Sun, 21 December 2008
This weekend I rented an excellent movie entitled "The Savages". Starring Philip Seymour Hoffman, Laura Linney and Philip Bosco, it is the story of a brother and sister, estranged from their father, who receive a call when Dad's girlfriend, whom he has been living with for 20 years, dies.
Dad has dementia and the children are told by his girlfriend's children that they must take Dad back with them since the home is not his. They fly him back to New York and place him in a nursing home.
The story deals with the relationships of the characters, the upheaval of their lives and the typical issues that we all must deal with, from finding the right long term care setting to sitting down with Dad to discuss his living will and burial arrangements to the conflicting emotions felt by the children who are trying to do the right thing.
The film even touches upon second marriages (or in this case a long term relationship). The children are stunned to learn that Dad has no right to live in the home because he signed an agreement waiving all rights. Having little money, his children must place him in a nursing home and apply for Medicaid.
The movie is both funny and sad but it is comforting to know that we all, regardless of wealth, cannot escape the issues of aging and dying and that sometimes the experience can bring families closer together.
Category:Aging -- posted at: 8:45pm EST
Thu, 4 December 2008
Elder Law Today Podcast Show #12 The Talk - How to Communicate with your Parents about Aging and Long Term Care
In show number 12 Yale Hauptman, a practicing elder law attorney sits down with Barbara Salvador of Nannymama.com and Barbara Friesner of Agewiseliving.com, a generational coach and author of “The Ultimate Caregiver’s Guide” to discuss how to have “the talk” with aging parents.
Generational differences and lack of communication pose some real challenges to children who are trying to help care for their parents. So many families never discuss long term care and finances until a crisis hits and that’s just too late. If you find yourself in the situation of not knowing what plans your parents have in place, what their wishes are with respect to long term care, or where all their important legal documents are – and you have no idea how to start the conversation - this is a must listen.
As with any interpersonal relationship, communication is paramount. How we say things is as important as the content itself. Yale and his guests discuss the best way to break the ice and the dos and don’ts of approaching a very difficult topic in a way that is sensitive to the fears and concerns of aging family members, intending to bring families together, instead of pulling them apart.
This 12th show contains valuable information that every family will find helpful in dealing with some of the most challenging issues we all face today.
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Fri, 7 November 2008
Elder Law Today Podcast Show #11 The Current Economic Crisis. What Does it Mean for Medicaid and Long Term Care
Much has happened in
both the economic and political arenas since the last show, including
the steep drop in the stock markets and the election of President
Obama and changing of power in Congress from Republican to Democrat.
In show number 11 of his podcast, Elder Law Today, practicing elder
law attorney, Yale Hauptman discusses how this all will affect the
average American who needs long term care.
Some of these changes have already begun to occur. Yale explains how rising unemployment, the government bailout of failing financial companies and the drop in stock markets and thereby, people’s savings, have all combined to create a “perfect storm” of conditions that will cause State Medicaid offices to delay and deny a greater number of Medicaid applications for long term care.
He discusses some of the scenarios in his office where this is already happening. Take the case of the daughter who took cash out for Mom over the years but didn’t keep good records as to how it was spent or the son who paid for Mom and Dad’s care at home out of his own funds when they had none left and now wants to be reimbursed from the sale of their home when they enter a nursing home. In both cases Medicaid has scrutinized these transactions and delayed approval.
We are now almost 3 years removed from the last round of changes to the Medicaid laws instituted under the Deficit Reduction Act (DRA). Learn why this law will have even more impact on the ability to qualify for government benefits as we go forward.
This 11th show is one you can’t afford to miss, with information and ideas that you need to act on now to be sure to protect yourself and your loved ones going forward. Be sure to tune in.
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Sun, 19 October 2008
Many times the children of my elderly clients ask whether they can be held responsible for Mom or Dad’s nursing home bill. My answer always was that there wasn’t anything to worry about unless you take your parents money. That no longer appears to be the case.
A recent case in Connecticut highlights how the new Medicaid laws passed as part of the Deficit Reduction Act of 2005 are really hurting residents and nursing homes alike and now potentially also affecting other family members. In that court case, the nursing home resident’s son signed the admission agreement on behalf of his mother. As in most nursing home agreements Son was asked to sign as responsible party, which he did not do. Nevertheless, Nursing Home advised him verbally that he was the responsible party.
Son then applied for Medicaid benefits on behalf of Mom. Son did not, however, follow through on the application process in a timely manner. He failed to provide all the information and documentation that the State needed and he did not spend down Mom’s assets quickly enough, delaying the application’s approval. As a result, months of benefits were lost, never to be regained, benefits that Nursing Home would have received.
Nursing Home sued Son on a breach of contract claim. It claimed that Son undertook an obligation on Mom’s behalf, when he signed the admission agreement, to promptly pursue Medicaid benefits. Son, in response, argued that he never signed the agreement so there was no contractual obligation on his part. The court sided with Nursing Home, finding that an oral contract was created between the two parties and that Son violated it by not conscientiously following through.
A good result for the nursing home, right? Well, not really, when you account for the time and money it took Nursing Home to get the judgment. It then has to collect on that judgment, assuming Son doesn’t appeal the decision, which will cause the matter to drag on even further. And it certainly wasn’t a good result for son, who lost and now is responsible for paying Mom’s bill.
So how could this have turned out better? If Nursing Home had encouraged Son to retain an elder law attorney to represent Mom in the Medicaid application process. Sure, there is an expense involved in hiring someone. But in the end Nursing Home would have received Medicaid benefits when it should have and Son would not be responsible for paying nursing home. A winning result for all.
Category:Medicaid -- posted at: 1:13pm EST
Sun, 5 October 2008
When money is running out and the family is faced with the need to apply for Medicaid to pay for long term care the question becomes “should we do this ourselves or should we hire an elder law attorney to help?” Sometimes the hospital or the nursing home tells the family they will qualify without too much difficulty. So they try to do it themselves.
The pitfalls of going it alone are many and varied, especially since the latest round of Medicaid changes effective February, 2006 made the laws and regulations in this area much more complicated. Timing is critical. By that, I mean to say, that when you spend down assets and what assets you have at a certain point in time will have an impact on qualifying for benefits. Let me illustrate by way of example.
John and Mary were in their 80’s and living in their home, which they owned. They had other countable assets of approximately $50,000. John and Mary had done no planning for their long term care needs. John became ill in October, was admitted to the hospital and then to a nursing home for rehabilitative services. His condition was such, that he could not go home and needed to remain in the nursing home on a long term basis, at a private pay cost of $10,000 per month.
Mary was told by various personnel at the hospital and the nursing home that based on their level of assets “John would qualify for Medicaid” in January and they arranged for her to meet with a Medicaid caseworker to make an application for benefits. Being stressed out by the reality that John would not go home and uncomfortable with the complicated process she did not understand that for John to qualify she would have to spend down a portion of their assets to get below a certain dollar amount. In her case that number was $27,000. The caseworker explained this to her at the interview but, quite frankly, she was receiving so much information that she really didn’t fully understand how important that was.
She waited for medical and nursing home bills to come in. She figured she owed the money so it was as good as spent. In other words, in her mind she didn’t have $50,000. They owed $28,000 so she had $22,000 left. Not true under Medicaid rules. Until she wrote those checks, John and Mary were “overresourced”, Medicaid’s term for having too much money to qualify for benefits. If you are overresourced by even $1.00 you won’t get Medicaid for that month. You will never get Medicaid for that month.
Had she paid those bills right away John would have qualified for benefits in January. Instead, she didn’t write those checks until June, meaning John didn’t qualify for Medicaid until July. Great, so Medicaid picked up the nursing home bill in July. There was one small problem. Who was going to pay the nursing home bill for January through June? The answer was John and Mary, and at the private pay rate of $10,000 per month that was $60,000. The shame is that this didn’t need to happen.
This example illustrates the pitfalls of going it alone. The rules are quite complicated and timing is critical. You don’t want to be left with a huge nursing home bill which you can’t pay. The nursing home doesn’t really want to be in the position of suing their residents. Having a knowledgeable elder law attorney representing you can save huge dollars and huge amounts of stress.
So how did John and Mary’s problem get resolved? She hired us to negotiate with the nursing home. We were able to reduce the bill a little bit and since she only had $22,000 in liquid assets and could not afford to pay the bill now, the home agreed to take a mortgage against her home. They’ll get paid when the home is sold. Not the best end result but as good as could be expected.
Category:Medicaid -- posted at: 5:14pm EST
Wed, 1 October 2008
In show number 10 of his podcast, Elder Law Today, practicing elder law attorney, Yale Hauptman interviews Anthony Aiello, a compliance officer at Commerce TD Bank on the hot topic of FDIC insurance. For many Americans, the collapse of financial giants such as Lehman Brothers, AIG, Merrill Lynch and Wachovia reminds them of other troubled economic times. Many seniors grew up during the Great Depression of the 1930’s and remember the Savings and Loan scandal of the late 1970’s and early 1980’s. The FDIC insurance program was instituted in the 1933 to protect depositors who lost money when their banks went under. Many Americans are now concerned once again about whether their assets are protected.
Yale and Anthony discuss the basics of how this insurance coverage works. Learn about the ways to stretch the amount of insurance coverage well beyond the $100,000 limit which most people assume, erroneously, is the maximum. There are different categories of accounts, which are treated separately for insurance purposes. For example, coverage for IRA and other retirement accounts is now $250,000 per person.
In his “In the News” segment, Yale discusses a recent government inquiry into accusations that a company which owns assisted living facilities in 20 states is kicking out residents once they have run out of money and apply for Medicaid. He also discusses a recent court case which highlights the pitfalls of having a joint owner on a bank account who then applies for Medicaid. In that New Jersey case, the judge sided with the applicant but learn why the fight may not yet be over. Finally, Yale talks about a new federal law effective October 1, 2008, intended to protect Americans from abusive practices in the sale of reverse mortgages to seniors.
show is timely and informative in light of the current turbulent
economic times. Be sure to tune in.
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Mon, 15 September 2008
The long term care system is a maze and Medicaid in particular is quite complicated. A recent call to our office illustrates that even after receiving Medicaid there are pitfalls to avoid that can cause one to lose Medicaid.
Mary (names have been changed) called us because she had been sued for $80,000 by the nursing home caring for her mother, Jane. Jane had entered Nursing Home on private pay and after spending down her assets qualified for Medicaid. Under Medicaid rules Jane’s Social Security check went to Nursing Home and Medicaid paid the rest of the bill. Mary and Nursing Home arranged for the check to go directly to Nursing Home and everything was fine for 8 years or so.
Mary then moved out of state. Apparently, Social Security assumed that Jane moved too and started sending her checks to her bank account. Mary did not take notice of this and neither, at least for several months, did Nursing Home. After 8 years, Jane lost her Medicaid eligibility.
How could this happen? While Mary does not yet have all the facts (she’ll find out more as the lawsuit winds through the court system), here’s what probably occurred. Because Jane’s income was accumulating in her account, once the balance exceeded $2000 she lost Medicaid eligibility. Jane’s Social Security is treated as income in the month received but if still in her possession the next month then it is treated as an asset. And each month her balance remained over $2000 she was Medicaid ineligible – and those lost months can never be recovered. So every month Jane was running up a bill at the nursing home’s private pay rate.
It is not clear why Nursing Home didn’t notice the change or why it took them several months to write to Mary. They did send Mary a new Medicaid application to complete and file but she either didn’t receive it or didn’t act on it. It appears that nobody on either side was following up on it so Medicaid was never reinstated for the last year of Jane’s life. Now Nursing Home is looking to recoup a year’s worth of lost payments and Mary is trying to avoid a judgment that she can’t afford to pay.
The sad thing is that this all could have been avoided. Medicaid rules are quite complex. Jane’s family and the nursing home needed to keep in contact and stay on top of any changes that could affect Medicaid eligibility. It is easy to miss something that can very quickly result in the loss of benefits.
What you would think is the most insignificant change can cause a chain of events that will lead to losing benefits. You can’t just go on autopilot. That’s when things fall through the cracks. That is exactly what happened here. And now both sides are pointing fingers at each other. Had Mary retained an elder law attorney to file the Medicaid application, both resident and nursing home would have benefited and perhaps this unfortunate result could have been avoided. An important lesson to be learned.
Category:Medicaid -- posted at: 6:28pm EST
Mon, 1 September 2008
In show number 9 of his podcast, Elder Law Today, practicing elder law attorney, Yale Hauptman welcomes as his guest Lauren J. Siegel, a registered nurse and certified life care planner. Lauren explains how she is typically brought into lawsuits brought by parents of disabled minor children and asked to devise a plan of care covering the various needs that the child may have over his/her life.
Yale and Lauren then discuss how this same planning is just as important to elderly parents of adult disabled children. Parents must address care issues for those children after they pass away and how to fund it. Yale points out that any assets intended to fund that care must be properly set aside while the parent is healthy or risk being spent down entirely for the parent’s long term care needs, leaving nothing for the child’s needs. Lauren offers some suggestions for parents to consider.
Yale also introduces a new “In the News” segment. He discusses a recent Pennsylvania court case that highlights the need to be specific in a power of attorney as to what gifting powers are given to an agent. He also discusses a recent Connecticut case in which a child was held responsible financially to pay mom’s nursing bill when he failed to immediately provide all information and documents necessary to complete her application for Medicaid benefits. Yale also updates listeners on a bill introduced in Congress to extend the federal estate exemption amount to $3,500,000 for 2010 and beyond and highlights the continuing trend by employers to provide services to their employees who are caring for elderly parents and loved ones.
This 9th show is packed with important information that anyone who is elderly or caring for, or concerned about, an elderly loved one, won’t want to miss.
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Wed, 27 August 2008
A number of years ago, I received a call from a potential client who had the following tale to tell. The woman’s husband had died leaving a will and some assets, one of which was a 401k. The marriage was a second for her husband, who had 2 sons from his first marriage. While he was single he had changed the beneficiaries of his life insurance and 401k plan to his sons and had redone his will.
After his second marriage, the husband and his new wife bought a new home together. They asked their real estate attorney, who handled the purchase for them, to draft new wills as well. The husband listed for his attorney the assets he wanted to pass to his sons and which to his new wife. The 401k he wanted to go to his wife. Unfortunately, the attorney didn’t understand the difference between probate and non-probate assets. So when he wrote a will that specifically left the 401k to the wife, he didn’t know that the will would have no effect on this asset because the beneficiary designations on file with the custodian of the 401k plan still listed the sons from the first marriage.
When the husband died, the wife received a big shock when she was told that she had no interest in the $500,000 account. That’s because a will doesn’t automatically control the distribution of all your assets. Contract property such as life insurance, annuities and retirement accounts pass in accordance with whom you have designated on the beneficiary forms completed and filed with the life insurance and annuity companies or retirement account custodians. Other types of property pass by operation of law such as joint accounts with right of survivorship or real estate that is owned by husband and wife. When one owner dies the property automatically passes to the surviving owner. It does not matter what the will says.
That is what happened in our story. The 401k is contract property so it passed according to the beneficiary designation form on file, not by the will. The wife tried unsuccessfully to get a court order directing the funds be paid to her. She did recover about half of the account balance, filing a malpractice action against the attorney who drafted her husband’s will, for failing to recognize that listing the 401k account in the will was meaningless.
The moral of the story is that although many people think drafting a will is simple and often undertake to do it themselves or ask the attorney who did other work for them to handle this task as well, they may miss important steps that must be taken that can save a lot of heartache and money.
Category:Probate -- posted at: 12:00pm EST
Wed, 6 August 2008
In show number 8 of his podcast, Elder Law Today, practicing elder law attorney, Yale Hauptman, discusses some real life case studies to illustrate how the Medicaid laws can trip people up and cause much stress and financial loss for the unprepared and unwary.
Yale first discusses the case of the granddaughter caring for her grandmother full time, with Grandmom providing the funds to support both of them. Things go wrong when Grandmom’s condition deteriorates to the point where nursing home care is necessary and the money has run out. Learn the mistakes that this family made and why it has become much harder to fix them under the new Medicaid laws.
Next, Yale discusses a call he received from a son in Mississippi who took in his parents to his own home, moving them from New Jersey. The parents transferred their home to Son, who then put it up for sale. The plan fell apart when Dad took ill and needed nursing home care much sooner than anticipated. He applied for Medicaid and was denied because of the home transfer. The Medicaid caseworker told the family they would need to transfer the home back and spend down the sale proceeds before Dad could then qualify. Learn why their course of action was the wrong one for more than one reason and what they could do fix it and immediately qualify Dad and preserve the funds for Mom.
Yale then discusses the call he received from the frantic daughter who was sued by the nursing home when, after 8 years, Mom lost her Medicaid eligibility. The nursing home sought $80,000, the private pay cost of care for Mom. Why did it happen and what do you need to do to prevent it from happening to your family? Tune in.
The final case study concerns a couple who was unprepared when suddenly Husband took ill, needing nursing home care. They were told that he would qualify for Medicaid but that some amount of money would have to be spent down first. Unfortunately, Wife did not fully understand the urgency and did not spend down to the necessary levels for 6 months. The nursing home presented them with a bill for $70,000, the private pay amount for that period of time, for which Medicaid will not cover. Yale talks about why this outcome didn’t have to happen and what could have been done to avoid it.
Yale also takes time to answer some more listener emails. Learn what to do when a bank resists honoring a power of attorney that is presented to it. This 8th installment is sure to answer many of the questions you have about common elder law issues.
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Fri, 18 July 2008
Adult Day Care is a wonderful alternative for families struggling with the care of an aging or disabled parent, spouse or loved one. Adult Day Care centers can also provide supervision and assistance each day for a senior who is not quite ready for assisted living or long term care.
Each center has a staff of trained health care professionals, including registered nurses and therapists, to help those members with complex physical or psychological problems and needs. Adult Day Care centers provide a structured program that includes a variety of health, social and supportive services in a safe, protective environment.
Services are provided during daytime hours allowing caregivers the peace of mind they need to continue working or simply providing them with a much needed respite so they’re able to face the challenges of day to day care giving.
Members of Adult Day Care centers can look forward to a variety of challenging, interesting and entertaining activities each day. Their caregivers can feel confident that excellent medical and therapeutic care will be provided by an experienced staff of healthcare professionals. Most centers provide a light breakfast or morning snack, lunch and an afternoon snack. Operating hours can vary but most centers operate during standard working hours, Monday through Friday 8 am to 5 pm. Some centers have extended hours are open on weekends and holidays.For those individuals who meet the requirements, Medicaid, Veterans Administration and other funded programs cover adult day care services. Long term care insurance policies may also cover the cost of adult day care centers so it is important to examine your policy carefully.
Category:Long term care planning -- posted at: 5:28pm EST
Thu, 3 July 2008
Sometimes the senior can’t stay at home any longer. Yale discusses with Dan Yanofski, the owner of Elite Realtors of New Jersey, some of the challenges he faces in helping seniors sell their homes. Dan shares his opinions on how to make a home more marketable when it is a bit outdated and the two talk about when is the best time to sell.
For others, staying at home is still a viable option, but some assistance in needed. Yale sits down with Murray Goldsmith, of Spectrum Home Services, whose company, among other services, provides assistance to senior homeowners in making their home a safer place to live. Murray and Yale go from room to room as Murray explains how, in some cases, relatively small modifications can make it easier and safer for a senior to navigate through his/her home and help minimize the risk of a life changing accident.
Yale also takes time to answer listener emails on such topics as whether a power of attorney can be too old, the advantages and disadvantages of making a child a co-owner on a parent’s bank account and whether Medicaid or the nursing home can take your home away from you. Another information packed show that you won’t want to miss.
Elite Realtors of New Jersey 973-994-9009
Spectrum Home Services 973-251-2543
Tue, 24 June 2008
I had a call not too long ago from a woman who was concerned about avoiding probate and paying estate taxes upon her death. She had figured out, or so she thought, how she could solve both problems and wanted confirmation from me that it would work. She had written out a check to her son leaving the dollar amount blank. She then instructed her son that upon her death, or if her passing was imminent, that he should write in the dollar amount and deposit the check in his account.
Of course, trying to outsmart the government in this way won't work. Firstly, going through probate will still be necessary as long as there are any assets that can only be accessed by appointing an executor. In many states probate is not something to fear anyway. Usually it is an inexpensive process that can be handled with little or no court involvement. In those states where probate is messy and expensive, however, this woman's solution still won't work as long as she has even a single asset that requires the appointment of an executor. Often, refund checks payable to the person who died will necessitate the appointment.
As for estate taxes, the government is smarter than that. In determining the size of one's estate all assets transferred within 3 years of one's death are included as part of the estate for tax purposes. This will specifically prevent the strategy of transferring all of one's assets before death to eliminate the estate tax. Now, you might be thinking that the estate tax is not something to worry about since the federal estate tax only kicks in on estates over $2,000,000 (and will go up to $3,500,000 in 2009). However, most states have their own estate tax as well and the amount exempt from tax is much lower. In New Jersey, for instance, the estate tax is owed on estates greater than $675,000 and in New York on estates greater than $1,000,000.
There are other ways this woman may be able to minimize taxes on her estate but writing blank checks with instructions to cash them when she dies is not one of them. The government is much too smart for that.
Category:Probate -- posted at: 2:46am EST
Wed, 4 June 2008
Heidi Schnapp Lisa Bayer Life Management Resources
Life Management Resources 973-533-0839
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Sat, 17 May 2008
A recent study of long term care shows that the percentage of elderly Americans living in nursing homes is on the decline. This appears to be in part because of improved health and partly because of more choices. According to census statistics, 7.4% of Americans 75 and older lived in nursing homes in 2006, down from 8.1% in 2000 and 10.2% in 1990. At home care and assisted living facilities, on the other hand, have been growing. Of the 85 and older group, fewer than 16% are now living in nursing homes, down from 21% 20 years ago.
As the oldest of the 79 million baby boomers turn 62 this year the long term care system is going to be overwhelmed in the next 20 years. Nursing homes will always be a necessary and important part of that system but if given a choice most people would prefer in home or assisted living care as an alternative. The numbers bear that out.
But what most people don't realize is that unless you have enough money to cover the cost of nursing home level care out of income then you run the risk of running out of money. So, here's what happens. You spend your money and when it is all gone you'll get government benefits. If you want that care at home or in an assisted living facility, however, government benefits will not pay for the entire cost. You'll need to pay for the part that the government benefits won't cover. But, of course, you don't have the money because you spent it all in order to qualify for the benefit program. A classic Catch 22. The only place where the government benefits will pay for 100% of your care is in a nursing home.
So, how can you avoid this dilemma? By planning ahead and moving your assets, out of your name, to a trust for your benefit. This way your assets are available to pay for some of your care at home or in an assisted living facility but you can qualify for whatever government benefits are available and you are able to stay out of the nursing home. But you can't wait until you need the care because transferring assets may cause you to be ineligible for government benefits. So you have to do it well in advance of when you might need the care.
Who can help you put this type of plan in place? A qualified elder law attorney. If done properly you are actually maintaining control of your future, exactly at a time when most people who didn't plan ahead lose control because their health no longer allows them to manage their own affairs and they haven't set down a plan of action. And as you can see, the system drives you into a nursing home, unless you plan for the alternatives.
Category:Long term care planning -- posted at: 1:00am EST
Thu, 1 May 2008
In the fifth installment of his podcast, Elder Law Today, Yale Hauptman, takes Elder Law Today on the road to a Caregiving Symposium he spoke at recently. Yale interviews a geriatric care manager, a contractor who makes modifies homes for the elderly and other vendors who attended the symposium about the variety of services they provide to the elderly.
Wed, 23 April 2008
Two weeks ago New Jersey became the third state (California and Washington being the others) to pass into law a bill requiring companies to offer paid leave to employees. The benefit will operate in a similar fashion to state disability benefits in that all employees will contribute an additional amount from their paychecks to help pay for this benefit.
Employees who are caring for a newborn or a newly adopted child are eligible. In addition, however, employees caring for a sick family member can take the leave, which can be as much as 6 weeks. Companies are concerned about the impact the law will have on their businesses if key employees exercise this option.
The law highlights what has become increasingly obvious, that as our population ages more people are caring for elderly loved ones than ever before. 77 million baby boomers will be reaching senior status in the next 20 years. While the paid leave bill, attempts to, in some way, address the crisis, it is clearly not the best approach. Employees who must take time off from work are dealing at that point with a full blown long term care crisis. It often begins with a call that Mom or Dad is in the hospital, then leads to the need for nursing home care, home based care or assisted living care. It is never best to deal with a problem when it has reached the critical stage.
The better approach is to address long term care issues before they arise, in what we call the preplanning stage. Usually, the signs of aging can be seen long before the crisis hits. If families can sit down and, with the assistance of an elder care attorney and other elder care professionals, prepare a plan before the need arises, chances are the employee will not need to take leave, or perhaps may need to take less time off. Preplanning also reduces stress levels for all involved and leads to better care.
Category:Long term care planning -- posted at: 10:25am EST
Wed, 2 April 2008
In the fourth installment of his podcast, Elder Law Today, Yale Hauptman, a practicing New Jersey elder law attorney, discusses how long term care planning actually decreases the likelihood of ever needing nursing home care. Learn how the long term care system actually works to push people towards nursing homes when they have no more money. Medicaid home based benefits often pay only a part of the cost of aides needed on a 24 hour 7 day a week basis, but will pay the entire cost of care if provided in a nursing home setting. It is, therefore, important to plan ahead to have the funds available to be able to stay at home.
In the second segment Yale interviews Angie Hicks of Angie’s List, a website offering reviews by consumers of local home improvement contractors. Yale and Angie talk about how Angie’s List is seeing more inquiries in recent years by children who need help finding services for their parents who live long distances away. Seeing the aging of America, Angie tells Yale that Angie’s List now offers ratings of various elder care services to assist families who are faced with the task of caring for the elderly members of the family unit from a distance.
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Wed, 19 March 2008
A term that has come into increasing usage is "negative inheritance". It describes the situation where an adult child, rather than receiving an inheritance when a parent dies, instead spends his/her own money to cover the parent's long term care needs because the parent has run out of money. It is caused by poor, or in most cases, no planning and is entirely avoidable.
A common scenario that we see is a parent living at home with round the clock home health aides. The parent has run out of funds, maybe even has tapped into as much equity as can be had from the home. The children then pay the cost with no end in sight. Sometimes they take out mortgages on their own home. Eventually, their spending will have an impact on their own retirement savings and ability to pay for their own long term care needs. The financial toll can be devastating, causing them to turn to their children for help when they run out of funds, a never ending cycle.
So, how can it be avoided? By the parent planning before long term care is needed. There are various government benefits that can be tapped to help pay for care. However, each program has its own set of rules that easily trip up the average person. With some careful planning, eligibilty for much needed benefits can be achieved. You never want to run out of money, especially before you reach the highest level of care, nursing home care. If the parent is home and runs out of money then getting into a quality nursing home, should it be needed, can be difficult. The only way to insure that will happen is to private pay to get in the door. But if you've spent all the money before you get there that's where the children are faced with a dilemma. Do we let the state send mom somewhere or do we pay privately to get her into the facility we want her to be in.
Proper planning can also increase the likelihood that the parent can stay out of the nursing home. If you need round the clock care and have no money the government will pay for it if you go to a nursing home. However, in many states, if you want that same care at home, the government won't pay for it all. Of course, if you've spent down everything to get the government benefits you don't have anything left to pay for what the government won't. That's where the planning helps.
The lesson to be learned is that the earlier you plan the better prepared you'll be. Because so much of the long term care system of benefits and laws is state specific it is important to consult with an experienced elder law attorney in the state where you live.
Category:Long term care planning -- posted at: 9:30pm EST
Thu, 6 March 2008
In the third installment of his podcast, Elder Law Today, Yale Hauptman, a practicing New Jersey elder law attorney, answers listeners’ questions by phone and email. Yale corrects common misconceptions people have about some of the basic legal issues facing seniors today. For example, Yale explains that making gifts up to the annual gift tax exclusion amount will carry a Medicaid transfer penalty. Yale explains what probate is and why you don’t necessarily have to fear and avoid it.
Learn why it is a good idea to have a will and not rely on a state’s intestacy laws to distribute your assets. Is it a good idea for a parent to transfer his/her home to the children? Yale discusses the pros and cons to consider from a Medicaid, tax and long term care perspective.
Yale answers a caller’s question on a little known Veterans Administration benefit that can provide much needed additional monthly income to be used for home care and assisted living care. These are just some of the topics covered in a very informative and enlightening evening.
Mon, 25 February 2008
The discussion of long term care and government benefits to pay for that care most often leads to the topic of Medicaid, however, there is another benefit available to qualified veterans of the U.S. military through the Veterans Administration that can be a source of funds to pay for assisted living and home based care. Eligible veterans and their widowed spouses may be eligible for a non-service connected pension, as much as $1801 per month for veterans, $976 per month for widowed spouses. The program is commonly known as the Aid and Attendance program and the applicant must be deemed permanently and totally disabled. But if you're thinking that it's probably too hard to prove a disability that's not necessary the case. The VA presumes that someone over 65 years of age and housebound or in an assisted living facility is permanently and totally disabled.
As is often the case with government benefits, the rules can be confusing. Similar to the Medicaid program applicants must meet certain income and asset limits. The pension amount is determined by a specific formula. Unreimbursed medical expenses are subtracted from gross income. That number is then subtracted from the maximum pension amount to determine the applicant's pension amount. It is important to understand that the cost of the assisted living facility and home health aides is usually counted as an unreimbursed medical expense. In many cases, it becomes easy to qualify for the maximum pension amount.
There is also an asset limit, approximately $40,000 for a single individual, $80,000 for married couples. Unlike the Medicaid program, however, there is no lookback period or penalty for transferring assets. This means that one can transfer assets to get below the asset limits and immediately qualify for Aid and Attendance.
However, things are not that simple. (They rarely are when it comes to the long term care system and government benefits). Transferring assets can result in additional benefits from the VA but those same transfers will result in ineligibility for Medicaid. Now, that's not to say that one should forget about Aid and Attendance. It does, however, require a carefully drafted plan so that should the applicant need the next level of care down the road (ie. nursing home care) the applicant will be able to qualify.
Consulting with a knowledgeable elder law attorney who will help a family plan for the next level of care, not just the care that is needed now, is advisable.
Category:Veteran's Benefits -- posted at: 8:00am EST
Sat, 16 February 2008
Elder Law Today LIVE
Here is your chance to talk live with show host Yale Hauptman on his first live call in show. If you have important questions that you need answered by an experienced elder law attorney here is your chance. On March 3 at 8 PM eastern time Yale will host his first live show.
In addition to answering questions live Yale will have some special guests on the show. This will surely be and educational and entertaining experience.
Click here to join us.
Here is the information to join the show
Category:News -- posted at: 3:34pm EST
Tue, 12 February 2008
Over the past 13+ year I've been able to help many families through what we call the elder care journey from healthy vigorous senior through home assistance, assisted living and nursing home care. Some of the more common mistakes that I see people make are the following:
1. Believing Medicare covers long term custodial nursing home care (it does not);
2. Thinking that a transfer of $12,000 per person per year will not cause Medicaid ineligibility (there is no gift tax but there is a Medicaid transfer penalty);
3. Failing to account for transfer penalties and loss of control of assets when trying to protect assets (I've seen disastrous outcomes because of it);
4. Failing to consider negative tax consequences and disruption of estate plan when transferring assets;
5. Transferring assets without providing a plan for where sources of funds will come from should long term care be necessary within the next 5 years after the transfer;
6. Confusing the Medicaid lookback and transfer penalty (they are not the same);
7. Believing that it is too late to plan (it rarely is);
8. Failing to recognize the sense of urgency in doing long term care planning by telling yourself "I'll wait till it looks like I will need long term care" (the earlier the planning the more that can be protected);
9. Believing that long term care planning means I will lose control of my assets and my decision making (in fact the opposite is true);
10. Hearing what other family members, friends or acquaintances have done and do exactly the same because it sounds like your situation is identical to theirs (it never is, every situation is unique, just as every person is unique);
Category:Long term care planning -- posted at: 9:45pm EST
Fri, 1 February 2008
In the second installment of Elder Law Today Podcast, Yale Hauptman, a practicing New Jersey elder law attorney, explains the basics of the Medicaid nursing home program. Yale explains how this needs-based program works, including the asset and income tests for eligibility. Learn what countable and non-countable assets, Medicaid transfer penalty and lookback period are and why Medicare will not cover most nursing home stays.
Yale also explains why long term care planning must be done well before entry to a nursing home becomes necessary. Congress passed significant changes to the Medicaid laws 2 years ago, known as the Deficit Reduction Act of 2005, changes that the average American is unaware of. Learn why even if you spend down your assets to the Medicaid levels you still may face a Medicaid transfer penalty.
In the second segment, Yale interviews Barbra London of Freedom Eldercare, a licensed home health care agency. Listen to Barbra and Yale talk about the types of services a home health care agency provides and common misconceptions people have about this important resource. They also discuss why, under the new Medicaid laws, hiring an aide directly, rather than through an agency, can trap the unwary and cause a Medicaid ineligibility period.
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To contact Barbra London 201-883-1200 or toll free 866-7 Freedom
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Tue, 29 January 2008
I was speaking with someone the other day who told me her Social Security monthly check declined from 2007 to 2008 and asked if that was possible or a mistake. While the government does on occasion make mistakes (hard to believe), an increase in the Medicare Part B premium may have resulted in the decrease. Part B generally covers outpatient services, such as doctors visits and home health services. Medicare recipients pay a portion of the premium for this benefit, which increases every year. (In 2008 the premium is $96.40.) The monthly Social Security benefit also increases, resulting in a net increase in the monthly check from year to year.
This year, however, for the first time, higher income beneficiaries will pay a higher premium for Part B. Individuals with income between $82,000 and $102,000 per year will pay a monthly premium of $122.20. Married couples with income between $164,000 and $204,000 will pay the same premium amount. There are 3 other income levels which result in higher premiums, the top level being $205,000 per year of income for individuals and $410,000 for married couples. The premium in that case is $238.40 per month.
Category:Medicare -- posted at: 9:00am EST
Fri, 18 January 2008
Every so often, I come across a situation that illustrates so clearly the dangers of going it alone or getting bad advice when dealing with the common issues and dilemmas that are aging in America. I received a call this week from a son in Mississippi. Mom and Dad, no longer able to live at home alone, moved in with Son. They owned their home in New Jersey which they transferred to Son.
Dad's health deteriorated to the point where he needed nursing home care. The couple then spent down their assets and applied for nursing home care for Dad. Meanwhile Son placed the New Jersey home up for sale.
Much to their surprise, the family was informed that the state Medicaid office denied Dad's application. Why? Because the transfer of the home to Son caused a Medicaid ineligibility period. Dad cannot receive Medicaid for 4 and 1/2 years. In other words, Son must give the money back to Mom and Dad and they must spend it down before Dad will receive Medicaid.
Son said that he was prepared to pay for Dad's care. I advised him to seek the advice of an elder law attorney in his state familiar with the Medicaid laws there before he does that. It may make more sense for Mom to take some of the money and buy a new home which would be exempt from Medicaid. There are other strategies that may be beneficial as well and should be explored in greater detail.
The lesson to be learned is to consult with a professional before making any decisions. There is a maze of laws and services in this country that affect seniors. It is easy to get tripped up by them and the cost to your family could be enormous.
Tue, 1 January 2008
In the debut of his podcast, Elder Law Today, Yale Hauptman, a practicing New Jersey elder law attorney, explains what elder law is and how an elder law attorney can be a valuable counselor to seniors and their families. Learn how elder law differs from traditional estate planning. A will, while important, addresses only one scenario, what happens when one dies. Elder law, however, encompasses so much more, what can be termed life planning or long term care planning. In other words, what happens if I don’t die, but instead have a lengthy illness, need increased care, (ie. home care, assisted living, or nursing home care) and do not have the funds to pay for it indefinitely.
Yale discusses the need to have a plan in place, one that includes the necessary documents (ie. power of attorney, health care directive, will, trust) but also brings the family together to work towards a common goal of assisting the senior family member to tackle head on the legal and social issues associated with aging and navigating through the maze of laws and available government benefits.
In the second segment, Yale interviews his first guest, Matthew Glass, a certified special needs advisor. Matthew explains how he assists young families with special needs children. Yale and Matthew then discuss how special needs planning will increase in frequency as parents age and are faced with their own long term care needs. Because that care is expensive, without proper planning they may be forced to spend most or all of their assets on their own care, leaving nothing for their children with special needs. A specifically tailored plan, usually involving a special needs trust, can avoid this drastic result and provide peace of mind to families.
To listen to the show click here
Here is how you can contact Matthew Glass
732-632-5854 or 800-333-7964 visit the The RHG Group Website
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Category:podcasts -- posted at: 3:40pm EST