More and more of us are living longer, and we need a Long-Term care solution more than ever.

"About half of all senior citizens will need to spend about $138,000 for personal care over two years"

Yet, for one in seven, five years of care becomes necessary, and the cost "is far beyond the ability to pay.” This according to Howard Gleckman of the Urban Institute. And that five-year cost can exceed $250,000.

Now a nonpartisan group, the Long-Term Care Financing Collaborative, has called for a push for a new national universal policy for just that – Long Term Care for Seniors. The Urban Institute is a part of that Collaborative.

With a goal of getting employers to automatically enroll their employees in long-term care insurance policies at work, with employees paying regularly toward insurance from each paycheck, businesses would get insurance companies to offer long-term care insurance again after fleeing the market during the last few years, and getting people to enroll in more affordable insurance than has been offered previously.

Many Americans do not realize that Medicare and other health insurance plans will not cover long term care such as bathing, dressing and other help seniors often end up needing as they become frail or suffer debilitating diseases like Alzheimer's later in life. Referred to as ADL’s or "Activities of Daily Living", this is care that seniors and their families can be left with, often becoming a crushing financial burden.

The group emphasized that family responsibility will continue, but the collaborative wishes to lessen the burden. The Urban Institute has estimated that services delivered by family members total about $470 million each year.

"A woman in her 50s who leaves a job to care for aging parents loses an average of $300,000 in lifetime income," the collaborative reported. "Unpaid family caregivers lose an estimated $3 trillion in lost lifetime wages and benefits," while employers suffer $17 billion to $33 billion in lost productivity and absenteeism.

According to the group's research, about half of all senior citizens will need to spend about $138,000 for personal care over two years. Yet, for one in seven, five years of care becomes necessary, and the cost "is far beyond the ability to pay," said Howard Gleckman of the Urban Institute. The five-year cost can exceed $250,000.

Senior care costs are rising

What about Medicaid and Long-Term Care?

It’s true, regular health insurance doesn’t cover Long-Term care, and neither does Medicare. The Medicare program covers only short nursing home stays or limited amounts of home health care when a senior requires skilled nursing or rehab. It does not pay for custodial care, which includes supervision and help with day-to-day tasks. So will Medicaid fill that gap? Not necessarily. You can get help through Medicaid, the federal and state health insurance program for low-income people, but only after you’ve exhausted most of your savings, depleting a retirement nest egg quickly. The median cost of care in a semiprivate nursing home room now tops $80,000 a year, according to Genworth’s 2015 Cost of Care Survey.

And if you have to rely on Medicaid, your choices will be limited to the nursing homes that accept payments from the government program. Medicaid does not pay for assisted living in many states.

And so it is easy to understand why groups such as the The Long-Term Care Financing Collaborative see such an urgent need to address this growing problem, a lack of adequate and affordable Long-Term Care insurance. What is seen as a failure of policy makers to reach agreement on viable solutions has pushed the issue to the forefront.

Today, 10-12 million adults require supports that help them maintain the best possible quality of life, supports and services such as non-medical assistance and help with food preparation, personal hygiene, assistive devices, transportation, as well as help with activities such as bathing and eating. And the number is expected to double by 2030.

What is the Long-Term Care Financing Collaborative?

The Collaborative brings together national experts and stakeholders who cross ideological divides in pursuit of a common goal: to improve the way Americans pay and prepare for the non-medical care needed by our frail elders and people living with disabilities to live with dignity and autonomy through consensus-based, concrete policy recommendations. – Convergencepolicy.org

For more about the groups efforts, and a list of the groups participants, you can follow this link to the Long-Term Care Financing Collaborative.

Long-Term Care for Seniors is a need that is growing fast. It's good news to see this kind of effort toward finding a long term solution.

Three People Accused in Massive Medicare Fraud in Florida

The U.S. Justice Department is calling it the largest criminal health care fraud case ever brought against individual suspects. The $1 Billion health care fraud took advantage of Medicare in Florida, agents said.

Three people are accused of a massive fraud involving a number of Miami-based health care providers. Many assisted living facilities may also have been part of the health care fraud.

The three facing charges are all from Florida's Miami-Dade County; they are Philip Esformes, 47, owner of more than 30 Miami-area nursing and assisted living facilities; hospital administrator Odette Barcha, 49; and physician assistant Arnaldo Carmouze, 56, according to the Justice Department .

"Medicare fraud has infected every facet of our health care system," U.S. Attorney Wifredo Ferrer said Friday while indictments against the three were announced.

Included in the indictments are accusations of leading "a complex and profitable health care fraud scheme that resulted in staggering losses, in excess of $1 billion," said Special Agent in Charge George L. Piro of the FBI's Miami field office.

Community Mental Health Centers and Home Health Care Providers Received Payments

Investigators say Esformes access to thousands of Medicare and Medicaid beneficiaries were instrumental to perpetrate the fraud. How this will affect the future of Florida Medicare remains to be seen.

It was also announced that money, in the form of kickbacks, were paid to Esformes and his co-conspirators in return for "steering beneficiaries to other health care providers including community mental health centers and home health care providers, who also performed medically unnecessary treatments that were billed to Medicare and Medicaid."

"Many of these beneficiaries did not qualify for skilled nursing home care or for placement in an assisted living facility. However Esformes and his co-conspirators nevertheless admitted them to Esformes Network facilities where the beneficiaries received medically unnecessary services that were billed to Medicare and Medicaid."

Charges of conspiracy, money laundering and health care fraud against Esformes and Barcha were also included in the announcement.

How will the new FLSA laws affect the cost of Assisted Living and Senior Care Homes? According to the official government website for the act, it will have an impact.

“Hospitals and other institutions “primarily engaged in the care of the sick, the aged, or the mentally ill” are covered employers under the FLSA (Fair Labor Standards Act).  Special rules (8 and 80 Overtime System) apply to the payment of overtime to employees of hospitals and residential care establishments, such as nursing facilities, skilled nursing facilities, assisted living facilities, residential care facilities, and intermediate care facilities for individuals with disabilities.” – United States Department of Labor, DOL website - italics ours

The overtime laws are sometimes referred to by employers and the DOL as - The “Eight and Eighty” (8 and 80) Overtime System. According to the government, many Assisted Living facilities will need to be certain to heed the updated law if they were not in the past, or face penalties.

The reality is many Assisted Living facilities will be paying more overtime to comply with the updated law. Others will try to increase staff working less than full time/overtime to try to keep costs down. Many times this can result in greater turn over of employees, thus another source of increased cost, as it can be expensive to train and integrate a new employee.

In the end, the monthly and yearly cost of Assisted Living and Senior Care Home living may very well go up. How much remains to be seen.

If you are concerned about this for existing seniors, or if you are starting to search for Senior Home living, the best thing you can do is use a source like Senior Home Search to find the homes and facilities operating in your area and to contact them directly to ask for information.

Senior Home Search is one of the leading Senior Home and Assisted Living websites that give you Direct Contact Information – not an “800” number to a sales person. Using our website you can get information such as:

  • Direct contact Phone Numbers to the homes.
  • Contact and Information forms that are delivered directly to the home owners.
  • Email addresses of the homes you see
  • Detailed information about the home including number of beds, services provided and amenities.
  • Photos of the home and its rooms
  • Maps and Directions directly to each home

These are just a few of the reasons why you should be using Senior Home Search to find how the new labor laws will affect the cost of Assisted Living near you.

 

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For Assisted Living and Senior Care Home operators, a good source of information is at the U.S. Department of Labor website. One page provides an FLSA Overtime Calculator Advisor section.

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