Elder law is an area of legal practice that focuses on the needs and challenges faced by seniors. One important issue that falls under this category is nursing home Medicaid eligibility. Medicaid is a government-funded healthcare program that provides medical assistance to certain populations, and it can be a crucial resource for seniors who require long-term care in a nursing home. However, Medicaid eligibility can be a complex and confusing process, particularly when it comes to nursing home care.

President Biden announced that the official Public Health Emergency (PHE) caused by COVID-19 will end on May 11, 2023.   What are the ramifications of this change for seniors?

1. Return of Medicare’s three-day rule

If an individual receiving Supplemental Security Income (SSI) receives certain types of payments, those payments must be reported to the Social Security Administration (SSA) and their benefits may be reduced, often quite significantly. The most common distribution that would need to be reported is payment of income in the form of food or shelter, referred to as In-Kind Support and Maintenance (ISM). This type of income is any payment from a third party (including from a trust) for the necessities of life—food and shelter. ISM occurs when distributions are made not only for groceries, rent, or a mortgage payment, but also for basic utilities such as natural gas, water, electricity, sewer service, and garbage collection.

Last week, the SSA published a proposed rule that seeks to exclude food from the ISM calculation.