Category Archives: Nursing Home Planning

Elder Law Tips & News

 

MetLife Mature Market Institute reported that the average cost of a semiprivate room in a Nursing Home rose 3.7% in 2012. In real numbers, that is an increase from $78,110 to $81,030 per year. If you have not started planning, there is no time like the present!

 

DISCLAIMER – Every case is different because every case is different. This blog does not give legal advice. This blog does not create an attorney client relationship. You are not permitted to rely on anything in this blog for any reason. This blog is an entirely personal endeavor. Every person’s situation is different and requires an attorney to review the situation personally with you.
No attorney-client relationship is created by this site.

The use of the Internet, this blog or email for communication with this firm or any individual member of this firm does not establish an attorney-client relationship. Before we represent any client, the client and the attorney will sign a written retainer agreement.
If you do not have a written, signed retainer agreement with us, we are not representing you and will not be taking any action on your behalf.

 

Senior Living Options and Costs

 

As seniors age, many will need help with daily tasks. Helping them make appropriate decisions about their living arrangements is critical to their health and well-being.

 

DISCLAIMER – Every case is different because every case is different. This blog does not give legal advice. This blog does not create an attorney client relationship. You are not permitted to rely on anything in this blog for any reason. This blog is an entirely personal endeavor. Every person’s situation is different and requires an attorney to review the situation personally with you.
No attorney-client relationship is created by this site.

The use of the Internet, this blog or email for communication with this firm or any individual member of this firm does not establish an attorney-client relationship. Before we represent any client, the client and the attorney will sign a written retainer agreement.
If you do not have a written, signed retainer agreement with us, we are not representing you and will not be taking any action on your behalf.

 

Long-Term Care Facility Contracts

 

By: Attorney Nathan Simpson

In my Medicaid practice, I see clients who come in from a variety of long-term care facilities across the state. Each of these has a different contract that they ask residents to sign when they are admitted. Recently, more and more facilities ask a resident (or their spouse or children) to sign stating that they agree not to transfer any assets. Many people sign these agreements without looking at them, or do not plan on giving any money away, so do not think anything of it.

What many clients do not know is that what the facility has really asked them to do is to sign an agreement that could prevent them from legally protecting their assets from the State and a Nursing Home spend down. Before signing these agreements, it is always advisable to read them carefully and to consult with an Elder Law Attorney who can advise you on the best course of action.

If you or a loved one are facing a long term care situation, Cooper, Adel & Associates can help counsel you on the next steps to protect your savings.

DISCLAIMER – Every case is different because every case is different. This blog does not give legal advice. This blog does not create an attorney client relationship. You are not permitted to rely on anything in this blog for any reason. This blog is an entirely personal endeavor. Every person’s situation is different and requires an attorney to review the situation personally with you.
No attorney-client relationship is created by this site.

The use of the Internet, this blog or email for communication with this firm or any individual member of this firm does not establish an attorney-client relationship. Before we represent any client, the client and the attorney will sign a written retainer agreement.
If you do not have a written, signed retainer agreement with us, we are not representing you and will not be taking any action on your behalf.

 

Ohio’s Assisted Living Waiver Program

 

By Michelle Mason

Assisted living facilities are designed to make it safe and convenient for seniors to continue living as independently as possible. It is for seniors who need some supervision and help with daily activities but don't need skilled nursing care. Assisted living facilities provide older adults with an alternative to nursing facility care.

Services offered by most assisted living facilities:

  • Preparing meals / Eating

  • Housekeeping

  • Laundry

  • Transportation

  • Bathing / Personal hygiene

  • Social activities

  • Some nursing care is provided, such as administering medication.

You can expect to pay between $2,000 and $5,000 each month for an assisted living facility.

Medicaid now recognizes that assisted living facilities are the best alternative to a nursing home facility and less expensive and therefore expanded coverage to include assisted living programs.

Ohio's Assisted Living Waiver Program: This program is a statewide Medicaid-funded program that provides services from a licensed care facility to delay or prevent nursing home placement. The program pays the costs of care in an assisted living facility for individuals who meet certain levels of care requirements. They must need hands-on assistance with daily living activities and meet the financial criteria to be eligible for Ohio's Assisted Living Waiver Program.

If you have a loved and considering an Assisted living facility. Our office can apply for these benefits for your loved one. If you are a veteran, you may qualify for veterans benefits that can be used to pay for the Assisted living facility. For more information, please call our office for a free consultation.

DISCLAIMER – Every case is different because every case is different. This blog does not give legal advice. This blog does not create an attorney client relationship. You are not permitted to rely on anything in this blog for any reason. This blog is an entirely personal endeavor. Every person’s situation is different and requires an attorney to review the situation personally with you.
No attorney-client relationship is created by this site.

The use of the Internet, this blog or email for communication with this firm or any individual member of this firm does not establish an attorney-client relationship. Before we represent any client, the client and the attorney will sign a written retainer agreement.
If you do not have a written, signed retainer agreement with us, we are not representing you and will not be taking any action on your behalf.

 

Will Medicaid Make You Sell Your Home?

 

By: Attorney Nathan Simpson

One aspect of Medicaid that many people are not familiar with is how the home is treated. Many do not realize that Medicaid places value limits on homes. If a home exceeds these value limits, an applicant cannot qualify for Medicaid. This means that a person with nothing other than their home could face a situation where they are not qualified for Medicaid and sell their home to cover the Nursing Home bills.

It does not have to be this way. By working with an Elder Law Attorney, you may be able to protect your home from a Nursing Home spend down. Even if you or a family member is currently in a Nursing Home, it is never to late to discuss strategies to protect your life's work. Contact us today.

 

DISCLAIMER – Every case is different because every case is different. This blog does not give legal advice. This blog does not create an attorney client relationship. You are not permitted to rely on anything in this blog for any reason. This blog is an entirely personal endeavor. Every person’s situation is different and requires an attorney to review the situation personally with you.
No attorney-client relationship is created by this site.

The use of the Internet, this blog or email for communication with this firm or any individual member of this firm does not establish an attorney-client relationship. Before we represent any client, the client and the attorney will sign a written retainer agreement.
If you do not have a written, signed retainer agreement with us, we are not representing you and will not be taking any action on your behalf.

 

How do you pick a good nursing home?

by Kathy Cooper

The first time my mom went in to a nursing home, we had about 3 hours to decide which would be best, and that included finding a nursing home with an open room and making all of the arrangements. She had had a stroke and needed rehabilitation and possibly on-going long term care after that. I thought she would be in the hospital for a week or two longer, but the doctor said she was ready to move to a facility … now! I can tell you that this is not in the least unusual. You generally have a very short time to place your loved one in a facility.

The second time, we were better prepared because we learned a few things from our first experience. A word to the wise: be prepared. You never know when you or your older loved one might be in need of a nursing home. Breaking a hip, having a stroke, developing Parkinson's, dementia or Alzheimers are only a few of the indicators that a nursing home is on the horizon.

How can you be prepared? First, know where you can get good rating information about nursing homes. The federal government has a website that compares the quality of facilities (see Medicare Nursing Home Comparison) and Pro Publica also provides information about problems in various facilities at Pro Publica Nursing Home Inspections. Second, check with friends and family for experiences they have had. Third, visit facilities to make sure they meet your standards; talk to the staff, tour the facility and speak with families who have residents there.

A more difficult and equally important issue is how you will pay for the care you need. This is where an elder law attorney can help you understand your options. Oftentimes, there are benefits available to help you, but you have to find out about them and plan in a specific way to get them. Each situation is unique and requires a strategy that is tailor-made. Call our office if you wish to discuss your options.

Do you have an answer to “Which nursing home do you want your loved one to go to tomorrow morning?”

IRS CIRCULAR 230 NOTICE: To ensure compliance with requirements imposed by the IRS, we inform you that any U.S. tax advice contained in this communication (or in any attachment) is not intended or written to be used, and cannot be used, for the purpose of (i) avoiding penalties under the Internal Revenue Code or (ii) promoting, marketing or recommending to another party any transaction or matter addressed in this communication (or in any attachment).

 

Who pays for nursing home care?

 

By Bob Kueppers

 

AARP has an interesting article addressing which states have a filial support law. For those of you unfamiliar with this law, it’s used to force adult children to pay for their parents nursing home care. View their website for an interactive map of which state enforce this law. (http://assets.aarp.org/www.aarp.org_/articles/bulletin/interactive/filialpiety/index.html)

 

 

 

If you would like to discuss what this might mean to you and your family, please call to arrange a free consultation.

IRS CIRCULAR 230 NOTICE: To ensure compliance with requirements imposed by the IRS, we inform you that any U.S. tax advice contained in this communication (or in any attachment) is not intended or written to be used, and cannot be used, for the purpose of (i) avoiding penalties under the Internal Revenue Code or (ii) promoting, marketing or recommending to another party any transaction or matter addressed in this communication (or in any attachment).

 

All In The Family

 

Superior Court rules son responsible for mother’s nursing home bills 

By Mitch Adel

Most of us want to pay our own way as we age. We don’t want to become dependent on our children. That may be changing with a recent landmark court decision in Pennsylvania that has the potential to make our children responsible for our nursing home bills here in Ohio.
In a recently decided case, the Superior Court of Pennsylvania ruled that a son can be held liable for his mother’s nursing home bills. The case—Health Care & Retirement Corporation of America v. John Pittas—could mark the beginning of an important change in the way that facilities seek to recoup some of the skyrocketing costs associated with long-term healthcare. The case involved a woman who moved to Greece without settling her $90,000 nursing home debt. The court found that her son was liable for her bill. It ruled that a child capable of paying their parent’s healthcare bills is required to pay them.
 
In addition, the state typically goes after the assets of the child who is most available. In this case, the court found that it was the responsibility of the son to go after his siblings for their share of their mother’s care. The court also found that it did not matter that the son was in no way involved with his parents’ financial dealings prior to his mother going into the nursing home.
 
What is especially troubling for Ohio families is that Ohio is one of 30 states that currently have similar (albeit rarely enforced) laws articulating the responsibility of children to provide financially for their parents in these circumstances. In fact, Ohio’s law is even more punitive than Pennsylvania’s, as the Ohio statute makes it a criminal offense to fail to provide that support. 
 
As more and more states face budget shortfalls, it is likely they will follow Pennsylvania’s example, seeking payment from children for parents who cannot meet their medical expense obligations. For Ohio families, this makes planning ahead to prepare for the financial uncertainties of aging more important than ever before. While every family’s financial and medical circumstances are different, there are some consistent big picture guidelines to remember when working with your loved ones to ensure that both health and wealth are adequately protected:
 
Plan ahead 
 
The single most important element of any long-term healthcare, senior care and financial planning strategy is to start planning early. Although you are never completely out of options until you are out of money, the sooner you start planning, the more you can save.

 

Involve your family

As the Pennsylvania courts have reminded us, family members should participate in this process. There are sound legal and financial options that can ensure that long-term care is provided for parents in a way that protects their children from civil and criminal liability.

Protect yourself

There are only two ways for children to protect themselves from being held responsible for their parent’s nursing home debts:

1. Pay for the nursing home bill themselves.
2. Properly qualify their parents for Medicaid benefits.

When a parent is properly qualified for Medicaid benefits, the child is no longer liable for their care.

Make sure you qualify

Veteran’s benefits and Medicaid are important sources of funding long term care for many seniors. The best scenario is to pre-plan so that you or your loved ones will qualify immediately when they need long-term care. Research benefit programs and resources that may help at home, in assisted living facilities and in nursing homes. Long-term care usually starts at home, often years before a nursing

home is needed, and there are programs and sources of funding that can help. Information for some of the most popular
and valuable programs is available through the following
online resources:

http://www.homecareohio.org/ http://www.ohioaging.org/ http://aging.ohio.gov/services/ombudsman/regional.aspx http://www.proseniors.org/ http://aging.ohio.gov/services/passport/ hhtp://vba.va.gov/VBA/

While these tips can serve as important general guidelines for families working to prepare for the challenges of long-term care, more detailed resources are available. An elder law attorney is a critical resource in the team that will support you and your family as you embark on the eldercare journey. A trusted professional can help design a plan to meet your family’s needs in a way that leaves both parents and children protected.

 

Son Held Responsible for Mother’s Nursing Home Bills

 

By Attorney Nate Simpson

Earlier this month, the Superior Court of Pennsylvania held that in Pennsylvania, a son liable for his mother’s nursing home bills. Health Care & Retirement Corporation of America v. John Pittas, 2012 PA Super 96 (May 7, 2012). This Pennsylvania case could mark the beginning of a change in the way states cope with the rising costs of long-term healthcare.

John Pittas' mother was injured in a car accident, and following her rehabilitation, she went into a nursing home from September 2007 until March of 2008. During the time she was in the nursing home she accumulated a bill of over $90,000. Pittas' mother withdrew from the nursing home in 2008 and moved to Greece, leaving the bill unpaid.

Under Pennsylvania’s “filial responsibility” law, the nursing home brought a lawsuit against her son, even though there was a pending Medicaid application. The Superior Court held that under state law, her son was responsible for the bill based solely on the fact that she was his mother. Under Pennsylvania law, a child is responsible for their parent's medical bills if their parent is indigent, and the court determines that the child can afford to pay the bills. This law is particularly onerous since it permits a private company (e.g. nursing home), rather than a state agency, to sue the child for the debts of the parents. The law also allows the nursing home to choose which child it sues, and did not require the court to consider the pending Medicaid application.

A majority of states currently have these types of statutes on their books, but up until now they have rarely been enforced. Ohio is one of over 30 states that currently has a filial responsibility law on the books. Ohio Rev. Code Ann. 2919.21 Ohio's law places responsibility on children to provide for their parents. Ohio is different than the Pennsylvania law in that the Ohio Revised Code makes it a CRIMINAL offense to fail to provide adequate support to your parents. As budgets around the state tighten, we could see a change to follow the example set by Pennsylvania to also permit private parties, such as nursing homes and care facilities, to sue children civilly for the unpaid costs of care for their parents. Pennsylvania borders Ohio, and it is not a stretch to imagine the State government getting ideas from its neighbor. In 2005, the National Center for Policy Analysis released a paper arguing for increased enforcement of these laws in order to reduce the strain on state budgets. http://www.ncpa.org/pub/ba521/.

So what can be done? For children, it is important to make sure that you are helping your parents plan for future long-term care expenses. There are many options available which will enable your parents to preserve a parent’s assets while also protecting their children from civil or criminal actions. This includes long-term care insurance, sound financial planning, and well as securing Medicaid benefits in a timely manner so that medical bills are not left unpaid. It is important to note that if you help your parents plan ahead and PROPERLY qualify for Medicaid, your parent's bill will be paid by Medicaid and you will not be liable. The bottom line is that you can help your parents to preserve their assets and also avoid filial liability, but planning is essential.

If you or a loved one are concerned about future long-term care costs, an elder law attorney such as Cooper, Adel & Associates can help guide you through the process.

 

Could You Get Stuck With Your Parent’s Nursing Home Bill?

 

 

 

That's a question you better ask yourself and know the answer to now.

Here's why. A recent Pennsylvania decision, Health Care & Retirement Corporation of America v. John Pittas, the Supreme Court of Pennsylvania ruled that a son can be held liable for his mother's nursing home bills. The case involved a woman who moved to Greece without settling her more than $90,000 nursing home bill. The court found that her son was liable for her nursing home bill. It ruled that a child capable of paying their parent's healthcare bills is required to pay them.

“So far, Pennsylvania is leading the charge to require adult children to foot their parents' long-term care bills. However, 29 states have laws in place that could require adult children to provide this financial support and there is reason to believe that other states will follow Pennsylvania's lead, although for now, states have varying degrees of enforcement,” says Mitch Adel, senior partner with the law firm of Cooper, Adel & Associates. “In Ohio, for example, the law is even more punitive than Pennsylvania's, as the Ohio statute makes it a criminal offense to fail to provide that support.”

What's driving the change? “The combined impact of states facing budget shortfalls and the demographics of aging Baby Boomers who are living longer and increasing the cost of long term care, means that states are reexamining laws that may assist third party creditors in compelling adult children to pay their parents' nursing home bills,” says Adel.

The tab can be huge. According to the Genworth 2012 Cost of Care Survey, the median annual rate for a private nursing home rate is $81,030.

“As in most situations, the wealthy will be able to afford a wide variety of long-term care options and have access to various financial planners and professional assistance. The poor will qualify for the various entitlements such as MediCaid/MediCal, unless the political landscape changes so drastically as to remove these entitle, they will not have major concerns. The middle-class family is in for a wild ride when it comes to planning for aging parents,” warns Forrest Hong, LCSW, C-ASWCM, a social work/care manager, who works extensively with families who are in the process of planning for their long-term care needs.

What can you do?

Talk to your parents long before trouble arises. Get a sense of what their financial situation is and how they will pay for care. Where are the gaps, discuss how you might fill them. “It's better to have the discussion up front than to manage in crisis mode,” says Jason Parker, a certified retirement financial advisor, and president of Parker Financial.

Encourage them to purchase long-term care insurance. Long term care insurance can help with costs like nursing home bills and other such costs.

Speak with a geriatric social worker/care manager. Before thinking about nursing home as a long-term care option, speak with a geriatric social worker/care manager. Develop a long-term care plan with that professional. They can provide referrals to reputable and knowledgeable financial and elder law professionals who can address those aspects of the plan, says Hong.

Do your research. Find out what benefit programs and resources are available that may help at your parents stay in their own home. What does your area offer in terms of assisted living facilities and in nursing homes. You want a good idea of what's what, before you need it. It's ill advised to make major decisions when you're in the middle of the situation, stressed and may not be thinking clearly or have time to explore all your alternatives. Poor decisions can be costly.

However, “Nursing home placement is a very expensive option and should only be considered if someone is bed-bound, needs 24-hour, 7-days a week care of a medical nature,” says Hong.

“Never take your parents to a nursing home without first consulting with a professional geriatric social worker. If you do this on your own, you will be left holding the bag, or in this, the bill,” he warns.

Pay the bill yourself. Another option, is to prepare to pay for the nursing bill yourself, says Adel. That's easier said than done, with many Boomers wondering how they will fund their own retirement, picking up the tab for mom or dad's care, much as they might want to, just isn't a realistic possibility.

Be proactive. Whatever you do, do something, now. The situation can be challenging to say the least. “My folks became unable to care for themselves at the same time when my oldest child was preparing for her freshmen year of college. The financial and emotional pressure from those two converging forces were tremendous,” says Michael Fliegelman, president of SWAN, Strategic Wealth Advisors Network.

His mother had Parkinson's disease and macular degeneration and his dad had a brain stem stroke followed by numerous TIAs (transient ischemic attack). Within five years their savings were wiped out by assisted living facility costs, the cost of an aid that lived with them in the assisted living facility, and medication. “These costs brought their cost of living to around $15,000 a month.” His parents passed a a couple of years ago. Says Fliegelman, “But my wife's parents are now ill.”

 



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