so it is recommended to consult an experienced New York elder lawyer before you start the process. Here are some of the common long-term care payment options:

Medicare

Medicare pays for skilled services or rehabilitation care in a nursing home for a maximum period of 100 days, and other skilled in-home health services. However, Medicare won’t pay for non-skilled help with daily living activities, which make up the majority of long-term care services. These expenses must be paid out-of-pocket if they aren’t covered by any private or public insurance.

Medicaid 

Medicaid is available for long-term services. But eligibility is determined based on one’s income. A recipient must also meet the state’s eligibility requirements. These eligibility requirements include the amount of ADL (Activities of Daily Living) assistance the person requires

Other federal programs

Other federal programs, such as those administered through the Department of Veterans Affairs (Older Americans Act), will cover long-term care services. However, these programs are only available for certain populations and conditions.

Private health insurance

Most private plans do not offer long-term health coverage. Even those that do tend to cover areas similar to Medicare.

Additional private payment options

In addition to the payment options described above, you have other options including reverse mortgages and life insurance options to pay for long-term care.

The information provided above provides a basic overview of the long-term care planning and payment process. It is recommended that you consult with an experienced New York elder law lawyer to determine which option is best for your needs. An experienced New York elder attorney can provide you with legal guidance about long-term care that is tailored to your specific circumstances. Contact Schlessel PLLC today to schedule a consultation.

What should be included in your Long Island long-term care plan?

While you should discuss your individual plan with your attorney, plans could include:

  • Your will
  • A living trust
  • Medical power of attorney
  • Durable power of attorney
  • Long-term care insurance
  • Life insurance
  • Gathered assets

You should also designate a personal care coordinator. This can be a trusted family member or adult child who will get copies of all of your documents as well as a list of your personal financial resources. 

You’ll also need to assemble your team. This should ideally include:

  • A professional care manager
  • A long-term care and financial planning specialist
  • An elder law attorney. 

If you are ready to start your planning, contact our offices today at (516) 574-9630. We can help ensure that your final years are lived out in dignity, and in accordance with your wishes.

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