Posts in category: Elder Law

One-half of all Americans who reside in nursing homes receive assistance from Medicaid to pay for their care. This is not surprising, given the extraordinarily high cost of long-term care. The real surprise is that half of all Americans don’t seek Medicaid assistance to cover nursing home costs. There are several reasons for this, but one of the most common can be summed up in a single word: hearsay. Or, if you prefer, the rumor mill. Here are just a few examples of the myths surrounding the use of Medicaid to pay for nursing home care:

• The healthy spouse will be kicked out of the family home
• The government will take all of your assets
• You’ll have to live in an old, dilapidated facility
• You’ll receive inadequate care, or no care at all

Rumors like these often come from well-meaning family members, friends, and neighbors. While none of them are true, many people believe that they are.

Rumors also spread by people we assume to be knowledgeable about the subject—nursing home intake staff, caregivers, doctors, nurses, and social workers. They might tell you, for instance, that you are too wealthy to receive assistance from Medicaid. Or that once you have moved to a nursing home you can no longer obtain Medicaid assistance to pay for your care. Again, these folks may mean well, but their information is often outdated or simply inaccurate. The fact is, Medicaid planning is complicated and the rules governing eligibility for various programs change constantly. Even lawyers who do not focus on this area of the law may be a source of inaccurate information.

Get the Facts from an Experienced New York Medicaid Planning Attorney

Don’t let rumors and misinformation prevent you from getting the financial assistance you need. Speak with an attorney who helps families obtain Medicaid assistance to pay for nursing home care on a daily basis.

According to a 2021 survey conducted by the Pew Research Center, nearly a quarter of U.S. parents find themselves struggling as part of the “sandwich generation,” those who are caught in a squeeze as they tackle caring for both their own parents and their children.

Being a multigenerational caregiver can be a financial, logistical, and emotional challenge to say the least. Add to that the stigma in the U.S. of care work being considered the responsibility of the family, coupled with moral judgments on what it really means to be a good parent or child. And yet, the burden of providing care to two generations is only expected to grow because not only are the number of people aged 65 and older projected to significantly increase by 2050, but Americans are continuing the trend of having children later in life as well.

SO WHAT CAN CAREGIVERS IN THE SANDWICH GENERATION DO?

TAKE TIME FOR YOURSELF. It may seem counterintuitive, but prioritizing self-care is extremely important for caregivers. This can even be as simple as prioritizing your meals, drinking water, and sleeping as regularly as possible. But it is also important to make time for activities you enjoy so you can sustain your own mental health and sanity. Remember, you can’t take care of others properly when you aren’t taking care of yourself.

EMBRACE COMMUNITY SUPPORT. Finding support and utilizing community resources can be a complete game changer for caregivers. Community relationships can come from something as simple as accepting an extra set of hands when they’re offered, to signing up for programs in your community that provide assistance services. It can also be important for caregivers to connect with each other because who will better understand what you are dealing with on a day-to-day basis than someone in your shoes? So, seek out support groups or have open conversations with people in your life who you know are dealing with similar stresses.

SHARE THE LOAD. Caregiving tasks can be delegated. You don’t have to do it all on your own. Don’t be afraid to ask other family members for help. Consider also reaching out to friends and neighbors. You may be surprised how willing those close to you are to lend a hand and offer support when you need it the most. And, assuming it fits into your budget, you can also seek out hired help for tasks that are adding stress, simply because you never seem to have time – like cleaning the house.

At the end of the day, care doesn’t have to be an all or nothing situation. There are ways for caregivers to ease their stress while still being there to care for the ones they love.

There are many factors to consider when choosing the right nursing home for you or your loved one. Here are a few you won’t want to forget:

1. INSPECT THE GROUNDS

When you arrive for your tour of the facility, start with a few basic observations. Check for non-skid floors and handrails. Note if the walkways are clear or if there are wheelchairs and other obstructions in the way that could lead to residents tripping and injuring themselves. Beyond safety concerns, observe whether dumpsters are concealed and relatively clean, whether the grounds are quiet or noisy, where there are seating areas, and whether the area feels relaxing and comfortable enough to spend time in.

2. TALK WITH THE CURRENT RESIDENTS

Make a point of asking current residents whether or not they enjoy living at the facility. Consider asking them about the food, what they do day-to-day, any activities they take part in, and whether they feel cared for. The facility may appear beautiful on the outside, but listening to the first-hand accounts of the residents will be a great way to make sure it is the perfect fit for you and your family.

3. TALK TO THE STAFF

During your visit, talk to a range of employees. It can be informative to hear from and speak with people working in different departments and different levels within the community. Ask the employees about the facility, their jobs, and the management. In your conversations, note if the staff knows details like the residents’ names. While you don’t want to come off too aggressive, it’s important to get a sense of the facility’s culture.

4. TRY THE FOOD

Or, at least check out the menu. While you shouldn’t be expecting a Michelin Star meal, ask about the variety of the food offered. The food should be appetizing, healthy, and fresh. Sit in the dining room while you’re there so you can observe how the staff and residents interact.

5. REMEMBER TO USE ALL OF YOUR SENSES

Stop along the way and note the sounds you hear, such as laughter or music versus silence or sounds of distress. Note any smells that stand out. The facility should be well ventilated and smell clean instead of musty or stale.

6. ENSURE THE ENVIRONMENT IS SAFE

COVID-19 introduced a whole new set of considerations for families looking into nursing home care. When you visit each facility, look for investments such as room cleaners with HEPA filters and the use of PPE. Federal regulations also mandate that nursing homes have an infection control and prevention program with written standards. At minimum, the facility should have a part-time staff member who is trained in infection prevention.

7. COME BACK DURING OFF – HOURS

When you schedule a guided visit during a weekday, you are likely seeing the facility at its very best. But before your loved one moves in, it can be very informative to visit on a weekend or in off-hours so you can ensure the experience you had during the guided visit is maintained when the facility is not on high-alert.

For more tips and ideas of what you should consider when choosing the right facility for you or your loved one, check out this AARP article about inspecting prospective nursing homes.

Approximately 50% of all Americans who reside in nursing homes receive assistance from Medicaid to pay for their care. This is not surprising, given the extraordinarily high cost of long-term care. The real surprise is that half of all Americans don’t seek Medicaid assistance to cover nursing home costs. Why not?

Perhaps the biggest reason is the preponderance of misinformation about Medicaid, the cost of long-term care, and how to pay for it. Here are just a few examples of the myths surrounding the use of Medicaid to pay for nursing home care:

• The healthy spouse will be kicked out of the family home when the spouse requiring care moves to a nursing home
• The government will take all of the family’s assets
• You’ll have to live in an old, dilapidated facility
• You’ll receive inadequate care, or no care at all

Myths like these often come from well-meaning family members, friends, and neighbors. While none of them are true, many people believe that they are.

Sometimes misinformation is spread by people we assume to be knowledgeable about the subject—nursing home intake staff, caregivers, physicians, nurses, and social workers. They might tell you, for instance, that you are too wealthy to receive assistance from Medicaid. Or that once you have moved to a nursing home it’s too late to obtain Medicaid assistance to pay for your care. Again, these folks mean well, but their information is often outdated or simply inaccurate. The fact is Medicaid planning is complicated and the rules governing eligibility for various programs are constantly changing. Even attorneys who do not focus on this area of the law may be a source of inaccurate information.

Don’t let misinformation prevent you from getting the financial assistance you need. Speak to an attorney with extensive experience in helping families obtain Medicaid assistance to pay for nursing home care.

Many entrepreneurs refer to their business as their “baby” and rightfully so. Like a child, entrepreneurs nurture their business from an idea through conception, to growth, and maturity. Running a business is much like raising a child. Both require a lot of time, tears, resources, and effort to be successful. People often prepare for what would happen to their children in the event they pass away unexpectedly, however, they don’t necessarily consider what would happen to their business – and how that would affect their family. While it can be scary to consider, life is uncertain. Creating an effective estate and succession plan is an ongoing process that will change in each phase of the business’s life.

Business owners pour blood, sweat, and tears into their business, often struggling and making sacrifices for the company to survive, in an attempt to create a legacy that will provide for themselves and their families. But what happens when they are no longer around to run their business? Entrepreneurs should be aware of the unique issues they face when creating an estate plan. They must take action to ensure their business continues on long after they are gone.

Entrepreneurs often think that estate planning and succession goals happen later in life or at maturity of the business. Let’s face it, the upkeep of running a business is more than enough to worry about, much less considering one’s own mortality in their younger years. In the past, young entrepreneurs and start-up owners were less likely to plan for these things right out of the gate. As we continue to come out of the pandemic, the roles have reversed for the first time in history, allowing 18-34 year olds to take the lead when it comes to creating an estate plan.

Often business owners don’t consider what would happen to their “baby” without a leader. What happens after the owner passes away – when the court system ties up the business assets for months or even years until your estate is settled? Or even worse, they hand the business over to an unprepared family member. Without a proper estate and business succession plan in place, these scenarios are entirely likely.

Contact a New York Estate Planning Attorney

Successful estate and succession planning requires a team of professionals. The team should include an estate planning attorney, accountant, financial planner, and an insurance agent. An important first step in creating the plan is consulting with an estate planning attorney and then ensuring that all of the professionals are in communication with one another in order to accomplish their succession goals.

Both Medicare and Medicaid can assist you with your individual long-term care plan. While the two programs sound similar, there are important differences to consider.

Let’s start with a brief definition of each program. First, it’s true, both programs provide medical care. However, Medicare is an entitlement program; meaning that everyone who reaches the age of 65 and is eligible to receive benefits from Social Security can also receive Medicare. In contrast, Medicaid is a public assistance program, meaning it is designed to help people with limited income and assets to pay for medical care. Recipients of Medicaid assistance must meet certain income and asset eligibility guidelines.

Now, let’s look at some of the fundamental differences between the programs.

WHO RUNS EACH PROGRAM?

Medicare is completely run by the federal government, whereas Medicaid is run as a joint, federal-state program. A few states use different names for their Medicaid programs. For example, Medi-Cal in California and MassHealth in Massachusetts.

Typically, the federal government pays for approximately one-half of a state’s Medicaid Program, with the state paying the balance. The eligibility rules will differ from one state to the next. However, in order for the state to receive money from the federal government, the program must adhere to certain federal guidelines.

LONG-TERM CARE COVERAGE

Medicare, by and large, does not cover long-term nursing home care. For example, Medicare Part A will only cover up to 100 days in a skilled nursing facility for a particular illness, and only after the patient has spent at least three days in a hospital. And, from day 21 to day 100, the individual at the skilled nursing facility must make a copayment of $167.50 per day. Few people actually receive Medicare coverage for the full 100 days, in part because of the copay, and in part, because restrictions and conditions for coverage are quite stringent.

In contrast, Medicaid covers long-term nursing home care for people who meet its income and asset limits. It does not matter whether you need assistance for one hundred days, one year, or five years—Medicaid will pay for the care as long as the recipient is eligible. Given the high cost of nursing home care, the dearth of affordable alternatives, and the restrictions inherent in Medicare coverage, Medicaid is now the single largest payer of nursing home stays in the United States.

DO I QUALIFY FOR MEDICAID?

If your income and assets are less than your state’s guidelines, you are already eligible for assistance. However, if your income and assets exceed state limits, you will have to take the appropriate steps to become eligible. An experienced elder law attorney will be able to determine the best way for you to secure your Medicaid benefits.

But be careful! Being eligible is not as simple as giving your “stuff ” away a few weeks before entering a nursing home, expecting Medicaid to pay for your stay. Instead, when you apply for Medicaid, any gifts or transfers of assets made within five years of the date of application will be subject to penalties that delay your benefits. This is known as the look-back period, and the penalty period is determined by dividing the amount transferred by what Medicaid determines to be the average private pay cost of a nursing home in your state. A skilled elder law attorney will be able to guide you through the planning and application process so you can receive your Medicaid assistance as expeditiously as possible.

In short, while Medicare can help you afford a short-term stay in a nursing home, Medicaid will be able to pay for your long-term care, if you are eligible. Through early and proper planning, you can obtain assistance from Medicaid to pay for your nursing home care and protect your hard-earned assets in the process.