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Preventing End of Life Costs from Destroying Your Estate

May 19, 2014

Filed under: Asset Protection Planning,Elder Law,Long Term Care,Medicaid,Nursing Homes — Tags: , , , , , — Neel Shah @ 9:58 pm

It’s very rare that anybody has covered all possible risks in terms of their wealth management when it comes to income and cash flow, guaranteed income, cash, investments, and the connection between long term care and your estate. If you skip planning for long term care expenses, you may find that your other wealth management tools and strategies don’t hold up to the rising cost of healthcare.

Preventing End of Life Costs from Destroying Your Estate
(Photo Credit: colourbox.com)

The average cost per month for a long-term care facility is over $7,000. That’s why long term care planning is so essential. When a long-term care insurance policy is too expensive or not an option because you do not qualify.

There are alternatives, however. Structuring your estate in a particular manner can help you guard against the cost of long term care. Two common strategies are eliminating assets through trusts and transfers. This means that down the road, if you need to reduce your assets for Medicaid eligibility, you’ve already done most of the work. If you are confronted with a long-term care event before you have done this, you could find yourself having to “spend down” your assets anyways before government assistance kicks in, depleting your savings and forcing you to do it rapidly, which is rarely in your best interest. However, if you do it incorrectly, it has the potential to have a severely negative impact on eligibility and penalty periods. To learn more about trust planning, gifting, and other strategies to mitigate risk in estate planning, email info@lawesq.net or contact us via phone at 732-521-9455.

‘Gifting’ May Be Penalized By Medicaid

March 11, 2014

Filed under: Gifting,Medicaid,Nursing Homes,Spending Down,Trusts — Neel Shah @ 4:44 pm

While people can “gift” up to $14,000 each to anyone they want to each year without tax penalty, that tactic is not going to fly if it is being done to “spend down” in order to get Medicaid to pay for nursing home care.

Centers for Medicare and Medicaid Services (Me...

Centers for Medicare and Medicaid Services (Medicaid administrator) logo (Photo credit: Wikipedia)

If a person is “gifting” money to family or friends in order to spend down to reach the resource limit for Medicaid nursing home coverage, it better be done five years ahead of time, according to an article in the New York Daily News.

Gifts made within five years of applying are likely to disqualify the gift giver from obtaining coverage for a period of time based on how much was given. The larger the gifts, the longer the wait.

Medicaid will presume the gifts were made to get around the criteria for coverage.

The penalty period is likely to be in place even if the gifts were put into a trust.

Because Medicaid planning and the use of trusts is complex, the article suggests consulting with a qualified estate planning or elder law attorney.

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More “Granny Cams” Used in Nursing Homes

December 25, 2013

Filed under: Elder Abuse,Elder Law,Elder Safety,Nursing Homes — Neel Shah @ 2:51 pm

After the story of Eryetha Mayberry – the nursing home patient whose abuse was caught on a hidden camera – became widely known, the type of surveillance used in the case has grown increasingly widespread. However, some have been quick to criticize the practice. A recent article discusses some of the arguments made for and against the use of “granny cams” in nursing homes.

Opponents contend that the secret monitoring raises ethical and legal questions. Not only is the family member being video taped, but whoever passes in and out of the room is caught on camera as well. Although a protective measure, the cameras are also an invasion of privacy. Some argue nursing home staff should be made aware of the cameras.

Proponents of this form of surveillance argue that the technology is incredibly accessible and widespread. For example, ‘nanny cams’ are often used when parents hire a new babysitter for a child. However, there is a difference between secretly filming a babysitter caring for an infant, and secretly filming aides caring for a full grown adult.

Whether you agree or disagree with the use of secret cameras in nursing homes, it is important to remember that the real problem is the abuse that is occurring. Perhaps nursing homes need to work harder to address the deep-seated issues at the many facilities that have had abuse complaints.

Long Term Care Planning: Understanding the Medicaid Look-Back Provision

November 13, 2013

Filed under: Elder Law,Long Term Care,Medicaid,Nursing Homes — Neel Shah @ 6:01 pm

For those engaged in the process of Long Term Care Planning, perhaps the most intimidating proposition is Medicaid’s look-back provision. This provision provides that certain assets that a person no longer owns will still count toward the calculation of his or her total assets to determine whether he or she qualifies for Medicaid coverage. A recent article discusses the look-back rules.

The Medicaid look-back period is the five years prior to that date upon which an individual applies for Medicaid benefits.  All transfers made during this period are subject to scrutiny by Medicaid officials. For the purposes of calculating benefits, it is as though all gifts made during this period never occurred. For example, if an individual gave his or her child $20,000 the year before he or she applied for Medicaid coverage, the government would likely count that $20,000 towards the person’s assets to determine whether he or she qualifies for Medicaid.

Some individuals try to avoid the look-back provision by setting up a trust. Although Medicaid officials do not consider a trust to be a part of a person’s assets, assets moved into a trust are considered. Therefore, if assets are transferred to a trust during the five-year look-back period, Medicaid officials will take them into account.

Individuals often mistakenly believe that Medicaid has an annual gift-giving exclusion similar to that of the IRS. However, this is not true. Although the IRS allows taxpayers to give gifts up to a certain amount without invoking tax consequences, there is no parallel in the Medicaid determination.

See Something, Say Something: It’s Okay to Report Elder Abuse

November 6, 2013

Filed under: Elder Law,Elder Safety,Nursing Homes — Neel Shah @ 5:41 pm

Too many of our nation’s senior citizens have suffered financial abuse from strangers, caregivers, and even their own family members. As a recent article explains, federal regulators at the Consumer Financial Protection Bureau have told banks that they can report suspected financial elder abuse to the authorities without violating privacy laws.

The announcement was intended to assist with a crackdown on financial elder abuse, which has reached epidemic proportions. The Government Accountability Office has recently reported that in 2010, financial elder abuse had cost America’s senior citizens $2.9 billion.

As director of the Consumer Financial Protection Bureau, Richard Cordray explains that those who work at banks and credit unions “may be able to spot irregular transactions, abnormal account activity, or unusual behavior that signals financial abuse sooner than anyone else can.” Before the announcement, however, bank and credit union employees were afraid to report suspicious activity due to the Gramm-Leach-Bliley Act.

Not only should the new guidance encourage bank and credit union tellers to report suspicious activity, but it will also make it easier for those investigating possible cases of financial elder abuse to access the suspicious accounts.

Dealing with Early-Stage Alzheimer’s

October 23, 2013

Filed under: Aging In Place,Caregivers,Elder Law,Long Term Care,Medicaid,Nursing Homes — Neel Shah @ 9:00 am

Currently, the sixth leading cause of death in the United States is Alzheimer’s disease. Between 2000 and 2010, the number of deaths caused by Alzheimer’s disease increased by 68 percent. By 2050, the number of Americans with Alzheimer’s disease is set to increase to 13.8 million. As a recent article explains, Alzheimer’s could quite possibly become an epidemic, if it is not one already.

English: PET scan of a human brain with Alzhei...

English: PET scan of a human brain with Alzheimer’s disease (Photo credit: Wikipedia)

If a loved one in your family begins to display the signs of Alzheimer’s disease, the first thing a family should do (beyond medical attention) is be sure that the family member has executed a will, durable financial power of attorney, and health care power of attorney. These documents allow the person to direct how his or her assets will be distributed upon his or her death, and also to direct who should make medical and financial decisions for him or her when he or she is no longer capable.

Importantly, a person diagnosed with early-stage Alzheimer’s may still be able to sign these legal documents. When a loved one is suffering from short-term memory or vocabulary loss, but still has a grasp on reality, he or she can often show the necessary mental capacity to create legal documents.  Although it is best if these documents are created prior to the early-stage dementia, if that is not possible, have a geriatric psychologist evaluate the person immediately prior to signing.

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“Safe at Home: New Programs Aim at Helping Senior Citizens to ‘Age in Place’”

August 28, 2013

Filed under: Aging In Place,Caregivers,Nursing Homes — Neel Shah @ 9:00 am

The vast majority of senior citizens aspire to “age in place,” or remain in their home for as long as possible. This desire can often be problematic, however, as most homes are not equipped to safely house an aging senior citizen. A recent article discusses a study currently being conducted to determine how to assist seniors in their goal of aging in place.

85 years

85 years (Photo credit: jaded one)

The purpose of the study, which is being conducted by researchers at the Johns Hopkins University, is to show that older Americans can delay an impending nursing home stay for at least a year. The delay is effectuated through assisting the seniors with inexpensive housing modifications and customized strategies for daily living.

Known as the Capable Project, the project will send handymen, occupational therapists, and nurses to 800 senior citizens. These professionals will implement minor safety improvements on the homes, as well as provide the seniors with individualized strategies for daily living. Each senior participant will receive approximately $1,100 in home improvements, which may include new banisters, grab bars in bathrooms, wider doorways, and better lighting. Seniors will also be given tools to address common challenges such as managing medications and cooking for themselves.

If senior citizens are successfully kept independent longer, taxpayers will save millions that would have been spent for nursing home care. In addition, senior citizens will have more personalized care and attention while enjoying their familiar lifestyle and home environment.

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Two Strategies for Medicaid Planning

August 21, 2013

Filed under: Asset Protection Planning,Medicaid,Nursing Homes — Neel Shah @ 9:00 am

Many individuals who require a nursing home stay at the end of their life deplete their assets in order to pay for the care. As a recent article explains, when people fail to protect their assets, it is because they failed to plan properly. The article urges readers to take steps towards Medicaid planning while they are still young and healthy.

One way to protect your assets is to exchange non-exempt assets for exempt ones. When determining whether you are eligible for Medicaid benefits, Medicaid representatives include all of your countable assets, those not exempted by State law, or that are otherwise inaccessible to Medicaid. Exempt assets vary from state to state, but typically include the family home, burial plots, one automobile, and term life insurance. Check with your state for an exact list of exempt assets.

Many people do not realize that Medicaid will count one’s spouse’s assets as well when determining Medicaid eligibility. If your spouse is still healthy, consider purchasing an appropriate single premium annuity benefit for them. This will provide your spouse with an additional income stream, while keeping the cost out of the countable assets for you, as well as your spouse.