To qualify financially for long-term care Medicaid in Virginia, you must have countable assets (“resources”) totaling $2,000 or less. If you are applying for Medicaid and you are married, your spouse who is not receiving Medicaid may retain countable resources valued at one-half of your collective countable resources, or $120,900 (in 2017), whichever is lower. Countable resources include (but are not limited to) bank accounts, investments, retirement accounts, and real property other than your primary residence. Non-countable resources include one automobile, certain types of savings bonds and irrevocable prepaid funeral contracts, household goods and personal effects, and your primary personal residence, if you or your spouse are living there.
If you are applying for Medicaid to help pay for long-term care services in your own home, your home will not count against you. If you are applying for Medicaid to help pay for long-term care services in a nursing facility, but your spouse is remaining in the home, the home will not count against you. If you are single and applying for Medicaid to pay for long-term care services in a nursing facility, then the home will not count against you for a period of six months, beginning on the date you left the home. After you have been out of the home for six months, if there is no spouse remaining in the home, it is considered a resource available to you and from which you should be paying for your long-term care expenses. To avoid having the home counted against you at that point, you will need to make a good faith effort to sell the home, by listing it for sale at its tax assessed value. Failure to do so will mean that your Medicaid benefits end, and you will be responsible for the entire cost of your care.
There are steps we can take to protect your home and avoid having to list it for sale, with a little pre-planning. In certain situations, it makes sense to transfer a home to an irrevocable trust as a part of five-year planning before the need for long-term care arises (the transfer is subject to Medicaid’s five-year lookback period). In other situations, we may be able to use the “caretaker child” exception and transfer the home without penalty to a child who has lived with you and cared for you for at least two years, preventing you from requiring care in a facility during that time. There are other exceptions and strategies we may use, as well – transfers to a blind or disabled child or to a sibling who has lived in the home for at least a year and who has some interest in the property, for example, may be made without penalty.
Medicaid’s rules and regulations are intricate and frequently misunderstood. For questions relating to Medicaid eligibility and how you may qualify, work with a professional who is well-versed in this complex area of the law.
Ask Kit Kat – Fake or Real Fur
Hook Law Center: Kit Kat, how can you tell if fur is fake or real?
Kit Kat: Well, I know all the rage now is fake fur, but you have to be careful, because some retailers are still using real fur and advertising it as fake or ‘faux fur.’ The word “faux” is French for false or fake. To tell the difference, separate the fibers, and look to the base of the item. If you see a weave backing, then it is fake or faux. Also, the ends of the fur will be more blunt, and not tapered, as they would with real fur. I am not sure what the motivation to use faux fur is, but the practice is continuing. Frequent sources of real fur are factory-farmed raccoons, dogs, and rabbits.
Thank goodness the Humane Society of the United States (HSUS) continues to monitor this situation. What they have found is not good news. All types of retailers from discount to high-end stores pass off real fur items as faux, when they are not. HSUS has alerted the FTC (Federal Trade Commission) that they have found 37 items sold by 17 retailers that are still using real fur. They make coats, footwear, purses, and keychains from the real fur. Up to now, the FTC has not fined any companies, but they have the power to do so. Pierre Grzybowski of HSUS says HSUS’ latest information is the result of 4 years of data collection. Until stronger action is taken by the FTC, the consumer can help by assuming that “anything that looks like animal fur might well be,” says Gryzbowski. Don’t fall for the fake products. Boycotting these items will speak volumes to retailers. (“Are you sure your fur is fake?” All Animals, November/December 2016, p. 9)
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 Will Medicaid Take My House? first appeared on SEONewsWire.net.]]>
I often describe proper estate planning for business owners as providing “schock absorbers” during a difficult time. Lets face it, the incapacity or death of a business owner impacts many things: the business, the employees, the family of the owner, other businesses that have contracts with the business, among others. Further complicating matters, is that transitions in ownership of the business (even due to death or incapacity) often trigger legal obligations under documents like leases, franchise agreements, loans, shareholder agreements, and more. Failing to address these obligations in the context of an estate plan can have disastrous results.
So what happens if you fail to plan? Well, it is a similar outcome to driving a care without shock absorbers over a rocky road, you may get through but your car will likely be damaged and the wheels may fall off. To be clear damage from an unplanned transition can impact the owner and the owner’s family, the business, or both. Effective planning means that there are “shock absorbers” on all areas that would be impacted by the death or disability of an owner.
Business succession planning at the business level provides for continuity in the business but may not prevent adverse impact against the business owner’s family. For instance, a business that provides a buyout of an owner’s shares may preserve the business, but an undercompensated buyout may leave the owner’s spouse and family in bad shape financially. In reviewing their estate plan a business owner should closely look at what would happen to their ownership interest in the event of incapacity or death.
Even if an attorney represents a business in which you have an ownership interest, properly integrating any business succession plan with your estate plan requires a comprehensive look at your personal needs and estate planning goals. The estate planning and elder law attorneys at Hook Law Center regularly assist business owners in establishing and implementing their personal estate plans so that they are coordinated with the business’ succession plan. If the opportunity to plan has passed then our attorneys also can help coordinate the aftermath so that the shocks to the individual and business are minimized.
Ask Kit Kat – Furless Fashion
Hook Law Center: Kit Kat, what can you tell us about fashion designers and their use of animal fur in their clothing lines?
Kit Kat: Well, there has been a lot of progress in this area. In 2015 the brand Hugo Boss discontinued its use of fur fashions. Now, there is word that Giorgio Armani will follow suit. In 2008 Armani stopped using fur in all its products, except for rabbit. Now that, too, will be eliminated. There had been and is tremendous pressure on fashion designers to use fur in their collections, especially the high end ones. Fur has traditionally meant elegance and wealth. However, thanks to lobbying efforts by the Humane Society of the United States (HSUS) among others, Armani decided the time had come to eliminate fur and stand up for what he believes is right. PJ Smith corporate engagement manager of HSUS says, ‘Having the leadership of somebody like Armani is very important: One of the cruelest form of fashion is unnecessary now, and you have the biggest name in fashion design saying that.’ Impacting their decision, in part, is the realization that fake fur has become so attractive, and is a great alternative to using the hide of helpless animals. It’s a win-win for all those involved.
So kudos to Mr. Armani! He is a cat lover and has two in his family. We continue to hope that other designers will follow his lead. HSUS and the Fur-Free Alliance, a coalition of 40 organizations from 28 countries, will continue to press their case for fur-free fashion the world over. (“Fashion without fur,” All Animals, September/October 2016, p. 32-33)
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 Planning for Small Business Owners Is Critically Important first appeared on SEONewsWire.net.]]>
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:
- the resident’s welfare cannot be met in the facility;
- the resident no longer needs the services provided by the facility;
- the safety of individuals in the facility is endangered;
- the health of individuals in the facility would otherwise be endangered;
- the resident has failed, after reasonable and appropriate notice, to pay for a stay at the facility; or
- 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:
- 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.
- 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.
- 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.
- 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.
- 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.
- 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)
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.]]>