Wednesday, December 12, 2012

Eliminating the Need for Improvement... Beneficial Changes for Some Medicare Patients

In our spring 2012 newsletter, we stated that nursing homes may mistakenly require a resident to be improving or showing progress in order to continue to be covered by Medicare. One may see an incorrect denial of further Medicare coverage if a resident plateaus, or if the nursing facility says the resident can no longer be rehabilitated.

Now, as recently reported in the New York Times, the Obama administration pursuant to a proposed settlement of a nationwide class-action suit, has agreed to scrap a practice that required many beneficiaries to show a likelihood of medical or functional improvement before Medicare would pay for skilled nursing and therapy services.

This agreement states that Medicare will now pay for such services if they are needed to "maintain the patient's current condition or prevent or slow further deterioration," regardless of whether the patient's condition is expected to improve.

Read the full article...

Tuesday, December 4, 2012

The Impact of Recent Elder Law Court Rulings

Earlier this year the Supreme Court upheld the Affordable Care Act, which by-and-large ensured the preservation and continued roll-out of improvements and protections for older adults.  

These improvements include the extension of Medicaid's spousal impoverishment protections to those seeking long-term care in the community, financial incentives for states to keep long-term care recipients out of institutions, the gradual closing of Medicare Part D's infamous doughnut hole, expanded access to preventive services for Medicare beneficiaries, and the Elder Justice Act.  

The Court did, however, scale back the Medicaid portion of the law, which could mean that fewer near-elderly will have access to health insurance than was originally envisioned. The law expanded Medicaid eligibility starting in 2014 to people with income up to 133 percent of the poverty line. But in its ruling, the Supreme Court gave states the freedom to opt out of this expansion without putting their current Medicaid funding at risk.

Naturally, these decisions will impact different people in different ways depending upon a number circumstances specific to each family's situation. To determine how your family might be affected, the safest course of action is to consult with your elder law attorney.

Thursday, November 22, 2012

Elder Law Caregiver Series...

Continuing with our caregiver theme, people often ask about the things they should be asking themselves and their loved ones as they plan for the future. 

We identified a half-dozen of these questions in our previous post. Here are some additional questions for you to think about, which might help you identify goals and what is important to you.

  • Do I expect family members to help me as I age?
  • What supports are available to help me live independent from my family?
  • Will I be able to take care of my own needs without help from other family members or government programs?
  • Do I have knowledge about the resources that are available to me to assist with my planning?
  • Am I living a healthy lifestyle and taking care of myself?
  • Do I have a plan in place in the event of an emergency

There are many resources available to help with these issues; please contact your elder law attorney for assistance.

Monday, November 5, 2012

Caregiver Series...

As we age, for planning purposes, people often ask about the questions they should be asking themselves and their loved ones. Here are some questions for you to think about, which might help you identify goals and what is important to you.   

  • Do I want to leave an inheritance for my children?
  • Do I want to make sure my spouse is taken care of?
  • Do I want to stay in my own home?
  • If I need help making decisions relating to my health care or finances, do I have the legal documents in place without the need for a guardianship?
  • If I have a disabled child, do I have the planning in place to ensure he/she is taken care of after I am gone?
  • Have I communicated my wishes to my loved ones regarding end of life decisions?

Wednesday, October 31, 2012

The Impact of Recent Elder Law Court Rulings

Earlier this year the Supreme Court upheld the Affordable Care Act, which by-and-large ensured the preservation and continued roll-out of improvements and protections for older adults. 

These improvements will likely bring about significant changes in elder law, the details of which are currently being evaluated. 

We will be sharing additional information in a future post. In the meantime, it's important to note that these decisions will impact different people in different ways depending upon a number circumstances specific to each family's situation. To determine how your family might be affected, the safest course of action is to consult with your elder law attorney.

Wednesday, September 19, 2012

Additional Elder Law FAQ...

Continuing the theme of our previous post, five additional questions that are often associated with the practice of elder law are:

  • How do I best protect assets?
  • When should I begin the process of asset protection?
  • How do I find an appropriate assisted care or nursing home?
  • How do I interpret long term care contracts or agreements?
  • Who should I contact to discuss services at my home?
Given increases in average life-expectancy and changes in family structure over the years, elder law is an emerging field that, by all expectations, will become an area of critical importance to most of us. With this in mind, our next several posts and newsletters will include relevant information on the subject, which we hope you'll find helpful.

Friday, August 17, 2012

Emerging Trends in Elder Law

The challenges of long-term care planning and the complicated nature of Medicaid continue to be among the most-frequent concerns of people we meet. These are the fastest-growing elements of an elder law practice...

Thursday, July 26, 2012

Key Estate Planning Issues

When first determining your estate planning goals, there are a number of items to consider regardless of your age. Most estate plans begin with fact finding, and an attorney usually has a standard questionnaire to facilitate a thorough assessment. Confidentiality will also be important, and if you don’t know an attorney you might seek a referral from a trusted advisor. 

It's also important to recognize that each family situation is different and will require an individualized assessment. Nonetheless, there are common issues that might influence your initial estate planning goals. 

These key issues typically include matters such as family occupational information, health and medical history. 

You can review a list of ten key issues that might impact your initial estate planning goals on our web site.

Friday, June 29, 2012

Recommended Reading About Alzheimers

Families dealing with Alzheimers or those who might have colleagues or clients touched by Alzheimers might find the book "Still Alice" by Lisa Genova a good resource.

It is an insightful and touching portrayal of the Alzheimer's journey. This fictional story is narrated by Dr. Alice Howland who is an esteemed psychology professor at Harvard. 

Alice is almost 50 years old when the first symptoms of Alzheimer's disease emerge and the author does a wonderful job describing what is going on in Alice's head as the disease worsens. As one reviewer of the book stated, this book will inform you, it will scare you and it will change you. 

Wednesday, June 20, 2012

A Common Myth About Family Care Givers

People often think that most of the nation's elderly are cared for by nursing homes or health care institutions.  However, this is a myth!

In fact, 87% of those who need long term care receive that care from unpaid caregivers. That being the case, what can you do to make care giving easier down the road? 

The key word is “plan.”

Tuesday, May 15, 2012

Things Family Care Givers Should Know

In earlier posts we suggested that family care givers are the backbone of long-term care. 

Beyond establishing a starting point and making sure to care for themselves as well, these care givers can also benefit by familiarizing themselves with certain elements of estate planning. 

Five key reasons for this are:

  1. Estate planning documents give the person you choose the power to appoint agents to make decisions when you cannot
  2. It can avoid guardianship
  3. It will help control what happens to your assets upon death
  4. It makes things easier for friends and family
  5. Even if you have documents, laws change and the documents should be reviewed to determine if any updates are needed; we typically recommend reviews at least every five (5) years
Read the full article... 

Monday, April 30, 2012

A Fundamental of Estate Planning

A fundamental of estate planning has to do with the portability of the estate tax exemption. This means that if the first spouse dies and doesn't use all of his or her federal exemption for estate taxes that the surviving spouse can add the unused estate tax exemption of the deceased spouse to their own exemption, allowing spouses together to transfer up to $10 million tax free.

However, it is important to note that portability is not automatic. To get it, the executor of the first spouse who died must file an estate tax return, even if no estate taxes are due. The safest course for most people is to review their situation with an attorney to make sure portability options are maximized.

Friday, April 20, 2012

Elder Law?

People sometimes ask about the fundamentals associated with the practice of elder law. Simply stated, when people become concerned about long term care planning for themselves as they age or for their aging parents, they often find solutions through the advice provided by an elder law firm. 

The issues may vary. Many fear losing all their assets to a nursing home,  and others need assistance with navigating through the complicated legal waters of Medicaid. 

Additional services may include:
  • Protecting the at-home spouse’s assets and income
  • Representation at elderly services and going to court for increased benefits for at-home spouse
  • Long term care planning
  • Addressing concerns about the high cost of nursing home care
  • Reviewing long term care insurance plans
  • Medicaid planning or assistance with the completion of the Medicaid application
  • Helping loved ones stay at home with home care assistance and caregiver help
  • Planning for disabled individuals

Friday, March 30, 2012

More on Revocable Trusts

In our last post we discussed the value of a revocable trust and how it can help people avoid probate.

Other reasons for creating a revocable trust include:
  • Minimizing estate taxes
  • Keeping assets available for children until they reach adulthood
Of course there could be additional advantages associated with creating a revocable trust that are unique to a family's specific circumstances. It's best to review your situation with an attorney and discuss the many reasons that revocable trusts are helpful to an estate plan.

Monday, March 12, 2012

Avoiding Probate Part 2: Revocable Trusts

As noted in our February 13 post, there are certain methods that can help you avoid probate. An additional method is to create a revocable trust.

One advantage of a revocable trust for probate avoidance is that, when it is established and properly funded, it ensures a consistent estate plan. Too often, when people rely on designated beneficiaries and joint ownership, the result is a plan that is skewed unintentionally toward one or another beneficiary. The reason for this is that if you have multiple beneficiary designations, and you change one but forgot to change the others, you may create a different distribution than the one you had in mind. 

By contrast, with a revocable trust, the change can be made once (by means of an amendment to the trust) and this will affect all assets.

Friday, February 24, 2012

Live Like You're Going to Die...

We we often meet with families who are experiencing significant stress typically originating from disability or the death of a loved-one. 

This being the case, in the course of reading online the Huffington Post, there are was an article by Mike Robbins that captivated my attention entitled, "Live Like You're Going to Die (Because You Are)."

The author's inspiration for contemplating death was Steve Jobs and in the article, he provides us with some things that we can think about and focus on and do on a regular basis that will allow us to live like we're going to die, in a positive way. 

Monday, February 13, 2012

Can Probate Be Avoided?

There are a number of different ways of holding assets that will avoid probate. 

The simplest is probably just joint ownership, such as a piece of real estate held as joint tenants or a bank account held jointly. This type of assets will pass automatically to the other joint owner when the first owner dies – but keep in mind, there will still be a probate at the second death. 

Another way to avoid probate is by assets which have 'designated beneficiaries', such as an insurance policy or a retirement plan (such as an IRA). These assets will pass to those beneficiaries when the owner of the asset dies.

Still another way to avoid probate is to hold assets in a revocable trust. More on this in our next post...

Monday, January 16, 2012

Myths About Wills & Trusts...

There are a number of things that people often assume about wills and trusts, and sometimes these assumptions can cause problems. With this in mind, we'll begin a short series of listing some of the more common myths associated with wills and trusts.

For a start, many people think if they die without a will, everything will go to their spouse...

Well, this is not necessarily true. If you don't have a will, your estate is distributed according to the intestacy statute and in some cases, it could be divided between your spouse and your children. This issue is especially relevant if you have children from a previous marriage.

Wednesday, January 4, 2012

Wills versus Trusts

People often ask about the differences between a will and trust, so here are some general contrasts...

A will does not avoid probate.  A trust can avoid probate, but only if the trust is properly funded.   A will only comes into effect when you pass away.  A trust can hold assets while you are alive.  A trust can be useful if you have property out of estate, as real estate is governed by the probate rules where it is located.  

As such if you own 3 pieces of property, each in a different state, if they are not owned by a trust, you are looking at three different probate procedures. For added perspective, you might review a related article on our website.