Contact Us
Frequently Asked Questions
Scottsdale Office

Follow Us



Explaining the Pension Protection Act


Event Sign Up
CE Course Fee Discount
Have You Heard The News?

Hospital visits grow too routine for long-term care residents

Hospitalizations for long-term care residents have become too routine, although they could be prevented, according to a report from the Kaiser Family Foundation.
long_term_care_facility_large The report, To Hospitalize or Not to Hospitalize, offers insights into factors behind high hospitalization rates and suggests solutions. It is based on interviews with physicians, nurses, social workers and family members of residents of long-term care facilities.
LTC residents account for a disproportionately large share of Medicare spending. According to KFF, 1.7 million Medicare beneficiaries in long-term care for all of 2006--or who died in care before the year's end--cost the program an average of $14,538 per person, more than twice the average expenditure for all Medicare beneficiaries. Medicare covers LTC residents' ER visits, hospitalizations and other medical treatments, but not stays in nursing homes, assisted living facilities or other long-term care programs.
Strategies the report suggests to cut avoidable hospitalizations include beefing up staff with more medical support and a philosophy shift about the appropriateness of hospitalization, instead of viewing it as the path of least resistance.

Among factors that drive hospitalization of LTC residents, interview participants said there were no disincentives to sending an LTC resident to the ER when a medical issue is suspected. Not only does hospitalizing a medically compromised resident reduce liability concerns and allow for more timely diagnostic tests, it also can be more convenient for physicians.
Staff and doctors may assume that the family prefers more aggressive treatment. And a lack of qualified staff, protocols and license restrictions, have further exacerbated the tendency to default to hospitalization. Often the perception of best care is 'Let's send Mrs. M to the emergency room and see what the ER finds,'" Dr. Cheryl Phillips, chief medical officer of the Bay Area nonprofit On Lok Lifeways, told Kaiser Health News. Some of the interviewees noted that residents often return from the hospital disoriented, on different meds and with new infections.
Dr. Donald Berwick, head of the Centers for Medicare and Medicaid Services, told Kaiser Health News that better coordination was needed, saying too many people experience "disintegrated care."
"The goal is to change through redesigning the system," he said.
To learn more:
- read the Kaiser Family Foundation report
- read other related reports from the Kaiser Family Foundation
- read the Kaiser Health News story


LTC Expert Carol J. Guilbault Talks about Long Term Care and the Family

LTC Simple president Carol Guilbault discusses long term care burden and families.

If and when a family member needs long-term care, it can put a severe emotional and financial burden on the entire family, particularly women who make up 2/3 of the caregivers in our country.

When a spouse or a parent needs extended care, women in particular can lose the lifestyle and the career they’ve worked so hard to achieve. Caregiving responsibilities will crush the dreams of millions of women in the next 10-20 years unless families plan ahead with long-term care insurance.

A significant number of younger people need long-term care due to strokes, accidents or debilitating conditions like brain tumors, Lou Gehrig’s disease, MS, and even early Parkinson’s or Alzheimer’s disease.2 If an event hasn’t occurred at a younger age, the experts tell us that there is a 61% chance that a 65 year old will need long-term care at some point in his or her life.3 The good news is that most people don’t need nursing home care as less than a third of long-term care is provided in nursing homes.4 However, home care can cost as much or more depending on how much is needed.

Click to read more ...


Eric Petroff--LTC Annuities: Two Safety Nets In One 

(Investopedia)The government must be getting worried about all those aging baby boomers. With healthcare in jeopardy, it recently took a step to shift healthcare costs back to the taxpayer. A new change to the tax law allows long-term care (LTC) insurance premiums to be paid with pretax dollars. This seemingly innocuous move has created the "LTC annuity", a combination of LTC insurance and an annuity.

Fundamentally, the LTC annuity is simply a repackaging of two existing products, but with a slight spin. As the name suggests, an annuity is overlaid with LTC insurance, but the new tax code allows premiums to be deducted from the annuity's income stream without creating a taxable event. This effectively lowers the cost of the LTC insurance premiums, thereby encouraging people to purchase these policies, alleviating future strain on social programs.

It is nearly impossible to offer a single analysis that can be applied across the board to all LTC annuities. Insurance products always differ slightly from one company to the next, and the tax code is constantly in a state of flux. What is possible is to examine the financial underpinnings of annuities and LTC insurance separately. This will assist in evaluating a combined LTC annuity product.

Annuity Portion
Annuities can take two forms. The first is that of a tax-deferred investment vehicle. The second is an insurance policy designed to protect income in retirement (a retirement annuity). It is the retirement annuity that is the basis for the LTC annuity. (To learn more about annuities, see An Overview Of Annuities.)

Read more

Eric Petroff is the director of research of Wurts & Associates, an institutional consulting firm advising nearly $40 billion in client assets. Before joining Wurts & Associates, Petroff spent eight years at Hammond Associates in St. Louis, another institutional consulting firm, where he was a senior consultant and shareholder. Prior to Hammond Associates, he spent five years in the brokerage industry advising retail clientele and even served as an equity and options trader for three of those years. He speaks often at conferences and has published dozens of articles for and the New Zealand Investor Magazine.


What the Pension Protection Act Means for You


Welcome to the PPA Advocate Network