Medicaid 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.

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.

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.

Estate Planning for Houston Families without the Stress

Published on: January 7, 2015 | By McCulloch & Miller, PLLC

Wouldn’t knowing someone will step in if you become incapacitated create a little peace of mind? Wouldn’t knowing that your family is taken care of create even more peace of mind? Wouldn’t knowing there is a plan in place – a plan you developed – if something happens to you take a significant weight off your shoulders?

Estate planning can do a lot of things for you, but one of the most valuable takeaways is peace of mind.

A recent Forbes article, titled “11 Fundamental Elements of a Stress-Free Estate Plan,” provides practical advice on how to design a plan that protects your assets and provides for loved ones. While everyone’s individual needs are a bit different, there are some basic components you need to examine along with deciding who gets what.

Recent Survey Says 80% of Americans Failed Retirement Literacy Test

Published on: December 30, 2014 | By McCulloch & Miller, PLLC

“We’re not surprised by the fact that people don’t know a lot about retirement income planning,” says David Littell, program director at the American College. “I was surprised at how badly they did.”

Could you pass a retirement literacy test? Apparently, 80 percent of Americans surveyed did not.

These Americans were polled on 38 retirement literacy questions on basics like Social Security, life expectancy, IRAs, life insurance and investments, and the mechanics of bonds. Sadly, only 20 percent were given passing grades, the college said. This isn't the first survey to raise concerns about Americans’ retirement readiness. In an article titled “Americans fail in retirement literacy,“ The (Palm Springs, CA) Desert Sunnoted similar shortcomings in a 2011 report.

WWII Vet Victim of Elder Abuse

Published on: December 11, 2014 | By McCulloch & Miller, PLLC

Through a series of legal maneuvers and Iowa's then-blind eye toward financial elder abuse, his caregiver betrayed the World War II Navy veteran's trust and drained his savings over a number of years, according to friends and court documents.

According to an article reported in The Des Moines Register, titled "Caregiver's $700K theft shakes elder advocates," the cost of financial exploitation against seniors is more than $2.6 billion a year in our country, and one in 10 financial abuse victims turns to Medicaid as a result.

Cases like World War II VeteranJames Ruby's are, unfortunately, not uncommon. Seniors fall victim to financial abuse every day.

Plan Wisely for Medicaid or Else! One State’s Warning

Published on: December 4, 2014 | By McCulloch & Miller, PLLC

This case has drawn plenty of attention due to its legal and financial implications. Essentially, the case has escalated to the point of a federal judge warning state regulators that she would consider issuing an order to drop Ohio from Medicaid enrollment altogether, leaving the Buckeye State without federal funds to provide medical care for its elderly residents.

The State of Ohio is penalizing seniors by refusing to grant them long-term care benefits because a spouse or close relative has purchased a Medicaid-compliant insurance annuity. Medicaid administrators in Ohio say that an elderly nursing home patient is not entitled to long-term care benefits as long as he or she has a relationship with an individual who has purchased an annuity.

Other cases have been filed in federal courts in Ohio, and one federal judge has warned Ohio officials that she may hold them in contempt if they don’t follow federal law. The latest lawsuits filed against Ohio’s Medicaid administrators were brought by three elderly women whose husbands used their retirement accounts to buy annuities, which State Medicaid investigators say is illegal.

Financial Pointers: Providing Care for Aging Parents in Houston

Published on: October 17, 2014 | By McCulloch & Miller, PLLC

Dealing with aging parents is not only tough emotionally, but financially.

As one's parents age, financial and health care discussions are essential for families to have in order to plan ahead for any care they may require.

A recent Newsday article, titled"Money Fix: The cost of caregiving," tackled this tough issue and offered some financial and non-financial advice to help with providing care for aging parents.

Long-Term Care Planning for Houston Boomers: Medicare vs. Medicaid

Published on: September 4, 2014 | By McCulloch & Miller, PLLC

Although their names are confusingly alike, Medicaid and Medicare are quite different programs.

What is the difference between Medicare and Medicaid? There are strict income and asset guidelines that must be satisfied to be eligible for Medicaid coverage. While Medicare is solely a federal program, Medicaid is a joint state-federal program. Each state operates its own Medicaid system, but it must adhere to federal guidelines to receive federal funds. Federal money pays for half the state’s Medicaid costs, and the state pays the rest.

Long-Term Care Planning