The Legal Checkup Blog
Tags: PACE, home care, long-term care, asset protection, elder law, Legal Check Up, Legal Documents, Estate Planning, disability planning, Medicare, Community Care, Medicaid, Medicaid Home Care, Durable Power of Attorney, Health Care Proxy, Last Will & Testament, nursing home, Program of All-Inclusive Care for the Elderly (PAC, Veterans Benefits, long-term care planning
Rockland- Aging is BIG business. The key word here is "business."
With the demographics as they are, people living longer, boomers coming of age, new products and services are introduced each day for seniors and their caregivers. Many of these products and services are fantastic and live up to their promises. Others, however, rely on fancy web sites and literature, celebrity endorsements and microscopic disclaimers to make a sale. These tactics are successful because they play on the vulnerabilities of the target audience, often when they are most overwhelmed and desperate for help.
Perhaps you are caring for your spouse who is suffering from Alzheimer’s or some other chronic condition. Maybe you are looking for guidance because your parents are no longer safe in their home. Whatever your situation, you need to be an informed consumer. You’ve got to ask some important questions in order to properly assess whether a product or service is right for you or your loved one.
In this first of a three-part series, we’ll discuss some of the hidden issues and questions that seniors and their caregivers need to consider asking in order to make educated, informed decisions.
Let's start by dispelling the myth that anything in business is "free." Let’s face it - if something was truly free, the provider would be a charity rather than a business. Once you accept that businesses exist to make money, you will want to understand how companies are being paid in order to determine whether the product or service will benefit you. You need to ask questions and demand answers. Below are a few common examples.
Senior Living Referral Services. Each morning while I am having my coffee and watching the news, I see the commercial with Joan Lunden promoting a “free senior living referral source.” And, each morning, I want to yell at my TV, frustrated that the consumer is not being provided with the full story. Sure, there is likely a disclaimer in print so small that it is illegible, but let’s face it - nobody is reading the fine print, even if it is large enough to see. Viewers trust Joan Lunden because they watched her for years on morning TV. They trust her because she tells about her own struggle to find the right resources for her aging mother, and that is very compelling. I went to the web site for this company to research a bit further and found the following disclaimer – again, in print so tiny and a font so light I had trouble reading it: “Our service is offered at no charge to families as the communities and providers in our network pay (our) fee …” We do not own, operate, recommend, or endorse any of these communities or providers.”
So, if a senior living referral source such as this does not recommend or endorse any of the communities they refer you to, you need to ask some questions in order to determine if this service will benefit you. Consider asking them the following questions:
1) If you do not recommend or endorse any of the facilities you will refer me to, what are the criteria that you use? Is it solely that they pay a fee for the referral?
2) How much will you be paid by a facility if my loved one is placed there?
3) Are there other facilities in the area that you have not referred us to and, if so, why not? Is it solely that they have not agreed to pay a fee for the referral?
4) Will you put the criteria you are basing the referral on in writing?
Web-based senior planning resources. These sites are multiplying like rabbits on the web, each promising to be the hub of information and a central place to locate quality geriatric care managers, elder law attorneys, assisted living facilities, nursing homes and more. Some of these sites do provide valuable information to seniors and caregivers but, again, you must understand how they are getting paid. Ask the following questions:
1) Do the “experts” on your site pay to be designated as experts?
2) If not, what is the criteria one must meet to qualify as an “expert?”
3) Do providers (geriatric care managers, elder law attorneys, facilities, etc) pay to be listed on your site, or to be highlighted or listed first in search results?
4) How do you ensure that the information listed on your site is current and accurate?
5) Can you guarantee the security of any personal information I provide through the site? How?
6) Do you share my information with any other person or entity?
7) Do I have to register or sign up in order to use the site?
One site that I recently tested asked for far too much personal information. In order to request information from a specific elder law attorney, for example, site users are asked to provide the name of the person they are concerned about and the details of their condition. It is unclear who receives the inquiries submitted online or whether this personal information is protected. This particular site also offers a forum for family members to share information and communicate about their loved one – to list doctor appointments and medications, post estate planning documents, etc. This sounds great in theory, but there is no guarantee that the communications are private or secure. There are a number of other forums where family members can communicate without going through a web-based senior planning site such as this, and I caution you not to provide any personal information on such a site unless your questions are answered to your satisfaction, preferably in writing.
Personally, I believe the best way to contact a professional is directly, with no third-party intermediary. The best resource to find an elder law attorney is through the Massachusetts Chapter of the National Academy of Elder Law Attorneys, at www.massnaela.com (or www.naela.org in other states). A qualified geriatric care manager can be found through the National Association of Professional Geriatric Care Managers at www.caremangers.org. You can research assisted living facilities through www.massalfa.org (Mass Assisted Living Facilities Association), and nursing homes through www.medicare.gov/nursinghomecompare. Nursing Home Compare provides you with the most recent inspection results for all nursing homes in the state, including any deficiencies you should be aware of.
There is nothing wrong with companies trying to make a profit by providing products and services that address the needs of seniors and their caregivers. But, it is up to you to look beyond the celebrity endorsements and glitzy marketing. It is up to you to determine if “experts” earn their designation through knowledge and experience, or by paying a fee to be listed as such; whether a referral service will refer you only to facilities that pay a fee to be included. If the fancy marketing and celebrity endorsements give you one impression, but the fine print says something completely different, you need to ask questions and demand answers before proceeding. Remember, businesses are in business for one reason - to make money. You must understand how they are being paid in order to truly understand if the product or service offers value to you.
Note: In our next post, we will discuss financial services sales and MassHealth application prep services.
Tags: PACE, home care, long-term care, asset protection, Legal Check Up, Estate Planning, Community Care, Elder Financial Abuse, loved ones, skilled services, nursing home, Program of All-Inclusive Care for the Elderly (PAC, Veterans Benefits, long-term care planning
THE LEGAL CHECK UP BOOT CAMP (c) - FALL WORKSHOP COMING SOON!
Posted by Judith Flynn on Tue, Sep 18, 2012 @ 22:09 PM
Note: Rockland and Mansfield Boot Camps are fully booked! We are maintaining a wait list and an additional date will be added when filled.
IT'S BACK BY POPULAR DEMAND AND SURE TO "SELL OUT" QUICKLY ...
THE LEGAL CHECK UP BOOT CAMP (c)
Families come in all shapes and sizes. Whether you are young, a boomer or a senior, single, married (traditional or same-sex), divorced, have children or not, have a family member with special needs, want to leave your estate to your pets ... whatever your situation, you need a comprehensive assessment and and an Estate Plan that is just right for you. Depending on your goals and your situation, your plan might focus on probate avoidance, tax minimization, asset protection, or special needs planning.
"I don't have enough to worry about" you say?
Well, be aware that whether you are wealthy, barely getting by, or somewhere in the middle -- there are basic documents you need to have in place in the event you become temporarily or permanently unable to act for yourself due to a physical or mental incapacity.
You can't afford not to have these basic documents in place in the event of an emergency. If you don't have basic disability documents that appoint an agent to act on your behalf in such cases, your loved ones would need to petition the probate court for a guardianship and/or conservatorship to obtain the authority to act on your behalf. These court processes can cost thousands of dollars.
So, delay no more.
Come and learn how to protect yourself, your family, and your assets in the event of disability or death.
Not just another boring seminar ... in this free, comprehensive workshop you will learn every thing you need to know about Estate and Long-Term Care Planning. Part of the workshop will be interactive to allow attendees to discuss particular problems, concerns and situations.
This workshop will cover:
* what estate planning documents you need in the event of disability;
* what estate planning documents you need in order to achieve your goals and objectives;
* how to properly select Agents, Personal Representatives, and Trustees;
* whether you need a Will, a Trust, or both;
* long-term care costs and payment options (Medicare, VA benefits, Long-Term Care Insurance, Private Pay and Medicaid);
* how to protect your home and other assets;
* how to provide for your child with special needs in a way that improves his or her quality of life without disrupting eligibility for public benefits;
Each attendee will receive a workbook and will "graduate" from the Boot Camp with a detailed, comprehensive plan of action.
The Fall workshops will be offered during the day (from 12-3 pm) and in the evening (from 5-8 pm). Seating is limited to 12 in each session in order to provide individualized guidance to each attendee. Session dates will be posted soon, but preference will be given to those who pre-register at:
http://www.thelegalcheckup.com/legal-check-up-boot-camp-registration/
Tags: PACE, home care, long-term care, asset protection, elder law, Legal Check Up, Legal Documents, Estate Planning, disability planning, Medicare, Community Care, Elder Financial Abuse, family, loved ones, Medicaid, Medicaid Home Care, improvement standard, undue influence, rights, Durable Power of Attorney, Living Wills, Health Care Proxy, Last Will & Testament, nursing home, Program of All-Inclusive Care for the Elderly (PAC, Veterans Benefits, long-term care planning
I've heard many excuses for putting off long-term care planning, including:
Because ...
"I'm never going to a nursing home."
"I have Medicare."
"I have my child's name on all of my accounts, so the state won't count those funds"
"I'm a veteran, so the VA will take care of all of my long-term care needs."
"My kids will take care of me."
"I don't have enough assets to worry about."
"I put my daughter's name on all of my accounts and she will divide everything equally among all my kids when I die."
"I have my assets in a revocable trust, so they are protected."
"I am leaving everything to my son so he can take care of my child with special needs."
"I don't want to hurt any body's feelings so I just won't do any thing."
"I'll do it LATER."
You've probably used a few that aren't on this list too. But, guess what? LATER has come. LATER is TODAY.
The Elder Law Office of Judith M. Flynn has developed a new workshop to help seniors get their affairs in order. The Legal Check Up Boot Camp (c) is a free, comprehensive workshop to give seniors all the knowledge they need about Estate and Long-Term Care Planning.
This workshop will empower the attendees to stop procrastinating and finally take control of the decisions they have been avoiding for too long.
This four-hour workshop will be taught in two sessions of two hours each. Part of the workshop will be interactive to allow attendees to discuss particular problems, concerns and situations.
This workshop will cover:
*what estate planning documents you need in order to achieve your goals and objectives;
* how to properly select Agents, Executors, and Trustees;
* whether you need a Will, a Trust, or both;
* long-term care costs and payment options (Medicare, VA benefits, Long-Term Care Insurance, Private Pay and Medicaid)
* how to protect your home and other assets;
Each attendee will receive a workbook and will "graduate" from the Boot Camp with a detailed, comprehensive plan of action.
For more details about the Boot Camp or to register, go to:
http://www.thelegalcheckup.com/seminars-and-workshops/
Tags: PACE, home care, long-term care, asset protection, elder law, Legal Check Up, Legal Documents, Estate Planning, disability planning, Medicare, Community Care, family, Medicaid, Medicaid Home Care, skilled services, rights, Durable Power of Attorney, Living Wills, Health Care Proxy, Last Will & Testament, nursing home, Program of All-Inclusive Care for the Elderly (PAC, Veterans Benefits, Personal Care Assistance Program
DISPELLING THE MYTHS ABOUT PAYING FOR LONG-TERM CARE
Posted by Judith Flynn on Mon, Oct 17, 2011 @ 18:10 PM
We all want to age in place in our own homes, on our own terms -- any place other than a nursing home. Sometimes situations change quickly, however, and for a number of reasons it just may not be possible to remain safely in the community. It is at these times of crisis that folks often discover that all the ideas they had about their long-term care security and how they would pay for nursing home care if needed are basically … well, wrong. There are five major payment sources for nursing home care, each worthy of its own full-length column, but I offer the following brief summary to help dispel some of the myths on this topic.
The most common misconception I hear from seniors is that Medicare is going to cover all of their nursing home costs. This simply is NOT true.
MEDICARE
Medicare will only cover “skilled” care, and only if all of the following conditions are met:
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You have Medicare Part A (hospital insurance) and have days left in your benefit period;
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You have a qualifying hospital stay, which is an inpatient stay of three consecutive days or more, starting with the day of admission and not including the day of discharge. (ALERT: If you are held for “observation” for part of your hospital stay prior to being admitted, you may not have met the minimum requirement. This is an issue that should be promptly appealed.)
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Discharge to the rehabilitation facility either directly or within 30 days;
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Your doctor orders the services you need for SNF care, which require the skills of professional personnel such as registered nurses, LPNs, phsyical, occupational, and speech therapists, and are furnished by or under the supervision of these skilled personnel;
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You require the skilled services on a daily basis (5 days per week qualifies).
The availability of 100 days is not, however, a guaranteed coverage period of 100 days. In fact, it is far from guaranteed with the average period of SNF care covered by Medicare being only 23 days. You must also qualify according to the clinical criteria set forth by Medicare. Medicare requires the facility to conduct periodic assessments of your condition and goals to determine whether you will be approved for extended skilled coverage.
Medicare will pay the full cost for days 1-20, and you will be responsible for a significant daily copayment from days 21-100. Medicare does not pay beyond the 100-day period, unless you have a break in your coverage for at least 60 days. In that case, with the above conditions met again, you would have a new 100-day period available.
(ALERT: If you receive a Notice of Medicare Provider Non-Coverage informing you that your Medicare coverage will terminate because you have “reached a plateau,” “are stable,” “custodial care” or not improving, consider filing an immediate appeal. If you need continued skilled services in order to maintain your present condition, then you are entitled to continued coverage under the Medicare Act and federal law.)
VETERANS BENEFITS
Nursing home care is not automatically available to all veterans enrolled in the VA health plan. Only the following veterans automatically qualify for unlimited nursing home care:
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Veterans who are seeking nursing home care for a service-related condition;
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Veterans with a service-connected disability rating of 70 percent or more;
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Veterans who have a service-connected disability of 60 percent and are unemployable;
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A service-connected disability is a disability that the VA has officially ruled was incurred or aggravated while on active duty in the military and in the line of duty. The VA must rule that your illness/condition is directly related to your active military service, and it assigns each disability a rating. The ratings are established by VA regional offices around the country;
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The VA may provide nursing home care to other veterans if space permits. Veterans with service-connected disabilities receive priority.
LONG-TERM CARE INSURANCE
The popularity of long-term care insurance is growing, for obvious reasons. The problem with this payment option, however, is that many people don’t consider purchasing long-term care insurance until they need it. When they need it, they simply will not qualify for it. If you have not had a diagnosis that would affect your ability to obtain long-term care insurance, look into it today. Even if you pay more for it based on your age, the statistics show that your investment will be well worth it down the road. In addition, there are tax incentives available for purchasing long-term care insurance, and certain qualifying policies can make your home a non-countable asset for Medicaid/MassHealth purposes. Call my office if you would like a referral to a trusted insurance professional.
PRIVATE PAYMENT
This is the most non-desirable payment option for extended nursing home payment, but most folks do not do adequate pre-planning. Let me be clear. Facilities provide care, and facilities need to be paid for their services. Pre-planning is critical, however, to ensure that you take advantage of laws that allow you to protect your spouse and protect your own quality of care for the future. Private payment can average from $10,000-$12,000 per month – could you afford to pay this expense for an extended period of time without putting your spouse or your security at risk? Have you taken the necessary steps to ensure that your security will not be left to chance?
MEDICAID
Medicaid is the federal program that is known as MassHealth inMassachusetts. When you run out of funds to pay for your nursing home care, you can apply for MassHealth coverage. An individual may only have $2,000 in assets, and a married couple may have a combined $111,560. There are some assets that are “non-countable” in that limit, such as the marital home, life insurance with a face value of $1,500 or less, a car, life insurance that you can not access or surrender (such as a group or term policy). There are a myriad of regulations that apply to specific situations, and penalties imposed if you give your funds away within the five years prior to applying for MassHealth. It is imperative to do advance planning to ensure that you apply the regulations to your particular situation in a manner that will maximize your future security without jeopardizing your eligibility for this important benefit.
This summary is far from comprehensive, but I hope it causes you to reflect on your own situation. If you would like more information on long-term care payment options or to schedule a Legal Check Up, contact us today.
Tags: long-term care, asset protection, elder law, Estate Planning, Medicare, Medicaid, termination of benefits, skilled services, improvement standard, rights, nursing home, Veterans Benefits