California Elder Law Attorney Blog

Medicare patients at St. Joseph's Medical Center in Yonkers, N.Y., had the second-highest rate of severe bed sores in the country, according to an analysis of Medicare data between Oct. 1, 2008, and June 30, 2010, by the Sunlight Foundation Reporting Group on medical errors.

Medicare patients at St. Joseph's suffered 13 instances of severe bed sores during their stay requiring additional treatment, a rate of nearly 2.9 per 1,000 treated, according to the report. At nearby St. John's Riverside Hospital, the rate was 20 times lower: Only one severe bed sore was reported, even though the larger St. John's discharged 8,270 Medicare patients during the period, compared with St. Joseph's 4,541.

Bed sores--pressure ulcers--are one of the conditions that the federal government is increasingly unwilling to pay for. Earlier this month, Health and Human Services Secretary Kathleen Sebelius announced the Partnership for Patients, a new national effort that is meant to stop millions of preventable injuries and complications in patient care over the next three years. The federal agency said the initiative has the potential to save up to $35 billion in health care costs nationally, including up to $10 billion for Medicare.

The federal government is asking hospitals to focus on nine types of medical errors and complications where the potential for dramatic reductions in harm rates has already been documented. They include pressure ulcers, as well as preventing adverse drug reactions, childbirth complications and surgical site infections.

Continue reading "Elderly Patients At Long Term Care Facility Have An Extremely High Rate of Pressure Sores and Bed Sores says Los Angeles Nursing Home Abuse and Neglect Attorney Steven Peck" »

For most people, the durable power of attorney is the most important estate planning instrument available--even more useful than a will. A power of attorney allows a person you appoint -- your "attorney-in-fact" -- to act in your place for financial purposes when and if you ever become incapacitated says California Elder Law Attorney Steven Peck.

In that case, the person you choose will be able to step in and take care of your financial affairs. Without a durable power of attorney, no one can represent you unless a court appoints a conservator or guardian. That court process takes time, costs money, and the judge may not choose the person you would prefer. In addition, under a guardianship or conservatorship, your representative may have to seek court permission to take planning steps that she could implement immediately under a simple durable power of attorney.

A power of attorney may be limited or general. A limited power of attorney may give someone the right to sign a deed to property on a day when you are out of town. Or it may allow someone to sign checks for you. A general power is comprehensive and gives your attorney-in-fact all the powers and rights that you have yourself.

A power of attorney may also be either current or "springing." Most powers of attorney take effect immediately upon their execution, even if the understanding is that they will not be used until and unless the grantor becomes incapacitated. However, the document can also be written so that it does not become effective until such incapacity occurs. In such cases, it is very important that the standard for determining incapacity and triggering the power of attorney be clearly laid out in the document itself.

However, attorneys report that their clients are experiencing increasing difficulty in getting banks or other financial institutions to recognize the authority of an agent under a durable power of attorney. A certain amount of caution on the part of financial institutions is understandable: When someone steps forward claiming to represent the account holder, the financial institution wants to verify that the attorney-in-fact indeed has the authority to act for the principal. Still, some institutions go overboard, for example requiring that the attorney-in-fact indemnify them against any loss. Many banks or other financial institutions have their own standard power of attorney forms. To avoid problems, you may want to execute such forms offered by the institutions with which you have accounts. In addition, many attorneys counsel their clients to create living trusts in part to avoid this sort of problem with powers of attorney.

While you should seriously consider executing a durable power of attorney, if you do not have someone you trust to appoint it may be more appropriate to have the probate court looking over the shoulder of the person who is handling your affairs through a guardianship or conservatorship. In that case, you may execute a limited durable power of attorney simply nominating the person you want to serve as your conservator or guardian. Most states require the court to respect your nomination "except for good cause or disqualification."

Continue reading "Power of Attorney Is A Very Important Estate Planning Tool Says California Elder Law Attorney Steven Peck" »