How Else Can Nursing Homes Be Impacted by COVID-19?

Lack of funding is a big issue for nursing homes.“You layer COVID on top of that and… it’s a crisis on top of a crisis,” David Grabowski, a professor of health care policy at Harvard Medical School, told Yahoo Finance. “And that you started with a lot of nursing homes that didn’t have adequate staffing models, weren’t exactly strong at infection control, lacked resources in many, many regards, and then this hits, it’s definitely the industry.”

Yahoo Finance’s recent article entitled “U.S. nursing homes face ‘a crisis on top of a crisis’ with coronavirus and funding woes” explains that the nursing home industry has been facing a financial shortfall since at least 2013, particularly for non-Medicare margins, according to the American Health Care Association (AHCA). Non-Medicare margins are the revenues and costs associated with Medicaid and private payers for all lines of business. They dropped 3% in 2018, an increase from the year prior.

“Over 60% of people in the country that live in nursing facilities are dependent upon Medicaid,” AHCA President and CEO Mark Parkinson told Yahoo Finance. “And unfortunately, in most states, the Medicaid rates have been set at less than the actual cost to take care of the residents. So, it makes it very difficult to provide the kind of care that providers want when they’re underfunded so dramatically.”

In addition, Parkinson commented, “most of the people don’t understand that Medicaid is really a middle-class benefit, because if people live long enough to outlive their resources, it’s the only way that they can afford to be taken care of in a facility.”

Medicaid is a federal benefits program that gives health coverage to seniors, pregnant women, children, people with disabilities and eligible low-income adults. However, the federal government permits states to level the payment amounts long as they meet federal requirements.

“The failure to adequately fund Medicaid is primarily a problem with the states,” Parkinson said. “Each state gets to make its own decision on what its reimbursement will be for Medicaid. Although the national average is around $200 a day, the rate varies dramatically by states, and some states are as low as less than $150 a day. In the low funding states, like Illinois and Texas, the politicians just haven’t decided it’s an important enough priority to adequately fund it.”

According to the New York Times, COVID-19 has infected more than 282,000 people at about 12,000 facilities as of June 26. It has killed more than 54,000. There are roughly 15,600 nursing homes in the U.S., with more than 1.3 million residents and over 1.6 million staff.

“It’s important to note that COVID hasn’t discriminated, so it’s not just those worst-quality nursing homes that have seen cases,” Grabowski said. “It’s been equally apparent across the high quality and low-quality facilities, high Medicaid and low Medicaid facilities. We’ve found that it’s really about where you’re located that has driven these cases.”

Adding to the financial situation is the fact that testing for coronavirus in the thousands of nursing homes across the country can be very expensive. The AHCA and National Center for Assisted Living (NCAL) found that testing every U.S. nursing home resident and staff member just once, would cost $440 million. As the pandemic continues, more supplies are also needed. A recent NCAL survey found that many assisted living communities are running low on PPE (N95 masks, surgical face masks, face shields, gowns, and gloves).

Parkinson says, it’s a “failure to recognize the importance of the elderly. It’s a conscious political decision to underfund elder care,” he said. “It’s not defensible on any level, but it’s occurring in the vast majority of states.”

He went on to say that with more funding, nursing homes can be better prepared for the next health crisis.

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Reference: Yahoo Finance (June 30, 2020) “U.S. nursing homes face ‘a crisis on top of a crisis’ with coronavirus and funding woes”

‘Siegfried & Roy’ Star Roy Horn Named Siegfried His Executor

Legal documents revealed that performer Roy Horn’s last will and testament was filed in the Las Vegas courts on June 18, 2020, according to the article “’Siegfried & Roy’ Star Roy Horn’s Will Names Siegfried As Executor Of His Multi-Million Dollar Estate” as reported in The Blast. The document gave Siegfried Fischbacher the power to administer and distribute Horn’s assets after his death. If Siegfried was not able to perform the tasks, Roy Horn had named Lynette G. Chappell as the alternate executor.

Lynette G. Chappell was the performer’s longtime assistant.

Roy Horn died at age 75 after contracting COVID-19. Siegfried had told an interviewer that he drove to the hospital with Lynette and was able to see his life partner one more time before he died.

Roy Horn also named Siegfried’s longtime lawyer, John Moran Jr., to be co-executor of his estate with Chappell, if Siegfried was unable or unwilling to be his executor.

The will, which was signed in 2016, also included directions that Roy Horn’s multi-million estate be distributed to beneficiaries, which were named in a private trust. The trust was not attached to the legal filing that included the last will and testament, so the names of his beneficiaries will remain private. The will does state that Roy Horn is unmarried and has no children. He was survived only by his brother, Werner Horn.

Siegfried was given broad powers to manage all of the financial issues of the estate, including paying for the funeral and any expenses regarding handling Horn’s remains. As the executor, the personal representative is empowered to perform any act necessary to administer the estate and any trust established under the will. The will also permits Siegfried to hold, retain, invest, sell or manage any real or personal property, distribute assets of the estate without requiring pro-rata distribution of specific assets, employ attorneys, accountants, custodians, and any other agents or assistants as the executor deems necessary and to pay them and pay for their expenses from income or principal.

According to reports, Siegfried and Roy had a combined estimated net worth of more than $100 million, after they had signed several highly lucrative contracts to perform their award-winning show on the Las Vegas Strip.

The duo performed on the Las Vegas Strip for decades, until 2003, when their show abruptly ended when Roy was attacked on stage by a white tiger. He was dragged off the stage by the tiger and suffered severe injuries, including a severed spine, a stroke and massive blood loss.

Siegfried revealed in a recent interview with a German publication that Roy Horn had been cremated and his ashes are being kept in a chapel in their Las Vegas compound.

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Reference: The Blast (June 27, 2020) “’Siegfried & Roy’ Star Roy Horn’s Will Names Siegfried As Executor Of His Multi-Million Dollar Estate”

Scammers Beef Up Efforts in a Crisis

As if the elderly didn’t have enough to endure, now comes word that scammers who typically prey on seniors are upping their game. Stating that Social Security offices around the country are closed, which is true, scammers are targeting seniors with letters threatening the suspension of their Social Security payments due to pandemic-related office closures.

It’s true that the offices across the country are closed, but Social Security employees are continuing to work, says the My Prime Time News article “Inspector General Warns Public About New Social Security Benefit Suspension Scam.”

What’s more, the Inspector General notes that the Social Security Administration (SSA) will not suspend or discontinue benefits because their offices are closed. The Inspector General has received reports that beneficiaries are receiving letters that advise them to call a phone number referenced in the letter.

Scammers then talk the callers into providing them with personal information or make arrangements for the seniors to send them retail gift cards, wire transfers, internet currency or even sending cash by mail. Otherwise, they tell the seniors that their benefits will be cut off until the office reopens.

Any communication that is received with that message, by mail, phone or email, is fraudulent and should be dismissed. Social Security will never:

  • Threaten with benefit suspension, arrest or legal action, if a fine or fee is not paid,
  • Promise a benefit increase or other help in return for direct payment,
  • Request or even accept payment by retail gift card, wire transfer, internet currency or prepaid debt card,
  • Demand secrecy about payments, or
  • Send letters or reports with personally identifiable information through the U.S. Mail.

Anyone who receives a letter, text, call or email that concerns an alleged problem with a Social Security number should not respond. The challenge is that the communications sometimes include a person’s Social Security number, or contains names, addresses or other information that is accurate. This is because scammers have purchased information illegally, not because the information is legitimate. Anyone receiving any communication from Social Security that demands immediate attention or threatens the end of benefits, should not respond directly to that communication.

Instead, report the scam to the Social Security Administration through its website. If you have any doubt about the validity of the letter or email, speak with a trusted friend, family member, or estate planning attorney. Don’t fall for it—especially during these tense times.

Reference: My Prime Time News (March 28, 2020) “Inspector General Warns Public About New Social Security Benefit Suspension Scam”

C19 UPDATE: Tax Filing Deadline Extended to July 15

There has been some confusion about the tax filing / tax payment deadline extensions. On Friday, March 20 we got clarity that both the filing and the payment deadlines have been extended from April 15 to July 15 giving all taxpayers and businesses additional time to file and make payments without interest or penalties.

If you are expecting a refund, however, the Treasury Department encourages you go ahead and file as soon as possible – the sooner you file, the sooner you will get your refund.

We will be updating you on Covid 19 related news as it comes in. If you are interested in more information, we have several blogs about C19 updates here.

Resource: Tax filing deadline moved to July 15, the latest measure to battle coronavirus downturn, The Washington Post, March 30, 2020