Estate Planning can help address Nursing Homes Costs

October 26, 2023

Estate planning can help address nursing home costs. Figures from a Bureau of Labor Statistics (BLS) report published recently showed that the growth in the price of nursing homes and adult care has been especially volatile this year, reports Kiplinger’s recent article entitled, “Nursing Home Costs Soared in July.”

The national average cost of nursing homes rarely declines. The cost declined for just five months in the last quarter century (the months between 1997 and 2022). Therefore, it’s surprising to see three months of decline in 2023 (April, May, and June). Nonetheless, the total 1.2% percent dip in those three months was more than offset by the 2.4% cost increase in July.

It’s hard to determine if the July price jump was an aberration or indicative of future price increases. This unusual volatility likely shows an industry struggling to regroup after the disruptions of the pandemic, which severely impacted nursing.

Nursing home and adult care is very expensive. Most people spend over $7,000 in out-of-pocket costs yearly.

This high cost is likely due to several factors, and the increased demand from a rapidly aging population, inflation and a shortage of qualified nurses top the list.

However, there is some good news: the U.S. Government plans to direct more funding to support the nursing workforce, though the effect of the program will take time to show up in the preparedness and availability of nurses.

For most active, middle-aged people, it’s hard to imagine that you might need significant nursing care one day. However, research shows that 70% of adults who survive to age 65 need at least some long-term support before they die, and 48% receive some paid care, according to a study by The Urban Institute.

The key is to pay attention to financial planning. A senior’s thoughtfulness will let her family move them to a high-quality nursing home and likely be covered financially for a long time.

Could your family say the same thing? Do you know the range of costs in your area?

For example, the typical annual cost of a nursing home ranges from $59,495 for a shared room in Louisiana to a yearly cost of $380,000 in parts of Alaska.

While Medicare may cover some expenses, partnering with a professional is wise to get your long-term care planning on the right track. Estate planning can help address nursing home costs. If you have children, you’ll be doing them an enormous favor. If you would like to learn more about elder care, please visit our previous posts.

Reference: Kiplinger (Aug. 16, 2023) “Nursing Home Costs Soared in July”

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Consider Hiring a Lawyer for Medicaid Applications

August 24, 2023

Medicaid can be a complicated and ponderous process to navigate. As with many government programs, it is easy to make mistakes that could potentially devastate your family’s finances. You might consider hiring a lawyer for Medicaid applications. Film Daily’s recent article, “Do You Need a Lawyer to Apply for Medicaid?” says that hiring a lawyer for Medicaid applications can provide many benefits. Let’s look at some of the big ones:

Expert Knowledge: Attorneys specializing in Medicaid are well-versed in the complex rules and regulations of the program. They stay updated with policy changes and can provide accurate guidance based on your unique circumstances.

Maximizing Eligibility: An experienced elder law lawyer can help structure your finances and assets to maximize your eligibility for Medicaid. They can also advise you on strategies to protect your assets, while satisfying the program’s requirements.

Streamlined Application Process: A Medicaid application can involve a ton of paperwork and documentation. A lawyer can help you gather the necessary information, complete the application correctly and submit it on time, reducing the chances of delays or mistakes.

Handling Complex Situations: If your situation is complicated, like owning a business or having multiple sources of income, a Medicaid lawyer can work through the intricacies and ensure that all relevant information is presented correctly in your application.

Appeals and Legal Support: If your application is denied or there are other issues, a lawyer can represent you in appeals or hearings. They can advocate for your rights and help resolve any disputes that arise during the application process.

While hiring a lawyer when applying for Medicaid is not mandatory, their expertise can be invaluable in navigating the complexities of the program.

A lawyer specializing in Medicaid can provide guidance, streamline the application process, and help you maximize your eligibility.

Sit down as a family and consider hiring a lawyer for your Medicaid applications. Depending on your circumstances, hiring a Medicaid attorney can be beneficial in complex financial situations, long-term care planning, dealing with denied applications, or staying informed about changing regulations.

With the right legal support, you can also increase your chances of a successful Medicaid application. If you would like to learn more about Medicaid and estate planning, please visit our previous posts.

Reference: Film Daily (July 25, 2023) “Do You Need a Lawyer to Apply for Medicaid?”

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An Attorney can help when applying for Medicaid

August 16, 2023

Medicaid is a vital program that provides healthcare coverage for individuals and families with limited income and resources. Hiring an attorney can help when applying for Medicaid. Their expertise can be invaluable in ensuring a smooth and successful application process.

Film Daily’s recent article, “Do You Need a Lawyer to Apply for Medicaid?” says that applying for Medicaid involves gathering the necessary documentation, filling out an application form and submitting it to the state Medicaid agency.

The application typically requires information about your income, assets, household composition and medical expenses. It’s important to provide accurate and complete information to avoid delays or potential issues with your case.

A lawyer specializing in Medicaid can walk you through the application process, ensure that you meet all of the requirements and provide the correct documentation.

A Medicaid planning lawyer can also help you understand any legal implications and address any concerns that may come up during the application process.

Here are some scenarios where hiring a lawyer might be a wise move:

Complicated Financial Situations: If you have complex financial arrangements or significant assets, a Medicaid planning lawyer can help you navigate the Medicaid eligibility requirements while protecting your interests.
Long-Term Care Planning: If you or a loved one requires long-term care services, a lawyer with expertise in elder law and Medicaid planning can help you develop a strategy to protect your assets while accessing the necessary healthcare services.
Denied or Delayed Applications: If your Medicaid application has been denied or delayed, a Medicaid planning lawyer can help you appeal the decision or address any issues that may have caused the delay.
Changing Regulations: The program rules and policies can change over time. An experienced Medicaid lawyer can ensure that you stay informed about any updates that may affect your eligibility or benefits.

Consider hiring an Elder Law attorney to help when applying for Medicaid. He or she may be the difference between receiving benefits and being denied. If you are interested in learning more about Medicaid planning, please visit our previous posts.

Reference: Film Daily (July 25, 2023) “Do You Need a Lawyer to Apply for Medicaid?”

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Checklist Helps Put Affairs in Order

August 15, 2023

As the Baby Boomer generation ages, so too come the very real conversations around end-of-life planning. It can be a daunting and emotionally difficult subject. A checklist helps put your affairs in order and provides you and your loved ones with some peace of mind. National Institute on Aging’s recent article, “Getting Your Affairs in Order Checklist: Documents to Prepare for the Future,” has some steps to consider when getting your affairs in order.

Plan for your estate and finances. Common documents include a will and a power of attorney. A will states how your property, money and other assets will be distributed and managed when you die. A power of attorney for finances names someone who will make financial decisions for you when you are unable.
Plan for your future health care. Many people choose to prepare advance directives, which are legal documents that provide instructions for medical care and only go into effect if you can’t communicate your wishes due to disease or severe injury. A living will tells doctors how you want to be treated if you can’t make your own decisions about emergency treatment. A power of attorney for health care names your health care proxy. This individual can make health care decisions for you if you cannot communicate these yourself.
Put your important papers and copies of legal documents in one place. You can set up a file, put everything in a desk or dresser drawer, or list the information and location of papers in a notebook. Consider getting a fireproof and waterproof safe to store your documents for added security.
Tell someone you know and trust the location of your important papers. Someone you trust should know where to find your documents in case of an emergency.
Talk to your family and physician about advance care planning. A doctor can help you understand future health decisions and plan the kinds of care or treatment you may want. Discussing this with your doctor is free through Medicare during your annual wellness visit, and private health insurance may also cover this. Share your decisions with your loved ones to help avoid any surprises about your wishes.
Give permission in advance to discuss your condition with your caregiver. You can give your caregiver permission to talk with your doctor, lawyer, insurance provider, credit card company, or bank. This is different from naming a health care proxy. A health care proxy can only make decisions if you cannot communicate them.
Review your plans regularly. Look over your plans at least once yearly and when any major life event occurs, like a divorce, move, or major change in your health.

A checklist helps put your affairs in order and gives you and your loved ones a roadmap to address any changes or issues that come up in the future. If you would like to learn more about end-of-life planning, please visit our previous posts.

Reference: National Institute on Aging (July 25, 2023) “Getting Your Affairs in Order Checklist: Documents to Prepare for the Future”

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Important to Evaluate your Planning before a Second Marriage

August 7, 2023

Second marriage, goes the saying, is the triumph of hope over experience. It’s a happy event for everyone, but different from the first time around. You might have created an estate plan during your first marriage. Still, chances are your life is a lot more complicated this time, especially if you both have children from prior marriages and more assets than when you were first starting out as a young adult. It is important to evaluate your planning before a second marriage. This is why a recent article from The Bristol Press is aptly titled “Plan your estate before you remarry.”

Here are some pointers to protect you and your new spouse-to-be:

Take an inventory of all assets and liabilities. This includes assets and debts, life insurance policies, retirement plans, credit card debt and anything you own. It’s important to be open and honest about your debts and assets, so that both people know exactly what they are marrying. Once you are married, you may be liable for your partner’s debts. Your credit scores may be impacted as well.

Decide how you are going to handle finances. Once you know what your partner is bringing to the marriage, you’ll want to make clear, unemotional decisions about how you’ll address your wealth. Are you willing to combine all of your assets? Do you want to keep your investment accounts separate?

For example, if one person is selling a home to move into the home owned by the other person, what costs, if any, will they contribute to the cost of the house? If one person has significant debt, do you want to combine finances or make joint purchases? These are not always easy issues. However, they shouldn’t be ignored.

Decide what you want to happen when you die. You and your future spouse should meet with an experienced estate planning attorney to create a will, Power of Attorney, Health Care Proxy and other documents. This lets you map exactly where you want your assets to go when you die. If there are children from prior marriages, you’ll want to ensure they are not disinherited when you die. This can be addressed through a number of options, including creating a trust for your children, making them beneficiaries of life insurance policies, or giving children joint ownership of property.

Even if there are no children, there may be family heirlooms or items with sentimental value you want to keep in the family, perhaps passing to a cousin, nephew, or niece. Discuss this with your future spouse and ensure that it’s included in your will.

Meet with an estate planning attorney. You should take this step even if you don’t have many assets. If you have children, it’s even more important. You’ll want to update your will and any other estate planning documents. If you have significant assets, you may decide to have a prenuptial or postnuptial agreement. The estate planning attorney will also help you determine whether you need a trust to protect your children.

If you had planning done in the past, it is important to sit down with an estate planning attorney to evaluate it in before to a second marriage. If you would like to learn more about estate planning for blended families, please visit our previous posts.

Reference: The Bristol Press (July 14, 2023) “Plan your estate before you remarry”

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How does HIPAA Authorization Work?

July 6, 2023

Many people have heard of HIPAA rules, often in terms related to medical care, but do not understand it. So how does a HIPAA authorization work? The HIPAA Privacy Rule provides federal protections for personal health information held by covered entities and gives patients an array of rights concerning that information. 45 CFR §164.508 states the uses and disclosures of PHI that require authorization from a patient/plan member before information can be shared or used.

It’s important to know that some organizations are considered “partial” or “hybrid” entities. These are usually organizations whose primary function isn’t healthcare or health insurance but who have access to health information that should be protected. An educational institution that provides health services to the public is an example of a partial or hybrid entity.

HIPAA Journal’s recent article entitled “What is HIPAA Authorization?” explains that in some situations, informal consent rather than formal authorization is enough to satisfy the requirement of the HIPAA Privacy Rule. These circumstances are called “Uses and Disclosures with an Opportunity to Agree or Object” and include inclusion in facility directories and notifications to friends and family (of admission into the hospital).

If an individual cannot give their authorization, covered entities must wait until the patient or their legal representative can give their authorization. When only informal consent is required, covered entities can use their professional judgment to determine whether the use or disclosure of PHI is in the patient´s best interests.

Note that the requirements for HIPAA authorizations aren’t the same throughout the country. The HIPAA Privacy Rule is a “federal floor” for permissible uses and disclosures. However, some state laws may pre-empt HIPAA, if they have more stringent regulations.

The clause “covered entities cannot condition treatment, payment, enrollment, or eligibility for benefits” means that a covered entity can’t withhold treatment, payment, enrollment, or eligibility for benefits because a patient or plan member refuses to sign an authorization giving the covered entity additional uses for their PHI, which stands for Protected Health Information (PHI). A patient or plan member shouldn’t be put under any duress to approve the uses and disclosures of PHI, in addition to those permitted by the Privacy Rule.

The law stipulates that there has to be written authorization for every use or disclosure of PHI not required or permitted by the Privacy Rule. The retraction of HIPAA authorization also has to be written. However, HIPAA consent can be verbal, but only when consent – rather than authorization – is an option. Understanding how a HIPAA authorization does and does not work can be the difference between staying informed and being excluded. If you are interested in learning more about medical directives like HIPAA, please visit our previous posts.

Reference: HIPAA Journal (October 9, 2021) “What is HIPAA Authorization?”

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Estate Plans Require Preparation for Success

June 13, 2023

Making wishes clear to family members is never enough to satisfy legal standards, according to a recent article, “Preparation is essential part of estate plan” from The News-Enterprise. Quite the opposite occurs when family members refuse to follow verbal requests, especially when personal grievances come to the surface during times of grief. Estate plans require preparation for success.

A second misconception concerns the spouse or children being able to step in and take action for a loved one whose health is declining solely based on the family relationship.

Many parents have children who would make poor agents, so many don’t name their children to act on their behalf. Even if you want your spouse or child to act on your behalf, you have to name them in the proper legal documents.

A third frequent misconception is that documents can be created when needed. Not so! Documents like Power of Attorney, Health Care Power of Attorney, Living Will and others must be created well in advance. An incapacitated person cannot sign legal documents, so if no planning has been done, the family will have to petition the court to name a guardian—an expensive, time-consuming and complicated process.

Every adult should have three basic documents while they are in good health: a Health Care Power of Attorney, a Durable Power of Attorney and a Last Will and Testament.

The Health Care Power of Attorney gives another person the right to make healthcare decisions for you if you are unable to do so. It also gives another person the right to access protected health care information, including medical and health insurance records. It may also be used to authorize organ and/or tissue donation and set limitations for donation. Finally, the document may direct end-of-life decisions regarding artificial life support.

The Durable Power of Attorney allows another person to handle legal and financial matters. It can be effective upon signing or upon incapacity. Without correctly executed Powers of Attorney, the family will need to apply for guardianship.

The Last Will and Testament determines who should receive any specific property and how your property is to be divided and distributed. Wills are only effective upon death, so any property in the will continues to be yours until death. Wills are also used to name the executor who will be responsible for administering the estate. It can also be used to set up additional protections for disabled beneficiaries, minor children and others who are not good with finances.

Speak with an experienced estate planning attorney to be certain to have these essential documents to prepare for the times when life doesn’t go as expected. Preparation is required for the success of your estate plan and those you love. If you would like to learn more about drafting an estate plan, please visit our previous posts.

Reference: The News-Enterprise (May 13, 2023) “Preparation is essential part of estate plan”

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Unmarried Couples must have Estate Planning Documents

June 1, 2023

Many couples make the choice not to wed, even after being together for decades, for personal or financial reasons. For example, some clients don’t marry so as not to impact their children’s inheritance, while others would rather not bother with the legalities, says a recent article, “Estate Planning for Unmarried Couples” from My Prime Time News. In some cases, marriage would cause the couple to lose pension or Social Security benefits, if they remarried. However, unmarried couples must take extra care to have estate planning documents in place to make their wishes clear and to protect each other in case of incapacity, serious illness and, ultimately, death.

From any statutory priority, a significant other does not have the legal rights granted to a spouse to serve as a personal representative or executor for their loved one’s estate. In addition, there is no statutory right to inherit property, including any family allowance or exempt property allowance.

The significant other also has no rights regarding acting as guardian or conservator for their partner and no ability to make medical decisions, if they become incapacitated or disabled.

All of these issues, however, can be resolved with the help of an estate planning attorney. Both partners should execute a will, health care power of attorney, general power of attorney and a living will to protect each other.

The last will and testament designates a personal representative or executor who will be in charge of the decedent’s estate and inherit the person’s assets. With no will, a partner will inherit no assets, unless they are owned jointly or the partner is a named beneficiary.

Having a health care power of attorney and a financial power of attorney gives a partner the power to make decisions if their loved one becomes incapacitated. In addition, these power of attorney documents are necessary for adult children to have priority in making these decisions, and guardianship proceedings will be required if there are no children or family members.

Disputes between the adult children of unmarried couples are common if a comprehensive estate plan still needs to be completed. For example, imagine a partner of many decades becoming too ill to communicate their end-of-life wishes. Even after a lifetime together, the adult children will have the legal upper hand, regardless of what the couple has discussed as their wishes for this situation.

It may be challenging for unmarried couples to discuss their living arrangements and family dynamics. However, the experienced estate planning attorney has met with and helped families of all kinds and will have the knowledge to prepare an estate plan to address all family dynamics.

Unmarried couples must have estate planning documents in place. Once this work is done, the couple can rest easy, knowing they have protected each other in the best and worst circumstances. If you would like to learn more about planning for unmarried couples, please visit our previous posts.

Reference: My Prime Time News (May 1, 2023) “Estate Planning for Unmarried Couples”

Durable Power of Attorney can Prevent Guardianship Issues

May 31, 2023

Guardianship or conservatorship documents are not easy to obtain and can take months to finalize, warns the article “Possible Guardianship Or Conservatorship in Your Future? Plan Ahead With A Durable Power of Attorney” from Idaho Senior Independent. However, there is a far easier way to plan for the future. A durable power of attorney can prevent guardianship issues.

Guardianship is a tool to solve the issue of a person who has become incapacitated and cannot make personal care, legal or financial decisions. With a durable power of attorney for health care decisions and a general durable power of attorney for financial matters, you can achieve the same level of control, with far less time, trouble and cost.

The ultimate goal is to gain the legal authority to make decisions for the incapacitated individual which will be honored by third parties, including financial institutions and health care providers and facilities.

Most estate planning attorneys advise married couples to give each other durable power of attorney (POA) for health care and finances. As long as the couple doesn’t die at the same time or become incapacitated at the same time, the well spouse can manage the couple’s health and assets. It may also be a good idea to give his legal authority to another person, usually one of their children.

Having an estate planning attorney create a comprehensive estate plan, which includes powers of attorney, health care powers of attorney, a last will and testament and other necessary legal documents, may seem like a lot to do. However, the alternative, pursuing guardianship or conservatorship, is just as lengthy, if not more so, and only solves one problem. A complete estate plan solves many, from care during incapacity to the distribution of assets after death.

Guardianship is needed if there is no durable health care POA for a loved one and they are unable to care for themselves or make medical decisions. This is especially true if they need some kind of housing assistance, such as assisted living or memory care. A conservatorship allows the named person to manage the loved one’s assets, including Social Security, investments and any property or vehicles they own. The POA also permits you to use their assets to pay for their care.

None of this can happen while going through the guardianship/conservatorship process, meaning you or someone else will have to pay the bills and time-sensitive decisions cannot be executed.

Achieving guardianship/conservatorship involves filing a petition with the court in the county where your loved one lives. In most cases, an estate planning attorney will advise the family member to obtain an appointment for their loved one with a physician who can evaluate the person’s ability to manage their life. A physician will need to provide a letter verifying the need for guardianship/conservatorship. The letter becomes part of the petition filed with the court.

The attorney will require a hearing based on the information provided.

Many courts require a different attorney to be retained to represent your loved one to avoid any conflict of interest. A different physician will, in many cases, also be required to evaluate the health of your relative. Courts also often require an assessment by a legal “visitor,” typically a licensed social worker who independently evaluates your relative and makes recommendations.

The visitor reports their findings to the court and to the attorneys. The guardianship/conservatorship applicant pays for the visit and subsequent reports, plus any attorney fees.

All of this takes time, although an attorney can request that the court grant temporary guardianship and conservatorship.

Having a legal, durable power of attorney for health and finances can prevent guardianship issues long before they will be needed. It is a far simpler way for you to care for loved ones, if and when they need it. If you would like to learn more about guardianship and elder law, please visit our previous posts.

Reference: Idaho Senior Independent (May 1, 2023) “Possible Guardianship Or Conservatorship in Your Future? Plan Ahead With A Durable Power of Attorney”

Singles Need Estate Planning for Incapacity

May 15, 2023

Estate planning is even more critical for singles than married couples—and it has nothing to do with whom you’ll leave assets to when you die. A recent article from AARP, “6 Estate Planning Tips for Singles,” explains how estate planning addresses support during challenging life events. Singles need estate planning during their lifetime for issues such as incapacity.

Estate planning addresses medical and financial decisions for an incapacitated person. For singles, these may be more complex questions to answer.

Whether someone has never married or is divorced or widowed, these are challenging questions to answer. However, they must be documented. In addition, singles with minor children need to nominate a trusted person who can care for their children if they cannot. Estate planning addresses all of these issues.

To be sure you complete this process, start with a conversation with an experienced estate planning attorney. This will help with accountability, ensuring that you start and finish the process.

Here are some pointers for singles who keep putting this vital task off:

What would happen if you don’t leave clear instructions about who will make medical decisions in case of incapacity? A doctor who doesn’t know your wishes will decide for you. If you don’t want to be placed on a ventilator for artificial breathing or fed by a stomach tube while in a coma, the decision will be made regardless of your wishes.

Dying without a will is known as dying “intestate.” All of your assets will be distributed according to the intestate succession laws in your state. If no relatives come forward to claim your property, the state receives your assets. This is not what most people want.

Part of your estate plan includes naming a personal representative—an executor—who will oversee your affairs after your death. You’ll want to designate someone who is organized, has good judgment and can handle financial matters. You should also name a backup, so that if the first person cannot or does not wish to serve, there will be someone else to take control. Otherwise, the court will name someone who doesn’t even know you to take on this task. It’s better to designate someone than leave this to the state.

Your estate plan includes the following:

Last will and testament. This is where you nominate your executor, heirs and how your assets will be distributed. You can also appoint a guardian for minor children. Note that anyone named as a beneficiary on a retirement, insurance policy, or investment account supersedes any instructions in your will, so be sure to update those and check on them every few years to be sure they are still aligned with your wishes.

Living trust. This is a legal entity owning assets to be given to beneficiaries, managed by a trustee of your choosing, and avoids the delays and costs of probate.

Financial Power of Attorney (FPOA). This document authorizes someone you name to act as your agent and make financial decisions if you cannot. An FPOA can prevent delays in accessing bank and investment accounts and paying your bills. The FPOA ends upon your death.

Living will, durable medical power of attorney, or advance health care directive. These documents allow you to designate someone to communicate your health care wishes when you cannot. For example, you can include instructions on pain management, organ donation and your wishes for life support measures.

Health care power of attorney (HPOA). Like the living will, which is more associated with end-of-life care, the HPOA lets someone make medical treatment decisions on their behalf.

Singles need estate planning to protect themselves for incapacity. Be sure to communicate your wishes with family and friends. Tell your executor where your documents may be found and provide them with the information they’ll need so they may act on your behalf. If you would like to learn more about planning for incapacity or disability, please visit our previous posts.

Reference: AARP (April 7, 2023) “6 Estate Planning Tips for Singles”

Category: Incapacity

Estate Planning can help address Nursing Homes Costs

Consider Hiring a Lawyer for Medicaid Applications

An Attorney can help when applying for Medicaid

Important to Evaluate your Planning before a Second Marriage

How does HIPAA Authorization Work?

Estate Plans Require Preparation for Success

Unmarried Couples must have Estate Planning Documents

Durable Power of Attorney can Prevent Guardianship Issues

Singles Need Estate Planning for Incapacity

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