Elder Law

AARP Creates New COVID-19 Dashboard

As COVID-19 continues to spread among nursing home residents and staff, valuable and accurate data pinpointing areas of concern is often rife with haphazard data collection providing skewed information. The most recent Kaiser Family Foundation data analysis indicates that federal policymakers are slow in meaningful response to the nursing home coronavirus crisis. The increasing loss of life is often due to this inadequate federal and state response during this fall flu season. To better address the concerns, AARP has created a COVID-19 Dashboard that will standardize information collection and provide better data integrity. The 5-point plan aims to save lives by better protecting nursing home and long-term care facility residents at state and federal levels through more accurate data collection and its use in timely responsiveness.

  1. Ongoing testing and sufficient personal protective equipment (PPE) for residents and staff must be a priority. PPE must also be readily available for inspectors and any visitors.
  2. Create better transparency with a focus on the daily public reporting of COVID-19 cases and deaths in facilities. Improving communication with families about transfers and discharges and increase accountability for state and federal funding provided to facilities.
  3. Following federal and state guidelines for safety, ensure access to in-person visitation as well as the continuation of virtual visitation for all residents.
  4. Ensure residents’ quality care via adequate oversight, staffing, and access to in-person formal advocates known as long-term care Ombudsmen.
  5. Reject immunity as it relates to COVID-19 for long-term care facilities.

The AARP Nursing Home COVID-19 Dashboard is a collaboration between the AARP Public Policy Institute and the Scripps Gerontology Center at Miami University in Ohio. The dashboard is a four-week snapshot of the coronavirus infiltration into nursing homes and its impact on residents and staff. The goal is to promptly identify specific areas of concern at a state and national level.

A second dashboard will aggregate and analyze the self-reported data from nursing homes provided by the Centers for Medicare and Medicaid Services (CMS) that cover specific three 4-week time intervals from mid-summer into autumn. This dashboard will specifically gather five key measures from nursing homes: resident death per 100 residents, resident cases per 100 residents, staff cases per 100 residents, percentage of nursing homes without a one-week supply of PPE, and percentage of nursing homes with staffing shortages. There will also be an additional 33 data points providing more information about each category and updated every month. As tracking continues and trends present themselves, additional categories will evolve to follow other measures of interest.

The second dashboard already presents five key findings, including:

  1. Nursing home resident and staff COVID-19 deaths and cases had been on the decline at a national level during the summer. The 2020 flu season brings an uptick to cases, and coronavirus community spread continues to rise rapidly throughout most of the country, increasing vulnerability to nursing homes, staff, and residents.
  2. State trends vary dramatically. Many states with previously high death and infection rates in the summer are improved in the most recent weeks; however other states, particularly in the Midwest, see rapidly increasing rates of cases and deaths in nursing homes.
  3. The variation across states can be as high as about 1 out of every 52 nursing home residents to no resident deaths in the four weeks between September 21 to October 18. Nationally, the same reporting period reported an average death rate of one in every 215 residents.
  4. Direct care staff continues to have infections at a very high rate during this same period from September to October. While more than one-quarter (26 percent) of nursing home residents had confirmed COVID-19 cases, twice as many (53 percent) had confirmed staff cases. More than 90 percent of the nursing home staff tested positive for the coronavirus in the hardest-hit states.
  5. All states indicate nursing homes have a PPE shortage, which is defined as not having a one-week supply of surgical masks, N95 masks, gloves, gowns, and eye protection. In the best-performing state, only 5 percent of nursing homes reported a PPE shortage, while the lowest-performing state had 53 percent of nursing homes reporting a PPE shortage.

Reliable, timely data regarding nursing homes and COVID-19 can help facility operators and personnel gain a better understanding of the crisis facing nursing homes and other long-term care facilities. The federal government has begun to require nursing homes to self-report COVID-19 cases and deaths at the national level and ordering testing, providing PPE, issuing guidance for the re-instituting of in-person visits, and more. However, as cases and deaths continue to rise, AARP and other organizations will continue to accumulate data and shine a light on the tragedy befalling nursing home residents to make policy and lawmakers accountable to the crisis. AARP has a webpage providing more information for you or a loved one in a nursing home.

If you have questions about anything you have read or would like to speak to us about planning for you or a loved one, please don’t hesitate to reach out.Please contact our Reno office by calling us at (775) 853-5700.

Estate Planning

During COVID-19 Americans of All Ages Are Creating Their Wills

Understandably, the coronavirus pandemic has created the scramble to set up wills and end-of-life-directives. There has been an explosion in the numbers of Americans rushing to make their will online. However, online do it yourself (DIY) wills are often deemed invalid as they do not comply with all of the legal requirements of your state. According to Caring.com, the prevalence of will and estate planning has been on the decline since 2017 but this trend is quickly reversing itself with the advent of the coronavirus pandemic.

So, who needs a will? Ask yourself if you care who gets your property or money if you die? If you have minor children, do you care who will act as their legal guardian? The answer is anyone married, anyone with children or anyone with assets needs a properly executed will. Wills are governed by state law. Your will should reflect your wishes in the language and format required by the state in which you live for it to be valid.

Many law offices are turning to teleconference with their clients to address social distancing protocols while still providing legal services such as writing a will. Businesses like Zoom are experiencing a quadrupling of daily users. Part of this significant increase includes hosting secure attorney/client meetings for will preparations. The importance of an attorney guiding you through the process of creating a will cannot be understated as they understand the nuances of how things need to be written. Once your will is complete, it must be correctly notarized as mistakes made in the will-signing process can potentially invalidate your will.  Your attorney will guide you through the signing process, and could involve signing during a video conference.

Beyond the creation of a will, many Americans are increasingly concerned about their powers of attorneys, health care surrogates, living wills, and end of life directives. These “life documents,” as they are active while you are alive, are equally as important as your will. Named executors, successors, beneficiaries, power of attorneys should have several back-up representatives as the mortality rate due to the coronavirus remains unknown.

According to research in a recent New York Times report, health care workers are more likely to contract COVID 19 than the average person. During this pandemic, many doctors and other medical professionals are rushing to have their wills drawn up. In addition to doctors, anyone on the front lines in the fight against COVID 19, from hospital custodians to nurses to EMS responders, should either make a will or review and possibly update their existing one. However, the truth is no matter what your profession or likelihood of contracting this virus, you should have a properly executed will during this time of considerable uncertainty.

There are few things you can act on during the COVID 19 pandemic that can bring you assurance and a sense of relief. The legal creation of your will and life-directives is an action you can take that protects you and your family. We can help. If you have questions, please do not hesitate to contact our Reno office by calling us at (775) 853-5700 to schedule an appointment.

Healthcare

How Telehealth Services are Growing Coverage on Medicare

The Centers for Medicare & Medicaid Services (CMS) recently announced, in response to the COVID-19 outbreak, an increase of access to Medicare telehealth services. This means that Medicare beneficiaries can receive more benefits from their doctors without having to travel to a healthcare facility.

The terms “telehealth” and “telemedicine” refer to the ability to exchange medical information from one site to another through electronic communication to improve a patient’s health.  With the rapid rise of COVID-19 cases, there is the urgency to expand the use of technology to help people who need routine care. Telehealth will keep vulnerable beneficiaries and those with mild symptoms in their home, but with access to the care they need by phone and video rather than requiring an office visit.

Prior to this change, Medicare would only pay for telehealth on a limited basis, and only for persons in a designated rural area. Now Medicare beneficiaries will be able to receive the following services through telehealth: common office visits, mental health counseling, and preventive health screenings. This will help keep more of the at-risk population (Medicare beneficiaries) able to visit with a doctor from home, rather than traveling to a doctor’s office or hospital which puts the beneficiary and others at risk. Telehealth visits will be treated the same as regular, in-person visits and will be paid by Medicare at the same rates.

These changes go into effect for services starting March 6, 2020, and will continue for the duration of the COVID-19 Public Health Emergency. For more information, view the fact sheet prepared by CMS.

Better access to telehealth is a big step in getting Medicare beneficiaries appropriate care in the least restrictive way If you have questions, please do not hesitate to contact our Reno office by calling us at (775) 853-5700.