Read more about the article What Does an Elder Law Attorney Do? Annapolis and Towson Estate Planning

What Does an Elder Law Attorney Do? Annapolis and Towson Estate Planning

Seniors are some of the most vulnerable members of our society. They can fall victim to a range of scams, abuse and misconduct. Seniors may also lack the ability to speak out and be heard. As a result, the combination of these factors can lead to tragic outcomes.

With a law firm that specializes in elder care law at your side, you can provide seniors with the advocacy they need to ensure that their rights are protected.

Seasons’ recent article entitled “Finding an elder care lawyer” reports that according to the WHO, one in six people over the age of 60 saw some type of abuse from 2021 to 2022. Two-thirds of staff members at nursing homes and long-term-care facilities admitted they committed abuse during that same period. Unfortunately, these issues are only getting worse with time, and elder abuse only increased during the COVID-19 pandemic.

Connecting with qualified, experienced elder law attorneys can be simple if you understand how they can help.

Elder law encompasses all aspects of legal representation and advocacy that involve the elderly and include the following:

  • Estate planning
  • Medicaid planning
  • Disability
  • Social Security benefits
  • Guardianship and Conservatorship
  • Elder abuse
  • Fraud
  • Neglect
  • Consumer protection
  • End-of-life planning
  • Retirement planning
  • Long-term-care planning
  • Discrimination
  • Nursing homes
  • Landlord/tenant disputes
  • Powers of attorney
  • Medical care option directives; and
  • Tax issues.

Elder care law deals with legal issues concerning a senior’s well-being in nursing homes and long-term-care facilities. These are areas where neglect, abuse and misconduct are quite common. Therefore, it might be a good idea to contact an elder care attorney as soon as you suspect abuse is occurring.

Contact us to review your estate plan with one of our experienced estate planning attorneys.

Reference: Seasons (Aug. 30, 2022) “Finding an elder care lawyer”

 

Sims & Campbell, LLC – Annapolis and Towson Estate Planning Attorneys

Read more about the article How Does Estate Planning Work for Caregiving Children? Annapolis and Towson Estate Planning

How Does Estate Planning Work for Caregiving Children? Annapolis and Towson Estate Planning

This situation requires considered estate planning to protect the arrangement, both for the parent and child, in the event of the parent’s incapacity and what may happen, if and when the parent needs to move to a care facility and/or passes away.

If the child is caring for the parent at the parent’s home, the parent’s estate planning often gives the child the ability to remain at the parent’s residence. It may also allow the child to access the parent’s bank accounts, if the parent becomes mentally incapacitated. A recent article from Lake County Record-Bee, “Estate planning for parents with caregiver children,” says if the planning is not done correctly, a series of unintended problems may arise, including disagreements with other family members and allegations of elder abuse, especially financial abuse.

Agreed-upon terms of any living arrangement should be included in the parent’s estate planning documents. If the parent has a living trust, the trust may allow the child to remain in the family home, so the document must clearly state the terms of the living arrangement. If the parents live in a rental property, the POA may be used to authorize the child’s continued occupancy and use of the parent’s money to pay household expenses. The rental agreement would need to include the child as a tenant.

What if the parent lives in the child’s home? The child’s estate plan would need to reflect on what terms the parent may remain in the child’s house, if the child were to become incapacitated or die unexpectedly. Consideration would also need to be given to how the parents receive care.

If the parent dies or moves into a nursing home or when the child moves out, the arrangement ends. What happens next? It depends on the situation. The parent may leave the residence to the adult care giver child. The following also to be addressed: how are expenses, including the mortgage, to be paid and is there an expressed transition period before the child moves out?

If the parent intends to leave the family home to the adult care giver, the estate planning documents need to gift the residence to the adult caregiver. This may include lifetime gifting, or it may entail renting the residence to provide income for the parent’s needs.

If there are siblings, or a spouse from a second marriage, the estate planning documents need to say whether and how other family members participate in the residence. The parents may want to gift the residence to all children, subject to an exclusive life estate for the care giver to live in the family home. When the care giver child becomes incapacitated or dies, the family home is usually sold, and the sale proceeds divided between the parent’s living descendants.

Something to be careful about: if the caregiver child is treated more favorably than siblings. While the parents are entitled to make their own decisions about how to distribute assets, a disgruntled sibling may object to how assets are distributed. An estate planning attorney will be able to formally document the parent’s wishes and prepare the estate for any challenges.

Finally, if no advance planning is done, it is possible the parent may end up needing a guardian and conservator to care for their finances and their well-being, respectively, if they become incapacitated. This becomes an expensive situation, and the result of court-supervised administrators may not agree with how the parent wished their affairs to be handled.

Contact us to review your estate plans with one of our experienced estate planning attorneys.

Reference: Lake County Record-Bee (Feb. 4, 2023) “Estate planning for parents with caregiver children”

 

Sims & Campbell, LLC – Annapolis and Towson Estate Planning Attorneys

Read more about the article Do You Need a Revocable or an Irrevocable Trust? Annapolis and Towson Estate Planning

Do You Need a Revocable or an Irrevocable Trust? Annapolis and Towson Estate Planning

It’s not always obvious which type of trust is the best for an individual, says a recent article titled “Which is Best for Me: A Revocable or Irrevocable Trust?” from Westchester & Fairfield County Business Journals.

In a revocable living trust (RLT), the creator of the trust, known as the “grantor,” benefits from the trust and can be the sole Trustee. While living, the grantor/trustee has full control of the real estate property, bank accounts or investments placed in the trust. The grantor can also amend, modify and revoke the trust.

The goal of a revocable trust is mainly to avoid probate at death. Probate is the process of admitting your last will and testament in the court in the county where you lived to have your last will deemed legally valid. This is also when the court appoints the executor named in your last will. The executor then has access to the estate’s assets to pay bills and distribute funds to beneficiaries as named in the last will.

Probate can take six months to several years to complete, depending upon the complexity of the estate and the jurisdiction. Once the estate is probated, your estate is part of the public record.

A revocable living trust and the transfer of assets into the trust can accomplish everything a last will can. However, distribution of assets at the time of death remains private and the court is not involved. Distribution of assets takes place according to the instructions in the trust.

By comparison, irrevocable trusts are not easily revoked or changed. Most irrevocable trusts are used as a planning tool to transfer assets for the benefit of another person without making an outright gift, or for purposes of Medicaid or estate tax planning. An Irrevocable Medicaid Asset Protection Trust is used to allow an individual to protect their life savings and home from the cost of long-term care, while allowing the trust’s creator to continue to live in their home and benefit from income generated by assets transferred into the irrevocable trust.

The grantor may not be a trustee of an irrevocable trust and the transfer of assets to a Medicaid Asset Protection trust starts a five-year penalty period for Nursing Home Medicaid and a two-and-a-half-year penalty period for Home Care Medicaid for applications filed after March 1, 2024. After the penalty (or “look back”) periods expire, the funds held by the trust are protected and are not considered countable assets for Medicaid.

An irrevocable trust can also be used to transfer assets for the benefit of a loved one, friend, child, or grandchild. Assets are not controlled by the beneficiaries but can be used by the trustee for the beneficiary’s health, education, maintenance and support.

Trusts are used to reduce the size of the taxable estate, to plan for the well-being of loved ones, and to protect the individual and couple if long-term care is needed. Speak with an estate planning attorney about which trust is best for your unique situation.

Contact us to review your estate plan with one of our experienced estate planning attorneys.

Reference: Westchester & Fairfield County Business Journals (Jan. 26, 2023) “Which is Best for Me: A Revocable or Irrevocable Trust?”

 

Sims & Campbell, LLC – Annapolis and Towson Estate Planning Attorneys

Read more about the article How Does Guardianship Work? – Annapolis and Towson Planning

How Does Guardianship Work? – Annapolis and Towson Planning

For family members of the estimated 6.5 million dementia patients in the U.S., it is crucial to understand whether guardianship may be an option for their loved one. A recent article from Next Avenue titled “Thinking of Becoming a Guardian?” explains how the guardianship process works and what factors go into the decision-making process.

Annapolis and Towson Estate Planning

Guardianship is the position of being responsible for someone else. State courts usually appoint a guardian to make decisions for a person, if the court finds that person to be incapacitated or unable to make safe and reasonable decisions for themselves. People who are placed under guardianship, known as “wards,” often lose their independence in making financial, legal and health care decisions.

If full guardianship is awarded, the person cannot make decisions about whether they may vote, marry, where they live, or make their own end-of-life decisions.

Two tasks that are evaluated when considering guardianship are a person’s ability to manage personal finances and to take medications as prescribed.

The court may call on a geriatrician or psychiatrist to evaluate the person’s functional behavior, cognitive function, disabling conditions and ability to meet their essential needs.

There are benefits to guardianship for someone who is not able to care for themselves. It ideally creates a safety net for a person who cannot make informed decisions for themselves.

this, of course, assumes that the guardian is honest and accountable, which is not always the case. The inconsistencies plaguing the guardianship system include minimum standards for guardians, lack of regular independent reviews of the need for guardianship and lack of educational requirements for guardians.

Once guardianship is assigned, there is a tendency for the person to become lost when no follow-up is done. The very same person who lacks capacity to care for themselves is not going to be able to advocate for themselves, contact an attorney or access funds for court proceedings.

There is also a tendency to assign full guardianship for a person, rather than less restrictive alternatives.

There are alternatives, but they require planning and discussion. More than 40% of Americans have not discussed their wishes for end-of-life care with their loved ones, according to an article in the Journal of the American Geriatrics Society. Families should have a conversation at the first sign of memory loss or when preparing for retirement regarding wishes for end-of-life care and write them down as part of an Advanced Directive—also known as a Living Will and Health Care Power of Attorney—when preparing their estate plan.

Another important document, although not legally binding, is a “Value History,” where you share your values and beliefs as they may impact care choices.

Designate a Power of Attorney and list two or even three back-up candidates. This person will be responsible for financial, legal and personal matters, avoiding the need for guardianship.

Appointing a family member or friend as a guardian is the ideal solution. However, there are instances when the best person to be a guardian is not a family member, but a court-appointed outsider. This relieves the family of being the ones who need to inform a person suffering from dementia with the news of having to move into a nursing home facility or sifting through financial records to learn that the family home is in foreclosure. The family can focus on being supportive and loving, while the guardian deals with the sometimes harsh realities of the person’s life.

Speak with your estate planning attorney to learn about how guardianship works, and whether it may be the right move for your family.

Contact us to review your estate plan with one of our experienced estate planning attorneys

Reference: Next Avenue (Dec. 23, 2022) “Thinking of Becoming a Guardian?”

 

Sims & Campbell, LLC – Annapolis and Towson Estate Planning Attorneys

Read more about the article What Estate Planning Can a Nursing Home Resident Do? – Annapolis and Towson Estate Planning

What Estate Planning Can a Nursing Home Resident Do? – Annapolis and Towson Estate Planning

It can be difficult trying to understand the estate settlement process. It’s a system so arcane and frustrating that it can take months to complete. Family members must deal with probate, taxes, assets and debts — all while navigating their grief.

McKnight’s Senior Living’s recent article entitled “5 estate-planning steps your residents should know” says “it doesn’t have to be that hard, especially if the estate owner helps organize the estate before the time comes. While you already might know some steps, the list of things to consider will prove useful. Handling those steps in life is the kindest thing a person, especially a resident of a care facility, can do for his or her family. That’s because these steps are far more difficult for an executor to complete, if they have not been thoughtfully planned.

  1. Name an executor. The first thing is to choose the person who will carry out the terms of the last will and testament. A senior should make certain this individual is able to take on such a complex role and notify them in advance. A critical part of the process for a care facility resident, depending on their circumstances, can be creating joint accounts with the executor. Doing this can ensure that money won’t be trapped in probate after the resident’s passing. Beware: there are risks associated with this approach because the surviving joint owner becomes the legal owner and may use it personally rather than for estate expenses.
  2. Create a list of assets and liabilities. Collect all important records on paper or in a digital vault for the executor to reference and fulfill when needed. This should include a list of all digital accounts, debts owed and to whom, any valuable and sentimental items, as well as assets passing outside of probate by joint ownership, beneficiary designations and title in trust. When questions arise, the executor won’t have to sift through documents and get frustrated if an important document or asset can’t be found.
  3. Determine how the estate should be distributed. The resident should have an estate distribution plan that can be added to the will to help lessen the burden on the executor.
  4. Draft a last will. When the last will is created, the resident should ensure that loved ones and beneficiaries are aware of the terms, so there are no issues. Make sure that the will can be authenticated easily later. Keep it in a central place with other important documents.
  5. Prepare for probate. Probate is the process of authenticating the last will. It lets debts and assets move from the deceased’s estate to the executor. Every state has its own probate rules. A resident must be aware of two primary things. First, finding the right probate court. If the resident has moved recently or lives in a senior living community far from his or her original home, then probate may be required in the new state rather than the state they call “home.” Second, the resident must understand and plan for probate-related fees.

There are ways to avoid probate, to include those mentioned earlier in this post, such as placing assets in a trust. Contact us to speak with an experienced estate planning attorney about probate avoidance tactics, if you want to explore options to simplify the estate settlement process.

Reference: McKnight’s Senior Living (Sep. 29, 2022) “5 estate-planning steps your residents should know”

Sims & Campbell, LLC – Annapolis and Towson Estate Planning Attorneys

What Should I Know About Long-Term Care? – Annapolis and Towson Estate Planning

Long-term care insurance is a specialty type of insurance that helps pay for costs that are typically connected with long-term care. This can include items such as care given in a hospital, nursing home services, medical services provided in your home and treatment for dementia.

WGN’s recent article entitled “10 Crucial Things to Know about Long-Term Care“ looks at these important items.

  1. The Biggest Financial Threat. The most significant threat to your financial nest egg is long-term care. About 70% of people over 65 will need some kind of long-term care during their life. The national average for home health care services is $16,743 per month. However, there are ways to manage this without buying a traditional long-term care insurance policy where “you use it or lose it.”
  2. Long-Term Care Insurance is Really “Lifestyle” Insurance. It’s NOT nursing home insurance.
  3. Reverse Mortgages. These have become a popular and accepted way of paying for expenses, including the cost of long-term care. Reverse mortgages are designed to keep seniors at home longer. A reverse mortgage can pay for in-home care, home repair, home modification and other needs.
  4. Using Medicaid to Pay for Long-Term Care. This should be a last resort to pay for long-term care, but it also may be the only way to protect family assets. Medicaid will pay for long-term care, but certain criteria must be satisfied. Talk to an elder law attorney before applying for Medicaid.
  5. Important Considerations When Selecting a Long-Term Care Plan. Four things to consider: (i) go with a company with an AM BEST rating of A+ or better; (ii) the assets of the insurance company should be in the billions; (iii) some long-term care insurers will allow for group discounts through employers, or “affinity” group discounts through a local organization; and (iv) the tax advantages for tax-qualified long-term care insurance plans. At the federal level, premiums for long-term care insurance fall into the “medical expense” category. On the state level, 26 states offer some form of deduction or tax credit for long-term care insurance premiums.
  6. The Annuity-Based Long-Term Care & The Pension Protection Act. In 2006, this law was enacted to permit those with annuity contracts to have long-term care riders with special tax advantages. The Act allows the cash value of annuity contracts to be used to pay premiums on long-term care contracts.
  7. Asset-Based Long-Term Care Solutions. The best planning approach for those who choose to self-insure is to “invest” some of their legacy assets so the assets can be worth as much as possible whenever they may be needed to pay for care. If unneeded, the money would then pass to the intended heirs, with no “use it or lose it” issues as with conventional long-term care insurance.
  8. Long-Term Care Strategy Using IRA Money. Most people use their IRA to supplement retirement. However, sometimes waiting until age 72 when mandatory required minimum distribution rules apply, some people have instead opted to take a portion of their IRA and fund an IRA-based annuity which then systematically funds a 20-pay life insurance plan with long-term care features. This type of IRA-based long-term care policy is unique in the sense that it starts out as an IRA annuity policy, also known as a tax-qualified annuity, and then over a 20-year period makes equal distribution internally to the insurance carrier and funds the life insurance.
  9. Important Documents for Long-Term Care Planning. Contact us to ask one of our experienced estate planning attorneys about a power of attorney for health care and financial power of attorney, as well as an advance directive or living will.
  10. Using Veterans Benefits to Pay for Long-Term Care. The VA offers a special pension: the Aid and Attendance (A&A) Benefit. This is a “pension benefit” and is not dependent upon service-related injuries for compensation.

Reference: WGN (2022) “10 Crucial Things to Know about Long-Term Care“

Sims & Campbell, LLC – Annapolis and Towson Estate Planning Attorneys

What Can Happen When You are Asked to Sign a Nursing Home Agreement? – Annapolis and Towson Estate Planning

The services provided by a skilled nursing facility are very important. They are also very expensive. The person who arrives at an elder law office with a bill from a nursing home for $19,400—$646.66 per day—is often the same person who signed an electronic version of an admissions form without knowing what would happen.

This is one of many ways people are held responsible for loved ones’ nursing home bills, according to the recent article “Should you sign a nursing home admission agreement?” from The Bristol Press. The stress of having a loved one admitted to a nursing home is an overwhelming experience, usually taking place at the same time you’re managing all the details, just when someone from the nursing home very politely and usually firmly tells you “these papers” must be signed immediately.

It’s important not to rush in this situation, because the agreement could contain illegal or misleading provisions. Try not to sign the agreement until after the resident has moved into the facility, when you may have more leverage. However, even if you have to sign the agreement before the resident moves in, have the agreement reviewed by an experienced elder law attorney and request that any illegal or unfair terms be deleted. Don’t take the nursing home’s word that they cannot do so.

Two terms to pay close attention to:

Responsible Party. The nursing home may try to get you to sign the agreement as the “responsible party.” Don’t do it. Nursing homes are legally prohibited from requiring third parties to guarantee payment of nursing home bills. However, there are some who try to get family members to voluntarily agree.

If at all possible, the resident should sign the agreement themselves. If the resident is incapacitated, you may sign but must be clear you are signing as the resident’s agent. Read carefully for terms like “guarantor,” “financial agent,” or “responsible party.” Before signing, you can cross out any terms indicating you are responsible for payment and clearly indicate you are only agreeing to use the resident’s income and resources to pay and not your own.

Arbitration Provisions: Many nursing home agreements contain provisions stating that all disputes regarding the resident’s care will be decided through arbitration and remove the ability to take the nursing home to court. This is not an illegal provision, although many feel it should be. Most people do not know they cannot be required to sign an arbitration provision. Cross out any language regarding arbitration before signing the agreement.

Private Pay Requirement. It is illegal for the nursing home to require a Medicare or Medicaid recipient to pay the private rate for a period of time, nor may the nursing home require a resident to affirm whether they are not eligible for Medicare or Medicaid.

Eviction Procedures: It is illegal for a nursing home to evict a resident for any reason other than the facility cannot meet the resident’s needs, the resident’s health has improved, the resident is endangering other residents, the resident has not paid, or the nursing home is closing.

Speak with an elder law attorney before facing the complexity of a nursing home admission agreement. The patient and their loved ones have rights to be protected.

Reference: The Bristol Press (Aug. 15, 2022) “Should you sign a nursing home admission agreement?”

Sims & Campbell, LLC – Annapolis and Towson Estate Planning Attorneys

Planning for Long Term Care Is Important – Annapolis and Towson Estate Planning

Elder law attorneys have far too many stories of people who fail to plan, plan incorrectly or incompletely, or plan to fail by doing nothing at all, as described in the article “Elder Care: People in a pickle” from The Sentinel. Here’s a sad story.

A woman calls the elder law office because her husband fell at home—a common occurrence among the elderly. He was hospitalized and is now receiving rehabilitation in a nursing home. The treating physician recommends that the husband remain in the nursing home because he has significant limitations and his wife, who has her own medical issues, isn’t physically able to care for him.

The wife agrees. However, she has a host of challenges to overcome that were never addressed. The husband took care of all of the finances, for decades telling his wife not to worry. Now, she has no idea what their resources are. Can they afford to pay for his nursing home care? She doesn’t know. Nor does she have the authority to access their accounts, because there are accounts in her husband’s name only and she does not have access to them.

Her husband’s insistence of being the only one in control of their finances has put her in a terrible predicament. Without the estate planning documents to give her access to everything, including his own accounts, she can’t act. Can he now sign a Power of Attorney? Maybe—but maybe not, if it can be shown he lacks capacity.

If the couple cannot pay the nursing home bill, they have given their children a problem, since they live in Pennsylvania, where the state’s filial support law allows the nursing home to sue one or more of the children for the cost of their parent’s care. (This law varies by state, so check with a local elder lawyer to see if it could impact your family). Even if the wife knew about the family’s finances and could apply for public benefits, in this case his eligibility would be denied, as they had purchased a home for one of their children within five years of his being moved to the nursing home. Medicaid has a five-year look back period, and any large transfers or purchases would make the husband ineligible for five years.

If this sounds like a financial, legal and emotional mess, it’s a fair assessment.

Unexpected events happen, and putting off planning for them, or one spouse insisting “I’ve got this” when truly they don’t, takes a big impact on the future for spouses and family members. All of the decisions we make, or fail to make, can have major impacts on the future for our loved ones.

Other situations familiar to elder lawyers: a parent naming two children as co-agents for power of attorney. When she began showing symptoms of dementia, the two children disagreed on her care and ended up in court.

A father has guardianship for a disabled adult son. He promised the son he’d always be able to live in the family home. The father becomes ill and must move into a nursing home. Neither one is able to manage their own personal finances, and no financial or practical arrangements were made to fulfill the promise to the son.

No one expects to have these problems, but even the most loving families find themselves snarled in legal battles because of poor planning. Careful planning may not reduce the messy events of life, but it can reduce the stress and expenses. By choosing to exert some control over who can help you with decisions and what plans are in place for the future, you can leave a legacy of caring.  Contact us and schedule a time to begin your planning with one of our experienced estate planning attorneys.

Reference: The Sentinel (Aug. 19, 2022) “Elder Care: People in a pickle”

Sims & Campbell, LLC – Annapolis and Towson Estate Planning Attorneys

What’s the Difference between a Living Will and a DNR Order? – Annapolis and Towson Estate Planning

A living will and a Do Not Resuscitate Order, known as a DNR, are very different documents. However, many people confuse the two. They both address end of life issues and are used in different settings, according to the article “One Senior Place: Know the difference between ‘living will’ and ‘do not resuscitate’” from Florida Today.

What is a Living Will?

A living will is a written statement describing a person’s wishes about receiving life-sustaining medical treatment in case of a terminal illness if they are near death or in a persistent vegetative state. This includes choices such as whether to continue the use of artificial respiration, a feeding tube and other highly intensive means of keeping a person alive.

The living will is used to make your wishes clear to loved ones and to physicians. It is prepared by an estate planning elder care attorney, often when having an estate plan created or updated. To ensure it is valid and the instructions can be carried out, be sure to have this document created properly.

What is a DNR?

A DNR is a medical directive used to convey wishes to not be resuscitated in the event of respiratory or cardiac arrest. This document needs to be signed by both the patient and their treating physician. It is often printed on brightly colored paper, so it can be easily found in an emergency.

The DNR should be placed in a location where it can be easily and quickly found. In nursing homes, this is typically at the head or foot of the bed. At home, it is often posted on the refrigerator.

The DNR needs to be immediately available to ensure that the patient’s last wishes are honored.

A key mistake made by well-meaning family members is to have the DNR with someone else, rather than at home or at the bedside of the patient. If the DNR cannot be found and emergency medical responders arrive on scene, they are legally bound to provide CPR or other medical care to revive the patient.

When the DNR is available, the emergency responders will not initiate CPR if they find the patient in cardiopulmonary arrest or respiratory arrest. They may instead provide comfort care, including administering oxygen and pain management.

If a person is admitted to the hospital, their living will is placed on the chart. Depending on the state’s laws, a certain number of physicians must agree the patient is in a persistent vegetative state or has an end-state condition and can no longer communicate. At that point, the terms of the living will are followed.

In addition to having these documents created with your estate plan, make sure that family members know where they can be found.

Reference: Florida Today (July 19, 2022) “One Senior Place: Know the difference between ‘living will’ and ‘do not resuscitate’”

 

Sims & Campbell, LLC – Annapolis and Towson Estate Planning Attorneys

Medicaid Crisis Plans for Long Term Care Costs – Annapolis and Towson Estate Planning

To the estate planning attorney, the situation is known as “crisis planning.” It almost always involves two things happening at once: the immediate need for additional healthcare and for a family’s assets to be protected. The end goal of crisis planning is to protect assets for both spouses, while ensuring that the sick spouse receives the care they need, as explained in the article “Crisis planning for couples focuses on asset protection” from The News-Enterprise.

What is Medicaid Crisis Planning?

Crisis planning for married couples requires a three-step process. First, does the spouse in crisis have the documents in place to allow another person to act on their behalf? This includes a financial power of attorney and a healthcare power of attorney.

Powers of Attorney need to be checked to ensure that they include specific powers needed to take action on the person’s behalf. These documents are “state specific,” meaning each state has laws determining what the POA must contain and how it must be prepared. Crisis planning requires a POA providing a broad set of powers, so agents can access and change documents like deeds, bank and investment accounts.

Once the documents and POAs are in hand, the next step is to get a detailed breakdown of the couple’s financial position and the cost of care. This becomes easier if the couple is organized and has information readily available for each income stream and asset.

What Information Will the Agent Need?

The agent must find several different types of financial documents. Proof of income for each income stream is needed. The actual proof of income will show taxes withdrawn or other deductions taken from income, such as health insurance.

The agent will also need access to several months of statements for each account, including bank statements, investment accounts, retirement accounts and deeds and titles for property. Proof of other assets, including insurance policies, burial plot deeds and other assets must also be included.

Some types of income and assets are countable, and some are non-countable. However, the non-countable income and assets may need to be considered, so the estate planning attorney will need to have all the information.

Medicaid Resource Assessment Request

Step three is to determine eligibility for programs and make the necessary applications. This will depend on the type of care needed. However, a typical crisis case is for nursing home care, which almost always means Medicaid eligibility. All income and assets are reported to Medicaid through a Resource Assessment request. The Medicaid office creates a breakdown of what will be counted against the applicant.

The remaining amount is what must be “spent down” for a person to be eligible for Medicaid coverage.

The most common way to do this is through a Medicaid Annuity. This annuity takes the spend down amount and returns the full amount as income to the spouse at home, effectively preserving the couple’s assets.

Crisis planning is stressful but does not have to be hopeless. By working with an experienced estate planning attorney and providing documentation as quickly as possible, health care needs can be met without the well spouse being impoverished.

Reference: The News-Enterprise (July 23, 2022) “Crisis planning for couples focuses on asset protection”

 

Sims & Campbell, LLC – Annapolis and Towson Estate Planning Attorneys