A new study reveals a growing trend of potentially unnecessary or harmful rehabilitation services for residents of nursing homes. The study finds that this trend, which may be driven by a desire to maximize profits, is particularly on the rise for patients in the last 30 days of life, indicating that these services could be interfering with appropriate end-of-life care.
The authors of the current study analyzed data from 647 nursing home facilities in New York State to better understand the patterns and growth of rehabilitation services. Specifically, they focused on residents who had received very high to ultrahigh rehabilitation services defined as 720 minutes or greater, or the equivalent of two hours of rehab per day.
They found that residents receiving ultrahigh rehabilitation was concentrated in the last seven days of life.
The study suggests this phenomenon is likely more pronounced in other states. A 2013 CMS study showed that nursing homes in at least 17 other states billed for ultrahigh intensity rehabilitation services at even higher rates than New York.
The authors acknowledge that some level of rehabilitation may be necessary and appropriate for patients approaching the end-of-life, such as speech therapy, which can assist with difficulties in swallowing. However, they contend that many of the goals of these therapies can be attained at low or intermediate levels of intensity and that ultrahigh levels for patients nearing end-of-life are generally unnecessary and, in many instances, could be harmful and interfere with appropriate care. This could also delay the timely introduction of hospice and palliative care.
Lipson Neilson P.C. is proud to announce that four lawyers in the firm’s Bloomfield Hills office have been selected to the 2018 Michigan Super Lawyers list: Jeffrey Neilson, Phillip Seltzer, Sandra Glazier and Mary Schmitt Smith. Jeffrey Neilson, Sandra Glazier and Mary Schmitt Smith are included on the team of CEP Lawyers.
Super Lawyers is a division of Thomson Reuters, a global leader in legal industry information and publications. The Michigan Super Lawyers list includes less than 5% of lawyers in the state.
Lipson Neilson 2018 Michigan Super Lawyers:
- Jeffrey T. Neilson: Selected for his work in Estate & Trust Litigation, he is also recognized for his work in Family Law and Professional Liability. This is Jeffrey’s twelfth consecutive year on the Michigan Super Lawyers’ list.
- Phillip E. Seltzer: Selected for his work in Professional Liability Defense Litigation, he is also recognized for his work in Business Tort Litigation. This is Phillip’s sixth consecutive year on the Michigan Super Lawyers’ list.
- Sandra D. Glazier: Selected for her work in Estate and Trust Litigation, she is also recognized for her work in Family Law, Estate Planning and Probate. This is Sandra’s second consecutive year on the Michigan Super Lawyers’ list.
- Mary T. Schmitt Smith: Selected for her work in Elder Law, she is also recognized for her work in Estate Planning and Probate, and Estate and Trust Litigation. This is Mary’s twelfth consecutive year on the Michigan Super Lawyers’ list.
Founded in 1985, Lipson Neilson has grown from three founding members to thirty-two attorneys located in three states. The firm offers a full range of practice areas including complex business tort litigation, professional liability defense, employment law and litigation, real estate, probate litigation, family law, estate planning, and trust and estate administration. Lipson Neilson attorneys represent and provide counsel to clients around the country, and around the world.
It is difficult for family to know when to step in and assist aging parents with their financial affairs. Conversations about money, bills and care expenses are uncomfortable, and aging parents may become defensive, suspicious or confused.
Unfortunately, as we all age, we inevitably lose the capacity to manage our financial affairs. Cognitive decline and family influences are powerful force that also makes elders easy targets for scam artists, misleading advertising and offers for high-priced, unnecessary goods and services.
Family should consider raising the topic of financial management for their aging parents well before they become incapacitated. Dealing with financial issues before the onset of cognitive decline allows aging parents to be fully involved in the management of their estate. Early and full involvement by aging parents not only preserves their dignity and right to self-determination but also allows family to have the mutual benefit of knowledge of their financial affairs.
A durable power of attorney or a trust can give the aging parent continued control over their financial affairs while also empowering family to step in and help when needed.
Family and caregivers who lack legal authority to intervene when warning signs arise have a challenging task ahead. At least one family member will need to move quickly in the Courts to acquire the legal authority to act on their parent’s behalf that can be avoided by simply planning ahead.
To find out more about the firm visit http://www.lipsonneilson.com/
CEP Attorney Sandra D. Glazier will present “Considerations and Ethical Responsibilities When Representing Vulnerable Adults” at the State Bar of Michigan Family Law Section’s Summer Conference on July 21, 2018 at the Boyne Mountain Resort in Boyne Falls, Michigan.
Family law is a very specialized area of law that is often state specific. In addition to staying current on the laws and how they are interpreted, family law attorneys must know their way around a courtroom, a referee’s office, the court rules, and case law. This conference will feature presentations by recognized family law practitioners providing state-of-the-law education and tips on family law issues.
An attorney for more than 35 years, Ms. Glazier is known for her expertise and successful track record in probate litigation, estate planning, trust and estate administration, and family law matters. The cases she works on tend to be very complex and require technical as well as legal expertise. An AV Preeminent® rated attorney, she has also been recognized by “Super Lawyers” in probate litigation and a “Top Lawyer” by DBusiness, in the areas of probate, estate and family law.
Ms. Glazier has had numerous articles nationally published by some of the legal industry’s leading publications. In addition, she has presented on estate planning and probate litigation related topics for the American Bar Association, Notre Dame Tax and Estate Planning Institute, Kansas City Estate Planning Symposium, Michigan’s Institute of Continuing Education, Oakland County Bar Association, Wayne County Probate Court appointed attorney training, Wilmington Trust’s New York Trust Symposium, Trust & Estates Magazine, and the Bloomberg BNA Estate and Gift Tax Advisory Board. She has presented on Family Law related topics for NBI, the OCBA, ICLE and the Michigan State Bar – Family Law Section.
Contact: Sandra D. Glazier
Co-ownership with family can work, however, siblings tend to be more forgiving of other siblings, but their spouses don’t have the same motivation to compromise. So the siblings can often times be caught between their spouse and their siblings. Financially strapped siblings may also seek to just cash out of a long time investment.
The best way to avoid controversy is to have a family discussion while the parents are still alive to explore everyone’s expectations and desires. Some of the considerations should include the following:
- Meet and decide if you ultimately want to sell or keep the property.
- If you wish to keep the property, and everyone is willing to share ownership, the family should draw up legal documents to prepare for the future. This can include a joint ownership agreement, Trust or Limited Liability Company.
- Key issues are how and when the property should be used and how expenses are paid.
- Include basic operating rules like schedules, cleaning, smoking, use by non family and damage.
- Consideration should be given as to how ownership should be passed onto future generations.
- Determine how ultimately siblings can be paid off, how would the price be determined.
The Lipson Neilson law firm is proud to have participated with a team in the 2018 Susan G. Komen Race for the Cure – Detroit. The firm’s team included 29 attorneys, staff, families and friends that are connected by their passion to help fight breast cancer. This year’s 5K run/fitness walk through the streets of downtown Detroit, held on May 5, 2018, drew an estimated crowd of 25,000 women, men and children coming together to fight breast cancer; the event raised a total of $343,599.
With offices in Michigan and Arizona, the CEP specializes in all aspects of estate planning, from estate administration to lifetime counsel and probate administration work. CEP attorneys work with individuals, closely-held businesses and charitable organizations. CEP founder, Steven Malach, specializes in elder law, estate planning, probate, wills, trusts and trusts administration. He also practices in the areas of wrongful death, family law, divorce, custody, child support, real estate and is general counsel to several local businesses.
Contact: Steven Malach
CEP lawyer Sandra D. Glazier has been selected by the American Bar Association to be on a panel that will discuss attorneys’ roles and responsibilities in protecting aging clients (and their assets) from the seemingly well-intentioned but overly-influencing next generation. This session, “It May Be a Small World, but You Still Need to Wait Your Turn – Issues with Elder Planning and Abuse”, will be moderated by The Hon. Cheryl D. Cesario, retired Circuit Court Judge of Cook County, Probate Division, Evanston, Illinois, and includes other attorneys from around the country. Ms. Glazier is one of only three Michigan attorneys selected by the ABA to present at this national Symposia that will be held in Orlando, Florida during May 10 – 11, 2018.
An attorney for more than 35 years, Sandra D. Glazier is known for her expertise and successful track record in probate litigation, estate planning, trust and estate administration, and family law matters. The cases Ms. Glazier works on tend to be very complex and require technical as well as legal expertise. She has represented contestants and proponents of estate planning documents, as well as fiduciaries, in significant trust litigation proceedings.
An AV Preeminent® rated attorney, Ms. Glazier is recognized nationally for her accomplishments and expertise in estate planning and probate litigation and is routinely requested to speak at some of the leading legal industry conferences across the country. She has been selected as a “Michigan Super Lawyer” by Thomson Reuters, the world’s leading source of information for the legal industry and has been recognized as a “Top Lawyer” by DBusiness, in the areas of probate, estate and family law. Ms. Glazier has had numerous articles published by some of the legal industry’s leading publications. and has taught “Valuation for Federal, Estate and Gift Tax Purposes” in a Masters’ level course. To learn more please visit www.lipsonneilson.com.
Contact: Sandra D. Glazier