John L. Roberts
Certified Elder Law Attorney
John L. Roberts, J.D., is an Elder Law Attorney serving clients in Hampden County, MA. After practicing for 15 years, he confronted the challenges of family caregiving when his own father developed dementia. The experience transformed his practice, enabling him to help clients who are family caregivers from a place of true understanding.
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Question
Planning for "spend down."
There are several Medicaid programs in Massachusetts that can help cover the costs of assisted living. The business office at the... There are several Medicaid programs in Massachusetts that can help cover the costs of assisted living. The business office at the facilities you are considering can tell you which programs they can access. There are other sources of information depending on which program you choose.
Group Adult Foster Care (GAFC) pays for services for elders in subsidized senior housing and in assisted living centers. GAFC pays for services such as daily personal care, homemaking, meals, and transportation.
The assisted living center may combine the GAFC services with the room and board which is paid by the resident, and another program called SSI-G. But you do not have to be eligible to receive SSI-G in order to qualify for GAFC.
To qualify for GAFC, the person must have low monthly income, or obtain the MassHealth Home and Community Based Services waiver.
Senior Care Options (SCO) combines Medicare and Medicaid benefits.There are several SCOs serving people age 65+ in Massachusetts. Ask to see the apartments that are allotted to these programs in the facility you are considering. It's likely the subsidized units are shared with a roommate.
Program of All-Inclusive Care for the Elderly (PACE) is for patients (including residents of some assisted living facilities)who are eligible for Medicare and Medicaid. The purpose of the program is to help prevent nursing home admissions, and keep the member safely at home or in assisted living for as long as possible. If a nursing home admission becomes necessary, the PACE plan pays for the long-term care in the facility. Services provided by the PACE Interdisciplinary Team are coordinated with assisted living facilities that participate in PACE. see more
Group Adult Foster Care (GAFC) pays for services for elders in subsidized senior housing and in assisted living centers. GAFC pays for services such as daily personal care, homemaking, meals, and transportation.
The assisted living center may combine the GAFC services with the room and board which is paid by the resident, and another program called SSI-G. But you do not have to be eligible to receive SSI-G in order to qualify for GAFC.
To qualify for GAFC, the person must have low monthly income, or obtain the MassHealth Home and Community Based Services waiver.
Senior Care Options (SCO) combines Medicare and Medicaid benefits.There are several SCOs serving people age 65+ in Massachusetts. Ask to see the apartments that are allotted to these programs in the facility you are considering. It's likely the subsidized units are shared with a roommate.
Program of All-Inclusive Care for the Elderly (PACE) is for patients (including residents of some assisted living facilities)who are eligible for Medicare and Medicaid. The purpose of the program is to help prevent nursing home admissions, and keep the member safely at home or in assisted living for as long as possible. If a nursing home admission becomes necessary, the PACE plan pays for the long-term care in the facility. Services provided by the PACE Interdisciplinary Team are coordinated with assisted living facilities that participate in PACE. see more
Question
Planning for "spend down."
There are several Medicaid programs in Massachusetts that can help cover the costs of assisted living. The business offices at the... There are several Medicaid programs in Massachusetts that can help cover the costs of assisted living. The business offices at the facilities you are considering can tell you which programs they can access. There are other sources of information to help decide which program is the best fit.
Group Adult Foster Care (GAFC) pays for services for elders in subsidized senior housing and in assisted living centers. GAFC pays for services such as daily personal care, homemaking, meals, and transportation.
The assisted living center may combine the GAFC services with the room and board which is paid by the resident, and another program called SSI-G. But you do not have to be eligible to receive SSI-G in order to qualify for GAFC.
To qualify for GAFC, the person must have low monthly income, or obtain the MassHealth Home and Community Based Services waiver.
Senior Care Options (SCO) combines Medicare and Medicaid benefits. There are several SCOs serving people age 65+ in Massachusetts.
Ask to see the apartments that are allotted to these programs in the facilities you are considering. It's likely the subsidized units are shared with a roommate.
Program of All-Inclusive Care for the Elderly (PACE) is for patients (including residents of some assisted living facilities) who are eligible for Medicare and Medicaid. The purpose of the program is to help prevent nursing home admissions, and keep the member safely at home or in assisted living for as long as possible. If a nursing home admission becomes necessary, the PACE plan pays for the long-term care in the facility. Services provided by the PACE Interdisciplinary Team are coordinated with assisted living facilities that participate in PACE.
When a patient becomes eligible for Medicaid, MassHealth covers the co-pays that Medicare would otherwise leave to the patient. But the Patient Paid Amount assessed by Medicaid is based on monthly income and leaves only the Personal Needs Allowance that you mentioned ($72.80 / month). see more
Group Adult Foster Care (GAFC) pays for services for elders in subsidized senior housing and in assisted living centers. GAFC pays for services such as daily personal care, homemaking, meals, and transportation.
The assisted living center may combine the GAFC services with the room and board which is paid by the resident, and another program called SSI-G. But you do not have to be eligible to receive SSI-G in order to qualify for GAFC.
To qualify for GAFC, the person must have low monthly income, or obtain the MassHealth Home and Community Based Services waiver.
Senior Care Options (SCO) combines Medicare and Medicaid benefits. There are several SCOs serving people age 65+ in Massachusetts.
Ask to see the apartments that are allotted to these programs in the facilities you are considering. It's likely the subsidized units are shared with a roommate.
Program of All-Inclusive Care for the Elderly (PACE) is for patients (including residents of some assisted living facilities) who are eligible for Medicare and Medicaid. The purpose of the program is to help prevent nursing home admissions, and keep the member safely at home or in assisted living for as long as possible. If a nursing home admission becomes necessary, the PACE plan pays for the long-term care in the facility. Services provided by the PACE Interdisciplinary Team are coordinated with assisted living facilities that participate in PACE.
When a patient becomes eligible for Medicaid, MassHealth covers the co-pays that Medicare would otherwise leave to the patient. But the Patient Paid Amount assessed by Medicaid is based on monthly income and leaves only the Personal Needs Allowance that you mentioned ($72.80 / month). see more
Question
Combining assets with parents; are there any legal pitfalls?
Suggest that your parents talk with an Elder Law Attorney in your state who also has expertise in residential real estate closings. Ask the... Suggest that your parents talk with an Elder Law Attorney in your state who also has expertise in residential real estate closings.
Ask the Attorney about options for managing the proceeds from sale of their home.
Depending on the current health of your parents (which sets up a timeline for possible need for a nursing home admission and Medicaid in the future) the Attorney may suggest that your parents buy a Life Estate interest in the new home you are buying.
Other Medicaid regulations to consider include the Caregiver Child exception for home transfers, which would exempt a transfer of the house if your parents owned the house and their adult child had lived in the house and cared for the parent needing Medicaid for 2 years before a nursing home admission.
Also consider a Caregiver Contract which would pay you for care, with reimbursement to you that is exempt from Medicaid transfer penalties.
Many other factors can fit into good Estate Planning and Elder Care Planning, since you have the foresight to anticipate future needs. If the Elder Law Attorney represents your parents in the sale and purchase closings, he or she will be able to coordinate everything for your family and help to optimize your resources. see more
Ask the Attorney about options for managing the proceeds from sale of their home.
Depending on the current health of your parents (which sets up a timeline for possible need for a nursing home admission and Medicaid in the future) the Attorney may suggest that your parents buy a Life Estate interest in the new home you are buying.
Other Medicaid regulations to consider include the Caregiver Child exception for home transfers, which would exempt a transfer of the house if your parents owned the house and their adult child had lived in the house and cared for the parent needing Medicaid for 2 years before a nursing home admission.
Also consider a Caregiver Contract which would pay you for care, with reimbursement to you that is exempt from Medicaid transfer penalties.
Many other factors can fit into good Estate Planning and Elder Care Planning, since you have the foresight to anticipate future needs. If the Elder Law Attorney represents your parents in the sale and purchase closings, he or she will be able to coordinate everything for your family and help to optimize your resources. see more
Question
Can you put your house as a transfer on death deed so it doesn't go into probate?
You're asking a good question that is well worth the insights from an elder law attorney in your state who knows about real estate and... You're asking a good question that is well worth the insights from an elder law attorney in your state who knows about real estate and your state's Medicaid regulations.
In my state (Massachusetts) there is no Medicaid estate recovery from the Remainder interest of property that passes at death, by operation of law outside of Probate under a deed from a property owner who retained a Life Estate.
But the property owner can't sign a deed transferring an interest in his or her real estate and expect to be eligible for Medicaid in my state, unless 5 years have passed since the transfer.
There may be better ways that a transfer upon death Deed to get the results you want. Ask about trusts, and your state's provisions for joint ownership.
Talking with an elder law attorney in your state will open your eyes to all the options, and alert you to the important tax considerations that other people have posted here, in response to your question. see more
In my state (Massachusetts) there is no Medicaid estate recovery from the Remainder interest of property that passes at death, by operation of law outside of Probate under a deed from a property owner who retained a Life Estate.
But the property owner can't sign a deed transferring an interest in his or her real estate and expect to be eligible for Medicaid in my state, unless 5 years have passed since the transfer.
There may be better ways that a transfer upon death Deed to get the results you want. Ask about trusts, and your state's provisions for joint ownership.
Talking with an elder law attorney in your state will open your eyes to all the options, and alert you to the important tax considerations that other people have posted here, in response to your question. see more
Question
My grandfather needs home aide care. We are looking to apply for Medicaid. He has about 40k in savings. How do...
An elder law attorney in your state can help your grandparents plan the best course to eligibility for the home care program that will help... An elder law attorney in your state can help your grandparents plan the best course to eligibility for the home care program that will help them stay safely at home.
Their modest life savings may be directed to the individual ownership of your grandmother, to non countable assets, to useful home improvements, or combinations of those, depending on the regulations in your state. They might consider setting the funds aside in a Pooled Trust account, but that step is probably unnecessary right now, considering the limited amount of funds available.
You mentioned the goal of transferring funds to their children. The elder law attorney can explain the transfer penalties that may apply to home care eligibility in your state, and to eligibility for Medicaid payment for care in a facility that will disqualify if care is needed within the lookback period over the coming 5 years.
But these transfer penalties don't apply to transactions made for value received by your grandparents, and if the children are providing any services, the elder law attorney can show them how to satisfy the requirements in your state for documenting payment for services that eliminates problems with Medicaid eligibility now or in the future.
Also, if there is a disabled family member, your state's regulations will explain how funds can be transferred for the disabled person's benefit, with no penalty to your grandparents. see more
Their modest life savings may be directed to the individual ownership of your grandmother, to non countable assets, to useful home improvements, or combinations of those, depending on the regulations in your state. They might consider setting the funds aside in a Pooled Trust account, but that step is probably unnecessary right now, considering the limited amount of funds available.
You mentioned the goal of transferring funds to their children. The elder law attorney can explain the transfer penalties that may apply to home care eligibility in your state, and to eligibility for Medicaid payment for care in a facility that will disqualify if care is needed within the lookback period over the coming 5 years.
But these transfer penalties don't apply to transactions made for value received by your grandparents, and if the children are providing any services, the elder law attorney can show them how to satisfy the requirements in your state for documenting payment for services that eliminates problems with Medicaid eligibility now or in the future.
Also, if there is a disabled family member, your state's regulations will explain how funds can be transferred for the disabled person's benefit, with no penalty to your grandparents. see more
Question
We may need to sell mom's house to pay for her assisted living. How do I proceed as POA?
You mentioned that your mother needs 24 hour care, but does not qualify for "medical." If you mean that your mother is not... You mentioned that your mother needs 24 hour care, but does not qualify for "medical." If you mean that your mother is not medically needy enough to need nursing home care, and you are considering less restrictive memory care in assisted living facility, your mother can privately pay for assisted living using her savings and the house sale proceeds.
With proper planning, there may even be PACE or other needs-based programs in your state that your mother could qualify for in the assisted living setting.
Talk with an elder law attorney in your state who knows the Medicaid regulations, and you can coordinate the house sale and the 401k liquidation with planning for eligibility for Medicaid if your mother needs a nursing home admission in the future.
When your mother meets the medical requirements for Medicaid paid nursing home care, there will be regulations in your state that allow your mother to use her life savings for non-countable assets, and/or to set the funds aside in a pooled trust for her supplemental needs.
The elder law attorney in your state will be able to:
review the Power of Attorney document,
confirm whether you have authority to sell the real estate (or need authority from a Court),
explain all of your Medicaid planning options, and
take care of all the details involved with real estate transaction for you.
Finding the right attorney who can handle all of these Medicaid planning and real estate tasks will save you time, allow you to focus on the priorities of life, and protect your mother now and in the future. see more
With proper planning, there may even be PACE or other needs-based programs in your state that your mother could qualify for in the assisted living setting.
Talk with an elder law attorney in your state who knows the Medicaid regulations, and you can coordinate the house sale and the 401k liquidation with planning for eligibility for Medicaid if your mother needs a nursing home admission in the future.
When your mother meets the medical requirements for Medicaid paid nursing home care, there will be regulations in your state that allow your mother to use her life savings for non-countable assets, and/or to set the funds aside in a pooled trust for her supplemental needs.
The elder law attorney in your state will be able to:
review the Power of Attorney document,
confirm whether you have authority to sell the real estate (or need authority from a Court),
explain all of your Medicaid planning options, and
take care of all the details involved with real estate transaction for you.
Finding the right attorney who can handle all of these Medicaid planning and real estate tasks will save you time, allow you to focus on the priorities of life, and protect your mother now and in the future. see more
Question
Purchasing a home with settlement funds plus a loan.
You mentioned that your mother is currently qualified to receive Medicaid, however if the cash she receives from her personal injury... You mentioned that your mother is currently qualified to receive Medicaid, however if the cash she receives from her personal injury settlement puts her over the $2,000 asset limit she becomes DISqualified.
As one of the Agingcare.com posters has already said, you need immediate advice from an elder law attorney in your state who works with clients who need Medicaid eligibility.
You have several good ideas about providing care if your mother returns home. Working with the regulations in your state, an elder law attorney can explain how your mother can use the settlement funds in ways that will not disqualify her now or in the future.
The elder law attorney can explain how your mother should report the settlement funds to Medicaid, and use the funds and preserve eligibility. see more
As one of the Agingcare.com posters has already said, you need immediate advice from an elder law attorney in your state who works with clients who need Medicaid eligibility.
You have several good ideas about providing care if your mother returns home. Working with the regulations in your state, an elder law attorney can explain how your mother can use the settlement funds in ways that will not disqualify her now or in the future.
The elder law attorney can explain how your mother should report the settlement funds to Medicaid, and use the funds and preserve eligibility. see more
Question
We're trying to draw up a care agreement. What is the proper pay to receive for being a full time caregiver?
A Caregiver Contract can prevent arguments and misunderstandings among other family members who can't or won't help... A Caregiver Contract can prevent arguments and misunderstandings among other family members who can't or won't help out. Without a written agreement, the elder (and other people involved in care such as physicians and health care providers) aren't sure who is responsible to maintain the needed level of care. Without a written agreement, the elder who pays cash to a family member for care can be disqualified from Medicaid coverage if they need nursing home care in the future.
Understanding these elements puts you on the path to preparing a document that establishes the compensation and services in a format that Medicaid can understand and accept.
As others have said here, it's worth hiring an elder law attorney in your state to put together the contract elements that best serve the elder, and protect you, as you provide these valuable services.
In my state (Massachusetts) Employers must give domestic workers who work 16 or more hours a week a written agreement.
https://www.mass.gov/service-details/domestic-workers
The laws in your state, and every other state, will be different, and Federal wage and hour law overlays all 50 states.
Even if your Caregiver Contract involves only members of your family, compliance with the labor and tax laws, and workers comp, provides protection and benefits for all the parties. see more
Understanding these elements puts you on the path to preparing a document that establishes the compensation and services in a format that Medicaid can understand and accept.
As others have said here, it's worth hiring an elder law attorney in your state to put together the contract elements that best serve the elder, and protect you, as you provide these valuable services.
In my state (Massachusetts) Employers must give domestic workers who work 16 or more hours a week a written agreement.
https://www.mass.gov/service-details/domestic-workers
The laws in your state, and every other state, will be different, and Federal wage and hour law overlays all 50 states.
Even if your Caregiver Contract involves only members of your family, compliance with the labor and tax laws, and workers comp, provides protection and benefits for all the parties. see more
Question
Will a revocable trust protect my parents' assets from being counted against Medicaid?
Revocable means the person who created the Trust (the Grantor or Donor) can change, amend, and revise the Trust provisions, and take back... Revocable means the person who created the Trust (the Grantor or Donor) can change, amend, and revise the Trust provisions, and take back any assets.
So, that person is still considered the owner of any assets that they titled as being owned by the Trustee.
Ownership and control of an asset makes it countable to the person who is applying for Medicaid.
Ask the attorney who drafted the Trust to explain how it works.
A Revocable Trust can become Irrevocable when the Grantor or Donor dies. Ask whether your parents have established a plan that would serve the long term care planning needs of the surviving spouse after death of one spouse.
If the purpose of the Revocable Trust was simply to avoid Probate, it's not designed to allow for Medicaid eligibility. see more
So, that person is still considered the owner of any assets that they titled as being owned by the Trustee.
Ownership and control of an asset makes it countable to the person who is applying for Medicaid.
Ask the attorney who drafted the Trust to explain how it works.
A Revocable Trust can become Irrevocable when the Grantor or Donor dies. Ask whether your parents have established a plan that would serve the long term care planning needs of the surviving spouse after death of one spouse.
If the purpose of the Revocable Trust was simply to avoid Probate, it's not designed to allow for Medicaid eligibility. see more
Question
Refund of long-term care insurance policy? Is it possible?
Unless there was misrepresentation or fraud that induced your wife to buy the Long Term Care Insurance Policy, or a breach of the terms of... Unless there was misrepresentation or fraud that induced your wife to buy the Long Term Care Insurance Policy, or a breach of the terms of the insurance contract, the courts wouldn't be able to help her get her money back.
Was the hefty increase in premiums an indicator of misrepresentation? Were the increases a breach of what she contracted for? You could get answers to those questions by asking an insurance lawyer in your state to read the LTC Policy and check on the laws in your state.
As others have posted here, you have to get up pretty early in the morning to beat an insurance company in court.
If you ever decide to check on LTC insurance in the future, remember that you do get a free look period that allows you to change your mind even after you sign the contract. From the Shopper’s Guide to Long-Term Care Insurance, published by the National Association of Insurance Commissioners:
If you decide you don’t want the policy soon after you bought it, you can cancel it and get your money back. You only have a certain number of days after you get the policy to tell the company you don’t want it. How many days you have depends on the “free-look” period. In some states the insurance company must tell you about the free-look period on the cover page of the policy. In most states you have 30 days to cancel, but in some you have less time. Check with your state insurance department.
https://www.ltcfeds.com/epAssets/documents/NAIC_Shoppers_Guide.pdf
Check the policy to see if there is a clause for Premium Refund at Death:
This benefit pays to your estate any premiums you paid minus any benefits the company paid. To get the refund, you must have paid premiums for a certain number of years. Also, some companies refund premiums only if the policyholder dies before a certain age, usually 65 or 75.
Posters here have pointed out how a Hybrid LTC policy combines Life Insurance with the coverage for risk of long term care, so survivors can get a death benefit if the policy isn't used up on care costs.
In my state, Massachusetts, LTC insurance policies have a unique exemption that protects the home from Medicaid estate recovery. LTC policies are different in every state. see more
Was the hefty increase in premiums an indicator of misrepresentation? Were the increases a breach of what she contracted for? You could get answers to those questions by asking an insurance lawyer in your state to read the LTC Policy and check on the laws in your state.
As others have posted here, you have to get up pretty early in the morning to beat an insurance company in court.
If you ever decide to check on LTC insurance in the future, remember that you do get a free look period that allows you to change your mind even after you sign the contract. From the Shopper’s Guide to Long-Term Care Insurance, published by the National Association of Insurance Commissioners:
If you decide you don’t want the policy soon after you bought it, you can cancel it and get your money back. You only have a certain number of days after you get the policy to tell the company you don’t want it. How many days you have depends on the “free-look” period. In some states the insurance company must tell you about the free-look period on the cover page of the policy. In most states you have 30 days to cancel, but in some you have less time. Check with your state insurance department.
https://www.ltcfeds.com/epAssets/documents/NAIC_Shoppers_Guide.pdf
Check the policy to see if there is a clause for Premium Refund at Death:
This benefit pays to your estate any premiums you paid minus any benefits the company paid. To get the refund, you must have paid premiums for a certain number of years. Also, some companies refund premiums only if the policyholder dies before a certain age, usually 65 or 75.
Posters here have pointed out how a Hybrid LTC policy combines Life Insurance with the coverage for risk of long term care, so survivors can get a death benefit if the policy isn't used up on care costs.
In my state, Massachusetts, LTC insurance policies have a unique exemption that protects the home from Medicaid estate recovery. LTC policies are different in every state. see more
Question
Medicaid or Aid and Attendance?
Aid & Attendance would not provide enough reimbursement to cover the full cost of care in a Skilled Nursing Facility. Unless your... Aid & Attendance would not provide enough reimbursement to cover the full cost of care in a Skilled Nursing Facility. Unless your mother has other monthly income that would cover the cost of private paid nursing home care, Medicaid would be the source of payment when Medicare benefits are exhausted.
Aid & Attendance is reduced to a small monthly benefit once a nursing home resident qualifies for Medicaid.
The best source for a strategy on how to safely transition your mother to another state is to talk with an elder law attorney in the destination state, close to the facility you are considering. If you hire the elder law attorney in the destination state to prepare to file the Medicaid application, you should be confident in knowing it will comply with the eligibility regulations there.
In my state (Massachusetts) all that is needed for a new nursing home resident is the intent to remain here.
There are nuances in every state governing the interplay of Aid & Attendance and Medicaid. For example, the Massachusetts legislature has added Veterans Benefits to the list of resources that are exempt from the Medicaid income and asset calculation in Massachusetts:
https://malegislature.gov/Laws/SessionLaws/Acts/2018/Chapter218
https://malegislature.gov/Laws/GeneralLaws/PartI/TitleXVII/Chapter118E/Section25
But that's just an example of how state specific your question is, and the value that an Elder Law Attorney in your destination state can bring to you and your mother. see more
Aid & Attendance is reduced to a small monthly benefit once a nursing home resident qualifies for Medicaid.
The best source for a strategy on how to safely transition your mother to another state is to talk with an elder law attorney in the destination state, close to the facility you are considering. If you hire the elder law attorney in the destination state to prepare to file the Medicaid application, you should be confident in knowing it will comply with the eligibility regulations there.
In my state (Massachusetts) all that is needed for a new nursing home resident is the intent to remain here.
There are nuances in every state governing the interplay of Aid & Attendance and Medicaid. For example, the Massachusetts legislature has added Veterans Benefits to the list of resources that are exempt from the Medicaid income and asset calculation in Massachusetts:
https://malegislature.gov/Laws/SessionLaws/Acts/2018/Chapter218
https://malegislature.gov/Laws/GeneralLaws/PartI/TitleXVII/Chapter118E/Section25
But that's just an example of how state specific your question is, and the value that an Elder Law Attorney in your destination state can bring to you and your mother. see more
Question
When you are a daughter and also the POA for an aging parent, is it ok to be paid?
If your mother is medically eligible for Medicaid now, why would you wait until all of her assets are spent down before preparing to apply?... If your mother is medically eligible for Medicaid now, why would you wait until all of her assets are spent down before preparing to apply? Talk with an elder law attorney in your state now, and learn how excess countable assets can be set aside for supplemental needs so your mother can be financially eligible sooner, rather than later.
And, Yes, you can be paid for your work, but if you want your mother to be eligible for Medicaid your compensation must comply with the Medicaid regulations in your state.
Talking with an elder law attorney in your state is a first step toward the results you are looking for your mother's care and your peace of mind. see more
And, Yes, you can be paid for your work, but if you want your mother to be eligible for Medicaid your compensation must comply with the Medicaid regulations in your state.
Talking with an elder law attorney in your state is a first step toward the results you are looking for your mother's care and your peace of mind. see more
Question
How can I get a sibling to move out of parents other property so he can receive Medicaid? Story inside...
As others have posted here, your question indicates you may need to take several steps to get authority over your father's financial... As others have posted here, your question indicates you may need to take several steps to get authority over your father's financial affairs before you can move toward stabilizing the situation.
You didn't mention a Power of Attorney document, which could provide authority to manage and sell real estate. If there is no POA, you can petition your state's probate or surrogate court for authority to manage and sell assets.
Your sibling would get notice of any court proceedings, and may oppose what you are trying to do.
If you contact an elder law attorney in your state who has experience with real estate and probate procedures, you can get ideas on how to begin solving the problems. The no-rent tenant living in your father's real estate, eligibility for at-home care payments from Medicaid, and reimbursement for your care giving work should be on your list of questions. see more
You didn't mention a Power of Attorney document, which could provide authority to manage and sell real estate. If there is no POA, you can petition your state's probate or surrogate court for authority to manage and sell assets.
Your sibling would get notice of any court proceedings, and may oppose what you are trying to do.
If you contact an elder law attorney in your state who has experience with real estate and probate procedures, you can get ideas on how to begin solving the problems. The no-rent tenant living in your father's real estate, eligibility for at-home care payments from Medicaid, and reimbursement for your care giving work should be on your list of questions. see more
Question
Can the nursing home take my father's life insurance?
Your question indicates that you are relying on the nursing home (or an application service that they hire) to prepare the Medicaid... Your question indicates that you are relying on the nursing home (or an application service that they hire) to prepare the Medicaid application. This may be a good approach for people who do not have any assets, and who don't have a spouse at home who is relying on the nursing home resident's income .
But many people are best served by hiring an elder law attorney in your state who can explain the entire eligibility picture, and how it applies to you and your father.
If your father has limited assets, there is no reason why he should not immediately qualify for Medicaid. The only requirement is that his assets be organized properly, to comply with the Medicaid regulations.
A life insurance policy worth $10,000 would disqualify him, but the excess value of the policy can be used to buy non-countable assets (like an irrevocable funeral contract). It's also possible to set aside any excess assets in a pooled trust arrangement for your father or transfer the assets to people who are exempt from Medicaid transfer penalties.
You won't know until you talk with the professional who can give you the big picture.
The problem with the free services provided by the nursing home is the volume of work that they must contend with. Often they can't give immediate attention to the many details that could help you. Timing matters when you need eligibility to begin now. see more
But many people are best served by hiring an elder law attorney in your state who can explain the entire eligibility picture, and how it applies to you and your father.
If your father has limited assets, there is no reason why he should not immediately qualify for Medicaid. The only requirement is that his assets be organized properly, to comply with the Medicaid regulations.
A life insurance policy worth $10,000 would disqualify him, but the excess value of the policy can be used to buy non-countable assets (like an irrevocable funeral contract). It's also possible to set aside any excess assets in a pooled trust arrangement for your father or transfer the assets to people who are exempt from Medicaid transfer penalties.
You won't know until you talk with the professional who can give you the big picture.
The problem with the free services provided by the nursing home is the volume of work that they must contend with. Often they can't give immediate attention to the many details that could help you. Timing matters when you need eligibility to begin now. see more
Question
Mom has been at nursing home for rehab and already they want us to pay privately. Any advice?
This is the time to talk with a geriatric care manager and an elder law attorney in your state. Nursing homes are often reluctant to keep... This is the time to talk with a geriatric care manager and an elder law attorney in your state.
Nursing homes are often reluctant to keep billing Medicare, because they think Medicare coverage depends on the beneficiary’s restoration potential; but the standard is whether skilled care is required.
Even if full recovery or medical improvement is not possible, a patient may need skilled services to prevent further deterioration or preserve current capabilities. The nursing home patient who needs these skilled services should still be covered by Medicare.
The February 16, 2017 statement by Centers for Medicare & Medicaid Services (CMS) says: "Skilled nursing services would be covered where such skilled nursing services are necessary to maintain the patient's current condition or prevent or slow further deterioration so long as the beneficiary requires skilled care for the services to be safely and effectively provided."
Medicare has posted plenty of material for you to read.
https://www.medicare.gov/coverage/skilled-nursing-facility-care.html
But the most efficient way to learn whether your mom needs skilled care is to talk with an advocate in your state who can give you an objective view. It's important to coordinate Medicare eligibility with other resources like LTC Insurance. see more
Nursing homes are often reluctant to keep billing Medicare, because they think Medicare coverage depends on the beneficiary’s restoration potential; but the standard is whether skilled care is required.
Even if full recovery or medical improvement is not possible, a patient may need skilled services to prevent further deterioration or preserve current capabilities. The nursing home patient who needs these skilled services should still be covered by Medicare.
The February 16, 2017 statement by Centers for Medicare & Medicaid Services (CMS) says: "Skilled nursing services would be covered where such skilled nursing services are necessary to maintain the patient's current condition or prevent or slow further deterioration so long as the beneficiary requires skilled care for the services to be safely and effectively provided."
Medicare has posted plenty of material for you to read.
https://www.medicare.gov/coverage/skilled-nursing-facility-care.html
But the most efficient way to learn whether your mom needs skilled care is to talk with an advocate in your state who can give you an objective view. It's important to coordinate Medicare eligibility with other resources like LTC Insurance. see more
Question
I cannot care for my husband anymore due to health problems, if I put him in a nursing home, will I keep his i...
If the nursing home resident is married to a spouse who lives at home or in assisted living, income from the nursing home spouse can be... If the nursing home resident is married to a spouse who lives at home or in assisted living, income from the nursing home spouse can be kept by the "healthy spouse" who is living in the community.
The healthy spouse is allowed to keep an amount of the nursing home resident spouse income (with no questions asked by Medicaid) called the Minimum Monthly Maintenance Needs Allowance ("Minimum MMNA").
Every year, on July 1st, the MMNA is increased. The Minimum Monthly Maintenance Needs Allowance (Minimum MMNA) for July 1, 2018 through June 30, 2019 will be $2,057.00 for all states, except Alaska and Hawaii. The "Spousal Impoverishment figures" are posted here:
https://www.medicaid.gov/medicaid/eligibility/downloads/spousal-impoverishment/ssi-and-spousal-impoverishment-standards.pdf
The Standard Shelter Expense is the amount included in the Minimum MMNA for your rent, or mortgage payment, property taxes and insurance, and/or condo maintenance. If the spouse’s housing expenses are over 30% of the MMMNA, (30% of $2,057 = $617.25), the additional need is referred to as the Excess Shelter Allowance, and it is credited to the community spouse as an additional income allowance.
The Maximum Monthly Maintenance Needs Allowance (Maximum MMNA) as of July 1, 2018 is $3,090.
If you need more to cover your home upkeep expenses or Assisted Living, Federal Medicaid Law [Section 1396a(a)(3)] gives you the right to a fair hearing. Federal Regulations [42 CFR 431.230] require that Medicaid payment for services be continued during the time an application is waiting for a fair hearing, and the state must make corrective payments if the applicant wins the fair hearing.
The other people who posted the advice to call a Certified Elder Law Attorney in your state are right. The CELA can listen to the specific facts of your situation, and explain how much income you can keep to stay safely at home. see more
The healthy spouse is allowed to keep an amount of the nursing home resident spouse income (with no questions asked by Medicaid) called the Minimum Monthly Maintenance Needs Allowance ("Minimum MMNA").
Every year, on July 1st, the MMNA is increased. The Minimum Monthly Maintenance Needs Allowance (Minimum MMNA) for July 1, 2018 through June 30, 2019 will be $2,057.00 for all states, except Alaska and Hawaii. The "Spousal Impoverishment figures" are posted here:
https://www.medicaid.gov/medicaid/eligibility/downloads/spousal-impoverishment/ssi-and-spousal-impoverishment-standards.pdf
The Standard Shelter Expense is the amount included in the Minimum MMNA for your rent, or mortgage payment, property taxes and insurance, and/or condo maintenance. If the spouse’s housing expenses are over 30% of the MMMNA, (30% of $2,057 = $617.25), the additional need is referred to as the Excess Shelter Allowance, and it is credited to the community spouse as an additional income allowance.
The Maximum Monthly Maintenance Needs Allowance (Maximum MMNA) as of July 1, 2018 is $3,090.
If you need more to cover your home upkeep expenses or Assisted Living, Federal Medicaid Law [Section 1396a(a)(3)] gives you the right to a fair hearing. Federal Regulations [42 CFR 431.230] require that Medicaid payment for services be continued during the time an application is waiting for a fair hearing, and the state must make corrective payments if the applicant wins the fair hearing.
The other people who posted the advice to call a Certified Elder Law Attorney in your state are right. The CELA can listen to the specific facts of your situation, and explain how much income you can keep to stay safely at home. see more
Question
Does a deceased husband's business automatically go to wife or does it have to go to probate?
Your question indicates there was no succession planning, not even a simple will. Your next call should be to an attorney in your state who... Your question indicates there was no succession planning, not even a simple will. Your next call should be to an attorney in your state who is familiar with probate, real estate, employment and business law. All of those fields will help form your decisions on whether to keep the business going, sell it, or wind it down.
For other people reading about this situation, be reminded there are many approaches the business person can use to avoid probate: business organizations such as Corporation or Limited Liability Company, Family Limited Partnership, and Living Trust or Irrevocable Trust.
The first step is to admit that our lifespans are limited, but the value of our life's work can continue to serve others after we pass on. see more
For other people reading about this situation, be reminded there are many approaches the business person can use to avoid probate: business organizations such as Corporation or Limited Liability Company, Family Limited Partnership, and Living Trust or Irrevocable Trust.
The first step is to admit that our lifespans are limited, but the value of our life's work can continue to serve others after we pass on. see more
Question
Is a quitclaim deed advisable for my mother?
Your question indicates there are monthly payments that must be made to a lender every month. When your mother borrowed the money, the loan... Your question indicates there are monthly payments that must be made to a lender every month. When your mother borrowed the money, the loan document probably said the debt would be "accelerated" if she transferred ownership of the house (meaning the whole balance would have to be paid up immediately).
While a Lender probably wouldn't become aware of a transfer if someone kept making the payments, your question, and several of the other answers posted here, point you to consider who is paying for care in the Nursing Home. If it's Medicaid, a transfer of the home will require an update of her eligibility status.
A disabled child could qualify as an exception to the Medicaid transfer rules, but you should talk with an elder law attorney in your state before considering any transfers of ownership, so that the interests of your brother and your mother are protected.
If you procrastinate and take no action to straighten out the home ownership status during your mother lifetime, the equity value of the house may pass into Medicaid's Estate Recovery system upon her death. see more
While a Lender probably wouldn't become aware of a transfer if someone kept making the payments, your question, and several of the other answers posted here, point you to consider who is paying for care in the Nursing Home. If it's Medicaid, a transfer of the home will require an update of her eligibility status.
A disabled child could qualify as an exception to the Medicaid transfer rules, but you should talk with an elder law attorney in your state before considering any transfers of ownership, so that the interests of your brother and your mother are protected.
If you procrastinate and take no action to straighten out the home ownership status during your mother lifetime, the equity value of the house may pass into Medicaid's Estate Recovery system upon her death. see more
Question
Brother is abusing POA. What can I do?
The protective services agency in your city or town is one resource that can assess the circumstances. But when you request help from... The protective services agency in your city or town is one resource that can assess the circumstances. But when you request help from public agencies, you are opening your family's private problems to scrutiny. You can't control where the case will end up.
Sadly, there are other cases where family members have misused the power in a Power of Attorney document. One case with a surprise ending is here:
https://www.agingcare.com/articles/adult-children-sue-caregiver-176514.htm see more
Sadly, there are other cases where family members have misused the power in a Power of Attorney document. One case with a surprise ending is here:
https://www.agingcare.com/articles/adult-children-sue-caregiver-176514.htm see more
If money is gifted before going into a nursing home, who is penalized?
Assisted Living may be a next step from her apartment; the services provided in Assisted Living could save or postpone the need for a nursing home admission. There may be subsidized Assisted Living units available in your mother's home area. If not, are there SSi-G or Group Adult Foster Care subsidies for Assisted Living available in your home area?
Your mother's reluctance to take the next step is also common. Consider consulting with an Elder Law Attorney and a Geriatric Care Manager in your mother's home town. These professionals could help you bridge the communication gap, and open her thinking to the possibilities for a new living situation, including a move to your home area, IF you are prepared to take on the work of care provider, or there are suitable Assisted Living facilities close enough for frequent visits.
An Elder Law Attorney in your state could explain subsidies available for Assisted Living and/or how you can be paid to provide the services needed to safely care for your mother. Your mother's life savings paid through a Caregiver Contract and/or Rental Agreement with you might be supplemented by Medicaid home care programs in your state (plus a Veterans Aid & Attendance pension if your father or mother served during time of war).
Others have posted here to remind you of the potential for transfers that don't disqualify and the non-countable assets that can be purchased, and an Elder Law Attorney can interview you to determine whether there are exempt individuals in your mother's family, to explore the possibility of transfers that would not be disqualifying to your mother.
Often, a reluctant parent can become interested in new living arrangements if financial advantages are presented to them. If you present the ideas as incentives to "save money" you may find the elder more receptive.
The $15,000 figure you mentioned has to do with an annual Gift Tax Exclusion for wealthy people who give away money during their lifetimes, to take advantage of the annual exclusion from the requirement they file Gift Tax Returns reporting gifts of more than that amount. The excluded gifts don't cut into their lifetime credit for transfers of wealth otherwise counted on their Estate Tax returns.
Your grief over confronting the spend down of funds is understandable. Continnue to approach it with your mother's best interests in mind, and rewards may be found in ways we could never have imagined. see more