Co-Author: Letha Sgritta-McDowell

During the holidays, it is not uncommon for emergency rooms to see an increase in visits by the elderly population. As we know, the elderly are more susceptible to catching pneumonia due to their waning immune systems, falling due to lower body weakness and poor balance, combined with vision problems or home hazards like throw rugs and/or clutter that can be tripped over, and even medication mismanagement caused by having too many prescriptions to take or being prescribed a combination of medications by several different doctors that do not work together but against each other.  With the rise of hospital admissions this time of year, come families who are thrust into a situation they have never experienced before; they are often worried, scared, and confused.

We often receive calls from family members trying to understand the processes for hospital admissions, rehabilitation services, and long-term care for their loved one. There are several points at which families can become easily confused.  The first is upon discharge from the hospital.  Hospitals are acute care facilities; meaning that a person’s stay is only temporary.  For longer term rehabilitation and care while a person is recovering from an acute illness, this type of care is provided either at home or in an outside facility.  Any number of terms are used at this juncture.  Families may hear “rehab,” “skilled nursing,” “nursing home,” or simply “therapy.”  The discharge planner at the hospital will offer you and your loved one options for this continuing care.  For individuals who are recovering from an acute illness, this possible discharge to a nursing home is not permanent.  This is merely a suggestion that the elderly person move to a facility where he or she can receive nursing services as well as all available therapy with the goal that they can recover enough to safely return home.  For many seniors who live alone, a short rehabilitation stay is the safest way to receive the care they need.  Understandably, many people would prefer to go home.  The same therapy may be offered on an outpatient basis.

When evaluating outpatient rehabilitation instead of going to a nursing home, the individual and their family need to consider who will be able to take their loved one to any and all doctor’s appointments and therapy sessions as well as who will cook, clean, do laundry and assist the loved one with bathing, dressing and other essential daily activities. It requires a strong support system and/or the ability to hire private duty care providers to ensure a successful rehabilitation in the home.  Therefore, when faced with this decision, it is important that the family consider all options.  If a discharge to a facility is chosen but rehabilitation in the home later becomes feasible, that certainly can happen.

If an individual is discharged to a nursing facility but does not fully recover or if they have needs which will continue long after rehabilitation is finished, then they often face another stressful and confusing crossroads. If the individual was admitted to the hospital for three nights or more prior to their discharge to the nursing facility, then Medicare can pay for up to 100 days, so long as the patient responds to the therapy being prescribed by his or her doctor, or if the stay in the facility is necessary to maintain the individual’s current level of health and functionality.  However, once the patient stops responding to therapy, refuses to participate, or if the care is not necessary to maintain his or her current level of health, representatives from the facility will discuss “discharge.”  Unfortunately, the context of discharge at this stage is often not explained fully, and many family members assume that this discussion means their loved one is being sent home.  As discussed earlier, for many the transition home is complicated and can be potentially dangerous for the senior.  Understandably, the sense that an elderly person is being sent home when provisions are not available to assist them can cause family members to panic.

However, the discussion of discharge at this juncture simply means that the patient is no longer eligible for Medicare-covered rehabilitation services. If, after rehabilitation, the individual still needs assistance with bathing, dressing, walking, eating and other activities of daily living, then the family can (and should) request that their loved one transition to long-term care within the facility.

Many times we hear that family members were not provided options and were simply told that their loved one was being discharged. This often leads to family members scrambling to find care for their loved one. In other situations, when the family asks about staying longer, a facility representative may explain to the family that no beds are available or they cannot accommodate the care needs of the patient.  There are laws in place which require the nursing facility to assist with a safe and appropriate discharge plan for the patient.  If no beds are available at that facility and services and supports are not sufficient in the community, then the facility representative must find another facility which has an available bed and which can accommodate the person’s care needs.  While looking for a suitable bed, the patient is allowed to stay at the same facility in their current bed.

The rules and regulations surrounding hospital discharge planning and discharge from Medicaid covered rehabilitation can be mysterious and, without proper understanding, can cause additional stress in an already emotional and stressful time. If you or your loved one find yourself in this position, you should immediately seek someone experienced with resident rights who can help navigate this process and develop a long-term care plan focused on developing a solution to the problem.  The attorneys and staff of Hook Law Center are experienced and prepared to assist you or your loved one through this process.  Please call us today to schedule an appointment to discuss your rights and options.

Ask Kit Kat – Mickey, Our Own Star

Hook Law Center:  Kit Kat, I hear that Hook Law Center has many employees who love pets. One in particular—Mickey—the beloved cat of Cynthia is making medical history. What can you tell us about her cat?

Kit Kat:  Mickey is an 18-pound male cat who has just been diagnosed with gigantism or its scientific name of acromegaly. His length from head to tail is more than 3 feet! He is a beautiful brown tabby with white feet who is 10 years old. On January 11, 2017, he will turn 11. Anyway, he was gaining weight, and at one point he weighed in at 21 pounds, even though he was  on a diet. Such a large figure caused him difficulty in jumping onto chairs, etc. When Cynthia took him to the vet, they treated him for arthritis and an underactive thyroid. Still the vet thought there might be something else affecting his condition. It was suggested that Cynthia collect a blood sample, and send it to a lab at Michigan State University in East Lansing, Michigan. Cynthia recently got the results. The suspected condition of gigantism was confirmed. This is an extremely rare condition in cats, caused by over production of the growth hormone (GH). It usually affects males around the median age of 11, so it looks unfortunately like Mickey falls into a classic case. He also displays some other common signs of the disease with his enlarged lower jaw and head.

Treatment can include radiation therapy. However, at this stage in his life and because of the severity of his case, the vet has not recommended anything other than to continue to address his arthritis and thyroid. Mickey is lucky he is in the home he is in. Cynthia and husband, Carl, have even built him a stand to hold his food and water bowls, so he doesn’t have to bend over so far. Eventually, he will undoubtedly succumb to heart disease or renal failure, though the latter is very common in cats as a whole, even those without gigantism. Cynthia and Carl will do their best to keep him comfortable and extend his life as long as possible. (http://www.cat-world.com/au/acromegaly-in-cats)

Upcoming Seminars

Distribution of This Newsletter

Hook Law Center encourages you to share this newsletter with anyone who is interested in issues pertaining to the elderly, the disabled and their advocates. The information in this newsletter may be copied and distributed, without charge and without permission, but with appropriate citation to Hook Law Center, P.C. If you are interested in a free subscription to the Hook Law Center News, then please telephone us at 757-399-7506, e-mail us at mail@hooklawcenter.com or fax us at 757-397-1267.The post ‘Tis the Season…for hospital admissions and long-term are planning! first appeared on SEONewsWire.net.]]> http://www.seonewswire.net/2016/11/tis-the-seasonfor-hospital-admissions-and-long-term-care-planning/ Mon, 28 Nov 2016 21:57:42 +0000 http://www.seonewswire.net/2016/11/tis-the-seasonfor-hospital-admissions-and-long-term-care-planning/ Author: Stephanie Washington Co-Author: Letha Sgritta-McDowell During the holidays, it is not uncommon for emergency rooms to see an increase in visits by the elderly population. As we know, the elderly are more susceptible to catching pneumonia due to their…

Author: Stephanie Washington

Co-Author: Letha Sgritta-McDowell

During the holidays, it is not uncommon for emergency rooms to see an increase in visits by the elderly population. As we know, the elderly are more susceptible to catching pneumonia due to their waning immune systems, falling due to lower body weakness and poor balance, combined with vision problems or home hazards like throw rugs and/or clutter that can be tripped over, and even medication mismanagement caused by having too many prescriptions to take or being prescribed a combination of medications by several different doctors that do not work together but against each other.  With the rise of hospital admissions this time of year, come families who are thrust into a situation they have never experienced before; they are often worried, scared, and confused.

We often receive calls from family members trying to understand the processes for hospital admissions, rehabilitation services, and long-term care for their loved one. There are several points at which families can become easily confused.  The first is upon discharge from the hospital.  Hospitals are acute care facilities; meaning that a person’s stay is only temporary.  For longer term rehabilitation and care while a person is recovering from an acute illness, this type of care is provided either at home or in an outside facility.  Any number of terms are used at this juncture.  Families may hear “rehab,” “skilled nursing,” “nursing home,” or simply “therapy.”  The discharge planner at the hospital will offer you and your loved one options for this continuing care.  For individuals who are recovering from an acute illness, this possible discharge to a nursing home is not permanent.  This is merely a suggestion that the elderly person move to a facility where he or she can receive nursing services as well as all available therapy with the goal that they can recover enough to safely return home.  For many seniors who live alone, a short rehabilitation stay is the safest way to receive the care they need.  Understandably, many people would prefer to go home.  The same therapy may be offered on an outpatient basis.

When evaluating outpatient rehabilitation instead of going to a nursing home, the individual and their family need to consider who will be able to take their loved one to any and all doctor’s appointments and therapy sessions as well as who will cook, clean, do laundry and assist the loved one with bathing, dressing and other essential daily activities. It requires a strong support system and/or the ability to hire private duty care providers to ensure a successful rehabilitation in the home.  Therefore, when faced with this decision, it is important that the family consider all options.  If a discharge to a facility is chosen but rehabilitation in the home later becomes feasible, that certainly can happen.

If an individual is discharged to a nursing facility but does not fully recover or if they have needs which will continue long after rehabilitation is finished, then they often face another stressful and confusing crossroads. If the individual was admitted to the hospital for three nights or more prior to their discharge to the nursing facility, then Medicare can pay for up to 100 days, so long as the patient responds to the therapy being prescribed by his or her doctor, or if the stay in the facility is necessary to maintain the individual’s current level of health and functionality.  However, once the patient stops responding to therapy, refuses to participate, or if the care is not necessary to maintain his or her current level of health, representatives from the facility will discuss “discharge.”  Unfortunately, the context of discharge at this stage is often not explained fully, and many family members assume that this discussion means their loved one is being sent home.  As discussed earlier, for many the transition home is complicated and can be potentially dangerous for the senior.  Understandably, the sense that an elderly person is being sent home when provisions are not available to assist them can cause family members to panic.

However, the discussion of discharge at this juncture simply means that the patient is no longer eligible for Medicare-covered rehabilitation services. If, after rehabilitation, the individual still needs assistance with bathing, dressing, walking, eating and other activities of daily living, then the family can (and should) request that their loved one transition to long-term care within the facility.

Many times we hear that family members were not provided options and were simply told that their loved one was being discharged. This often leads to family members scrambling to find care for their loved one. In other situations, when the family asks about staying longer, a facility representative may explain to the family that no beds are available or they cannot accommodate the care needs of the patient.  There are laws in place which require the nursing facility to assist with a safe and appropriate discharge plan for the patient.  If no beds are available at that facility and services and supports are not sufficient in the community, then the facility representative must find another facility which has an available bed and which can accommodate the person’s care needs.  While looking for a suitable bed, the patient is allowed to stay at the same facility in their current bed.

The rules and regulations surrounding hospital discharge planning and discharge from Medicaid covered rehabilitation can be mysterious and, without proper understanding, can cause additional stress in an already emotional and stressful time. If you or your loved one find yourself in this position, you should immediately seek someone experienced with resident rights who can help navigate this process and develop a long-term care plan focused on developing a solution to the problem.  The attorneys and staff of Hook Law Center are experienced and prepared to assist you or your loved one through this process.  Please call us today to schedule an appointment to discuss your rights and options.

Ask Kit Kat – Mickey, Our Own Star

Hook Law Center:  Kit Kat, I hear that Hook Law Center has many employees who love pets. One in particular—Mickey—the beloved cat of Cynthia is making medical history. What can you tell us about her cat?

Kit Kat:  Mickey is an 18-pound male cat who has just been diagnosed with gigantism or its scientific name of acromegaly. His length from head to tail is more than 3 feet! He is a beautiful brown tabby with white feet who is 10 years old. On January 11, 2017, he will turn 11. Anyway, he was gaining weight, and at one point he weighed in at 21 pounds, even though he was  on a diet. Such a large figure caused him difficulty in jumping onto chairs, etc. When Cynthia took him to the vet, they treated him for arthritis and an underactive thyroid. Still the vet thought there might be something else affecting his condition. It was suggested that Cynthia collect a blood sample, and send it to a lab at Michigan State University in East Lansing, Michigan. Cynthia recently got the results. The suspected condition of gigantism was confirmed. This is an extremely rare condition in cats, caused by over production of the growth hormone (GH). It usually affects males around the median age of 11, so it looks unfortunately like Mickey falls into a classic case. He also displays some other common signs of the disease with his enlarged lower jaw and head.

Treatment can include radiation therapy. However, at this stage in his life and because of the severity of his case, the vet has not recommended anything other than to continue to address his arthritis and thyroid. Mickey is lucky he is in the home he is in. Cynthia and husband, Carl, have even built him a stand to hold his food and water bowls, so he doesn’t have to bend over so far. Eventually, he will undoubtedly succumb to heart disease or renal failure, though the latter is very common in cats as a whole, even those without gigantism. Cynthia and Carl will do their best to keep him comfortable and extend his life as long as possible. (http://www.cat-world.com/au/acromegaly-in-cats)

Upcoming Seminars

Distribution of This Newsletter

Hook Law Center encourages you to share this newsletter with anyone who is interested in issues pertaining to the elderly, the disabled and their advocates. The information in this newsletter may be copied and distributed, without charge and without permission, but with appropriate citation to Hook Law Center, P.C. If you are interested in a free subscription to the Hook Law Center News, then please telephone us at 757-399-7506, e-mail us at mail@hooklawcenter.com or fax us at 757-397-1267.The post ‘Tis the Season…for hospital admissions and long-term care planning! first appeared on SEONewsWire.net.]]> http://www.seonewswire.net/2016/11/life-saving-tech-tip-for-cell-phone-users/ Fri, 18 Nov 2016 19:23:48 +0000 http://www.seonewswire.net/2016/11/life-saving-tech-tip-for-cell-phone-users/ Your cell phone may have a life-saving feature that you should be aware of. For iPhone users, the feature is called “Medical ID.”  Medical ID lets others access important medical information about you without unlocking your phone.  From the “unlock”…

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The post Life-Saving Tech Tip for Cell Phone Users first appeared on SEONewsWire.net.]]> Your cell phone may have a life-saving feature that you should be aware of. For iPhone users, the feature is called “Medical ID.”  Medical ID lets others access important medical information about you without unlocking your phone.  From the “unlock” screen, a first responder can tap the “Emergency” option in the bottom left corner, then “Medical ID,” and view your name, date of birth, a photo of you, emergency contacts, blood type, height, weight, allergies, medications, and medical conditions – or any other information you wish to include.

To set up your Medical ID, locate and open the “Health” app that is installed by default onto your iPhone, then press “Create Medical ID.” Enter the information that you would like displayed in the event of an emergency, and be sure to turn on “Show When Locked,” then click “Done.”

For other types of cell phones, a similar feature may be available either as a phone setting or in the form of an “ICE: In Case of Emergency” app. Check for an emergency contact feature in your phone’s settings or consider editing your lock screen or wallpaper to include important information.

In addition to including personal information, you may want to use these cell phone features to indicate that your advance medical directive is a part of the U.S. Living Will Registry, so that medical professionals can access that document if needed.

Don’t have an advance medical directive, or want to participate in the U.S. Living Will Registry? Give the Hook Law Center a call today.

Ask Kit Kat – Falling Cats

Hook Law Center:  Kit Kat, what can you tell us about the phenomenon of cats always landing on their feet?

Kit Kat:  Well, the answer is not as simple as it may appear, but it is extremely interesting. Actually, it’s not a definitive answer, because scientists are not really sure how it occurs or if it occurs in only one way. They do agree, however, that cats will right themselves after falling from most distances, even from as little as a height of 2 feet. The only exception is a height of less than 2 feet. From distances less than 2 feet, there is not enough room or time to perform their acrobatics.

Here’s what we know now. Falling cats have been a fascination of the scientific community since the 19^th century. George Gabriel Stokes and James Clerk Maxwell were 19^th century scientists who were intrigued by the falling cat phenomenon. They experimented and dropped many cats; in all cases, they righted themselves. Yet, later scientists were not satisfied. How could cats accomplish this feat which defied the law of conservation of angular momentum? That law involves the person or object to push off from something, but cats were not pushing off from anything, and they were still able to right themselves. Now enters Etienne Jules Marey, a French scientist and engineer, who used high-speed photography in 1894 to capture 32 shots of cats in midair. His photos revealed what was happening – “…the cat first tucked in its forelegs while stretching out its back legs, then switched them, which allow it to use the inertia of its own mass to flip.” Marey called this ‘the tuck and turn’ method. It is what modern gymnasts do when they accomplish their amazing flips and turns.

20^th century scientists have since quantified the process. In 1935, Dutch physiologists GGJ Rademaker and JWG Ter Braak created a mathematical drawing of a falling feline which further refined the theory. By bending at the waist, their drawing showed the cat’s body as 2 can-like cylinders rotating on 2 axes in different directions. The net energy expended created an equilibrium of 0. A 21^st century scientist, Greg Gbur of UNC-Charlotte calls this the ‘bend and twist’ method. The research continues. Scientists would like to find one definitive answer, but the crafty feline is not bound to comply. Gbur laments, ‘Probably the cat uses multiple different strategies to turn over. Physics prefers and tends to look for the simplest explanation for a phenomenon, whereas evolution—if I anthropomorphize it—is always looking for the most efficient. Living creatures are doing whatever works best, which may not be the simplest option.’

(Karen Bruillard, “Scientists just can’t stop studying falling cats,” The Washington Post, Animalia section, November 4, 2016)

Upcoming Seminars

Distribution of This Newsletter

Hook Law Center encourages you to share this newsletter with anyone who is interested in issues pertaining to the elderly, the disabled and their advocates. The information in this newsletter may be copied and distributed, without charge and without permission, but with appropriate citation to Hook Law Center, P.C. If you are interested in a free subscription to the Hook Law Center News, then please telephone us at 757-399-7506, e-mail us at mail@hooklawcenter.com or fax us at 757-397-1267.The post Life-Saving Tech Tip for Cell Phone Users first appeared on SEONewsWire.net.]]> http://www.seonewswire.net/2016/10/establishing-retroactive-survivor-benefit-plan-payments-sbp-for-a-dependent-child/ Mon, 31 Oct 2016 20:52:15 +0000 http://www.seonewswire.net/2016/10/establishing-retroactive-survivor-benefit-plan-payments-sbp-for-a-dependent-child/ In December 2014, Congress passed the Disabled Military Child Protection Act as part of the National Defense Authorization Act of 2015. This important piece of legislation amended 10 U.S.C. 1450 by permitting monthly Survivor Benefit Plan (SBP) annuity payments to…

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The post Establishing Retroactive Survivor Benefit Plan Payments (SBP) for a Dependent Child first appeared on SEONewsWire.net.]]> In December 2014, Congress passed the Disabled Military Child Protection Act as part of the National Defense Authorization Act of 2015. This important piece of legislation amended 10 U.S.C. 1450 by permitting monthly Survivor Benefit Plan (SBP) annuity payments to be assigned to a special needs trust for the sole benefit of a dependent child. Since this time, one of the major concerns has been whether benefits could be established by a parent with a dependent child when an election was not made previously.

Absent another valid election, a retiree of the United States Armed Forces begins to receive retirement income and, is enrolled in the Survivor’s Benefit Plan (SBP). With a full election of the SBP, upon the death of the retiree, up to 55% of the retiree’s retirement pay will be paid to a spouse or dependent child. Under the SBP, a “dependent child” includes an adult child that is incapable of self-support as a result of a physical or mental disability, provided such disability occurred prior to the age of 22. By making an election to provide the SBP to a dependent child, the retiree ensures a continuation of income to support the dependent child when the retiree and any surviving spouse have passed. Absent such an election, upon the death of the retiree, military retirement pay will cease.

You can revoke an election at any time; however, there are very few scenarios for which you can retroactively establish benefits. After receiving my first approval of retroactive establishment of SBP coverage for a dependent child, I now know that under certain circumstances, establishment of retroactive coverage of the SBP is possible in light of the new change in legislation. While Hook Law Center has been successful on this one occasion, we cannot guarantee approval and I anticipate approval of retroactive coverage will be limited in duration. As a result, if you are interested in making changes to your election, you should act sooner, rather than later. Furthermore, you should be prepared to pay the government a rather  check to cover the monthly payment for the benefit since date of retirement.

Ask Kit Kat – Faithful Friend

Hook Law Center:  Kit Kat, what can you tell us about the faithful dog in Spokane, Washington who stayed with a toddler in a house fire?

Kit Kat:  Well, this is one story that doesn’t have a happy ending. However, it does reveal the faithfulness of a wonderful canine, a terrier mix, who stayed with the toddler during the fire. Unfortunately, both perished. It happened like this—a fire broke out around 11:30 PM in the Hillyard neighborhood of Spokane on Friday, October 21, 2016. A neighbor noticed the fire and heard screaming. He called 911, and immediately ran outside to fight the fire with his garden hose. Three other children and two adults escaped, but one child, a young toddler, did not make it out. His dog and a teddy bear were found with him in a 2^nd story bedroom. Firefighters believe the dog stayed behind to protect him. What more can one ask than that? The dog was more than heroic!

The fire is under investigation, as the battery in the house’s smoke detector had been removed. That is all the information that the newspaper article provided. Perhaps, however, we can learn some tips for preventive action—always know where the occupants of one’s house are. If you leave your children with others, make sure they are aware of escape routes and are familiar with the property’s layout. Also, keep all smoke detectors functional. Hopefully, we can learn from this tragedy, so that it never happens again. (Martha Bellisle, “Toddler dies in fire, his dog at his side,” The Virginian-Pilot, October 23, 2016, p. 14)

Upcoming Seminars

Distribution of This Newsletter

Hook Law Center encourages you to share this newsletter with anyone who is interested in issues pertaining to the elderly, the disabled and their advocates. The information in this newsletter may be copied and distributed, without charge and without permission, but with appropriate citation to Hook Law Center, P.C. If you are interested in a free subscription to the Hook Law Center News, then please telephone us at 757-399-7506, e-mail us at mail@hooklawcenter.com or fax us at 757-397-1267.The post Establishing Retroactive Survivor Benefit Plan Payments (SBP) for a Dependent Child first appeared on SEONewsWire.net.]]> http://www.seonewswire.net/2016/10/using-person-first-language-to-communicate-with-and-about-people-with-special-needs/ Mon, 24 Oct 2016 22:08:09 +0000 http://www.seonewswire.net/2016/10/using-person-first-language-to-communicate-with-and-about-people-with-special-needs/ About 54 million Americans, or 1 in every 5 people, report having a disability. Most Americans will experience a disability at some point, and for many, the disability will occur very suddenly and unexpectedly.  It could happen to anyone, at…

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The post Using Person-First Language to Communicate With and About People with Special Needs first appeared on SEONewsWire.net.]]> About 54 million Americans, or 1 in every 5 people, report having a disability. Most Americans will experience a disability at some point, and for many, the disability will occur very suddenly and unexpectedly.  It could happen to anyone, at any time.  As special needs attorneys, we aim to give individuals with disabilities a voice, comprehensive planning, and access to benefits to which they are entitled.  We also strive to raise awareness and encourage understanding.

Individuals with disabilities have historically been marginalized and treated as if their disabilities defined them. Gone are the days that calling someone an “invalid,” “handicapped,” or “retarded” is acceptable.  In its place, we use person-first language to appropriately and respectfully describe and speak about individuals with disabilities.

Instead of referring to a person with disability, “person-first language” (also called “people-first language”) emphasizes the person first, not the disability.   It describes what a person has, but not who a person is.  When describing someone who has a disability, refer to him as “a person with ________,” or “a person who has __________________.”

For example:

Say This:	Not This:
Person who is deaf	Deaf person
Person who uses a wheelchair	Wheelchair-bound/ handicapped
Person with an intellectual disability	Retarded
Person with epilepsy	Epileptic
Person with autism	Autistic
Person with a learning disability	Learning disabled
Student who receives special education services	Special ed student

This is not political correctness; it is a demonstration of respect. Why does it matter?  Because the words we use affect how people see themselves and others, contribute to social norms, and ultimately influence changes in the law.  Using antiquated terminology that defines a person in terms of his disability sends the message that you have an underlying prejudice or see them as nothing more than their disability.  It’s demeaning and belittling.  Using person-first language, however, sends the message that the person is of value and worthy of respect, and gives the person an opportunity to define himself using his talents, characteristics, and other abilities.

It has been said that the population with disabilities is the only minority group that anyone can join at any time, whether at birth, as the result of an accident or illness, or simply as a part of growing older. If it were to suddenly happen to you, how would you want to be described?

Ask Kit Kat – Nurse Kitty

Hook Law Center:  Kit Kat, what can you tell us about the cat who saved his owner from death?

Kit Kat:  Well, this is an unusual story. Glen Schallman adopted a cat whom he named Blake. Turned out it was a smart move! Blake has repeatedly saved Glen’s life by biting Glen’s toes or jumping on him when he senses danger. Glen has some rare medical conditions which mostly affect his brain. Two are polymicrogyria and unilateral schizencephaly. In addition, he has a brain tumor known as hypothalamic hamartoma. The latter causes seizures which are very frequent, almost daily. However, thanks to Blake, Glen is known as oldest living person with this combination of conditions. Without any training, Blake seems to sense when a seizure is about to happen, and he bites Glen’s toes or rouses him, so that Glen can move to a safe place before it happens. Once, Glen was having a seizure in the middle of the night. Blake bit his toes and woke him up before the seizure went on too long. In another, when Glen’s hands began to tremor, Blake jumped in Glen’s lap, stroked his arms and purred and purred until the tremors stopped. This helped to calm Glen, and help him recover more quickly than he otherwise might have done.

Usually it is dogs who are used as therapy companions, but in this case, a cat has fulfilled that role extremely capably. It appears that both our canine cousins and we felines have potential in feeling and perceiving that you humans are only beginning to understand. (Sheeka Sanahori, “Nurse Kitty! Cat bites owner’s toes, saves him from deadly seizure,” USA Today, (Humankind section), Oct.6, 2016)

Upcoming Seminars

Distribution of This Newsletter

Hook Law Center encourages you to share this newsletter with anyone who is interested in issues pertaining to the elderly, the disabled and their advocates. The information in this newsletter may be copied and distributed, without charge and without permission, but with appropriate citation to Hook Law Center, P.C. If you are interested in a free subscription to the Hook Law Center News, then please telephone us at 757-399-7506, e-mail us at mail@hooklawcenter.com or fax us at 757-397-1267.The post Using Person-First Language to Communicate With and About People with Special Needs first appeared on SEONewsWire.net.]]> http://www.seonewswire.net/2016/10/musings-on-financial-aid/ Fri, 14 Oct 2016 18:25:37 +0000 http://www.seonewswire.net/2016/10/musings-on-financial-aid/ My oldest child is a senior in high school, and we are filling out the financial aid forms for the first time. There has been a big change in the world of collegiate financial aid. In prior years, the Free…

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The post Musings on Financial Aid first appeared on SEONewsWire.net.]]> My oldest child is a senior in high school, and we are filling out the financial aid forms for the first time. There has been a big change in the world of collegiate financial aid. In prior years, the Free Application for Federal Student Aid (FAFSA) form was released on January 1 and required families to report the income for the prior calendar year. The sooner the FAFSA was filed, the more likely your child was to receive aid. However, beginning this year, the FAFSA was released on October 1 and allows families to use the income tax return for the prior year. Thus, for most families, the income tax returns have been filed and the required financial information is more or less readily at hand. For many students, there is also another and more complicated financial aid form, the CSS/Financial Aid PROFILE which is required at many private and/or prestigious schools, including the University of Virginia, William and Mary and all the Ivy League schools.

However, as we have discovered, filling the forms out can be more difficult than it seemed at first glance. First, we applied in the last week of September for a FSA ID which linked to our account at the IRS to allow us to link the FAFSA form (but not as we were later to discover the CSS PROFILE) to our 2015 income tax date as filed. Second, there was the frantic gathering of current information: bank statements, mortgage and car loan information, retirement account values, investment account values, including the 529 accounts and UGMA accounts set up for both the child applying for college and his/her siblings. Third, we set up the FAFSA form and imported the information from the IRS – so far so good.

The trouble arose when, after reading the instructions for the forms multiple times, we discovered we had “special” circumstances that we needed to address. When my mother passed away, she created a testamentary trust primarily for the benefit of my father. However, my brother and I were included as permissible principal beneficiaries. Knowing my mother, it was meant to be “just in case” of a catastrophic emergency. Nonetheless, because I am a permissible beneficiary currently, we have to report one-third of the value of the trust on these forms even though I have no ability to compel a distribution from the trust. Thankfully, my children only have interests in the trust contingent on my prior death, so the trust is considered my asset and not the asset of my child for financial aid. Interestingly, we do not need to report the trust created by my grandfather because my interests in that trust are contingent upon my surviving various family members.

Discerning exactly what had to be reported on the various forms in connection with trust funds was not easy. Ultimately, I gave up and called a financial aid officer at the University of Virginia, because I am an alumna and because my child intends to apply there. I did get the answer I needed. Finally. However, here are a few pointers in regards to eligibility for financial aid:

1. Keep in mind that parents’ resources are assessed at a much lower level than assets owned by a student when determining how much the family should contribute towards college. 529 accounts owned by a parent are assessed as an asset of the parent, not as an asset of the student, even if the student is the named beneficiary of the account. Account balances of 529 accounts owned by a grandparent do not get reported on the financial aid form; however, distributions from the account used for the grandchild’s educational expenses are counted as the grandchild’s income for the year of distribution.
2. Eligibility for financial aid is heavily based on your income. Although you do get credit for certain obligations, such as a mortgage or a home equity loan secured by your home and on which you are paying, you do not get credit for consumer loans or unsecured debt (such as credit cards). In addition, the contribution that you make towards your retirement account is added back into your adjusted gross income for these purposes.
3. The balance of your retirement account is not assessed for these purposes.
4. Interests held in trust are assessed as an asset of the beneficiary, even if the restrictions on the trust fund are such that the beneficiary cannot access the funds. However, contingent beneficiaries are ignored.

If you are interested in creating a trust that is meant to be used for your children’s or grandchildren’s college education, the nuances of how the trust is worded may be unimportant. After all, if you are providing a fund from which college expenses are to be paid, then the funds should be so used. On the other hand, if you are creating a trust that is not necessarily meant to fund a college education, as in the case of a trust primarily for the benefit of a surviving spouse, it may be important to assess and think through the ramifications of giving the descendants of your primary beneficiary current access to trust assets. Your decision will be influenced by the specifics of your family situation. Please feel free to make an appointment to discuss these important issues with the attorneys at the Hook Law Center so we can help guide your estate planning decisions.

Ask Kit Kat – Fish Smarts

Hook Law Center:  Kit Kat, what can you tell us about how fish think and feel?

Kit Kat:  Well, there is a lot to tell, actually. Even very tiny fish have some amazing capabilities. Jonathan Balcombe, director of animal sentience with the Humane Society Institute for Science and Policy has written a new book, entitled What a Fish Knows: The Inner Lives of our Underwater Cousins. It turns out that fish have many things in common with other animals, including us humans. That is why they are such a fascinating subject for research. For example, let’s examine the frillfin goby, which is a fish that lives in intertidal areas. They have the capability of jumping from one tidal pool to another when they sense danger. How do they do that so successfully without being stranded on rocks or caught up in vegetation? Scientists tell us that they can memorize the geography of a particular tidal pool and remember it 40 days later. That knowledge serves them well when they sense they can no longer stay in a specific location.

Another example is the case of groupers and moray eels. These two look nothing alike, but they use their differing physical attributes to work together to hunt for food. The grouper elicits the attention of the eel through the use of a head shake or body shimmy. Then they work as a team. The eel chases their prey into a nook or crevice of a rock. Sometimes, the eel gets to the prey first, and has a delicious meal. However, if unsuccessful, the prey swims out, and is captured by the large-bodied grouper. Another capability which grouper have is a pointing ability. They can actually point with their body position to the eel that prey is nearby. Thus the hunt starts, and they begin their cooperative arrangement to capture food.

For more examples, you might want to read the book. It really is fascinating. As more and more people become aware that fish can think and feel, they will treat them with more respect. That is not to say we shouldn’t continue to enjoy them as a source of our own nourishment, but perhaps we can become a little more careful about how they are harvested. Commercial fishing tends to use large nets over many miles which scoop up whatever is in a particular area, including dolphins, when what they are really after that day might be tuna. Hopefully, we can develop more strategic ways to fish without the collateral damage to others, which are not the intended objects of the fishing operation. The author says another thing anyone can do is, if you see a stranded fish washed up on a beach, pick it up and get it back into the water. We all need a little help once in a while. (“Kinder School of Thought,” All Animals, September/October 2016, p.34-35)

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Hook Law Center encourages you to share this newsletter with anyone who is interested in issues pertaining to the elderly, the disabled and their advocates. The information in this newsletter may be copied and distributed, without charge and without permission, but with appropriate citation to Hook Law Center, P.C. If you are interested in a free subscription to the Hook Law Center News, then please telephone us at 757-399-7506, e-mail us at mail@hooklawcenter.com or fax us at 757-397-1267.The post Musings on Financial Aid first appeared on SEONewsWire.net.]]> http://www.seonewswire.net/2016/09/determining-the-appropriate-level-of-care/ Mon, 26 Sep 2016 22:40:28 +0000 http://www.seonewswire.net/2016/09/determining-the-appropriate-level-of-care/ Nearly all clients want to remain in their home for as long as possible. Determining when additional levels of care are necessary and when it is not safe for an individual to remain at home often requires the intervention of…

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The post Determining the Appropriate Level of Care first appeared on SEONewsWire.net.]]> Nearly all clients want to remain in their home for as long as possible. Determining when additional levels of care are necessary and when it is not safe for an individual to remain at home often requires the intervention of a team of persons dedicated to ensuring the client receives appropriate care and oversight.

Rather than bore you with technical requirements when assessing whether your loved one needs care, you should consider whether the individual has a diagnosis or receives medical treatment that limits the individual’s ability to manage his/her own care or maintain himself or herself in their home independently. If he/she is unable to manage care independently, your loved one may need additional services – whether provided in home, or in a facility.

To meet the nursing home level of care requirement, the individual who needs assistance must be unable to manage three Activities of Daily Living (ADL). ADLs include: feeding, bathing, dressing, walking, transferring, and continence.  Many of our clients may have sufficient needs, but are still able to manage their ADLs. As a result, a nursing home is not a suitable placement.

When individuals are able to manage the majority of their ADLs, but are unable to perform Instrumental Activities of Daily Living (IADL), such as cooking, driving, shopping, managing finances, managing medication, cleaning, etc., we recommend less restrictive care options. Many clients who have some impairment can sufficiently live independently, or remain in their home with minimal assistance. Other clients may need to be placed into a more structured environment for more intensive oversight.

Whether your loved one needs immediate care, is in a financial crisis, or whether your loved one should start planning in light of possible long-term care needs down the road, we can help assess care options and financing.

Ask Kit Kat – The Lowly Vole

Hook Law Center:  Kit Kat, what can you tell us about voles?

Kit Kat:  Well, it turns out a lot. I’ve written previously on moles and mice, but the prairie vole it turns out has a lot to offer, too, in the way of contributing to scientific research and its applicability to humans. Researchers at the University of Virginia have chosen them as research subjects, because they are a lot like humans with regard to mating and parenting. The prairie vole breeds year round and can have as many as 4 pups per litter. They are found in the central part of the United States from New Mexico to Ohio and West Virginia. They are small and never weigh more than 3 ounces!

Anyway, there is a relatively new field in science call behavioral epigenetics in which cell changes from environmental factors are examined. The cell itself does not really change, but how it reacts can change depending on things that happen to it. Additionally, some scientists believe that these cell reactions can be passed down to future generations. ‘Offspring of low-care parents (voles) become low-care parents themselves, and this alters the epigenome of the next generation of offspring,’ says Kelly Wroblewski (UVA Grad ’20). It happens through a process called methylation, in which the effectiveness of the gene is reduced. In the case of prairie voles, they found that voles with parents who spent little time with them had more trouble bonding with potential mates and their own offspring. The implication for humans is that offspring of parents with mental health weaknesses such as depression or victims of trauma could be pass their impaired coping mechanisms down through the generations.

More research needs to be done, but it is intriguing that this humble creature is very useful to humans in their quest to understand how emotions and their resulting behaviors can be passed down to offspring, just as much as a predisposition to acquire certain physical ailments.

(“What can voles tell us about ourselves,” UVA Magazine, Fall 2016, p. 45)

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Distribution of This Newsletter

Hook Law Center encourages you to share this newsletter with anyone who is interested in issues pertaining to the elderly, the disabled and their advocates. The information in this newsletter may be copied and distributed, without charge and without permission, but with appropriate citation to Hook Law Center, P.C. If you are interested in a free subscription to the Hook Law Center News, then please telephone us at 757-399-7506, e-mail us at mail@hooklawcenter.com or fax us at 757-397-1267.The post Determining the Appropriate Level of Care first appeared on SEONewsWire.net.]]> http://www.seonewswire.net/2016/08/department-of-defense-rolls-out-a-new-retirement-plan/ Mon, 22 Aug 2016 22:05:29 +0000 http://www.seonewswire.net/2016/08/department-of-defense-rolls-out-a-new-retirement-plan/ The Department of Defense has unveiled a new retirement plan that will go into effect on January 1, 2018. The new “blended” plan will not impact a majority of the currently enlisted members, but will present a complex financial decision…

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The post Department of Defense Rolls Out a New Retirement Plan first appeared on SEONewsWire.net.]]> The Department of Defense has unveiled a new retirement plan that will go into effect on January 1, 2018. The new “blended” plan will not impact a majority of the currently enlisted members, but will present a complex financial decision for mid-career service members with less than 12 years of service.

The new plan is specifically limited to service members who “opt-in” to the new plan before January 1, 2019 provided they have less than 12 years of service prior to January 1, 2018, and any individual who enters the military once the new plan goes live. For those service members who have more than 12 years of service or do not opt-in, the traditional retirement plan will remain in effect.

Unlike the traditional retirement plan that provides a fixed pension payout for retirees who serve at least 20 years, the new plan will promote contributions to the Thrift Savings Plan (TSP). Specifically, under the new plan, contributions equivalent to 1% of the annual base pay will automatically be contributed to the service member’s TSP account, and provide additional matched contributions of up to 5% of the service member’s annual base pay. In exchange, the pension payments will be reduced by 20% of the current value. Currently, the Department of Defense does not make any contribution to a service member’s TSP account.

Additional perks to the new plan include lump sum payments. Not only does the plan provide a service member with a mid-career continuity bonus, but upon retirement, a service member will receive a lump sum payment that is equal 25% or 50% of a promised pension benefit. This will then cause a reduction in the monthly pension checks until the retiree reaches age 67.

For service members who do not intend on retiring, the new plan, unlike the old “all or nothing” plan, provides an increased retirement benefit. On the other hand, it is clear that service members who are impacted by the new plan should consult with an experienced financial planner. The failure to develop a proper financial plan at the beginning of a military career could have a detrimental impact on the financial status of the service member upon retirement.

Hook Law Center works with a team of financial planners who have developed plans to maximize benefits under the new plan. Should you need any assistance in determining whether to opt-in, how to allocate your TSP portfolio, or how much you should contribute to the TSP, please contact us and we will help make a connection.

Ask Kit Kat – Dog Coming to Scotland

Hook Law Center:  Kit Kat, what can you tell us about the little dog, Gobi, who will be coming to live in Scotland?

Kit Kat:  Well, this story you’re going to love! Dion Leonard is a distance runner from Scotland who has participated in some unique events. While he was running in the June 2016 Gobi (Desert) March, which is part of the 4 Deserts Race Series, a small dog approached him. There are 6 stages in the race adding up to a 155-mile trek. During the first day, Gobi just followed the group of runners, but on the 2^nd day, she seemed to favor Leonard and stuck close to him. He is not sure of the breed, but she’s copper colored and has pointy ears, and was just a puppy at the time. To me, she looks like she’s part Akita, but that’s just my observation. Anyway, by Day 2, it was clear that Gobi had adopted Leonard. She followed him all that day through 23 miles of varying terrain, making it up to 20,000 feet to cross the Tian Shan mountain range, and finally cross into the Gobi Desert. Leonard shared some of his provisions with her, letting her feast on beef jerky and water. He says he’s not sure why she chose him out of the 101 participants in the race. ‘I didn’t do anything in particular to gain her attention. She chose me. I was the one that she was going to stick to.’

Day 3 arrived and she was still with him. At some points, he carried her, like when they crossed chest-high rivers. In all, she completed stages 2,3, and 6 with him, amounting to 105 miles. During stages 4 and 5, race staff drove her to the finish lines for that day, because of extreme heat when temperatures hovered around 125 degrees.

Leonard finished the race in 2^nd place, and both he and Gobi received a medal. By that point he was hooked, and he knew he had to get her back to his home in Scotland. What he found out was that it was possible, but she would have to be quarantined and get various shots and clearances. The cost would be more than $6,500. No problem—he and his wife started an online campaign, and the money was raised. Now, they are just waiting for her to arrive, which they anticipate will be around Christmas! (https://www.washingtonpost.com/news/animalia/wp/2016/08/07/stray-dog-wins-hearts-and-…)

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Hook Law Center encourages you to share this newsletter with anyone who is interested in issues pertaining to the elderly, the disabled and their advocates. The information in this newsletter may be copied and distributed, without charge and without permission, but with appropriate citation to Hook Law Center, P.C. If you are interested in a free subscription to the Hook Law Center News, then please telephone us at 757-399-7506, e-mail us at mail@hooklawcenter.com or fax us at 757-397-1267.The post Department of Defense Rolls Out a New Retirement Plan first appeared on SEONewsWire.net.]]> http://www.seonewswire.net/2016/08/the-effect-of-divorce-on-your-estate-plan/ Tue, 16 Aug 2016 20:43:45 +0000 http://www.seonewswire.net/2016/08/the-effect-of-divorce-on-your-estate-plan/ An unfortunate, but common, scenario: You and your spouse get divorced.  You remarry, but die shortly thereafter.  Your loved ones discover that amidst all the excitement of your divorce and remarriage, you forgot to update your estate plan.  Your will…

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The post The Effect of Divorce on Your Estate Plan first appeared on SEONewsWire.net.]]> An unfortunate, but common, scenario: You and your spouse get divorced.  You remarry, but die shortly thereafter.  Your loved ones discover that amidst all the excitement of your divorce and remarriage, you forgot to update your estate plan.  Your will and beneficiary designations all leave everything you own to your first spouse.  What happens now?

You may be surprised to learn that in Virginia, unless otherwise provided in the divorce decree or your separation agreement, a divorce automatically revokes some provisions of your estate plan, while having no effect on others.  Here is a summary on the effect a divorce may have on each of aspect of your estate plan.

Wills

Va. Code § 64.2-412(A) provides that upon divorce or annulment, any provision in a client’s existing will in favor of a former spouse is revoked.  This includes not only provisions leaving assets to the former spouse, but also provisions conferring a general or special power of appointment or nominating the former spouse as an executor, trustee, conservator, or guardian.  If there is a remarriage between the parties, though, the provisions made for the former spouse in the will are revived.

Relying on this Code section rather than updating your will would be a mistake, however.  Why give your former spouse something else to argue about in the event of your death?  Go the extra mile and update your will following a divorce.

Trusts

The Uniform Trust Code (Va. Code §§ 64.2-700 through 64.2-808) does not provide for the revocation of a trust or its provisions (including the naming of a former spouse as trustee) either upon the filing of a divorce action or upon entry or a final decree of divorce or annulment.  In other words, if your revocable trust left everything you own to your wife Mary upon your death, but you and Mary are divorced, Mary is nonetheless entitled to receive everything.

Because divorce has no effect on a trust, you must amend or revoke your trust agreement to avoid your assets passing through it to a former spouse and your former spouse serving as trustee.

Power of Attorney

Va. Code § 64.2-1608(B)(3) provides that the authority of an agent under a power of attorney terminates (1) when an action for divorce or annulment is filed, (2) upon the parties’ legal separation, or (3) by either the agent or the principal when an action for separate maintenance from the other is filed, or when the action for custody or visitation of a child in common is filed.

Due to the contentious nature of divorce, you should revoke any existing power of attorney upon your separation rather than waiting for the entry of a final divorce decree, regardless of whether the power of attorney is effective immediately or only on your incapacity, to prevent your soon-to-be former spouse from handling your affairs without your permission.  Give a copy of the document revoking the power of attorney (or your new power of attorney) to any financial institutions and third parties who are in possession of the prior power of attorney, to put them on notice that if the soon-to-be former spouse attempts to use the prior power of attorney, it is no longer valid.  A third party cannot be held liable for accepting a revoked power of attorney, if it has no knowledge that the power of attorney is no longer valid.

Advance Medical Directives

The Virginia Health Care Decisions Act (Va. Code §§ 54.1-2981 through 54.1-2993) does not provide for the automatic revocation of an advance medical directive (sometimes referred to as a “living will” or “medical power of attorney”) upon separation or divorce.  Therefore, if you become separated or divorced, you should revoke any existing advance medical directive which names your former spouse as an agent.

Designation of Individual to Make Arrangements for Disposition of Remains

Va. Code § 54.1-2825(A) gives individuals the authority to name someone who will be responsible for the “arrangements and be otherwise responsible for his funeral and the disposition of his remains, including cremation, interment, entombment, or memorialization, or some combination thereof, upon his death,” in a signed, notarized writing.  Divorce has no effect on the naming of a former spouse as the agent under this document; therefore, if you have signed a designation naming your spouse to handle these arrangements, be sure to revoke it.

Beneficiary Designations

Under current Virginia law, upon entry of a divorce decree, “any revocable beneficiary designation . . . that provides for the payment of any death benefit to the other party is revoked.  A death benefit prevented from passing to a former spouse by this section shall be as if the former spouse had predeceased the decedent” (Va. Code § 20-111.1(A)).  This includes payments from life insurance policies, annuities, retirement accounts, compensation agreements, and any other contracts which provide for the payment of benefits to a spouse at death.  This does not apply, however, if the divorce decree provides otherwise, or if the law is preempted by federal law.  For example, federal employees’ group life insurance (FEGLI) that names a former spouse as beneficiary will be paid to the former spouse regardless of whether a divorce decree has been entered.  Don’t rely on the Virginia statute providing for the revocation of a beneficiary designation upon divorce; provide for your loved ones by updating beneficiary designations to name the individual(s) you wish to inherit your assets at your death.

As you can see, divorce affects different aspects of your estate plan in different ways.  Don’t rely on Virginia’s default rules about which portions of your estate plan will be revoked automatically upon your divorce; take matters into your own hands by meeting with an estate planning attorney to make all changes necessary in the event of your separation or divorce.

Ask Kit Kat – Bear in a Bucket

Hook Law Center: Kit Kat, what can you tell us about the bear who got its head stuck in a plastic cheese puff bucket?

Kit Kat: This was one lucky bear! It happened in Glenwood Springs, CO during the week of July 18. It was a 2-year old bear, and somehow he got his head stuck in a cheese puff bucket. Those tasty snacks were just too much to resist. When anyone tried to help, he would scamper off. A local Good Samaritan, Jim Hawkins, age, 66, decided to take things in his own hands. He got some heavy duty gloves and some rope and waited for the bear to show up again. Hawkins owns a bed and breakfast, and the bear walked right into the B & B’s backyard. Hawkins lassoed the bear around its middle, and a tussle ensued. The bear then ran up a tree, and Hawkins tied the rope, so the bear couldn’t move. Hawkins suffered minor scrapes on his forearms. Next, Hawkins called Colorado Parks and Wildlife. Personnel from the agency came, tranquilized the bear, and removed the bucket. They also relocated the bear to a less populated area 12 miles away.

Hawkins, a retired firefighter, was quite brave! He himself doesn’t think his gallantry was so unusual. He definitely made a calculated decision. He weighs 200 pounds, and he estimates the bear weighed about 100 pounds. He laughs off his actions with this quote, “This was a little bear with a big problem.” (https://www.washingtonpost.com/news/animalia/wp/2016/07/23/this-man-rescued-a-bear…)

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Distribution of This Newsletter

Hook Law Center encourages you to share this newsletter with anyone who is interested in issues pertaining to the elderly, the disabled and their advocates. The information in this newsletter may be copied and distributed, without charge and without permission, but with appropriate citation to Hook Law Center, P.C. If you are interested in a free subscription to the Hook Law Center News, then please telephone us at 757-399-7506, e-mail us at mail@hooklawcenter.com or fax us at 757-397-1267.The post The Effect of Divorce on Your Estate Plan first appeared on SEONewsWire.net.]]> http://www.seonewswire.net/2016/08/asset-protection-in-virginia-what-can-i-do-that-wont-break-the-bank/ Fri, 05 Aug 2016 16:00:31 +0000 http://www.seonewswire.net/2016/08/asset-protection-in-virginia-what-can-i-do-that-wont-break-the-bank/ About a year ago (May 22, 2015), I wrote a newsletter article highlighting the possibilities of protecting your assets using a relatively new (to Virginia) device called a self-settled asset protection trust. In case you missed the article, a self-settled…

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The post Asset Protection in Virginia: What can I do that won’t break the bank? first appeared on SEONewsWire.net.]]> About a year ago (May 22, 2015), I wrote a newsletter article highlighting the possibilities of protecting your assets using a relatively new (to Virginia) device called a self-settled asset protection trust. In case you missed the article, a self-settled asset protection trust is a trust that you create well in advance of having creditor issues or sustaining potential liability for some event – be it professional malpractice, a car accident, or an accident in your home. If you are reasonable and transfer only so much of your assets to a self-settled asset protection trust that leaves you with sufficient assets in your name to satisfy your current and foreseeable creditors, you can be a beneficiary of the trust and still obtain creditor protection for the assets transferred into the trust. Creditors cannot sue to set aside the transfer to the self-settled asset protection trust after 5 years in Virginia. The advent of this new planning tool can be a boon to a family who would like to set aside a safety net or nest egg. Unfortunately, for many folks out there, the criteria that we would use to be sure that the protection would be available may be a little out of reach. Either they already have creditor issues or the cost of setting up and maintaining the asset protection trust is too high given the amount they have available to protect. What other solutions do we have to help?

For a married couple, one of the easiest forms of asset protection is to hold title to property as tenants by the entirety. Married couples can hold real and personal property (e.g., homes, and investment and bank accounts) as tenants by the entirety. When assets are held in this fashion, the creditors of one spouse cannot force the sale or partition of the asset held as tenants by the entirety. If the debtor spouse dies first, the surviving spouse takes title to the asset free of the deceased spouse’s creditors’ claims. Of course, if the surviving spouse is the debtor, then upon the death of the first spouse, the asset is available to the creditors. This protection is only available to married couples, and it does not protect the assets from the debts incurred by the spouses jointly (like a mortgage, typically).

Another option and probably one of the most overlooked ways to protect your assets is personal liability umbrella insurance. Approximately 20% of people with considerable wealth do not own one of these policies. An umbrella policy pays after your car and homeowners’ insurance has reached the limits of its coverage. In many cases, that amount may be below $500,000. In the event that a liability award is made against you in excess of the policy limits, your personal assets would be at risk. By purchasing an umbrella policy, you can protect your personal assets to a greater extent. Of course, you need to make some effort to match the amount of coverage in the umbrella policy to your assets with a little cushion to spare in the event of a verdict or settlement slightly in excess of your net worth. For instance, if your net worth is in the $1 million range, it makes sense to obtain an umbrella in the $2 million range. The truly remarkable thing about the umbrella policy is how affordable it is. Insurance for one home, two cars, and two drivers may be well under $500/year for $1 million in umbrella liability.

The attorneys at the Hook Law Center are well versed in asset protection in all its forms and are happy to talk with you about all your options.

ASK LUCIE

(Substituting for Kit Kat this week)

Howdy- Bark again! Phew!  It’s been HOT!  My owner won’t let me play as hard outside these days– something about getting overheated.  I didn’t like what she was telling me, so I played a good old game of ‘nose soccer’ by myself and, boy oh boy, did it do me in!

If it’s too hot for your owner, it’s too hot for us pets!  And YOWSER BOWSER that hot sidewalk!  If it’s too hot for your owner to walk barefoot, imagine 4 bare (or bear??) feet!  Same goes for cars– would your owner sit in a car with the windows barely cracked in a fur coat for very long before using their opposable thumbs to hold the cell phone and dial 9-1-1??? Nope…  Pets, lets keep our owners on their toes!!!

Let’s talk hurricane preparedness for pets– Did you now that most shelters do NOT accept pets?  I know right???  How insulting!  So, if the humans in your family have to leave home and have to seek shelter someplace that we’re not welcome, here are some tips:

 

• Leave a day ‘s worth of food and PLENTY of water accessible for your pet.
• Write your cell phone (land lines may not be working) number on your pet’s collar in waterproof marker. Include area code!!
• Got a tiny pet/tiny collar? Wrap duct tape around a portion to make a larger writing surface– who cares if it’s fashionable– it will get you found!
• If your pet has a micro-chip, make sure it’s activated and the information on file is up-to-date. Hmm. As she was helping me write this, my human muttered something naughty!
• Make sure the tags on your pet’s collar are current.
• YOU STAND A MUCH BETTER CHANCE OF BEING REUNITED WITH YOUR PET IF ANIMAL CONTROL CAN IDENTIFY IT AS BEING ‘OWNED’.
• If you’re going to be traveling with your pet, do some research and find out if there are pet friendly shelters in the area, just in case.

 

This reminds me of a true story.  Several years ago, during one of the hurricanes, my owner looked out on the front porch and was surprised by a Great Dane cowering in the corner.  She had a current Rabies Tag, so the next morning my owner called the animal hospital on the tag, and they located the dog’s owner!  Their fence had blown down, they didn’t realize it, and the dog got out.  We may not get a lot of devastating storm damage, but something as simple as a blown-down fence can be just as bad for us pets!

Take care– take your heartworm, flea and tick treats!

BAYL (Bark At You Later)

Lucie

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Distribution of This Newsletter

Hook Law Center encourages you to share this newsletter with anyone who is interested in issues pertaining to the elderly, the disabled and their advocates. The information in this newsletter may be copied and distributed, without charge and without permission, but with appropriate citation to Hook Law Center, P.C. If you are interested in a free subscription to the Hook Law Center News, then please telephone us at 757-399-7506, e-mail us at mail@hooklawcenter.com or fax us at 757-397-1267.The post Asset Protection in Virginia: What can I do that won’t break the bank? first appeared on SEONewsWire.net.]]> http://www.seonewswire.net/2016/08/recent-court-ruling-creates-difficulty-obtaining-documents-from-nursing-facilities/ Mon, 01 Aug 2016 20:37:08 +0000 http://www.seonewswire.net/2016/08/recent-court-ruling-creates-difficulty-obtaining-documents-from-nursing-facilities/ Frequently, disputes with nursing homes related to resident care arise. When they do, the contracts, policies, and documents of the nursing facility become critically important. A recent Supreme Court of Virginia decision found an executor’s attempt to obtain those documents…

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The post Recent Court Ruling Creates Difficulty Obtaining Documents from Nursing Facilities first appeared on SEONewsWire.net.]]> Frequently, disputes with nursing homes related to resident care arise. When they do, the contracts, policies, and documents of the nursing facility become critically important. A recent Supreme Court of Virginia decision found an executor’s attempt to obtain those documents via court action to be inappropriate. This ruling affects the ability to bring an action on behalf of a loved one (or their estate), and it is important to understand for anyone who has loved ones in a nursing facility.

On July 14 in Cherrie v. Virginia Health Services, Inc., the Supreme Court of Virginia precluded an Executor’s action under the Declaratory Judgment Act compelling the production of policies and documents by a healthcare facility. The Executor’s action used rights found in Virginia administrative regulations as premise for the action. The Supreme Court of Virginia avoided construing the application of the term “residents and their designated representatives” found in the regulation and instead limited the holding to the availability of the Declaratory Judgment Act in enforcing duties of regulated parties. The method used to seek the documents was found to be improper, because administrative remedies were more appropriate than a court proceeding. Furthermore, the administrative regulations were held not to create a right to bring an action.

This decision clearly eliminates an avenue for obtaining documents from nursing facilities, but does not resolve the issue of how to obtain such documents when necessary. If the individual is in the nursing home is still alive, the nursing home resident or the resident’s designated representative can request copies of the documents. In the case of a deceased resident, it is unclear whether the nursing home has to provide those documents to the personal representative of the administrator’s estate. Given the confusion generated by this case, it is critical to obtain copies of these documents before a problem occurs at the nursing home.

In the event an incident occurs at a nursing home, it is critical to consult an attorney. The nursing facility may refuse to provide requested documents unless a party has certain documented authority. An attorney can assist in obtaining necessary documents and taking necessary action.  If no designated representative has been appointed, an attorney can assist in working around that limitation. Furthermore, an attorney can help take necessary actions against the nursing home in a timely manner. If out-of-court disputes with a nursing home drag on, then a subsequent action against the nursing home may be barred due to statutory time limitations. Seeking the counsel of an attorney can help prevent this from happening. The attorneys at Hook Law Center are available to counsel you in how best to manage you or your loved one’s relationship with their nursing home and assist in any disputes that may arise.

Ask Kit Kat – Drones with Peanut Butter

Hook Law Center:  Kit Kat, are there really such things as drones armed with peanut butter?

Kit Kat:  I know it sounds wild, but yes, the US Fish and Wildlife Service is considering using drones to drop peanut-butter pellets in northeast Montana. The reason—the peanut-butter pellets would be food for prairie dogs who frequently are infected with plague contracted from fleas. The pellets have a vaccine against the flea-based plague. However, the ultimate goal is to help black-footed ferrets, who are currently listed as endangered. In 1987, only 18 black-footed ferrets still existed.

The favorite food source for ferrets? You guessed it—prairie dogs! Prairie dogs make up 90% of this particular type of ferret’s diet. So in a roundabout way, the drones would be actually helping ferrets! The importance of the black-footed ferret is that is also the only one native to the United States. Its food source—prairie dogs—have significantly declined in number as the West has become developed either through farming or increased human population. The pellets have been used in lab trials, but now the government wants to expand their use to 1,000 acre tracts. The only alternative to drones appear to be sending in humans on an ATV. That would be more costly and disruptive to both animals, so the drone is being developed as we speak.

The concept of using drones may be new, but airdrops from planes or helicopters have been used in the past. For example, in 2013, helicopters were used in Guam to get rid of brown tree snakes. 2,000 dead mice, injected with Acetaminophen, a common painkiller for humans, were dropped in the forests there. Acetaminophen, while helpful to humans, is poisonous to snakes. In the 1970s and 1980s, vaccine-stuffed chicken heads were dropped in Switzerland to keep foxes free of rabies. The state of Texas fights rabies to this very day by airdrops of millions of fishmeal-coated anti-rabies packets. Consumers of this bait are coyotes, foxes, and even skunks.

So, once again, technology is being used to help man solve complex problems more efficiently and quickly. Stay tuned as we await more information about this interesting and creative project! (https://www.washingtonpost.com/news/animalia/wp/2016/07/15/drone-fired-peanut-butter…)

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Hook Law Center encourages you to share this newsletter with anyone who is interested in issues pertaining to the elderly, the disabled and their advocates. The information in this newsletter may be copied and distributed, without charge and without permission, but with appropriate citation to Hook Law Center, P.C. If you are interested in a free subscription to the Hook Law Center News, then please telephone us at 757-399-7506, e-mail us at mail@hooklawcenter.com or fax us at 757-397-1267.The post Recent Court Ruling Creates Difficulty Obtaining Documents from Nursing Facilities first appeared on SEONewsWire.net.]]> http://www.seonewswire.net/2016/07/understanding-a-residents-transfer-and-discharge-rights-under-the-nursing-home-reform-act/ Tue, 26 Jul 2016 16:23:38 +0000 http://www.seonewswire.net/2016/07/understanding-a-residents-transfer-and-discharge-rights-under-the-nursing-home-reform-act/ by Shannon A. Laymon-Pecoraro, Esq. One of the most frequent issues I face revolves around the discharge of a resident from a nursing home. Often times, an agent or advocate visits my office with a concern, because their loved one…

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The post Understanding a Resident’s Transfer and Discharge Rights under the Nursing Home Reform Act first appeared on SEONewsWire.net.]]> by Shannon A. Laymon-Pecoraro, Esq.

One of the most frequent issues I face revolves around the discharge of a resident from a nursing home. Often times, an agent or advocate visits my office with a concern, because their loved one is being discharged from the nursing home, and they want to assess what their options are. The good news is that the nursing home cannot just kick a resident out of the nursing home.

A common discharge is related to a loss of Medicare coverage for rehab or skilled nursing care. Under Medicare rules, coverage of rehab services will not extend beyond day 100 and will be cut short due to a refusal to participate in therapies or if daily skilled care is no longer necessary. However, what most facilities fail to explain to the residents and their advocates is that they have the option to remain in the facility, and the nursing home may only involuntarily discharge under a set of parameters as set forth under the Nursing Home Reform Act. Specifically, a nursing home must allow a resident to remain in the facility unless one of the following conditions is met:

1. the resident’s welfare cannot be met in the facility;
2. the resident no longer needs the services provided by the facility;
3. the safety of individuals in the facility is endangered;
4. the health of individuals in the facility would otherwise be endangered;
5. the resident has failed, after reasonable and appropriate notice, to pay for a stay at the facility; or
6. the facility ceases to operate.

And, even under those circumstances, the facility is still responsible for the development of a safe-discharge plan. Specifically, a facility is responsible for developing a post-discharge care plan that assesses the continuing care needs and development of a plan designed to ensure the individual’s needs will be met after discharge from the facility into the community.

All too frequently, we receive a statement from a discharge planner that the “safe-discharge plan” includes going to an assisted living facility or returning home with private duty staff to assist with 24/7 care. The problem; however, is that the resident may not be able to afford either of those options, and as a result, would not be safe alternatives to the nursing home. Not only has the nursing facility not informed the resident of his or her right to remain at the facility under private pay (or that Medicaid may be able to assist with paying for care), but has failed to consider whether the “safe-discharge plan” is a viable option.

The question then becomes what is the motivation to discharge a patient. It is simple– the nursing home is a business. Most nursing homes prefer Medicare reimbursement or private pay over Medicaid reimbursement to protect the financial stake of the company. Furthermore, most nursing homes prefer residents who do not have extraneous care needs or advocates that are determined to present a problem to a nursing home.

So, you are probably wondering what you can do in light of an improper discharge:

1. Appeal the discharge. If you feel that your loved one still requires skilled nursing care or is otherwise being improperly discharged, you may appeal the decision. The facility is required to provide you with a statement pertaining to your right to appeal with the discharge notice.
2. Demand bill. If you disagree with a facility’s decision of coverage, you may request that the facility submit the bill to Medicare even when the facility believes that services will not be covered by Medicare. The facility cannot bill the beneficiary for the disputed charges until the Medicare fiscal intermediary issues a formal claim determination. If the determination is unfavorable, you should be prepared to pay for the expense.
3. Find an alternative source for payment. Understand that your loved one’s stay in the nursing home will not be covered by Medicare as of day 101 of institutionalization. If your loved one cannot afford the private pay rate, act promptly to develop a plan for long-term payment in facility. It is imperative that you determine whether an application for Medicaid is necessary, and that the necessary planning for Medicaid, and the submission of an application, occur prior to the expiration of the Medicare covered period.
4. Investigate bed certification. Many facilities will inform a resident that they do not have any more Medicaid beds available, despite the fact that most facilities have dually-certified beds. What this means is that if you are currently in a bed, they must allow you to stay in the bed even if you are on Medicaid – the number of “Medicaid beds” is most often determined by the facility itself for budgetary purposes.
5. Be Prepared for a Hospital Discharge. A facility may have the resident admitted to a hospital on in-patient status and deny readmission. Since Virginia Medicaid does not pay for a bed hold, you should consider privately paying for a bed hold.
6. Do not sign in an individual capacity. If you are an agent for the resident, you should never sign the nursing home admission documents in your personal capacity, and the nursing home cannot require you to sign as a responsible party. Instead, you should clarify, in writing that you are signing on behalf of the resident.

Seek an experienced advocate. If you feel something isn’t right, you should seek someone experienced with resident rights.

Ask Kit Kat – Helping Feral Cats

Hook Law Center:  Kit Kat, what can someone do to help feral cats which may be living in a neighborhood?

Kit Kat:  Well, there are some things which can be done, but you will need help from your community. At least, that is what is suggested in a recent article in the All Animals magazine published by the Humane Society of the United States (HSUS). In that article, it is suggested that the person spearheading the effort must first talk to their neighbors and get their input. If one person just captures a few cats with traps, there may be many more out there who will continue breeding, and the situation will not become manageable. Let me provide an example, so you will see what I mean.

Beth McNulty, an operations manager with the HSUS, who lives in rural Monrovia, MD noticed in 2010 a spike in the number of stray cats which were wandering through her yard. Occasionally, she would see one or two, but this was almost a dozen. She herself had 3 indoor cats, and one was just recovering from a spraying behavior, so she was afraid to take in anymore cats would set hers off again. In her sleuthing, she discovered that the cats had been living in a nearby junkyard which was being cleaned out. The cats fled in the confusion. To make a long story short, she discovered that the best way to start the process of helping the feral cat colony was to involve her neighbors. Their awareness and help resulted in a neighborhood-wide trapping effort. Thirty older cats and older kittens were sterilized, and returned to their former abode (the now clean junkyard). Three small kittens were placed with a rescue group. McNulty hasn’t seen another addition to the clan yet. This approach of capturing feral cats, sterilizing them, and returning them to live on their own is known as TNR (trap-neuter-return). It appears to be a humane way of caring for them without resorting to euthanasia.

You can tell if a feral cat has been sterilized by a clipped ear lobe. That is done after the sterilization, so all will know. How can you tell the difference between someone’s pet who has just gotten lost or a feral cat? Usually, the feral cat will not eat in the presence of a human. The feral cat will only eat after the human has walked away. So, be aware of stray cats in your community. There may be a way to humanely maintain them there, as they live out their lives.(Julie Falconer, “The Outsiders-How to Help your Neighborhood’s Felines,” All Animals, July/August 2016, p. 16-21)

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Distribution of This Newsletter

Hook Law Center encourages you to share this newsletter with anyone who is interested in issues pertaining to the elderly, the disabled and their advocates. The information in this newsletter may be copied and distributed, without charge and without permission, but with appropriate citation to Hook Law Center, P.C. If you are interested in a free subscription to the Hook Law Center News, then please telephone us at 757-399-7506, e-mail us at mail@hooklawcenter.com or fax us at 757-397-1267.The post Understanding a Resident’s Transfer and Discharge Rights under the Nursing Home Reform Act first appeared on SEONewsWire.net.]]>
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