The Congress returns from its winter break next week with the same issues confronting it when it left in December.

While the Congress and the White House agreed to a temporary, two month “fix” for physician payments, that fix will expire on February 29.

Meanwhile, the House and Senate have appointed Members to a conference committee to try to reconcile differing versions of a one year physician payment fix. The conferees have begun meeting, but little progress has been made so far.

The same programs, providers and stakeholders are at risk as Congress seeks to find 25 billion dollars or more in order to offset the increased payments to physicians.

The nursing home industry should continue to monitor the conference committee’s activities closely.

We will keep you posted on further developments.

As you may be enjoying sweet treats this week in honor of Valentine’s Day, the day we take time out of our busy schedules to celebrate the love we have for our significant others, it is also a good time to remember the spouses of our residents.

I know many of you have witnessed the emotional struggles of many spouses coming to the realization that they are no longer able to provide the level of care their beloved requires. We seek to do everything in our power to make this transition easy for them, however, navigating the labyrinth of Medicaid regulations affecting community spouses can cause additional stress.

In our continued effort to make a spouse’s transition easier, offer the following reminders:

1. Be sure to provide all resource information to the caseworker during the application process. A common denial of a Medicaid application is not due to the resident having excess resources, but instead a failure to provide necessary resource information.

2. You usually have a right to appeal the spousal resource assessment. In determining Medicaid eligibility, the caseworker will issue a form dictating the amount of resources the spouse is allowed to retain. When this assessment is filed with an application for benefits both the resident and spouse will usually have appeal rights.

3. There are community outreach programs to help with this transition. Many communities have support groups for caregivers and family members.

I still believe that love conquers all, and hope you do too! Happy Valentine’s Day!

Julie works out of our Canfield, OH office.

It’s that time of year again. It’s time to figure out what our resolutions are for 2012! Here at Schutjer Bogar, the number one resolution on our list every year is to provide the best Medicaid legal services to our clients.

In order to ensure the Medicaid process goes as smoothly as possible, the one resolution we ask our clients to make is to try and gather as much information as possible from the resident and/or the resident’s family at the time of admission. The time of admission is the best time to gather this information because it is when the resident is most likely to provide the details necessary to process the Medicaid application. Later, after the resident has resided at the facility for a while, oftentimes the family stops visiting, or the resident becomes incompetent; making it very difficult to even obtain the most basic information.

The information that should always be compiled at Admission includes the following:
1. A signed Admission Agreement
2. Any valid Power of Attorney documents
3. Contact information for all next of kin; including work, home and cell phone numbers
4. Resident ‘s date of birth and copy of birth certificate
5. Copies of any and all medical insurance cards
6. Marital status of resident, and information regarding divorce records
7. Information regarding social security benefits
8. Asset information; address of any real properties; and bank names and account numbers where accounts held; pensions, 401K information; life insurance information; burial trusts;

With this information in hand, the Medicaid application can basically be completed at the time it is initially made, making the entire process much easier for all.

Happy 2012!

Eva works out of our Mount Laurel, NJ office with Ivana Grujic, Penelope Jones and Laura Fabiano.

If there is a specific topic that you would like to learn more about, please post your ideas here. We are looking for ideas for blog posts and webinars for the upcoming year.

This is also a reminder that Brad is always available to visit your facility at no charge and conduct a Medicare Training/Refresher.

To submit your ideas or if you would like to schedule a free Medicaid training, contact Janet Wright at jwright@schutjerbogar.com

We look forward to hearing your ideas!

The entire staff of Schutjer Bogar would like to say Happy Holidays and have a wonderful New Year! We look forward to working with you in 2012!

The Harrisburg office recently held a cookie exchange to get us in the holiday spirit! Everyone that brought in cookies got to bring home a nice assortment of cookies and treats. Did your office do anything special for the holidays? Feel free to let us know!

Congress has yet to resolve paying for the “doctor fix” (SGR) and as a result, CMS sent notifications to physicians to hold back claims for 10 days in early January to allow Congress more time to resolve the issue.

 A one year fix would cost approximately 20 billion dollars, but the Senate passed a more modest two month extension that will be rejected by House Republicans today.

 Should Congress not resolve the SGR issue this week, physicians would see a 28 percent cut in Medicare payments – probably in late January or early February. 

 The Obama Administration is preparing its new budget for Fiscal Year 2013, which will be released in early February of 2012. 

 While no details have been leaked yet, expect that the Administration will resort to large budget savings measures, including cuts to Medicaid in some form – whether it be the elimination of provider taxes, a “blended rate” approach that was discussed with Republicans during the “Super Committee” process, or other cost cutting measures.

 Nursing home owners and operators should be ready to engage actively with Congress over the coming months as budget cutting is sure to continue.

Please stay tuned for more details.

The dawning of the New Year is good time to reflect on the year past, take stock of all that we have learned, all that we have to be grateful for, and set goals for the year to come.  In my time at Schutjer Bogar, I have learned a great deal from my colleagues, the facilities that we serve, the residents, and their families.  In the spirit of the season, I would like to share with you three important lessons that I will take with me as we embark on 2012:

1. Don’t underestimate the power of good faith.  Time and time again I have seen previously denied Medicaid applications be re-opened and benefits approved because the facility, the resident, and/or their family has made a good-faith effort to provide the information requested by the county.  Diligent efforts to obtain the documentation and keeping the caseworker informed of the status of those efforts will to a long way toward the goal of securing Medicaid benefits.  If you have been trying to obtain those last few bank statements, or a copy of that deed, but just can’t get it, don’t despair!  Tell the caseworker.  Ask for more time.  Or ask for the caseworker to assist with getting the needed information.  The caseworker should accommodate a reasonable request and failure to do so can be grounds for an appeal and, ultimately, lead to the approval of Medicaid benefits.
2. Be kind to your fellow man.  The process of securing Medicaid benefits for a resident can be, as we all know, a lengthy and frustrating process.  Maintaining a cordial and professional relationship with the caseworker, the resident, and their family can go a long way toward securing their assistance and cooperation.  In some cases, the resident and their family may appear hostile or uncooperative simply because they do not understand the process and the need for their cooperation.  Reach out to them.  I have had many cases where a previously uncooperative spouse or child would, once the eligibility process and the importance of securing Medicaid benefits for their family member was explained to them, prove not only cooperative but eager to assist.  There are, of course, unfortunate instances where the unwillingness of the resident and/or their family is evident and appropriate legal action must be taken, but holding firm in your position without sacrificing civility has, in my experience, yielded a far better result under any circumstance.   
3. Communication is key.  Communicating with your residents, their family, and the caseworker is the best way to ensure that an application for Medicaid benefits is timely processed.  Although many counties are backlogged and routinely process applications well beyond the required period, regular and continuous efforts to contact the caseworker to determine the status of an application or inquire whether additional information needed are important.  Even if the caseworker does not respond, the effort that has been made can prove useful in the event that an appeal is necessary.  Keeping a log of attempts to contact the caseworker or, as the case may be, the resident’s family, is also extremely helpful should an appeal or other legal action be necessary to secure Medicaid benefits.

I have no doubt that the New Year will bring challenges, new lessons, and, hopefully, triumphs.  As I go forward, I will take with me the experiences I have had in the hope that they will guide me toward achieving a better outcome for our clients so that they can focus on doing what they do best – caring for their residents.

 Best wishes to all for 2012!

 Erin works in our Washington, DC office with Elizabeth Meadows, Monica O’Connell, Elizabeth Spawn-Stotler and Lucretia Bailey.

2011 has been the most successful year the firm has experienced to date; we saw exceptional growth and continued to open offices across the nation. Hiring four graduates from one of the top law schools in the country makes for an exciting addition to our team, and will be a key factor in the continued success of the firm. Please join me in welcoming Schutjer Bogar’s new attorneys; Kali Backer, Julia Daly, Elizabeth Meadows, and Mitchell Ronningen.

Vanderbilt Law School, affectionately referred to as “Vandy” by its students, holds a consistent top-20 spot on the annual US News and World Report Graduate School Rankings. Vanderbilt Law School (VLS) accepted an elite 24% of applicants in 2011; those accepted boasted a median undergrad GPA of 3.72 and LSAT score of 168 (which is the 96th percentile). The firm’s new hires come from the 191-person 2011 class, which was hand-selected from the largest pool of applicants VLS had ever seen.

Kali Backer is a graduate of the University of Pennsylvania where she studied art history. While at VLS, Backer served as an editor for the Vanderbilt Journal of Transitional Law and worked as a summer associate for Barrett Johnson, LLC. Backer will join Schutjer Bogar’s office in Denver, CO.

Julia Daly attended Macaulay Honors College at Hunter College where she earned a bachelor’s degree in political science and urban studies. At VLS she served as vice president of the Environmental Law Students Association and worked as a law clerk with the Vanderbilt University Athletic Department. Daly will join Schutjer Bogar’s Charleston, SC, office.

Elizabeth Meadows earned her bachelor’s degree in American studies at the University of Alabama. While studying at VLS she served as the treasurer for the Vanderbilt Alternative Dispute Resolutions Organization and worked as a research assistant at Scruggs & Land, PLLC. Meadows will join Schutjer Bogar’s office in Washington, DC. Read her entry on the Schutjer Bogar Blog here.

Mitchell Ronningen attended Vanderbilt Law School after earning his bachelor’s degree in cultural studies at the University of Tennessee. At VLS he participated in the Moot Court and the Legal Aid Society and worked as a legal fellow for the Tennessee Justice Center. Ronningen will also join Schutjer Bogar’s office in Denver, CO.

If there is anything that I have learned while working with Schutjer Bogar – it is that our clients truly love their residents. As the holiday season gets in full swing, it is great time to make your residents feel extra special. Some residents have friends and family who will come to visit in droves. However, there are other residents who may not have any visitors at all.

There are so many things that you can do to bring holiday cheer to your residents and staff. Consider contacting a local church or synagogue to see if they have a choir who might be willing to do some holiday caroling throughout your halls. Contact your local animal shelter and arrange a short visit with a couple of furry friends. Organize an activity trip to take your residents to view a local “Festival of Lights” or a popular light display in your city.

Magnolia Manor of Spartanburg, located in Spartanburg, South Carolina has organized an Angel Tree. All of the staff members purchase small gifts requested by the residents. Late on Christmas Eve, the Business Office Manager, Director of Social Work, and their families, surprise residents by delivering the presents and spending a little bit of quality time with them.

Remember, the holiday season is a great time to give back to your residents and spread a little bit of cheer. Schutjer Bogar encourages its’ employees to spend some time at a local facility with residents during the holiday season. If you have a Schutjer Bogar office located near you, which is very likely due to our continued growth and expansion, feel free to give us a call. Our wonderful attorneys and support staff are always willing to come deck your halls with joy and holiday spirit.

Happy Holidays from the South Carolina office!

Jackie works in our South Carolina office with Julia Daly and Allison Black.