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Elder Law Blog

Wednesday, April 8, 2020

Coronavirus Spreading in Nursing Homes

Large outbreaks of the Covid-19 virus have occurred among residents and staff at Texas long-term care facilities in San Antonio, Lubbock, Texas City, La Porte, and other cities.  State regulators have asked facilities to report coronavirus cases, and to inform residents and their families of cases within the facility.  While state government is collecting this data, it has failed to publicly release the numbers of cases and names of facilities where coronavirus has been reported. 



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Wednesday, March 18, 2020

Covid-19: Expanded Medicare Telehealth Services


Telehealth & related services

Medicare has temporarily expanded its coverage of telehealth services to respond to the current Public Health Emergency. These services expand the current telehealth covered services, to help you have access from more places (including your home), with a wider range of communication tools (including smartphones), to interact with a range of providers (such as doctors, nurse practitioners, clinical psychologists, and licensed clinical social worker). During this time, you will be able to receive a specific set of services through telehealth including evaluation and management visits (common office visits), mental health counseling and preventive health screenings.


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Tuesday, February 4, 2020

The Long-Term Care Path from Medicare to Medicaid


Although Congress enacted Medicaid in the 1960s to provide health care coverage for the poor, Medicaid has become the primary pay source for nursing home and long-term care for the vulnerable elderly population.  The majority of nursing home residents, or 80%, are age 65 or older and 62% of residents are covered by Medicaid, which is available to beneficiaries with limited income and assets. 

Medicare – the national health insurance program for seniors and the disabled who work a sufficient number of quarters and pay Social Security and Medicare taxes – covers nearly 60 million people, mostly seniors, however Medicare provides very limited coverage of long-term nursing home care, just 100 days of rehabilitation in a facility after a 3-day hospital stay.  This and other Medicare coverage gaps, premiums, and copayments help explain why Medicare beneficiaries spend a larger share of income on health care costs than non-Medicare beneficiaries, according to the Kaiser Family Foundation.  Few can afford long-term care insurance or the annual cost of nursing home care, which was $82 thousand in 2016, more than three times the annual income of most seniors, according to KFF.


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Friday, January 10, 2020

New Retirement Account Rules for the New Year


Happy 2020!  Major changes to the federal retirement account rules were signed into law December 20, 2019, under the SECURE Act (Setting Every Community Up for Retirement Enhancement Act).  Under the new rules, a retirement account can no longer be "stretched" and must be distributed within 10 years to non-spouse beneficiaries.  This will increase the taxes that beneficiaries pay on the funds.  An exception was provided for disabled beneficiaries, thanks to the advocacy work of the National Academy of Elder Law Attorneys (NAELA). 

Fortunately, most retirement accounts continue to be excluded as a resource in long-term care Medicaid.


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Monday, September 23, 2019

Medicare Enrollment: Public Option vs. Private Insurance

The annual Medicare Open Enrollment Period is October 15 – December 7.  Here are some things you can do during the annual enrollment period

  • Join a Medicare Prescription Drug Plan [1] or switch from one Medicare drug plan to another Medicare drug plan.
  • Change from a Medicare Advantage Plan [2] back to Original Medicare [3].
  •  Join a Medicare Advantage Plan or change to another Medicare Advantage Plan.

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Wednesday, July 17, 2019

List of Poor-Performing Nursing Homes

The Centers for Medicare and Medicaid Services (CMS) has released a list of under-performing nursing homes, including over thirty facilities in Texas. 


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Wednesday, January 2, 2019

New Year's Greetings

The Stone Law Firm wishes you a healthy, prosperous, and happy 2019!  We greatly appreciate the opportunity to provide elders and special needs individuals in the community with legal services.  In 2019, we look forward to assisting clients with navigating complex Medicaid long-term care programs and other public benefits, and with estate planning to maximize independence and protect assets for the benefit of clients and their families.  Our blog will also focus on key issues in improving dementia care, quality of care, and therapy services in long-term care nursing facilities.  Happy New Year to all!


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Wednesday, November 28, 2018

You Can Disenroll from a Medicare Plan January-March, 2019


Medicare Advantage plans, offered by private insurance companies as an alternative to the traditional Medicare program, are improperly denying many medical claims, according to a New York Times article.   Based on a new report by the U.S. Dept. of Health and Human Services, the "plans, which now cover more than 20 million people - more than one-third of Medicare beneficiaries - have an incentive to deny claims 'in an attempt to increase their profits.


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Tuesday, August 28, 2018

Changes to Statutory Durable Power of Attorney


The Texas Legislature has approved major changes to the Statutory Durable Power of Attorney (SDPOA) - the form that allows you to appoint an agent to act for you in certain financial matters - making it imperative to review and consider updating your power of attorney.  Legislators expanded the instrument to include important new powers - including "hot powers" - which may be granted to your agent and may be especially useful for Medicaid Planning, Estate Planning, and Tax Planning purposes.  New agent duties and responsibilities were also added.

The so-called "hot powers" include authorities which may be essential in elder law situations:  for example, the authority to create a trust, to change a beneficiary designation, to create a right of survivorship, and to transfer property to the agent. 


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Monday, May 14, 2018

Nursing Home Rules Revised

The federal rules for nursing homes that participate in Medicare and Medicaid have been comprehensively revised, affecting requirements for admission contracts, care planning, resident rights, quality of care, transfer and discharge procedures, protections against abuse neglect, and exploitation, and other aspects of facility life.  Attorney Nancy Stone has co-authored a comprehensive article about the changes, which was published in the spring issue of the National Academy of Elder Law Attorneys (NAELA) Journal.  To go to our web page and read the article, click here.


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Wednesday, November 29, 2017

Tax Bill Cuts Medicare, Repeals ACA, Threatens Social Security and Medicaid


Senate leaders are working to ram through a tax bill this week which will greatly increase deficits, triggering $25 billion in Medicare cuts and leading to major cuts in Social Security and Medicaid to pay for the deficit.  The bill would chiefly benefit the highest earners while hurting the middle class, according to the Congressional Budget Office, the Joint Committee on Taxation, and other experts. In addition, the bill would repeal the Affordable Care Act's individual mandate to purchase health insurance, leading to higher health insurance premiums and making access to health care unaffordable for as many as 13 million. 


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Attorney Nancy Stone assists clients with Elder Law, Medicaid Planning, and Estate Planning throughout Harris County, TX. I am now based in Sugar Land and serve all of Houston, Harris County, Bellaire, Jersey Village, Cypress, West University, The Heights, Pearland, Alvin, Sugar Land, Missouri City, Kingwood, Humble, The Woodlands, Spring, Tomball, Richmond, Rosenberg Pasadena, Baytown, La Porte, Clear Lake, Texas City, Katy, Friendswood, Stafford, as well as Fort Bend County, Brazoria County, Montgomery County, Galveston County, Liberty County, Chambers County, Waller County and throughout Southeast TX.



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2245 Texas Drive, Suite 300, Sugar Land, TX 77479
| Phone: 713.434.6310 | 281.566.2500

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