OSHIIP and Aging in Place Planning

The Ohio Senior Health Insurance Information Program is a free, state-sponsored service provided by the Ohio Department of Insurance, designed to help Medicare beneficiaries navigate complex health insurance options. As Ohio's official State Health Insurance Assistance Program (SHIP), a network funded by the Centers for Medicare & Medicaid Services (CMS), OSHIIP offers unbiased, one-on-one counseling to seniors, their families, and caregivers, ensuring informed decisions about coverage without sales pressure.

Key Services Provided by OSHIIPOSHIIP focuses on empowering older adults (65+ or those eligible for Medicare due to disability) to maximize their benefits while minimizing costs. Core offerings include:

• Personalized Counseling: Free phone, email, or in-person sessions to explain Medicare Parts A/B/D, Medicare Advantage (Part C), Medicare Supplement (Medigap) plans, and long-term care insurance. Counselors review eligibility, compare plans during Open Enrollment (October 15–December 7), and help appeal denials.
• Education and Resources: Workshops, speaker bureaus, and trained volunteers cover topics like prescription drug coverage, fraud prevention, and coordinating benefits with employer plans. They also assist with applications for low-income programs like Extra Help or Medicare Savings Programs.
• Hotline Support: Call 1-800-686-1578 (Monday–Friday, 9 AM–4:30 PM ET) for immediate guidance—no appointment needed. Email: OSHIIPmail@insurance.ohio.gov. Website: insurance.ohio.gov (search "OSHIIP").

In 2024, OSHIIP assisted over 100,000 Ohioans, saving an estimated $50 million in premiums through better plan choices. It's especially valuable during Medicare's Annual Enrollment, when switching plans can reduce out-of-pocket costs by 20–30% for many.Why OSHIIP Matters for Aging in Place and Elder Law PlanningFor Ohio families committed to aging in place, staying home with support like in-home aides or modifications rather than nursing facilities, OSHIIP is an informational lifeline. It helps consumers bridge gaps in Medicare coverage, which doesn't pay for most custodial long-term care (e.g., daily activities like bathing). Key ties to planning include:

• Medicaid Coordination: OSHIIP counselors can explain how Medicare pairs with Ohio's Medicaid (e.g., PASSPORT waiver for home care, income under $2,901/month in 2025), and asset protection strategies like irrevocable trusts to navigate the five-year lookback.
• Avoiding Pitfalls: OSHIIP provided guidance on spotting scams (e.g., fake Medicare cards) and reviewing contracts prevents costly errors, like signing unintended guarantees in facility admissions (as seen in recent cases like Bartley Healthcare v. Ott).
• Estate Planning Synergy: Use OSHIIP to align insurance with trusts or powers of attorney, ensuring assets fund home-based care without estate recovery claims.

Avoiding pitfalls is essential to aging-in-place planning.  First, assets lost to scams and mismanagement threaten independence and autonomy by removing financial capability.  Second, being subjected to scams can raise questions regarding capacity and capability; a senior who has been taken advantage of is more likely to be deemed incapacitated and in need of guardianship services, legally removing that senior's decision-making authority.  Third, agents appointed or nominated by powers of attorney, or trustees of a trust, can be removed for being unable to protect assets from scammers, separating the senior from his or her most trusted advisors.  

How to Get Started

• Contact OSHIIP: 1-800-686-1578 or visit insurance.ohio.gov/oshii p.
• Local Access: Find counselors via your Area Agency on Aging (e.g., Central Ohio: 614-645-7250) or SHIP locator at shiphelp.org.
• Pro Tip: Schedule a session early in Open Enrollment to lock in 2026 coverage—pair it with an elder law attorney for holistic planning.

OSHIIP isn't insurance itself but a trusted navigator, helping Ohio seniors avoid overpaying and underinsuring. For personalized advice, reach out today; independence starts with informed choices.

Kentucky Supreme Court Ruling Protects Consumers from Forced Arbitration in Nursing Homes

For families navigating long-term care, a recent Kentucky Supreme Court decision offers a significant win. On August 14, 2025, the court ruled in Lexington Alzheimer’s Investors, LLC v. Norris that a spouse who signed a mandatory arbitration agreement on behalf of a loved one entering a nursing facility is not  bound unless she was explicitly authorized by law or a legal document to execute the agreement on his behalf. This decision could shield consumers from institutions that use arbitration clauses to limit their rights, especially in cases of negligence or abuse. Let’s break down this ruling and explore why it matters for long-term care and aging in place, alongside the broader push by consumer advocates to curb such agreements.

The Case: A Spouse’s Struggle for JusticeIn 2019, Sandra Norris became her husband Rayford’s conservator after his Alzheimer’s diagnosis, appointed by a Tennessee court. Seeking care for Rayford, Sandra admitted him to The Lantern, a private-pay personal care facility in Lexington, Kentucky. The facility required her to sign a mandatory arbitration agreement, a contract forcing any future disputes (like lawsuits) into private arbitration rather than open court. Sandra didn’t specify her signing capacity (e.g., as conservator) when she signed the agreement, and the Tennessee order wasn’t registered in Kentucky, leaving its legal effect unclear. Rayford lived at The Lantern until March 2020, during which Sandra alleged he suffered multiple falls, significant weight loss, and an infected bed sore, ultimately passing away in August 2020.
Sandra sued The Lantern for negligence, medical negligence, and wrongful death. The facility moved to compel arbitration, arguing Kentucky’s Living Will Directive Act (KRS § 311.631) gave Sandra authority to sign the agreement as Rayford’s spouse. Both the circuit court and Kentucky Court of Appeals disagreed, and the Supreme Court upheld their decisions.The Ruling: Arbitration Isn’t a Healthcare DecisionThe Kentucky Supreme Court clarified that the Living Will Directive Act allows a spouse to make healthcare decisions (e.g., consenting to or withdrawing medical treatments) only when a doctor determines the individual lacks decisional capacity. However, signing an arbitration agreement, a legal contract about how disputes are handled, doesn’t qualify as a healthcare decision. Since Sandra wasn’t Rayford’s legally recognized agent, guardian, or surrogate under a valid Kentucky order, and no physician had documented his incapacity, she lacked authority to bind him to arbitration.
The court also dismissed The Lantern’s reliance on the U.S. Supreme Court’s 2017 Kindred Nursing Ctrs. Ltd. P’ship v. Clark ruling, which struck down a Kentucky ruling that authority to bind a principal to arbitration must be explicitly stated in a power of attorney violated the Federal Arbitration Act.  The Kentucky court found its decision rested on a general contract principle (lack of authority), not a statute that discriminated against arbitration, meaning that its holding is consistent with federal law.Why This Case Protects ConsumersThis ruling is a victory for consumers, particularly those relying on institutional care for short or long-term care. Mandatory arbitration agreements often favor institutions by:

• Limiting public lawsuits, keeping negligence cases (like Rayford’s falls or bed sores) out of the spotlight.

• Restricting access to juries, which can award higher damages than arbitrators, who may lean toward businesses.

• Reducing transparency, as arbitration proceedings are private, not public court records.

By invalidating Sandra’s unauthorized signature, the court ensures families can pursue justice in court when care fails, rather than being funneled into a process that may favor the facility. For readers, this decision highlights the need to scrutinize admission contracts.Why Consumer Advocates Favor Limits on Arbitration Agreements

Consumer advocates, including groups like AARP and the National Consumer Voice for Quality Long-Term Care, have long pushed to restrict arbitration in nursing homes. Here’s why:

• Unequal Power Dynamics: Nursing homes often present arbitration agreements during admission, a stressful time when families may feel pressured to sign without understanding the consequences. Advocates argue this coerces consent, especially for vulnerable seniors or their caregivers.

• Lower Accountability: Studies show arbitration awards average significantly less than jury verdicts in nursing home cases, and facilities win 2–3 times more often in arbitration. This can let substandard care slide, as seen with Rayford’s alleged neglect.

• Hidden Abuses: Private arbitration hides patterns of neglect or abuse, preventing public awareness and systemic reform. For example, a 2023 report found 60% of nursing home arbitration cases involved unreported safety violations.

• Legal Barriers: Arbitration clauses can limit appeals or class actions, leaving families like Sandra’s with little recourse against corporate chains, which own 70% of U.S. nursing homes.

• Conflict of Interest: Arbitrators are often chosen by the facility or from a pool tied to the industry, raising bias concerns—unlike impartial judges in court.

Advocates push for federal or state laws requiring opt-in arbitration (not mandatory), clear disclosure, or bans in long-term care, arguing it protects seniors’ rights to fair legal recourse.Implications for Aging in PlaceFor families aiming to age in place, this ruling underscores the importance of legal clarity. If facility care is needed (e.g., as a backup to home care), ensure:

• Legal Authority: Review legal authority to execute agreements.  Although this situation probably worked out for the family, there may be others where the family will want to enforce an agreement.  The door swings both ways; facilities can invalidate agreements made without legal authority, just like a family can.  
• Review Contracts: Scrutinize admission agreements for arbitration clauses and clauses that enforce family responsibility for a person's debts (see, e.g.,  "Promissory Note Executed by Nursing Home Resident’s Daughter Is Not Illegal Third-Party Guarantee" and the discussion in that article regarding institutions seeking to unlawfully enforce filial responsibility).  Consult an elder law attorney to challenge unauthorized terms.
• Alternative Planning: Use Medicare Advantage plans with robust home-based benefits (e.g., telehealth, in-home PT/OT) to delay facility reliance, avoiding such disputes.
• Advocacy: Join family councils or groups like Ohio’s Area Agencies on Aging to push for consumer-friendly policies.

A Call to ActionThe Norris decision empowers consumers by rejecting forced arbitration when legal authority is absent. As nursing home litigation grows, this ruling could deter facilities from overreaching. For Ohio and Missouri families, it’s a reminder to plan ahead. Review your long-term care strategy with an elder law attorney. Don’t let institutions dictate your legal options; act now to protect your future.