Long-Term Care Planning

Guardianships Used by Nursing Homes to Collect from Residents

Published on: February 12, 2015 | By McCulloch & Miller, PLLC

Lillian Palermo tried to prepare for the worst possibilities of aging. An insurance executive with a Ph.D. in psychology and a love of ballroom dancing, she arranged for her power of attorney and health care proxy to go to her husband, Dino, eight years her junior, if she became incapacitated. And in her 80s, she ended up in a nursing home as dementia, falls and surgical complications took their toll. He sings her favorite songs, feeds her home-cooked Italian food, and pays a private aide to be there when he cannot. But one day last summer, after her husband disputed nursing home bills that had suddenly doubled Mrs. Palermo's copays, and complained about inexperienced employees who dropped his wife on the floor, Mr. Palermo was shocked to find a six-page legal document waiting on her bed. It was a guardianship petition filed by the nursing home, Mary Manning Walsh, asking the court to give a stranger full legal power over Mrs. Palermo, now 90, and complete control of her money.

A New York Times article titled "To Collect Debts, Nursing Homes Are Seizing Control Over Patients" states that few people are aware that a nursing home can do this. Guardianship cases are usually confidential, but the Palermo's situation isn't uncommon.

More than 12 percent of guardianship cases are brought by nursing homes. Many of these may have been brought as a means of bill collection, which was never intended when the New York legislature enacted the guardianship statute. Some courts have ruled that this legal tactic by nursing homes is an abuse of the law, but these petitions—even if unsuccessful—make families spend time and money in costly legal ordeals.

Do You Know Your Long-Term Care Options in Houston?

Published on: February 11, 2015 | By McCulloch & Miller, PLLC

When asked about long-term care insurance, one senior said, "I've thought about it. I don't think it's worthwhile to buy at my age." She's 83. "I've thought about it but I really haven't looked into it," another woman said. Others simply don't want to talk about it. But a don't-ask-don't-tell attitude toward paying for long-term care isn't an effective strategy for the 75 million baby boomers, the oldest of whom will start hitting age 70 in 2016.

A recent article in the Memphis Daily News, titled "OK, Baby Boomers: Time for Some Hard Decisions," reminds us that care for seniors can come from family members or from outside services such as adult day care, assisted living centers, home-care services and nursing homes. These services often include assistance with daily activities, home health care, respite care, hospice care, adult day care, care in a nursing home, and care in an assisted living facility.

People pay for long-term care by using personal resources, long-term care insurance, and Medicaid if they qualify. Medicare, Medicare supplement insurance, and private health insurance typically don't pay for long-term care. Individuals may also look to other resources such as veterans' benefits, Social Security, community services, and family caregivers.

Can You Get Out of Dodge?

Published on: February 10, 2015 | By McCulloch & Miller, PLLC

One attorney calls it the "Get out of Dodge plan"—the best way to keep your assets intact before applying for Medicaid to cover nursing home costs. New Jersey is one of the most restrictive states when it comes to permitting residents to preserve assets for their benefit while Medicaid pays for nursing home care. In the Garden State, there are steps that should be taken before applying for Medicaid, the government insurance program for people of all ages who are too poor to afford health care including long-stay nursing home care. Nursing homes can cost $120,000 a year in New Jersey, sometimes more.

Even though Medicaid is a federal program that's regulated by each state, the way in which the money is distributed can vary. Restrictive states are siding with protecting public money over letting individuals and their spouses keep assets, the Asbury Park Press article titled "Protecting assets: Three things to know before Medicaid" explains. So your retirement strategy can be quite different based upon your state of residence. Not everyone can Get Out of Dodge, meaning not everyone can move into a second home in Florida.

But do-it-yourself planning may not be the way to go. Elder law and Medicaid planning is constantly changing, and your assets can easily be wiped out by nursing home costs without careful planning. For example, when a husband places his wife in a nursing home, their home may be excluded from assets that must be spent for nursing home care before Medicaid pays for it. So the husband is still able to live there. However, if the husband dies before the wife enters the nursing home, it gets complicated: the house could be lost to the nursing home for the cost of her care.

Health Care Costs: Integral Part of Retirement Planning

Published on: February 6, 2015 | By McCulloch & Miller, PLLC

Consulting financial and tax advisers as part of planning the retirement process is essential to get the health-care piece covered. Enjoying truly golden retirement years means a lot of different things to different people, but it should include planning for long-term health care now so we obtain the end-of-life care we desire without becoming a burden on our children or the state.

According to a recent article in cincinnati.com, titled “Consider health care when retirement planning,” long-term health care may be a considerable expense during our retirement years, with most of this spent during the last three years of life.

Health care spending has outpaced inflation over the past decade—from a 6percent increase to just 2.5 percent for core inflation.

Florida Puts Focus on Elder Rights and Guardianship

Published on: February 2, 2015 | By McCulloch & Miller, PLLC

This year, two legislators who pressed for reform in 2014 are back with new bills they believe have stronger chances of success, as the excesses possible within Florida's guardianship system become more widely known.

A recent article in The Herald Tribune, titled “Legislation aims to curb abuses in guardianship system,” reports that two of Florida’s legislators are addressing the excesses possible within Florida's guardianship system. Florida law has a list of 14 rights that an elder may surrender as a result of the guardianship process. These include the rights to marry, vote, manage finances, determine where to live and accept medical care.

The Florida bill includes these types of actions:

Tips for Houston Families Caring for Aging Parents

Published on: January 26, 2015 | By McCulloch & Miller, PLLC

Adult children who become caregivers often pay a steep price. However, with some smart strategies, you can avoid sabotaging your financial future.

What can you do ahead of time to help ease the financial burden of caring for your aging parents?

Look into potential tax breaks.

New Year…New Financial Goals for Houston Families

Published on: January 21, 2015 | By McCulloch & Miller, PLLC

The New Year is a great time to regroup on your financial plans, reevaluate and/or create new financial goals. By sticking to your financial resolutions throughout the year, you can keep on track towards achieving your financial objectives in 2015 and beyond.

Make the New Year a happy one by getting your finances in order. Setting some basic goals can help make 2015 one of the best years yet.

Make a budget. Creating a budget is the key to long-term financial success. Nonetheless, a 2013 Gallup poll found that only one in three Americans maintained a budget. A budget takes on even more importance when you plan to move into retirement and leave a steady paycheck to live on a fixed income.

Three Questions to Ask Your Houston Elder Law Attorney

Published on: January 16, 2015 | By McCulloch & Miller, PLLC

Three estate planning questions to ask your parents right now.

Caring for aging parents poses many questions, some of which you want to get out of the way early on. A recent article in The Oprah Magazine,titled“Sanity-Saving Secrets For Caring For Your Aging Parents,” suggests three questions to ask your parents right now.

1. Do you have a living will? There are about 72% of seniors who already have advance directives specifying end-of-life medical wishes, according to a recent study funded by the National Institute on Aging. That’s terrific, but make sure your parents are in that group. As long as you’re on the subject, see if their documents have been revised in the last five years and that you know its location.

Finding Financial Resources for Your Houston Parents

Published on: January 15, 2015 | By McCulloch & Miller, PLLC

We asked experts to let us in on a few resources most people overlook.

Need more cash to help care for mom and dad? A recent Oprah Magazine article, titled “Sanity-Saving Secrets For Caring For Your Aging Parents,” has some ideas where to look for funds to support your parents in retirement.

Here are some of those ideas from the original article:

Got Medicaid? Get Prepared, Houston!

Published on: January 14, 2015 | By McCulloch & Miller, PLLC

Here are some "Get's" that will help you prepare for the Medicaid application process.

Get going five years before you think you need to. Medicaid has a five-year look back to all your parents' financial dealings. Which means transactions conducted during that time may be counted in determining their program eligibility. With this requirement, it’s good to have your parents' banks' names and numbers accessible. Regulators are looking at two things: if you're hiding any money and if you've given any away.

Also, if one or both of your parents still live in the family home and you’d like to keep it, you should try to transfer ownership or set up a trust at least five years before they apply for Medicaid. Although there are some exceptions, typically if you don’t address this issue, you will be forced to sell the home.