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
Can I take my husband's name off of our deed if I have a POA to make all decisions concerning the home?
Does your husband’s Power of Attorney document have a clause that allows “Self Dealing” ? This is the clause that a title examiner would... Does your husband’s Power of Attorney document have a clause that allows “Self Dealing” ? This is the clause that a title examiner would look for in the future, when you sell or transfer the real estate to someone else.
The Power of Self Dealing allows you, the attorney-in-fact, to make transactions that benefit you.
Without this Power, third parties can’t be sure that a transaction (in this case the conveyance of full ownership of the house) is not improper. They could view the conveyance of the house as a defect in title.
A person who signs a Power of Attorney document may decide they don’t want their agent (attorney-in-fact) to be able to make deals that benefit the agent. So, they intentionally don’t include a Power of Self Dealing in the document.
Your question illustrates, for everyone who is reading this, another reason to hire an attorney to draft your Power of Attorney document based on your specific needs and intentions. The attorney is trained to think of all the ways the Power of Attorney document can help you and your family.
Your case is common. The spouse of a memory loss patient who needs nursing home care must transfer the family home to their individual ownership, in order to qualify the memory loss patient for Medicaid.
In your case, you can consult an elder law attorney who knows the real estate conveyancing rules in your state. The attorney will read your husband’s power of attorney document, and determine whether it has sufficient power to do what you want it to. If you hire the attorney to handle the real estate conveyance that makes you the sole owner, the attorney will be responsible to make sure you will be able to sell or transfer the house in the future.
The attorney you hire can also provide valuable guidance on how to obtain Medicaid home care benefits, and plan for the potential need for care in a facility. see more
The Power of Self Dealing allows you, the attorney-in-fact, to make transactions that benefit you.
Without this Power, third parties can’t be sure that a transaction (in this case the conveyance of full ownership of the house) is not improper. They could view the conveyance of the house as a defect in title.
A person who signs a Power of Attorney document may decide they don’t want their agent (attorney-in-fact) to be able to make deals that benefit the agent. So, they intentionally don’t include a Power of Self Dealing in the document.
Your question illustrates, for everyone who is reading this, another reason to hire an attorney to draft your Power of Attorney document based on your specific needs and intentions. The attorney is trained to think of all the ways the Power of Attorney document can help you and your family.
Your case is common. The spouse of a memory loss patient who needs nursing home care must transfer the family home to their individual ownership, in order to qualify the memory loss patient for Medicaid.
In your case, you can consult an elder law attorney who knows the real estate conveyancing rules in your state. The attorney will read your husband’s power of attorney document, and determine whether it has sufficient power to do what you want it to. If you hire the attorney to handle the real estate conveyance that makes you the sole owner, the attorney will be responsible to make sure you will be able to sell or transfer the house in the future.
The attorney you hire can also provide valuable guidance on how to obtain Medicaid home care benefits, and plan for the potential need for care in a facility. see more
Question
How deeply do you really think that Medicaid looks into assets when determining if a person qualifies for Medi...
Anyone who does not disclose all the income and assets that are relevant to a request for benefits should be losing sleep over their... Anyone who does not disclose all the income and assets that are relevant to a request for benefits should be losing sleep over their decision.
To start with, each case worker is audited by supervisors who try to make sure that the applications are being carefully processed and properly approved.
If someone does fail to disclose the true extent of income and assets on a Medicaid application, and it gets past the case worker, the applicant can be assured that their State Medicaid agency will be swapping data with federal and state taxation agencies (IRS, state revenue departments) and other government departments. The bank and other financial institutions file annual reports on all of your accounts with the IRS and state revenue department. All this data is sifted and matched up with any public benefits payments you may be receiving.
It may take time for the data matching to detect a problem, but eventually the problem will be found.
In addition to the routine data matching programs within the state Mediciad agency, states have independent auditing departments which select and focus on certain Medicaid programs. The auditors learn to identify gaps in the application process, and follow up on applications that appear in the screens they set up to hold the Medicaid agency and the applicants accountable.
Data matching applies to all government benefits programs. If an applicant for a VA Aid & Attendance pension "forgets" to mention a bank account on an application, the account will eventually be matched to the applicant and the VA will impose an overpayment for all the money during all the months it had provided reimbursement for care.
It is unfortunate that the government must expend resources on the review and investigation of public benefits expenditures, but without these systems, more people would try to abuse the system, and there would be even less available for people who truly need the help.
We all have a duty to fully and honestly disclose the truth on applications for benefits. see more
To start with, each case worker is audited by supervisors who try to make sure that the applications are being carefully processed and properly approved.
If someone does fail to disclose the true extent of income and assets on a Medicaid application, and it gets past the case worker, the applicant can be assured that their State Medicaid agency will be swapping data with federal and state taxation agencies (IRS, state revenue departments) and other government departments. The bank and other financial institutions file annual reports on all of your accounts with the IRS and state revenue department. All this data is sifted and matched up with any public benefits payments you may be receiving.
It may take time for the data matching to detect a problem, but eventually the problem will be found.
In addition to the routine data matching programs within the state Mediciad agency, states have independent auditing departments which select and focus on certain Medicaid programs. The auditors learn to identify gaps in the application process, and follow up on applications that appear in the screens they set up to hold the Medicaid agency and the applicants accountable.
Data matching applies to all government benefits programs. If an applicant for a VA Aid & Attendance pension "forgets" to mention a bank account on an application, the account will eventually be matched to the applicant and the VA will impose an overpayment for all the money during all the months it had provided reimbursement for care.
It is unfortunate that the government must expend resources on the review and investigation of public benefits expenditures, but without these systems, more people would try to abuse the system, and there would be even less available for people who truly need the help.
We all have a duty to fully and honestly disclose the truth on applications for benefits. see more
Question
Will Medicaid count the gross rent or the net rent against my mother?
The Medicaid regulations in your state should explain how you can calculate the rental income that must be contributed to payment for your... The Medicaid regulations in your state should explain how you can calculate the rental income that must be contributed to payment for your mother's care.
In my state (Massachusetts) the regulations explain that (C) Rental Income is reduced by allowable business expenses:
"(1) Allowable business expenses from rental income include carrying charges, cost of fuel and utilities provided to tenants, and any maintenance and repair costs."
Property taxes would be a carrying charge.
You would benefit by consulting an elder law attorney in your local area who can help you plan for continued eligibility, and the reporting requirements in your state. see more
In my state (Massachusetts) the regulations explain that (C) Rental Income is reduced by allowable business expenses:
"(1) Allowable business expenses from rental income include carrying charges, cost of fuel and utilities provided to tenants, and any maintenance and repair costs."
Property taxes would be a carrying charge.
You would benefit by consulting an elder law attorney in your local area who can help you plan for continued eligibility, and the reporting requirements in your state. see more
Question
What to do with a husband that pees all over the bathroom?
Many memory loss patients have increasing difficulty with activities of daily living. But there are ways to help with capacity for daily... Many memory loss patients have increasing difficulty with activities of daily living. But there are ways to help with capacity for daily life. Dr. Paul Raia of the Alzheimer's Association has helped people solve this problem:
"A principle of habilitative design is that we use color and textural contrast to draw attention to important features of the environment, and we camouflage or hide dangerous or distracting elements of the environment. To illustrate, I was called to a caregiver’s apartment because her husband, a mid-stage Alzheimer's patient, was urinating in a closet.
The problem as I saw it was that the couple had recently moved to a new apartment and he more often than not chose the wrong door when he felt he needed to use the bathroom. In fact, the bathroom and closet doors were adjacent to one another. By painting the bathroom door red, the color automatically drew the gentlemen’s attention and he reliably chose the correct door. However, once in the bathroom he was confronted by white walls and floor, a white sink, toilet, and bathtub. He often would urinate in the bathtub. I instructed the caregiver to purchase a red toilet seat. The problem was solved."
Dr. Raia's approach to solving these problems is important for all of us, and can have a positive effect on everything involving the case of a memory loss patient, including legal planning and how assets and resources are allocated. see more
"A principle of habilitative design is that we use color and textural contrast to draw attention to important features of the environment, and we camouflage or hide dangerous or distracting elements of the environment. To illustrate, I was called to a caregiver’s apartment because her husband, a mid-stage Alzheimer's patient, was urinating in a closet.
The problem as I saw it was that the couple had recently moved to a new apartment and he more often than not chose the wrong door when he felt he needed to use the bathroom. In fact, the bathroom and closet doors were adjacent to one another. By painting the bathroom door red, the color automatically drew the gentlemen’s attention and he reliably chose the correct door. However, once in the bathroom he was confronted by white walls and floor, a white sink, toilet, and bathtub. He often would urinate in the bathtub. I instructed the caregiver to purchase a red toilet seat. The problem was solved."
Dr. Raia's approach to solving these problems is important for all of us, and can have a positive effect on everything involving the case of a memory loss patient, including legal planning and how assets and resources are allocated. see more
Question
We are asking my wife's Mother to pay us $2000 a month to live in our home and be taking care of 24/7. Any opi...
The top response to your question by MaggieMarshall is very important. Without a Caregiver Contract, and records to verify the work that... The top response to your question by MaggieMarshall is very important. Without a Caregiver Contract, and records to verify the work that you are doing, your mother's payments to you will be questioned if your mother needs Medicaid in the future, and those transfers could disqualify her.
Ask an elder law attorney to explain all of the options. Was your father a war-time veteran? Aid & Attendance pension can reimburse the veteran's surviving spouse for care expenses, even payments to family members.
Medicaid home care programs in your state may also be available, if your mother's income and assets can be coordinated with the application process. see more
Ask an elder law attorney to explain all of the options. Was your father a war-time veteran? Aid & Attendance pension can reimburse the veteran's surviving spouse for care expenses, even payments to family members.
Medicaid home care programs in your state may also be available, if your mother's income and assets can be coordinated with the application process. see more
Question
How much does Medicaid pay for me to care for my Mom in my home?
The Medicaid program in your state may have several programs to help you and your mother. Whether you can provide sufficient care at home... The Medicaid program in your state may have several programs to help you and your mother.
Whether you can provide sufficient care at home is another question though. Consider hiring a geriatric care manager to help you prepare a care plan the would be acceptable to the facility's discharge planner, and your mother's physician.
Agingcare.com has an excellent article on: The Money Follows the Person Program. Use the search box on this page to find it.
https://www.agingcare.com/articles/The-Money-Follows-the-Person-Program-189162.htm
Other programs that are available in my state (Massachusetts) are: Adult Foster Care (AFC), Community Choices, Group Adult Foster Care (GAFC), and Personal Care Attendant Program (PCA).
There is also a form of health insurance that combines Medicare with Medicaid to offer day care and come in-home home health aid hours. It is called PACE.
Talking with an elder law attorney who knows the Medicaid programs in your state, and your local ASAP (Aging Services Access Point), could open up many doors to achieve your objectives! see more
Whether you can provide sufficient care at home is another question though. Consider hiring a geriatric care manager to help you prepare a care plan the would be acceptable to the facility's discharge planner, and your mother's physician.
Agingcare.com has an excellent article on: The Money Follows the Person Program. Use the search box on this page to find it.
https://www.agingcare.com/articles/The-Money-Follows-the-Person-Program-189162.htm
Other programs that are available in my state (Massachusetts) are: Adult Foster Care (AFC), Community Choices, Group Adult Foster Care (GAFC), and Personal Care Attendant Program (PCA).
There is also a form of health insurance that combines Medicare with Medicaid to offer day care and come in-home home health aid hours. It is called PACE.
Talking with an elder law attorney who knows the Medicaid programs in your state, and your local ASAP (Aging Services Access Point), could open up many doors to achieve your objectives! see more
Question
Medicaid 5-year look back - what is looked at, and to what level of detail, as far as determining penalties?
Now is the time to talk to an elder law attorney who serves people in your area, to protect your mother in law's remaining assets, and... Now is the time to talk to an elder law attorney who serves people in your area, to protect your mother in law's remaining assets, and prepare for the sale of her house.
Medicaid is the government program that covers custodial care provided by nursing homes. In order to qualify for Medicaid Long Term Care, an applicant must be financially eligible. The person who needs care must fie a detailed application which discloses to the government all of the applicant's assets and financial resources.
If the applicant owns assets worth more than the government allows ($2,000 for a single individual), the applicant's assets must be used to pay the nursing home, before the government will provide Medicaid benefits to pay the nursing home. Asset transfers must be listed on a Medicaid application, unless 5 years have passed since date of transfer.
But, if proper steps are taken, your mother in law does not have to continue spending down her assets before filing the Medicaid application, and qualifying for Medicaid benefits.
A pooled trust account can be opened to hold your mother in law's excess assets. Money saved in a Pooled Trust account can be used for Quality of Life enhancements for a nursing home resident. Ask the elder law attorney to provide you with a list of Pooled Trust administrators in your state. Pooled Trusts, also known as (d)(4)(C) Trusts, are sponsored by charitable agencies for the benefit of disabled people.
Also, there may be other Medicaid regulations in your state that could help your mother in law. For example, money that is transferred to a properly prepared trust that benefits a disabled family member will not be counted against your mother in law.
Hiring an elder law attorney now will benefit your mother in law, and your entire family. The detailed work required to plan for and obtain Medicaid eligibility can be handled by the attorney, allowing you and other family members to spend more time visiting and caring for your loved one. see more
Medicaid is the government program that covers custodial care provided by nursing homes. In order to qualify for Medicaid Long Term Care, an applicant must be financially eligible. The person who needs care must fie a detailed application which discloses to the government all of the applicant's assets and financial resources.
If the applicant owns assets worth more than the government allows ($2,000 for a single individual), the applicant's assets must be used to pay the nursing home, before the government will provide Medicaid benefits to pay the nursing home. Asset transfers must be listed on a Medicaid application, unless 5 years have passed since date of transfer.
But, if proper steps are taken, your mother in law does not have to continue spending down her assets before filing the Medicaid application, and qualifying for Medicaid benefits.
A pooled trust account can be opened to hold your mother in law's excess assets. Money saved in a Pooled Trust account can be used for Quality of Life enhancements for a nursing home resident. Ask the elder law attorney to provide you with a list of Pooled Trust administrators in your state. Pooled Trusts, also known as (d)(4)(C) Trusts, are sponsored by charitable agencies for the benefit of disabled people.
Also, there may be other Medicaid regulations in your state that could help your mother in law. For example, money that is transferred to a properly prepared trust that benefits a disabled family member will not be counted against your mother in law.
Hiring an elder law attorney now will benefit your mother in law, and your entire family. The detailed work required to plan for and obtain Medicaid eligibility can be handled by the attorney, allowing you and other family members to spend more time visiting and caring for your loved one. see more
Question
What do you do to distract Alzheimer's patients from going out so often?
Agingcare.com has a section devoted to memory loss care, and the Alzheimer's Association has a helpful brochure that outlines how you... Agingcare.com has a section devoted to memory loss care, and the Alzheimer's Association has a helpful brochure that outlines how you can set up "Activities at Home" to match your loved one's level of capacity:
alz/national/documents/brochure_activities.pdf see more
alz/national/documents/brochure_activities.pdf see more
Question
My father-n-law is a WWII Veteran, but has never used any benefits, he now needs assisted care. Are there bene...
Basic information is at: https://www.agingcare.com/articles/veteran-aid-attendance-benefit-long-term-care-156656.htm... Basic information is at:
https://www.agingcare.com/articles/veteran-aid-attendance-benefit-long-term-care-156656.htm
https://www.agingcare.com/articles/veteran-aid-and-attendance-improved-pension-136402.htm
Information about coming changes to the Aid & Attendance eligibility is at:
https://www.agingcare.com/articles/va-aid-attendance-new-eligibility-rules-177294.htm
https://www.agingcare.com/articles/propsed-changes-to-aid-and-attendance-affect-caregiver-pay-178761.htm see more
https://www.agingcare.com/articles/veteran-aid-attendance-benefit-long-term-care-156656.htm
https://www.agingcare.com/articles/veteran-aid-and-attendance-improved-pension-136402.htm
Information about coming changes to the Aid & Attendance eligibility is at:
https://www.agingcare.com/articles/va-aid-attendance-new-eligibility-rules-177294.htm
https://www.agingcare.com/articles/propsed-changes-to-aid-and-attendance-affect-caregiver-pay-178761.htm see more
Question
When Mom dies do I have to be appointed executrix to get her tax refund?
IRS Publication 559 explains that: If no personal representative has been appointed and if there is no surviving spouse, the person in... IRS Publication 559 explains that: If no personal representative has been appointed and if there is no surviving spouse, the person in charge of the decedent's property must file and sign the [decedent's final income tax] return as “personal representative.”
https://www.irs.gov/pub/irs-pdf/p559.pdf
There is a line on the Form 1040 that allows for direct deposit of income tax refunds.
Turbo Tax has a discussion on "Death in the Family."
IRS Form 1310 asks whether you will distribute the income tax refund according to the laws of your state:
https://www.irs.gov/pub/irs-pdf/f1310.pdf see more
https://www.irs.gov/pub/irs-pdf/p559.pdf
There is a line on the Form 1040 that allows for direct deposit of income tax refunds.
Turbo Tax has a discussion on "Death in the Family."
IRS Form 1310 asks whether you will distribute the income tax refund according to the laws of your state:
https://www.irs.gov/pub/irs-pdf/f1310.pdf see more
Question
How can I set up the child caregiver exemption?
The caregiver child exception allows a person who applies for Medicaid nursing home coverage to make a penalty free transfer of their house... The caregiver child exception allows a person who applies for Medicaid nursing home coverage to make a penalty free transfer of their house to a child who has taken care of them in the home.
42 U.S.C. 1396p says that:
An individual person won't be ineligible for medical assistance if he or she transfers a home to a son or daughter of such individual who was residing in such individual’s home for a period of at least two years immediately before the date the individual becomes an institutionalized individual, and who (as determined by your State's Medicaid agency) provided care to such individual which permitted such individual to reside at home rather than in such an institution or facility.
www.ssa.gov/OP_Home/ssact/title19/1917.htm
The key is to make sure your mother's doctor is aware that her daughter is living in the home and making it possible for your mother to avoid a nursing home admission. After at least 2 years of this valuable care service provided by the daughter, a letter from the physician should convince the Medicaid case worker that the mother qualifies for the Caregiver Exception, allowing her to transfer the house to the daughter.
It’s always interesting to read the issues that other Agingcare.com community members see in each question. Some community members mentioned income tax issues in answering the question about transferring the house to the caregiver child. Their concerns may be taken care of if the caregiver child becomes the home owner and continues living in the house and decides to sell it after two years. The Principal Residence Exclusion is an income tax law that saves people from paying a capital gains tax on the sale of their home.
www.law.cornell.edu/uscode/text/26/121 see more
42 U.S.C. 1396p says that:
An individual person won't be ineligible for medical assistance if he or she transfers a home to a son or daughter of such individual who was residing in such individual’s home for a period of at least two years immediately before the date the individual becomes an institutionalized individual, and who (as determined by your State's Medicaid agency) provided care to such individual which permitted such individual to reside at home rather than in such an institution or facility.
www.ssa.gov/OP_Home/ssact/title19/1917.htm
The key is to make sure your mother's doctor is aware that her daughter is living in the home and making it possible for your mother to avoid a nursing home admission. After at least 2 years of this valuable care service provided by the daughter, a letter from the physician should convince the Medicaid case worker that the mother qualifies for the Caregiver Exception, allowing her to transfer the house to the daughter.
It’s always interesting to read the issues that other Agingcare.com community members see in each question. Some community members mentioned income tax issues in answering the question about transferring the house to the caregiver child. Their concerns may be taken care of if the caregiver child becomes the home owner and continues living in the house and decides to sell it after two years. The Principal Residence Exclusion is an income tax law that saves people from paying a capital gains tax on the sale of their home.
www.law.cornell.edu/uscode/text/26/121 see more
Question
My brother has DPOA of health care for my Mother. Do I need his permission to access her medical records?
Has your brother told your mother's health care providers not to provide her health care information to you or other family members?... Has your brother told your mother's health care providers not to provide her health care information to you or other family members?
Health care providers have flexibility when working with people who are helping a family member with health care arrangements. A government website answers Frequently Asked Questions and explains:
"The HIPAA Privacy Rule at 45 CFR 164.510(b) specifically permits covered entities to share information that is directly relevant to the involvement of a spouse, family members, friends, or other persons identified by a patient, in the patient’s care or payment for health care."
http://www.hhs.gov/hipaa/for-professionals/faq/488/does-hipaa-permit-a-doctor-to-discuss-a-patients-health-status-with-the-patients-family-and-friends/index.html
If your brother has given intrusions to the health care providers that makes them unwilling to talk with you, talk to an elder law attorney for ideas on how to help him cooperate with you, other family members and your mother's health care providers.
If your mother is able to communicate verbally, the regulation mentioned in the FAQ explains that your mother can verbally give permission to the health care provider to disclose her information to you.
https://www.gpo.gov/fdsys/pkg/CFR-2003-title45-vol1/xml/CFR-2003-title45-vol1-sec164-510.xml see more
Health care providers have flexibility when working with people who are helping a family member with health care arrangements. A government website answers Frequently Asked Questions and explains:
"The HIPAA Privacy Rule at 45 CFR 164.510(b) specifically permits covered entities to share information that is directly relevant to the involvement of a spouse, family members, friends, or other persons identified by a patient, in the patient’s care or payment for health care."
http://www.hhs.gov/hipaa/for-professionals/faq/488/does-hipaa-permit-a-doctor-to-discuss-a-patients-health-status-with-the-patients-family-and-friends/index.html
If your brother has given intrusions to the health care providers that makes them unwilling to talk with you, talk to an elder law attorney for ideas on how to help him cooperate with you, other family members and your mother's health care providers.
If your mother is able to communicate verbally, the regulation mentioned in the FAQ explains that your mother can verbally give permission to the health care provider to disclose her information to you.
https://www.gpo.gov/fdsys/pkg/CFR-2003-title45-vol1/xml/CFR-2003-title45-vol1-sec164-510.xml see more
Question
If my Mom has a live-in from Medicaid does she have to provide food/meals?
You question about meals raises many important issues, including your mother's liability for unexpected things that can happen in home... You question about meals raises many important issues, including your mother's liability for unexpected things that can happen in home care.
Is your mother's caregiver an employee of a care agency or company that is reimbursed or contracted by Medicaid? Or is the caregiver a person who is hired by your mother? Is there a third party agency that administers the Medicaid payment?
Understanding the answers to these questions can help you determine the policies and guidelines for caregiver meals, and establish who would be responsible for a caregiver injury.
A California case, where the caregiver was an employee of an agency or company, illustrated why it is important to make sure that the caregiver is covered by worker's compensation insurance:
https://www.agingcare.com/articles/can-hired-caregivers-sue-patients-172542.htm see more
Is your mother's caregiver an employee of a care agency or company that is reimbursed or contracted by Medicaid? Or is the caregiver a person who is hired by your mother? Is there a third party agency that administers the Medicaid payment?
Understanding the answers to these questions can help you determine the policies and guidelines for caregiver meals, and establish who would be responsible for a caregiver injury.
A California case, where the caregiver was an employee of an agency or company, illustrated why it is important to make sure that the caregiver is covered by worker's compensation insurance:
https://www.agingcare.com/articles/can-hired-caregivers-sue-patients-172542.htm see more
Question
My mother is on medicaid and will be receiving an inheritance of approximately 250,000. How can she spend this...
Is your mother a resident of a facility, or is she receiving Medicaid benefits to pay for home care? The answer to your question about the... Is your mother a resident of a facility, or is she receiving Medicaid benefits to pay for home care? The answer to your question about the $250,000 bequest depends on your specific circumstances.
Medicaid vs Inheritance was discussed in a recent AgingCare.com article:
https://www.agingcare.com/articles/Medicaid-vs-Inheritance-192510.htm?utm_source=Newsletter&utm_medium=Email&utm_campaign=Newsletter%20-%20January%202,%202016
If your mother is a nursing home resident, one option to consider is setting the money aside in a Pooled Trust, to supplement the care that the nursing home is providing. 42 U.S. Code § 1396p(d)(4)(C) allows a Medicaid beneficiary to put assets into a Pooled Trust established and managed by a non-profit association, with a separate account maintained for each beneficiary of the trust, solely for the benefit of individual, and as long as any money remaining in the beneficiary’s account upon the death of the beneficiary are paid to the State from such remaining amounts in the account an amount equal to the total amount of medical assistance paid on behalf of the beneficiary.
https://www.law.cornell.edu/uscode/text/42/1396p
If available in your state, the pooled trust option lets you to set funds set aside, without losing Medicaid eligibility, so you will always have a reserve to pay for services and supplies your mother needs.
If you consult an elder law attorney near you, you can get complete advice on pooled trust accounts, the probate laws that may apply to your circumstances, and any other options that are available to help your mother. see more
Medicaid vs Inheritance was discussed in a recent AgingCare.com article:
https://www.agingcare.com/articles/Medicaid-vs-Inheritance-192510.htm?utm_source=Newsletter&utm_medium=Email&utm_campaign=Newsletter%20-%20January%202,%202016
If your mother is a nursing home resident, one option to consider is setting the money aside in a Pooled Trust, to supplement the care that the nursing home is providing. 42 U.S. Code § 1396p(d)(4)(C) allows a Medicaid beneficiary to put assets into a Pooled Trust established and managed by a non-profit association, with a separate account maintained for each beneficiary of the trust, solely for the benefit of individual, and as long as any money remaining in the beneficiary’s account upon the death of the beneficiary are paid to the State from such remaining amounts in the account an amount equal to the total amount of medical assistance paid on behalf of the beneficiary.
https://www.law.cornell.edu/uscode/text/42/1396p
If available in your state, the pooled trust option lets you to set funds set aside, without losing Medicaid eligibility, so you will always have a reserve to pay for services and supplies your mother needs.
If you consult an elder law attorney near you, you can get complete advice on pooled trust accounts, the probate laws that may apply to your circumstances, and any other options that are available to help your mother. see more
Question
Can wrist restraints be used legally in SC for a dementia patient who is aggressive?
Federal laws and regulations talk about restraints on people who are residents of care facilities. Under Federal law, patients have the... Federal laws and regulations talk about restraints on people who are residents of care facilities. Under Federal law, patients have the right to be free from:
"any physical or chemical restraints imposed for purposes of discipline or convenience and not required to treat the resident’s medical symptoms.
Restraints may only be imposed—
(I) to ensure the physical safety of the resident or other residents, and
(II) only upon the written order of a physician that specifies the duration and circumstances under which the restraints are to be used.”
42 U.S.C. § 1395i-3(c)(1)(A)(ii) and 42 U.S.C. § 1396r(c)(1)(A)(ii).
These broad guidelines may be helpful as you search for solutions to the combative behavior. Talk with a social worker at your local ASAP (Aging Services Access Point) and an elder law attorney, to learn about laws and regulations in your state that may protect people in your home care situation.
Continue talking with the physicians to see if you can spot behavioral triggers that can be alleviated. Dr. Helen Kyomen, a geriatric psychiatrist, has written online articles on Agitation in Older Adults, suggesting the questions you can ask when an elder show signs of agitation. Paul Raia, Ph.D. of the Alzheimer’s Association has explained how a behavior plan can be developed to identify triggers for agitation and anxiety in dementia patients. see more
"any physical or chemical restraints imposed for purposes of discipline or convenience and not required to treat the resident’s medical symptoms.
Restraints may only be imposed—
(I) to ensure the physical safety of the resident or other residents, and
(II) only upon the written order of a physician that specifies the duration and circumstances under which the restraints are to be used.”
42 U.S.C. § 1395i-3(c)(1)(A)(ii) and 42 U.S.C. § 1396r(c)(1)(A)(ii).
These broad guidelines may be helpful as you search for solutions to the combative behavior. Talk with a social worker at your local ASAP (Aging Services Access Point) and an elder law attorney, to learn about laws and regulations in your state that may protect people in your home care situation.
Continue talking with the physicians to see if you can spot behavioral triggers that can be alleviated. Dr. Helen Kyomen, a geriatric psychiatrist, has written online articles on Agitation in Older Adults, suggesting the questions you can ask when an elder show signs of agitation. Paul Raia, Ph.D. of the Alzheimer’s Association has explained how a behavior plan can be developed to identify triggers for agitation and anxiety in dementia patients. see more
Question
Spousal impoverishment under VA healthcare/assisted living. Any advice?
An advocate in your city or town could help you sort out the confusion the discharge planners are having with your husband's level of... An advocate in your city or town could help you sort out the confusion the discharge planners are having with your husband's level of care. The primary care doctor's recommendation for a neuropsychologist evaluation is an excellent first step. If your husband gets a thorough examination that documents the deficits you describe, an elder law attorney or veterans benefits attorney could begin the process of convincing the VA providers to provide the needed level of care and resources. Use your state or county bar association to find a local attorney who specializes in veterans benefits and elder law. Your state may also have a veterans agent assigned to advocate for residents of your city or town. see more
Question
Money follows the person waivers. Have you used a waiver?
What state do you live in? In Massachusetts, Money Follows the Person (MFP) is a demonstration program that moves eligible elderly and... What state do you live in? In Massachusetts, Money Follows the Person (MFP) is a demonstration program that moves eligible elderly and disabled people out of nursing homes and into the community. To be eligible, you must be ready to go home after living for at least 90 days in a nursing home paid by MassHealth long term care.
MFP provides up to one year of benefits not normally covered by MassHealth, to transition a nursing home resident back to their home in the community. There are two waivers under this program;
Residential Supports Waiver provides 24/7 supervision and staffing in a "qualified residence" including residential habilitation, assisted living, or day care services.
Community Living Waiver covers people who live in their own home, or the home of another,
A transition coordinator supervises the patient’s successful reintegration into the community. The regulations and law are at:
130 CMR § 529.007(H); Mass. Gen. Laws ch.10, §35TT
https://malegislature.gov/Laws/GeneralLaws/PartI/TitleII/Chapter10/Section35TT see more
MFP provides up to one year of benefits not normally covered by MassHealth, to transition a nursing home resident back to their home in the community. There are two waivers under this program;
Residential Supports Waiver provides 24/7 supervision and staffing in a "qualified residence" including residential habilitation, assisted living, or day care services.
Community Living Waiver covers people who live in their own home, or the home of another,
A transition coordinator supervises the patient’s successful reintegration into the community. The regulations and law are at:
130 CMR § 529.007(H); Mass. Gen. Laws ch.10, §35TT
https://malegislature.gov/Laws/GeneralLaws/PartI/TitleII/Chapter10/Section35TT see more
Question
Can a guardian live in a different state than the ward?
Your question requires an understanding of how your mother is paying for nursing home care in Florida, and real estate title law in... Your question requires an understanding of how your mother is paying for nursing home care in Florida, and real estate title law in Georgia. Talk to an elder law attorney in Florida who can help coordinate the work of a real estate title attorney in Georgia.
There is a Uniform Adult Guardianship and Protective Proceedings Jurisdictions Act that many states have adopted, to help people manage inter state guardianships. But do you need guardianship proceedings? You have Power of Attorney. Again, the elder law attorney can coordinate things for you! Thanks for taking care of your Mom's care. see more
There is a Uniform Adult Guardianship and Protective Proceedings Jurisdictions Act that many states have adopted, to help people manage inter state guardianships. But do you need guardianship proceedings? You have Power of Attorney. Again, the elder law attorney can coordinate things for you! Thanks for taking care of your Mom's care. see more
Question
Do we have to pay taxes on my Dad's cashed out life insurance policies?
In your question, you say: "We are filing for medicaid for my dad. he is in a nursing home" and "we will have to use all the... In your question, you say: "We are filing for medicaid for my dad. he is in a nursing home" and "we will have to use all the money to pay for nursing home."
You may be able to set aside all of the insurance policy cash in a pooled trust account for your father. Talk with an elder law attorney in your state, who can assist you with the Medicaid application, and help you protect your father's quality of life.
Funds deposited in a pooled trust account (also known as (d)(4)(C) trusts) can be used for any suitable purpose that assists the account beneficiary. Hiring an accountant to take care of tax filings and all of your questions would benefit your father. An accountant can be paid from the funds that you set aside in the pooled trust.
More important, the trust funds can be used to supplement care that staff in the nursing home are not able to provide. see more
You may be able to set aside all of the insurance policy cash in a pooled trust account for your father. Talk with an elder law attorney in your state, who can assist you with the Medicaid application, and help you protect your father's quality of life.
Funds deposited in a pooled trust account (also known as (d)(4)(C) trusts) can be used for any suitable purpose that assists the account beneficiary. Hiring an accountant to take care of tax filings and all of your questions would benefit your father. An accountant can be paid from the funds that you set aside in the pooled trust.
More important, the trust funds can be used to supplement care that staff in the nursing home are not able to provide. see more
Does a resident family member (with POA) have to pay nursing home, when resident can't?
Why do you think that: “Resident can't apply for Medicaid, until house is sold (it has a mortgage) and money is spent down.”? Who provided you with this misinformation?
Medicaid regulations allow eligibility if the applicant is taking steps toward selling the real estate. When the property is sold, the proceeds can be immediately deposited into a pooled trust account that will benefit the nursing home resident, or into a trust that benefits another disabled person. You may miss out on many options if you decide to try to go it alone through this difficult time of transition. An elder law attorney in your state can give you good advice and services that protect you and the nursing home resident.
To read the nursing home law:
https://www.law.cornell.edu/uscode/text/42/1396r
Scroll down to §1396r(c)(5)(A)(ii)
A nursing facility must have identical policies and practices for transfer, discharge, and services, regardless of source of payment. 42 U.S.C. §1396(c)(4). In my state (Massachusetts) state law prohibits nursing homes from discriminating based on a person’s source of anticipated payment. 940 CMR 4.03(1).
Medicaid reimbursements to the nursing home will probably be lower than if you privately pay, but the nursing home cannot require a resident to waive their right to Medicaid benefits.
A nursing home may be motivated to give preference to people who can pay privately, but they are not permitted to require a resident to give up the right to Medicaid benefits by requiring private payment for a time before the resident applies for Medicaid.
http://www.mass.gov/ago/docs/regulations/940-cmr-4-00.pdf see more