tag:blogger.com,1999:blog-4366631956589788932024-03-13T22:02:10.751-07:00The Elder Firm, LLCDiscussion of Elder Law and Estate Planning and Missouri Medicaid eligibility.Nathan J. Forck, Attorney at Lawhttp://www.blogger.com/profile/06304074249483162612noreply@blogger.comBlogger67125tag:blogger.com,1999:blog-436663195658978893.post-53821435755959324182013-12-10T14:48:00.004-08:002013-12-10T14:51:58.809-08:00FROM ElderCareMatters.com “What long term care benefits does the VA pay for?”<br />
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<span style="font-size: small;"><strong style="border: 0px; line-height: 1.714285714; margin: 0px; padding: 0px; vertical-align: baseline;">Question: </strong><span style="line-height: 1.714285714;">What long term care benefits does the VA pay for?</span></span></h1>
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<strong style="border: 0px; margin: 0px; padding: 0px; vertical-align: baseline;">Answer: </strong>The VA has a benefit called the Veteran’s Improved Pension, commonly known as the VA Aid & Attendance Benefit. In order to qualify for the Veteran’s Pension Benefit, the veteran must not have been dishonorably discharged, must have served at least 90 days active duty with at least one day served during a declared state of war, and must be either disabled or over age 65. Widows of veterans may also qualify. Applicants must meet certain income and asset limitations to qualify, and they must need assistance with Activities of Daily Living (ADLs) such as eating, bathing, and dressing. This benefit can help married veterans may qualify for up to $24,239 of tax free assistance annually. This money can be used to cover the costs of care in the home, in an assisted living community, or in a nursing home. </div>
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If you think that you or a loved one might qualify for benefits, the next step would be to enlist the service and advice of an experienced Veterans Administration Accredited attorney who understands the Pension Benefit, as well as Medicaid planning rules and other estate planning issues. Advisors such as a VA accredited attorney and a knowledgeable, experienced financial planner can help veteran households rearrange assets, make legally effective transfers, and assist with other estate planning needs in order to qualify a veteran household for a pension benefit. It is extremely important that you involve an attorney who has experience with Medicaid planning if you plan on moving or otherwise rearranging assets in order to qualify for the Veteran’s Pension Benefit. There is a high probability that the veteran, the spouse, or the surviving spouse of a veteran household may need nursing home care in the future. Such care is very expensive and the individual’s income plus the veterans benefit rarely pay for the cost of a nursing home. This means the veteran may have to rely on Medicaid to cover the deficit. Assets reallocated to qualify for VA benefits could create penalties for Medicaid eligibility, underscoring the importance of planning for the possibility of having to apply for Medicaid in the future. </div>
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In addition to the Aid and Attendance Benefit, the VA in its various facilities around the country will provide nursing home care the qualifying veterans. However, the number of beds are very limited. The VA provides service-connected disability ratings that range from 10% to 100%. Those veterans who are 100% disabled because of the service-connected injury or illness will receive priority for admission with priority moving down the rating scale. In addition to the beds available in VA operated facilities in some states the VA has contracted with other nursing homes to make beds available to qualifying veterans.</div>
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To find Elder Care Professionals near you who can help you with these elder care matters, go to: <a href="http://www.eldercarematters.com/" style="border: 0px; color: #9f9f9f; font-weight: bold; margin: 0px; outline: none; padding: 0px; text-decoration: none; vertical-align: baseline;" title="America's National Directory of Elder Care / Senior Care Resources for Families">ElderCareMatters.com </a>- America’s National Directory of Elder Care / Senior Care Resources for Families.</div>
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<a href="http://www.eldercarematters.com/eldercareanswers/wp-content/uploads/2013/09/hweatherby2.gif" style="border: 0px; color: #9f9f9f; font-weight: bold; margin: 0px; outline: none; padding: 0px; text-decoration: none; vertical-align: baseline;"><img alt="hweatherby" class="alignnone size-full wp-image-2977" height="140" src="http://www.eldercarematters.com/eldercareanswers/wp-content/uploads/2013/09/hweatherby2.gif" style="border-bottom-left-radius: 3px; border-bottom-right-radius: 3px; border-top-left-radius: 3px; border-top-right-radius: 3px; border: 0px; box-shadow: rgba(0, 0, 0, 0.2) 0px 1px 4px; height: auto; margin: 0px; max-width: 100%; padding: 0px; vertical-align: baseline;" width="140" /></a><br />
Henry C. Weatherby, Esq., CLU, ChFC, CEBS<br />
Weatherby & Associates, PC<br />
<a href="http://www.eldercarematters.com/StateCoordinators.php" style="border: 0px; color: #9f9f9f; font-weight: bold; margin: 0px; outline: none; padding: 0px; text-decoration: none; vertical-align: baseline;" title="Connecticut State Coordinator - ElderCareMatters.com">Connecticut State Coordinator – ElderCareMatters.com</a></div>
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<br />Nathan J. Forck, Attorney at Lawhttp://www.blogger.com/profile/06304074249483162612noreply@blogger.com1tag:blogger.com,1999:blog-436663195658978893.post-81214654360922818892013-09-17T08:51:00.002-07:002013-09-17T08:51:58.714-07:00Landmark Jimmo vs. Sebelius Settlement Helps Medicare Patients Receive Skilled Nursing Care<span class="userContent">No longer do individuals have to show
"improvement" for Medicare to pay for the cost of their skilled care
after hospitalization:</span><br />
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<a href="http://www.naela.org/Public/Library/Publications/Publications_Main/NAELA_Journal_Archive/NAELA_Journal_2013/NAELA_Journal_Fall_2013/Klein.aspx">LINK</a>Nathan J. Forck, Attorney at Lawhttp://www.blogger.com/profile/06304074249483162612noreply@blogger.com1tag:blogger.com,1999:blog-436663195658978893.post-1539644422745714522013-03-04T11:11:00.005-08:002013-03-04T11:12:05.278-08:00New Bottom Limit of MMMNA Announced<h1 class="heading">
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<span style="font-size: large;">The Department of Health and Human Services has announced the
new poverty income guidelines for 2013. The new guidelines mean that the
lower limit of the minimum monthly maintenance needs allowance (MMMNA)
will rise to <b>$1,938.75</b> in the 48 contiguous states and
the District of Columbia, effective no later than July 1, 2013. The
current amount is $1,891.25.</span><br />
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</span><span style="font-size: large;">The new figure will be <b>$2,422.50</b><span class="apple-converted-space"> </span>in Alaska and<span class="apple-converted-space"> </span><b>$2,231.25</b><span class="apple-converted-space"> </span>in Hawaii. The minimum MMMNA is 150 percent of the monthly poverty guideline for a couple.</span>Nathan J. Forck, Attorney at Lawhttp://www.blogger.com/profile/06304074249483162612noreply@blogger.com0tag:blogger.com,1999:blog-436663195658978893.post-26717998275689163832013-02-07T08:45:00.000-08:002013-02-07T08:48:40.683-08:00Do You Find Annuities Confusing? <br /><br /><span style="font-size: large;">FROM <a href="http://www.medicaidannuity.com/">www.medicaidannuity.com</a>:<br /><br />You're not alone. If you're not an insurance agent annuities can be confusing. I'm frequently asked questions regarding the difference of annuities, and how the difference kinds are treated for eligibility purposes. What purpose do they really serve? What kind is appropriate? How do you tell the difference between all the types? <br /><br /> </span><div>
<span style="font-size: large;"><b>Why Use an Annuity?</b><br /></span><span style="font-size: large;">The primary reason for using an annuity is to convert excess assets into an income stream. Thus, the problem assets, whether they consist of cash, checking and savings accounts, stocks, bonds, mutual funds, cash value life insurance, or an IRA, can be converted into an annuity, without jeopardizing eligibility. Additionally, using certain types of annuities can provide a safe investment vehicle when preplanning for Medicaid or gifting assets.</span><span style="font-size: large;"><br /><br /> </span></div>
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<span style="font-size: large;"><b>Immediate Annuities</b><br /></span><span style="font-size: large;">An immediate annuity is a financial contract that delivers regular payments from an insurance company to the payee that begins soon after the signing of the contract - there is no accumulation period. For Medicaid purposes, if the immediate annuity meets certain restrictions outlined in the Deficit Reduction Act of 2005, it is considered income only. For Veterans Benefits purposes, an immediate annuity is considered income only regardless of its provisions.</span><span style="font-size: large;"><br /><br /> </span></div>
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<span style="font-size: large;"><b>Tax-Deferred Annuities</b><br /><br />A tax-deferred annuity is an investment with an insurance company which continues to grow until the owner makes a complete withdrawal or annuitizes the contract. Established under § 403(b) of the Internal Revenue Code, tax-deferred annuity owners have the opportunity to accumulate funds on a tax-deferred basis. Contributions and the investment returns can grow quickly in that taxes are deferred until the owner receives the funds. For Medicaid and Veterans Benefits purposes, a tax-deferred annuity is a countable asset, which becomes part of the applicant or spouse's net worth. Tax-deferred annuities are primarily used as investment vehicles in preplanning for Medicaid, or in gifting assets.<br /><br /><br />Copyright ©2013 <a href="http://www.medicaidannuity.com/Blog/tabid/76/entryid/207/Do-You-Find-Annuities-Confusing.aspx">Krause Financial Services</a></span></div>
Nathan J. Forck, Attorney at Lawhttp://www.blogger.com/profile/06304074249483162612noreply@blogger.com3tag:blogger.com,1999:blog-436663195658978893.post-43282361172712482052013-01-09T14:12:00.004-08:002013-01-09T14:12:53.732-08:00Beautiful...<span style="font-size: large;"><span style="background-color: white; font-family: 'lucida grande', tahoma, verdana, arial, sans-serif; line-height: 20px;">My dear girl, the day you see I'm getting old, I ask you to please be patient, but most of all, try to understand what I'm going through. If when we talk, I repeat the same thing a thousand times, don't interrupt to say: "You said the same thing a minute ago"... Just listen, please. Try to remember the times when you were little and I would read the same story night after night until you would fall asleep.</span><br style="background-color: white; font-family: 'lucida grande', tahoma, verdana, arial, sans-serif; line-height: 20px;" /><br style="background-color: white; font-family: 'lucida grande', tahoma, verdana, arial, sans-serif; line-height: 20px;" /><span style="background-color: white; font-family: 'lucida grande', tahoma, verdana, arial, sans-serif; line-height: 20px;">When I don't want to take a bath, don't be mad and don't embarrass me</span><span class="text_exposed_show" style="background-color: white; display: inline; font-family: 'lucida grande', tahoma, verdana, arial, sans-serif; line-height: 20px;">. Remember when I had to run after you making excuses and trying to get you to take a shower when you were just a girl?<br /><br />When you see how ignorant I am when it comes to new technology, give me the time to learn and don't look at me that way ... remember, honey, I patiently taught you how to do many things like eating appropriately, getting dressed, combing your hair and dealing with life's issues every day... the day you see I'm getting old, I ask you to please be patient, but most of all, try to understand what I'm going through.<br /><br />If I occasionally lose track of what we're talking about, give me the time to remember, and if I can't, don't be nervous, impatient or arrogant. Just know in your heart that the most important thing for me is to be with you.<br /><br />And when my old, tired legs don't let me move as quickly as before, give me your hand the same way that I offered mine to you when you first walked. When those days come, don't feel sad... just be with me, and understand me while I get to the end of my life with love. I'll cherish and thank you for the gift of time and joy we shared. With a big smile and the huge love I've always had for you, I just want to say, I love you ... my darling daughter.<br /><br />Original text in Spanish and photo by Guillermo Peña.<br />Translation to English by Sergio Cadena</span></span>Nathan J. Forck, Attorney at Lawhttp://www.blogger.com/profile/06304074249483162612noreply@blogger.com1tag:blogger.com,1999:blog-436663195658978893.post-91000238313808255722012-12-12T11:07:00.000-08:002012-12-12T11:07:23.073-08:00New VA Pension Rates for 2013<span style="font-size: large;">From Krause Financial (www.medicaidannuity.com): LINK is at the end of post.</span><br />
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<span style="background-color: white; font-size: large;"><strong>For the Veteran</strong></span></div>
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<span style="background-color: white;"><span style="font-size: large;">Service Pension $1,037<br />One Dependent $1,359</span></span></div>
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<span style="background-color: white;"><span style="font-size: large;">Housebound $1,259<br />One Dependent $1,570</span></span></div>
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<span style="background-color: white;"><span style="font-size: large;">Aid and Attendance $1,731<br />One Dependent $2,053</span></span></div>
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<strong><span style="background-color: white; font-size: large;">For the Surviving Spouse</span></strong></div>
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<span style="background-color: white;"><span style="font-size: large;">Death Pension $695<br />One Dependent $911</span></span></div>
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<span style="background-color: white;"><span style="font-size: large;">Housebound $851<br />One Dependent $1,110</span></span></div>
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<span style="background-color: white;"><span style="font-size: large;">Aid and Attendance $1,112<br />One Dependent $1,327</span></span></div>
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<span style="font-size: large;"><a href="http://www.medicaidannuity.com/Blog/tabid/76/entryid/203/New-VA-Pension-Rates-for-2013.aspx">LINK</a></span></div>
Nathan J. Forck, Attorney at Lawhttp://www.blogger.com/profile/06304074249483162612noreply@blogger.com0tag:blogger.com,1999:blog-436663195658978893.post-75917044121537790922012-12-12T10:57:00.000-08:002012-12-12T10:57:25.548-08:00"I Have to Make Medicaid a Beneficiary?!"<span style="font-size: large;"><u>From Krause Financial (www.medicaidannuity.com)</u></span><u style="font-size: x-large;">: Link at end of article...</u><br />
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<span style="background-color: white;"><span style="font-size: large;">"Then what's the point of using a Medicaid Compliant Annuity?" I hear this quite often, in both working with newer elder law attorneys and families of the elderly. With the state Medicaid agency required to be a beneficiary, then doesn't it make the purchase moot?</span></span></div>
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<span style="background-color: white;"><span style="font-size: large;">Not necessarily. Consider these three common planning scenarios:</span></span></div>
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<span style="background-color: white;"><span style="font-size: large;">1: Individual Gifting Scenario.</span></span></h3>
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<span style="background-color: white;"><span style="font-size: large;">An individual makes a gift and purchases a Medicaid Compliant Annuity. The Medicaid Compliant Annuity is structured to provide income throughout the divestment penalty period associated to the gift. Designating the state Medicaid agency is one of the requirements for the purchase of the Medicaid Compliant Annuity not to be deemed a transfer for less than fair market value. However, in the event the individual predeceases the Medicaid Compliant Annuity, the Medicaid agency would not be entitled to any of the residual benefits remaining in that the agency did not provide any medical assistance benefits to the individual due to the divestment penalty period. As such, the individual's intended beneficiaries would be entitled to receive any residual benefits remaining in the Medicaid Compliant Annuity.</span></span></div>
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<span style="background-color: white;"><span style="font-size: large;">2: Individual with a Diminished Longevity.</span></span></h3>
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<span style="background-color: white;"><span style="font-size: large;">In a case where an individual has a very short life expectancy a stand-alone Medicaid Compliant Annuity may provide a greater advantage than a gifting plan (aka a half-a-loaf plan). By purchasing a Medicaid Compliant Annuity over the individual's life expectancy, he or she is immediately eligible for Medicaid benefits. The Medicaid Compliant Annuity payout becomes the applicant's Medicaid copay. <em>This type of planning is traditionally only advised if the applicant is expected to life for 12 months or less.</em> When the individual predeceases the Medicaid compliant Annuity, the state Medicaid agency is entitled to recover from the residual benefits <em>up to the amount of Medicaid paid on behalf of the applicant. </em> If the individual passes shortly after the annuity has commenced, the state's claim amount will be very small, leading to a greater remainder amount for intended heirs. But why even proceed with the annuity? Why not just continue to privately pay until the individual passes? Because the state's claim amount will be at the Medicaid rate, not the private pay rate. Even after repaying the state Medicaid agency, the family will have paid less than had they done zero planning at all.</span></span></div>
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<span style="background-color: white;"><span style="font-size: large;">3: Spousal Medicaid Compliant Annuity Planning.</span></span></h3>
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<span style="background-color: white;"><span style="font-size: large;">In a traditional community spouse case, funds in excess of the community spouse resource allowance will be structured in a Medicaid Compliant Annuity owned by the community spouse. The community spouse is usually entitled to keep all income, regardless of the amount. However, the community spouse is also usually required to designate the state Medicaid agency as a beneficiary <em>up to the amount of Medicaid benefits paid on behalf of the institutionalized spouse.</em> In light of this, should the community spouse predecease the Medicaid Compliant Annuity the state Medicaid agency is able to reocver what has been paid on behalf of the institutionalized spouse, leaving very little to potentially be transferred to intended heirs. Due to this fact, more and more community spouse Medicaid Compliant Annuities are seeing shorter terms, dependent on the anticipated longevity of the community spouse.</span></span></div>
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<span style="background-color: white;"><span style="font-size: large;">As you can see, in most cases it is not a "lost cause" to utilize a Medicaid Compliant Annuity, even though the state Medicaid agency does need to be designated as a beneficiary. </span></span></div>
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<span style="font-size: large;"><a href="http://www.medicaidannuity.com/Blog/tabid/76/entryid/202/I-Have-to-Make-Medicaid-a-Beneficiary.aspx">LINK</a></span></div>
Nathan J. Forck, Attorney at Lawhttp://www.blogger.com/profile/06304074249483162612noreply@blogger.com0tag:blogger.com,1999:blog-436663195658978893.post-26119959852712805842012-12-03T12:33:00.001-08:002012-12-03T12:35:17.581-08:00Spousal Impoverishment Standards from Elderlawanswers.com<br />
<span style="font-size: large;">The Centers for Medicare and Medicaid Services has released its Spousal Impoverishment Standards for 2013 and they confirm the earlier projections of Pennsylvania ElderLawAnswers member Jeff Marshall, who based his estimates on the consumer price index for urban consumers for September and which we reported in October. </span><br />
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<span style="font-size: large;">For the record, the official spousal impoverishment allowances for 2013 are as follows (we include Medicaid's home equity limits, which Mr. Marshall did not project):</span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">Minimum Community Spouse Resource Allowance: $23,184</span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">Maximum Community Spouse Resource Allowance: $115,920</span><br />
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<span style="font-size: large;">Maximum Monthly Maintenance Needs Allowance: $2,898</span><br />
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<span style="font-size: large;">The minimum monthly maintenance needs allowance for the lower 48 states remains $1,891.25 (2,365 for Alaska and 2,176.25 for Hawaii) until July 1, 2013.</span><br />
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<span style="font-size: large;">Home Equity Limits:</span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">Minimum: 536,000</span><br />
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<span style="font-size: large;">Maximum: 802,000</span><br />
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<a href="http://attorney.elderlawanswers.com/official-2013-spousal-impoverishment-and-home-equity-figures-released--10086"><span style="font-size: large;">LINK</span></a>Nathan J. Forck, Attorney at Lawhttp://www.blogger.com/profile/06304074249483162612noreply@blogger.com0tag:blogger.com,1999:blog-436663195658978893.post-82448161447201860612012-11-30T09:49:00.001-08:002012-11-30T09:49:52.942-08:00Does Government Want To Drain Americans' 401(k) Plan? <span style="font-size: large;">From Investors Business Daily:</span><br />
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<span style="font-size: large;">What could go wrong?</span><br />
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<a href="http://news.investors.com/ibd-editorials/112812-634984-401k-on-the-table-for-fiscal-cliff.htm"><span style="font-size: large;">LINK</span></a>Nathan J. Forck, Attorney at Lawhttp://www.blogger.com/profile/06304074249483162612noreply@blogger.com0tag:blogger.com,1999:blog-436663195658978893.post-35094199903552978262012-10-17T11:17:00.002-07:002012-10-17T11:18:39.243-07:00Another WIN for Medicaid-compliant Annuities!<br />
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<span style="background-color: white;">(From medicaidannuity.com</span><span style="background-color: white;">) "</span><span style="background-color: white;">John Lopes was married, residing in a nursing home, and in need of assistance. Amelia Lopes, John's spouse residing in the community, purchased a Medicaid Compliant Annuity, and shortly thereafter made a Medicaid application on behalf of her husband. The Connecticut Department of Social Services denied the application after determining that the payment stream Amelia was receiving was a resource that rendered John ineligible for Medicaid.</span></div>
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<span style="background-color: white;">The matter progressed to the United States District Court for the District of Connecticut, under the argument that the payment stream was income that did not count against John's eligibility in light of the annuity being non-assignable. The district court granted summary judgment to the Lopeses, and Connecticut appealed.</span></div>
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<span style="background-color: white;">The U.S. Court of Appeals for the Second Circuit upheld the district court ruling that the income stream from a Medicaid Compliant Annuity cannot be considered an available asset for the purposes of Medicaid eligibility. <em>Lopes v. Dept. of Social Services (2nd Cir., No. 10-3741-cv, Oct. 2, 2012).</em> The court further ruled that it was irrelevant that the Medicaid Compliant Annuity was purchased just prior to John's Medicaid application. Thankfully the U.S. Department of Health and Human Services lent their opinion in this case, affirming that the Lopeses position was consistent with Medicaid's primary purpose of providing healthcare to the indigent and protecting community spouses from impoverishment."</span></div>
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<a href="http://www.medicaidannuity.com/Blog/tabid/76/entryid/197/Lopes-v-Dept-of-Social-Services-Another-Win.aspx">LINK</a></div>
Nathan J. Forck, Attorney at Lawhttp://www.blogger.com/profile/06304074249483162612noreply@blogger.com0tag:blogger.com,1999:blog-436663195658978893.post-11869984790363298792012-10-17T10:59:00.003-07:002012-10-17T11:00:51.853-07:00Federal retirement COLA of 1.7 percent announced (Washington Post)<br />
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"Federal retirees will receive an inflation adjustment of 1.7 percent in January, translating to about a $50 increase in the average monthly payment under the annuity program for most of them.</div>
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The increase, based on an inflation measure announced Tuesday, mirrors the cost-of-living adjustment (COLA) <a data-xslt="_http" href="http://www.washingtonpost.com/business/social-security-announces-monthly-benefit-increase-tuesday-morning-expect-it-to-be-small/2012/10/16/b705cd5c-1764-11e2-a346-f24efc680b8d_story.html?hpid=z4" style="color: #0c4790;" target="_blank">to be paid</a> to Social Security beneficiaries."</div>
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<a href="http://www.washingtonpost.com/blogs/federal-eye/post/federal-retirement-cola-of-17-percent-announced/2012/10/16/03cb656e-1794-11e2-9855-71f2b202721b_blog.html">LINK</a>Nathan J. Forck, Attorney at Lawhttp://www.blogger.com/profile/06304074249483162612noreply@blogger.com0tag:blogger.com,1999:blog-436663195658978893.post-70117360762539936372012-10-05T09:50:00.000-07:002012-10-05T09:50:09.865-07:00(Forbes.com) Medicaid Expansion under the Affordable Care Act: What happens when states refuse to enlarge this coverage to its residents?<br />
<a href="http://i.forbesimg.com/assets/img/forbes_logo/forbes_logo_white.svg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="50" src="http://i.forbesimg.com/assets/img/forbes_logo/forbes_logo_white.svg" width="200" /></a><br />
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<span style="font-size: large;">I get a lot of questions about how the ACA or "Obamacare" will effect Medicaid benefits for my elderly clients. Theoretically, it should have no effect on them since the ACA primarily expands Medicaid to persons under the age of 65 and doesn't do anything to specifically reduce the amount of benefits currently available to seniors. It is almost impossible to address this issue without addressing the politics, but I think <a href="http://www.forbes.com/sites/bernardkrooks/2012/07/10/medicaid-expansion-under-the-affordable-care-act-what-happens-when-states-refuse-to-enlarge-this-coverage-to-its-residents/">this article from forbes.com</a> does a pretty good job laying out the basics of the ACA's effect on Medicaid.</span><br />
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<br />Nathan J. Forck, Attorney at Lawhttp://www.blogger.com/profile/06304074249483162612noreply@blogger.com1tag:blogger.com,1999:blog-436663195658978893.post-62338820599795903102012-09-05T13:59:00.000-07:002012-09-05T14:02:32.981-07:00Heartwarming Story of Two Princesses<div class="separator" style="clear: both; text-align: left;">
<span style="background-color: white; font-family: 'century gothic', 'Bitstream Charter', serif; font-size: 16px; line-height: 24px;">From positivemed.com: </span></div>
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<span style="background-color: white; font-family: 'century gothic', 'Bitstream Charter', serif; font-size: 16px; line-height: 24px;">6-year-old Diamond Marshall, who was diagnosed with stage 4 cancer last year and lost her mother to the disease when she was 18-months-old, <a href="http://positivemed.com/2012/09/04/diamond-kate/">met Kate Middleton in Calgary with help from the Children’s Wish Foundation after she wrote this letter</a>:</span><span style="background-color: white; font-family: 'century gothic', 'Bitstream Charter', serif; font-size: 16px; line-height: 24px;"> </span></div>
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<br />Nathan J. Forck, Attorney at Lawhttp://www.blogger.com/profile/06304074249483162612noreply@blogger.com0tag:blogger.com,1999:blog-436663195658978893.post-85193489908990612162012-09-05T12:00:00.000-07:002012-09-05T12:00:44.360-07:00NY Times Article: "For Veterans, an Alternative to the Nursing Home"<div class="separator" style="clear: both; text-align: center;">
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Paulia and Bienne Bastia set two dinner tables in their house in Mount Airy, Pa., each night, one for their three children, and another for themselves and the two older men the children call “Grampa.”</div>
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The Army veterans Booker Lovett, 79, and Wesley Ottis Furr, 95, are not related to the Bastias or to each other, but this has been their home since late winter. They’re participants in the <a href="http://www.va.gov/GERIATRICS/Guide/LongTermCare/Medical_Foster_Homes.asp" style="color: #666699;">Department of Veterans Affairs Medical Foster Home</a> program, which places veterans who need round-the-clock care in private homes.</div>
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Mr. Lovett, who previously lived with his sister in Philadelphia, had a stroke — he still has trouble speaking — and has glaucoma. Mr. Furr, who maintained his own Philadelphia home, remains talkative and agile despite his age.</div>
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The Bastia children, ages 5, 6, and 7, consider the veterans family. Mr. Bastia thinks of them as father figures — he calls each “my king.”</div>
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“I felt at home as soon as I come here,” Mr. Furr said.</div>
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Mrs. Bastia, 36, a certified nursing assistant, and Mr. Bastia, 45, owner of a tax preparation business, drive the men to appointments, serve meals tailored to their dietary needs and administer medications. The Bastias can communicate with a nurse through a V.A.-provided telehealth monitor equipped with a video camera, blood pressure cuff and other equipment.</div>
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On a recent afternoon, Mrs. Bastia fastened the cuff on Mr. Furr’s thin arm while a nurse at the Philadelphia V.A. Medical Center 13 miles away observed. “Thank you, your blood pressure reading has been accepted,” said an automated voice from the monitor.</div>
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Medical foster homes provide an alternative to nursing homes for veterans who are unable to live safely and independently at home or lack a strong family caregiver. Conceived in 2000 by V.A. social workers in Little Rock, Ark., the program currently serves 535 veterans; it has cared for 1,468 since it began.</div>
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Though the veterans range in age from 23 to 101, their average age is 70. About half have some form of dementia. They often stay until they die, an average of 459 days.</div>
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“I know a lot of people suffering,” Mrs. Bastia said, explaining why she decided to participate. “I used to work in nursing homes. I know how it’s like when you get 14, 16 people to take care of. You don’t have time to do what you’re supposed to do. I figure out, if I take them to my house they can get more care.”</div>
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Now operating through 73 V.A. sites in 36 states, the medical foster homes program is scheduled to expand to 10 more states within two years. Eventually, the V.A. hopes to introduce the program to all 153 of the agency’s medical centers, said Dan Goedken, national program analyst.</div>
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It costs a site about $260,000 a year to introduce the program; each site can serve up to 30 vets. The V.A. finances each place for two years, after which the program is expected to be self-sustaining, said Dr. Thomas Edes, national director of geriatrics and extended care operations at the V.A.</div>
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Though medical foster homes are intended to provide better care, not to reduce costs, they operate for half the cost of nursing homes. “It is quite likely that it will save V.A. money and taxpayer money and veterans’ money,” Dr. Edes said.</div>
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The Bastias, who met in Florida after emigrating from Haiti, went through months of interviews and background checks to qualify as caregivers. A social worker, a nurse, a dietitian and a fire-safety expert inspected their two-story home on a quiet suburban street, and it will be reinspected annually.</div>
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Given the vulnerability of the older veteran population, the V.A. approval process is rigorous. Only one in 10 to 15 applicants are selected. People with no formal training can apply, however, and many with family caregiving experience do. Once a veteran is placed in a home, the V.A. provides training for tasks like cleaning wounds, managing incontinence and safely transporting the new residents.</div>
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And it provides periodic respite for caregivers. “It really is 24/7 care,” Mr. Goedken said. “This is a fairly intensive expectation on our part on what they’re going to do. Some willingly back away.”</div>
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Veterans pay $1,800 to $3,000 a month for care, depending on their medical needs, often using their combined V.A. and Social Security benefits. Mr. Furr and Mr. Lovett each pay the Bastias $2,000 a month for their shared bedroom and their care. The couple has another room available and is awaiting a third veteran, the maximum allowed.</div>
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A national V.A. study measuring veterans’ satisfaction and costs won’t be completed until 2013 and 2015. But 30 percent of veterans who would qualify for V.A.-paid nursing homes choose instead to pay out of pocket for medical foster homes — evidence, Dr. Edes said, that they prefer a home setting.</div>
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Even with dementia or mental illness, “they recognize this as their home. It’s very familiar,” he said. “They’re given a lot of autonomy. And it’s very one-on-one attention.”</div>
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Mr. Furr and Mr. Lovett get along well in their dorm-style room, with its twin beds and flat screen television. They take turns — Mr. Furr watches the news, while Mr. Lovett prefers football. One is a Democrat and the other a Republican, so they keep political talk to a minimum. Members of Mr. Furr’s congregation drive him to and from his Methodist church twice a week, and he often takes walks. He recently surprised his roommate, who prefers napping and relaxing at home, with a box of Lorna Doone cookies.</div>
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<span data-num="1" style="background-color: #f2f4f5;">“I don’t expect him to be like me, and I can’t be like him,” Mr. Furr said.</span> <span data-num="2" style="background-color: #f2f4f5;">“So, I accept him as he is and he accepts me as I am.</span> <span data-num="3" style="background-color: #f2f4f5;">It’s a good deal.”</span></div>
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<span style="color: purple; font-size: large;"><a href="http://newoldage.blogs.nytimes.com/2012/07/18/for-veterans-an-alternative-to-the-nursing-home/">LINK TO NY TIMES ARTICLE</a></span>Nathan J. Forck, Attorney at Lawhttp://www.blogger.com/profile/06304074249483162612noreply@blogger.com1tag:blogger.com,1999:blog-436663195658978893.post-46922798945237413122012-09-05T10:41:00.000-07:002012-09-05T10:41:04.634-07:00The 13 Most Frequent Medicaid Mistakes for Nursing Home Care<div class="tr_bq">
<span style="font-size: large;">I wish I had written this! What a great article that exposes many of the myths surrounding Medicaid planning and Medicaid eligibility. Although it is written by a Florida Elder Law attorney (<a href="http://www.thecolemanlawfirm.net/Attorneys.php#"><span style="color: blue;">C. Randolph Coleman</span></a>), almost everything that is mentioned in the article could apply to Missouri (or other state's) residents as well. </span> </div>
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<blockquote>
<a href="http://images.quickblogcast.com/9/7/1/3/1/121215-113179/RandyColeman_Picture_150.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="200" src="http://images.quickblogcast.com/9/7/1/3/1/121215-113179/RandyColeman_Picture_150.jpg" width="133" /></a><span style="background-color: white;"><span style="font-family: verdana;">As our population grows older, more and more families will face the need for long term care for their loved ones. The cost of a skilled nursing home care in Florida averages about $7,000 to $8,000 per month. That number increases each year.</span></span> </blockquote>
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<span style="background-color: white;"><span style="font-family: verdana;"><span style="font-family: verdana;">Medicare does not cover the cost of skilled nursing home care (except for rehabilitation usually with a limit of 100 days of coverage). Beyond that limited coverage, the family must pay the full cost of skilled nursing home care.</span></span></span></blockquote>
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<span style="background-color: white;"><span style="font-family: verdana;">Most <a href="http://www.genworth.com/content/non_navigable/corporate/about_genworth/industry_expertise/cost_of_care.html" target="_blank">studies suggest</a> that the average family will exhaust the family's life savings within the first year of skilled nursing home care! Without long term care insurance, practically all nursing home residents will eventually end up needing Medicaid to pay for the nursing home care.</span></span></blockquote>
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<span style="background-color: white;"><span style="font-family: verdana;">When faced with the reality of the cost of nursing home care, and the almost certain eventual need for Medicaid eligibility to pay for the nursing home, most families engage in actions that can result in loss of eligibility for Medicaid benefits, or a long penalty period in which Medicaid benefits are not available to cover the costs of the nursing home care.</span></span></blockquote>
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<span style="background-color: white;"><span style="font-family: verdana;">In an effort to help families avoid costly mistakes, that can cause them to lose their life savings unnecessarily, we have compiled this list of 13 most frequest mistakes that families make when a loved one enters a nursing home.</span></span></blockquote>
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<span style="background-color: white;"><span style="font-family: verdana;"><br /></span><span style="font-family: verdana;"><strong>1. Failure to Take Advantage of the Avalable Spend-Down Options.</strong></span><span style="font-family: verdana;"><br /></span><span style="font-family: verdana;">Many families assume when they are told the family must <a href="http://www.thecolemanlawfirm.net/Medicaid_Planning_Attorneys.php" target="_blank">"spend-down"</a> the family's assets to qualify for Medicaid benefits to pay for nursing home care, that the spend-down must be paid to the nursing home. The fact is, there are more than a dozen strategies that can be used to meet the Medicaid requirement for spend-down, without spending the money on nursing home care. These strategies allow you to protect your assets from Medicaid and the cost of nursing home care.</span></span></blockquote>
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<span style="background-color: white;"><span style="font-family: verdana;"><br /></span><span style="font-family: verdana;"><strong>2. Transferring Assets to Other Family Members or Friends Without a Plan.</strong></span><span style="font-family: verdana;"><br /></span><span style="font-family: verdana;">Probably the most common reaction to the realization that you must spend-down your assets to qualify for Medicaid nursing home benefits is to gift the assets to other family members or friends. There are Medicaid rules and regulations that create negative consequences, sometimes severe, when gifts of assets are made in contemplation of applying for Medicaid benefits for nursing home care. These same Medicaid rules, however, when used properly, can result in the protection of substantial assets for the family. You must understand how to use those rules and regulations to make them work in your favor.</span></span></blockquote>
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<span style="background-color: white;"><span style="font-family: verdana;"><br /></span><span style="font-family: verdana;"><strong>3. Assuming Your Existing Annuity Provides Asset Protection from Medicaid Spend-down.</strong></span><span style="font-family: verdana;"><br /></span><span style="font-family: verdana;">Prior to the passage of the Deficit Reduction Act of 2005 (which became effective in 2006, "DRA"), annuities were widely used as effective planning to preserve assets from Medicaid spend-down. The <a href="http://www.seniorlaw.com/dra2005.htm" target="_blank">rules changed dramatically with the DRA</a>. Most all of the annuities that were effective prior to the DRA no longer provide asset protection. There are a few annuities that are "DRA Compliant" that can be purchased in today's market. These DRA compliant annuities can provide significant asset protection. If an annuity is not DRA compliant, it is not likely to provide any meaningful protection.</span><span style="font-family: verdana;"><br /></span><span style="font-family: verdana;"><ins style="border: none; display: inline-table; height: 60px; margin: 0px; padding: 0px; position: relative; visibility: visible; width: 468px;"><ins id="aswift_0_anchor" style="border: none; display: block; height: 60px; margin: 0px; padding: 0px; position: relative; visibility: visible; width: 468px;"><iframe allowtransparency="true" frameborder="0" height="60" hspace="0" id="aswift_0" marginheight="0" marginwidth="0" name="aswift_0" scrolling="no" style="left: 0px; position: absolute; top: 0px;" vspace="0" width="468"></iframe></ins></ins></span><span style="font-family: verdana;"><br /></span><span style="font-family: verdana;"><strong>4. Having No Plan or Procrastinating Too Long to Take Action.</strong></span><span style="font-family: verdana;"><br /></span><span style="font-family: verdana;">This year hundreds of millions of dollars will be lost to <a href="http://www.genworth.com/content/etc/medialib/genworth_v2/pdf/ltc_cost_of_care.Par.85518.File.dat/Executive%20Summary_gnw.pdf" target="_blank">nursing homes or other long term care providers </a>because families failed to take any action. Often this is a result of the family assuming, wrongly, that after the loved one is in the nursing home there is nothing that can be done. In almost all cases, most of the family's assets could have been saved for the spouse living at home, or other family members, if action had been taken immediately after the family member enters the nursing home. The reality is, the longer you wait to take action, the more money will be lost to the nursing home that could have been protected from the Medicaid spend-down.</span></span></blockquote>
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<span style="background-color: white;"><span style="font-family: verdana;"><br /></span><span style="font-family: verdana;"><strong>5. Trying to Hide Assets from Medicaid.</strong></span><span style="font-family: verdana;"><strong><br /></strong></span><span style="font-family: verdana;">Sometimes families try to hide assets from Medicaid. Sometimes they conveniently "forget" about some assets. How will Medicaid know about the family farm or vacation home in another state? Or, the coin collection in the safe deposit box? The reality is that Medicaid has access to all the real property records in the US, as well as access to the most sophisticated asset databases. Be aware that failure to disclose known assets is a federal crime (<a href="http://www.leg.state.fl.us/Statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=0400-0499/0409/Sections/0409.9201.html" target="_blank">Medicaid fraud</a>), conviction of which can result in signficant monetary fines and prison terms. Medicaid can also pursue legal action to recover the cost of the benefits paid to someone who procures Medicaid benefits through fraud. Do not ever seek to hide or otherwise perpetuate Medicaid fraud. There are legitimate and legal options that allow protection of signfiicant assets without violating the law.</span></span></blockquote>
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<span style="background-color: white;"><span style="font-family: verdana;"><br /></span><span style="font-family: verdana;"><strong>6. Taking the Advice of the Medicaid Case Worker.</strong></span><span style="font-family: verdana;"><br /></span><span style="font-family: verdana;">The Medicaid case worker, employed by the <a href="http://www.dcf.state.fl.us/programs/access/docs/ssifactsheet.pdf" target="_blank">Department of Children and Families</a> in Florida, has no interest in helping you preserve your family's assets from spending down those assets on long term care. In fact, the Medicaid case worker's responsibility is to process and evaluate whether you are eligible for Medicaid benefits to pay for nursing home care. The Medicaid case worker is not allowed to give financial or legal advice. To protect your family's assets as much as you legally can you need your own advocate - one who is looking after your best interests. The Medicaid case worker is not that person.</span></span></blockquote>
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<span style="background-color: white;"><span style="font-family: verdana;"><strong>7. Relying on Advice from Friends and Neighbors.</strong></span><span style="font-family: verdana;"><br /></span><span style="font-family: verdana;">It is appalling how many people rely on their neighbors, hair stylist, insurance agent, or others who are not Medicaid professionals for Medicaid advice. Even more appalling is relying on information from friends and relatives who live in other states. The Medicaid rules and regulations have been referred to as the most complex laws in the country, second only to the Internal Revenue Code (tax law). To further complicate this area of the law, Medicaid is a federal program that is administered by the various states. Each state is free to establish its own rules and regulations, within certain parameters. The law is implemented differently by each state. What applies in New York, or Pennsylvania, or New Jersey or Ohio, does not apply in Florida. So not only do you want to restrict your source of advice to a qualified Medicaid professional, but you want to restrict your counsel to those within the state in which you reside. For those who are familiar and experienced with the particular <a href="http://www.dcf.state.fl.us/programs/access/docs/ssifactsheet.pdf" target="_blank">state's rules and regulations</a>, Medicaid asset protection can be quite effective.</span></span></blockquote>
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<span style="background-color: white;"><span style="font-family: verdana;"><br /></span><span style="font-family: verdana;"><strong>8. Choosing the Wrong Attorney</strong></span><span style="font-family: verdana;"><br /></span><span style="font-family: verdana;">In most cases, the family is going to need an attorney to achieve the most favorable outcome for preserving the family's assets. There are legal documents that are often required, such as a qualified income trust. Attorneys, like all professionals in other disciplines, usually have a specific area of the law in which they are knowledgeable and experienced. To obtain the proper counsel and advice you will want to work with an experienced elder law attorney to deal with <a href="http://www.thecolemanlawfirm.net/Medicaid_Planning_Attorneys.php" target="_blank">Medicaid spend-down planning </a>for asset protection. You do not want to rely on the advice of a divorce attorney, personal injury attorney, real estate attorney, corporate attorney, or attorneys who practice in other disciplines. Probably less than 10 lawyers out of a 100 have experience in elder law and Medicaid asset protection planning. Of those 10, probably only 2 or 3 of them have substantial experience over a number of years. Your most effective Medicaid spend-down plan for nursing home care will likely come from one of the elder law attorneys with substantial experience.</span></span></blockquote>
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<span style="background-color: white;"><span style="font-family: verdana;"><br /></span><span style="font-family: verdana;"><strong>9. Making Transfers Without Authority</strong></span><span style="font-family: verdana;"><br /></span><span style="font-family: verdana;">Some families, in a desperate attempt to protect the assets of a family member who is no longer legally competent, will transfer assets without the property authority. For instance, we sometimes find that deeds have been signed by the legally incompetent senior, or assets have been transferred un the authority of a <a href="http://blog.thecolemanlawfirm.net/2012/06/06/why-do-i-need-a-new-power-of-attorney.aspx" target="">power of attorney</a> that does not include the authority to make the kinds of transfers involved. Such actions may be viewed as harmless (that's what Dad would have wanted) or convenient. However, those actions may actually be fraudulent, create title problems for future transfers of real property, or may be considered "<a href="http://www.leg.state.fl.us/Statutes/index.cfm?App_mode=Display_Statute&URL=0800-0899/0825/0825ContentsIndex.html&StatuteYear=2012&Title=%2D%3E2012%2D%3EChapter%20825" target="_blank">financial abuse of the elderly</a>" (which is a criminal act in Florida). Furthermore, such transfers may ultimately be challenged by Medicaid as uncompensated transfers that result in signficant penalty periods during which no Medicaid benefits can be received.</span></span></blockquote>
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<span style="background-color: white;"><span style="font-family: verdana;"><br /></span><span style="font-family: verdana;"><strong>10. Mistakenly Giving $13,000 (or $10,000) Won't Impact Medicaid Eligibility.</strong></span><span style="font-family: verdana;"><br /></span><span style="font-family: verdana;">The <a href="http://www.law.cornell.edu/uscode/text/26/2503" target="_blank">Internal Revenue Code</a> (tax code) currently allows an individual to transfer $13,000 (up from the original $10,000) to another person as a gift, without incurring any gift tax liability. For Medicaid eligibility purposes, the tax code doesn't matter. ANY gift or transfer of property, including cash, to another person within five years of the date your loved one applies for Medicaid benefits to pay for nursing home care, will result in a penalty period during which the nursing home resident will not be eligible to receive Medicaid benefits. In Medicaid planning, if you are going to make any gifts, make sure it is according to a specific plan and that you have properly evaluated the potential consequences of the gfit.</span></span></blockquote>
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<span style="background-color: white;"><span style="font-family: verdana;"><br /></span><span style="font-family: verdana;"><strong>11. Relying on a Revocable Living Trust to Protect Assets from Medicaid Spend-down.</strong></span><span style="font-family: verdana;"><br /></span><span style="font-family: verdana;">Many people have used revocable living trusts as their primary estate planning tool, in an effort to avoid probate. Many believe that the <a href="http://www.thecolemanlawfirm.net/Revocable_Living_Trusts.php" target="_blank">revocable living trust</a> provides some asset protection value for Medicaid spend-down plan purposes. Notwithstanding the benefits provided by revocable living trusts from the perspective of estate planning and probate avoidance, such a trust provides no asset protection - either from Medicaid spend-down planning, nor for any other purpose. Any and all assets titled to the revocable living trust will be considered available resources for purposes of Medicaid eligibility.</span></span></blockquote>
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<span style="background-color: white;"><span style="font-family: verdana;"><br /></span><span style="font-family: verdana;"><strong>12. Applying for Medicaid Too Early.</strong></span><span style="font-family: verdana;"><br /></span><span style="font-family: verdana;">Some families file the application for Medicaid eligibility for nursing home benefits for the sole purpose of determining whether they <a href="http://www.dcf.state.fl.us/programs/access/docs/ssi_fin_elig_chart.pdf" target="_blank">qualify for benefits</a>. The belief is the worst thing that can happen is that the application is declined. However, the Medicaid rules and regulations have many issues that could result in an application that is filed too early to cause substantial penalty periods during which Medicaid benefits cannot be received by the applicant. These penalty period can be for a longer time than the 5 year look back period. You should never file a Medicaid application unless you fully understand the possible consequences of the application being denied.</span></span></blockquote>
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<span style="background-color: white;"><span style="font-family: verdana;"><br /></span><span style="font-family: verdana;"><strong>13. Failure to Avoid Estate Recovery.</strong></span><span style="font-family: verdana;"><br /></span><span style="font-family: verdana;">Often someone can qualify for Medicaid benefits to pay for nursing home care and retain the ownership of some assets. Each state has the right to "<a href="http://www.leg.state.fl.us/Statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=0400-0499/0409/Sections/0409.9101.html" target="_blank">Medicaid Recovery</a>." Medicaid recovery is a procedure where the state can recover from the estate of the person receiving Medicaid benefits, after the person has died. The State can recover the value of the benefits paid on behalf of the deceased person. Most states can recover only from the "probate estate." Other states have defined the "estate" to include assets that are not included in the deceased person's probate estate. To effectively protect assets from Medicaid estate recovery, you must first understand what constitutes the "estate" for a particular estate, and then understand how you can title assets to avoid estate recovery for the specific state that is involved.</span></span></blockquote>
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<span style="background-color: white;"><span style="font-family: verdana;"><br /></span><span style="font-family: verdana;"><strong>Conclusion</strong></span><span style="font-family: verdana;"><br /></span><span style="font-family: verdana;">These 13 mistakes cost families millions upon millions of assets every year that are paid to nursing homes when those assets could be preserved for the spouse or other family members. If you have a loved one in a nursing home, or about to enter a nursing home, there are many actions you can legally take to avoid spending down the family's assets for nursing home care.</span><span style="font-family: verdana;"><br /></span><span style="font-family: verdana;">Our attorneys can help you protect your family's assets from the costs of nursing home care.</span></span></blockquote>
<a href="http://blog.thecolemanlawfirm.net/2012/08/26/the-13-most-frequent-medicaid-mistakes-for-nursing-home-care.aspx?ref=rss?results=1"><span style="color: red;">LINK</span></a>Nathan J. Forck, Attorney at Lawhttp://www.blogger.com/profile/06304074249483162612noreply@blogger.com2tag:blogger.com,1999:blog-436663195658978893.post-19129915759706368452012-08-24T07:44:00.000-07:002012-08-24T07:53:03.005-07:00MO Supreme Court Finds Cap on Non-Economic Damages Unconstitutional<span style="background-color: white; color: #333333; font-family: 'lucida grande', tahoma, verdana, arial, sans-serif; line-height: 18.88888931274414px;">How did I just now find out about this? Apparently, the Missouri Supreme Court overturned the statutory limit on non-economic damages ($350,000). I applaud the Court for retaking its Constitutional territory and not allowing the legislature to infringe on the right to a trial by jury.</span><br />
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<a href="http://www.courts.mo.gov/file.jsp?id=55761">LINK TO MO SUPREME COURT DECISION</a><br />
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<a href="http://www.news-leader.com/article/20120801/NEWS12/308010053/Missouri-Supreme-Court-liability-lawsuits-Springfield-Cox">Springfield News-Leader Article</a>Nathan J. Forck, Attorney at Lawhttp://www.blogger.com/profile/06304074249483162612noreply@blogger.com0tag:blogger.com,1999:blog-436663195658978893.post-23288865055030114202012-08-22T12:25:00.000-07:002012-08-22T12:25:03.332-07:00Medicaid Estate Recovery Could Reach Home Regardless of Which Spouse Owned It at Death (Idaho)<br />
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During their marriage, Martha executed a quitclaim deed putting her home into the names of her and her husband, George. Later, she executed a power of attorney with George as her agent. Using the power of attorney, George later transferred Martha’s remaining interest in the home to him solely. Martha then applied for and was approved for Medicaid benefits. Until her death, the Department provided in excess of $100,000 in benefits. George had predeceased Martha and the personal representative of the estate sold the home for just over $81,000. The Department filed a contingent claim with the probate court for the amounts of benefits paid. The Department claimed entitlement under I.C. § 56–218, which allowed recovery from “any property which, at any time, had been the community property of the decedent and decedent's spouse, or which had been the property of decedent's spouse.<br />Both the probate and appellate courts denied the claim, finding that I.C. § 56–218 limited recovery to property in which the recipient spouse had an interest at the time of death. Since Martha validly conveyed her interest in the home to George via the power of attorney before that time, there was no estate recovery. The Idaho Supreme Court reversed. The court noted that while 42 U.S.C. § 1396p(b)(1) expressly allowed recovery from only “the individual's estate, it also allowed states to expand the definition of ‘estate’ to include any other property in which the individual had any legal title or interest “at the time of death.” Idaho had adopted this more expansive definition of “estate.” The court noted that the definition of “estate” in 42 U.S.C. § 1396p(b)(4)(B) included the phrase “other arrangements,” while the definition of “assets,” in 42 U.S.C. § 1396(h)(1) plainly included the resources of the recipient's spouse, as well as assets the recipient disposed of before death. The federal definition of “resources” included the home for purposes of recovery. In light of the ambiguously inclusive nature of 42 U.S.C § 1396p(b)(4)(B) and the plain definition of “assets” in 42 U.S.C. § 1396(h)(1), the court could not find that federal law preempted States from providing for recovery of assets from both spouses' estates under I.C. § 56–218(1), including assets that were community property during the marriage. <br style="margin-left: 20px;" /><em><a href="http://naela.informz.net/z/cjUucD9taT0yNTc5ODI3JnA9MSZ1PTEwMjQxMDIzNDcmbGk9MTI5NTQyNDg/index.html" style="color: #1155cc;" target="_blank">Estate of Perry</a></em>, 2012 WL 3206771 (August 9, 2012)</blockquote>
<b>This is why it is important, at least in Missouri, to get your assets into a trust! Missouri's Medicaid program has NOT expanded it's definition of "estate" to include trusts, but it might at some point. Most people don't really think about their property being at risk of estate recovery because Medicaid considers the applicant's homestead to be an exempt asset for eligibility purposes. HOWEVER, that does not mean that MO FSD cannot come after the homestead through Medicaid estate recovery in order to recover any money that it pays out on behalf of the applicant's medical care during their lifetime. </b><br />
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Nathan J. Forck, Attorney at Lawhttp://www.blogger.com/profile/06304074249483162612noreply@blogger.com0tag:blogger.com,1999:blog-436663195658978893.post-72309749575317990702012-07-30T10:59:00.001-07:002012-07-30T10:59:10.850-07:00Annuity Purchased Post-Initial Eligibility Determination Is Not Available Resource<span style="font-size: large;">Great news for Medicaid-compliant annuities for married couples! Way to go 10th Circuit!</span><br />
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<span style="font-size: large;">Reversing a district court, a U.S. court of appeals holds that an annuity is an unavailable resource even if it is purchased in addition to the community spouse resource allowance, and that there is no transfer penalty for the couple's purchase of the annuity prior to a determination of Medicaid eligibility. <em>Morris v. Oklahoma Dept. of Human Services </em>(10th Cir., No. 10-6241, July 9, 2012).</span></blockquote>
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<a href="http://attorney.elderlawanswers.com/home/news/id/9954">LINK </a><br />Nathan J. Forck, Attorney at Lawhttp://www.blogger.com/profile/06304074249483162612noreply@blogger.com0tag:blogger.com,1999:blog-436663195658978893.post-43986203362392215552012-07-02T15:28:00.000-07:002012-07-02T15:28:36.284-07:00RED ALERT! Congress Attempting Bipartisan Shafting of Veterans Once Again!<span style="color: red; font-size: large;">RED ALERT! </span><br />
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<span style="background-color: white; font-size: large;">FROM www.elderlawanswers.com</span><br />
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<i><span style="font-size: large;">The text of a Senate bill imposing asset-transfer rules on VA pension applicants is now available. <a href="http://www.gpo.gov/fdsys/pkg/BILLS-112s3270is/pdf/BILLS-112s3270is.pdf" style="color: #003399; margin: 0px; padding: 0px; text-decoration: none;" target="_blank">S. 3270</a>, introduced by Sen. Ron Wyden (D-OR) and Sen. Richard Burr (R-NC), would require the Secretary of Veterans Affairs to look back 36-months for any uncompensated transfers that a veteran, spouse, surviving spouse or child otherwise eligible for a pension may have made. </span><span style="font-size: large;">As <a href="http://attorney.elderlawanswers.com/home/news/id/9907" style="color: #003399; margin: 0px; padding: 0px; text-decoration: none;" target="_blank">ElderLawAnswers reported</a>, the bill comes on the heels <span style="color: #999999;">a</span> <a href="http://www.gao.gov/products/GAO-12-540" style="color: #003399; margin: 0px; padding: 0px; text-decoration: none;" target="_blank">U.S. Government Accountability Office (GAO) report</a><span style="color: #999999;"> </span>that found abuses among a small group of attorneys and financial planners who help veterans transfer assets in order to qualify for VA pension benefits like Aid and Attendance.</span><span style="font-size: large;">Under the bill, the Secretary would look for any resource that was part of the “corpus of the estate” of the veteran and of the veteran’s spouse that the secretary considers would be “reasonable” to be consumed for claimant’s maintenance. The look-back period would commence on the date of the pension application or the transfer, if it is later. </span><span style="font-size: large;">The legislation calls for the imposition of a penalty period if an uncompensated transfer has been made, and the penalty would be calculated by dividing the value of the transferred resources by the amount of the monthly pension the claimant would otherwise be entitled to. The panalty could not exceed 36 months.</span><span style="font-size: large;">A pension will not be denied if transferred assets are returned or if the denial or discontinuance of payment would work an undue hardship.</span><span style="font-size: large;">The legislation would take effect one year after enactment and apply to pensions applied for or redeterminations after that date.</span></i></blockquote>
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<span style="font-size: large;"><a href="http://www.gpo.gov/fdsys/pkg/BILLS-112s3270is/pdf/BILLS-112s3270is.pdf">S. 3270</a>.</span></div>
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<span style="font-size: large;">Right now, there is no "transfer penalty" for transfers of assets for less than fair market value when applying for VA Aid and Attendance pension benefits. This bill, if passed, would impose a transfer penalty of up to 36 months of ineligibility for veterans benefits that the veteran would have otherwise qualified for based on the amount that was transferred by the veteran within three years prior to applying for benefits. </span><br />
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<span style="font-size: large;">VA benefits are hard enough to obtain for veterans as it is and this law will <u>exponentially</u> complicate and frustrate veterans who would otherwise be eligible for benefits. The complex nature of calculating transfer penalties and look-back periods can be mitigated with the help of an experienced elder law attorney in the context of an application for Medicaid. </span><br />
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<span style="font-size: large;">HOWEVER, a ridiculous federal law exists that does not allow attorneys to receive compensatino for assisting applicants for VA benefits. Consequently, there is a tremendous lack of advocacy for veterans that need help with applying for these benefits and therefore many veteran applicants simply give up after their initial application is rejected. This rule will only exacerbate the problem of eligible veterans being unable to qualify for benefits because of the complexity of the application process. </span><br />
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<span style="font-size: large;">This is particularly disheartening as it seems as though this is focused on the Aid and Attendance Pension program that the vast majority of veterans don't utilize because they don't realize that they could become eligible.</span><span style="background-color: white; font-size: large;"> Unlike the Veterans Disability program, a veteran can be eligible even if they were never deployed to a combat zone and their eligibility is NOT predicated on a service-connected injury or disability.</span><br />
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<span style="background-color: white; font-size: large;">If you have any questions about qualifying for the VA Aid and Attendance program, please feel free to call my office at (573) 635-3436. </span><br />
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<span style="font-size: large;"><a href="http://attorney.elderlawanswers.com/home/news/id/9920">LINK</a> to article on www.elderlawanswers.com.</span></div>Nathan J. Forck, Attorney at Lawhttp://www.blogger.com/profile/06304074249483162612noreply@blogger.com0tag:blogger.com,1999:blog-436663195658978893.post-30049971940139786462012-06-28T08:30:00.001-07:002012-06-28T08:30:08.858-07:00Seminar in Linn, MO TONIGHT!<span style="font-size: large;">I will be speaking at a community awareness meeting on Medicaid eligibility and the Veteran's Aid in Attendance program. It will be held at the Osage County Community Center, which is located next to Linn Tech and the seminar will start at 6 PM. </span><br />
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<span style="font-size: large;">Come on out and say "Hi". (I also hear that there will be food and drinks involved.) </span><br />
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<span style="font-size: large;">In the meantime, if you have any questions, please feel free to contact me at (573) 635-3436.</span>Nathan J. Forck, Attorney at Lawhttp://www.blogger.com/profile/06304074249483162612noreply@blogger.com0tag:blogger.com,1999:blog-436663195658978893.post-83389813759280573012012-05-16T13:37:00.001-07:002012-05-16T13:39:08.348-07:00<span style="background-color: white; font-family: 'lucida grande', tahoma, verdana, arial, sans-serif; font-size: large; line-height: 14px; text-align: left;">Medicaid and Veterans Benefits Seminar at 6 PM tomorrow night at my office for any that are interested. The address is 2701 W. Main Street, Jefferson City, MO. If you have questions about the seminar or anything else, please feel free to contact my office at (573) 635-3436.</span>Nathan J. Forck, Attorney at Lawhttp://www.blogger.com/profile/06304074249483162612noreply@blogger.com0tag:blogger.com,1999:blog-436663195658978893.post-76155679590852507232012-05-07T13:17:00.004-07:002012-05-07T13:18:59.900-07:00Upcoming Seminars for May 2012<h2>
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<em style="color: black;">May 10, 2012 </em><span style="color: black;">at Knights of Columbus, Taos, MO (6:00 PM-7:00 PM)</span></h2>
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<br /><em style="color: black;">May 17, 2012</em><span style="color: black;"> at Millard Family Chapels Annex, </span><span style="color: black;">2701 W. Main Street, Jefferson City, MO (</span></h2>
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<br /><em>May 29, 2012</em> at Heisinger Bluffs (Media Room), 1002 W. Main Street, Jefferson City, MO (6:00-7:00PM)</h2>
</span><br /><strong><span style="font-size: large;"><em>May 31, 2012</em> at Millard Family Chapels, 919 E. Main Street, Linn, MO (6:00-7:00PM)</span></strong><br />Nathan J. Forck, Attorney at Lawhttp://www.blogger.com/profile/06304074249483162612noreply@blogger.com0tag:blogger.com,1999:blog-436663195658978893.post-84137901478983336892012-03-20T12:10:00.000-07:002012-03-20T12:10:05.506-07:00Missouri Estate Recovery Claim Fails<div style="background-color: white; font-family: Arial, Helvetica, sans-serif; line-height: 1.5em; margin-top: 10px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-align: left;"><span style="font-size: large;">A Missouri court of appeals rules that in a state's claim for recovery of Medicaid benefits against an estate, computerized records showing checks were issued to the Medicaid recipient's health care providers is insufficient evidence that payment was made to the providers, so the claim must fail. <a href="http://www.courts.mo.gov/file.jsp?id=53156" style="color: #003399; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-decoration: none;" target="_blank"><em>Estate of Nelson v. Missouri Dept. of Social Services</em></a> (Mo. Ct. App., W. Div., No. WD73957, March 20, 2012).</span></div><div style="background-color: white; font-family: Arial, Helvetica, sans-serif; line-height: 1.5em; margin-top: 10px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-align: left;"><span style="font-size: large;">When Katherine Nelson died, the state filed a claim against her estate for reimbursement of Medicaid benefits paid on her behalf. As proof of the claim, the state provided computer records of expenditures made for Ms. Nelson's care.</span></div><div style="background-color: white; font-family: Arial, Helvetica, sans-serif; line-height: 1.5em; margin-top: 10px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-align: left;"><span style="font-size: large;">The trial court denied the claim, ruling that the state did not present evidence that checks it issued to Ms. Nelson's health care providers were in fact presented and paid. The state appealed, arguing that it need only provide proof that a check was sent.</span></div><div style="background-color: white; font-family: Arial, Helvetica, sans-serif; line-height: 1.5em; margin-top: 10px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-align: left;"><span style="font-size: large;">The Missouri Court of Appeals, Western Division, affirms, holding that the state's evidence is insufficient because it does not establish that the checks it issued in payment of Ms. Nelson's health care services were either presented or honored. According to the court, computerized records providing the date a check was issued are not sufficient evidence of payment.</span></div><div style="background-color: white; font-family: Arial, Helvetica, sans-serif; line-height: 1.5em; margin-top: 10px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-align: left;"><span style="font-size: large;">For the full text of this decision in PDF, go to: <a href="http://www.courts.mo.gov/file.jsp?id=53156" style="color: #003399; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-decoration: none;" target="_blank">http://www.courts.mo.gov/file.jsp?id=53156</a>.</span></div>Nathan J. Forck, Attorney at Lawhttp://www.blogger.com/profile/06304074249483162612noreply@blogger.com0tag:blogger.com,1999:blog-436663195658978893.post-13818242882365020922012-02-29T11:52:00.000-08:002012-02-29T11:52:03.786-08:00Medicaid-Compliant AnnuitiesIf anyone has any questions on "Medicaid-Compliant" Annuities, please feel free to call my office. In my opinion, these annuities are an <em><strong>outstanding</strong></em> vehicle for asset protection, <em>especially for a married couple</em>. However, there is a lot of misinformation about what can and cannot be done with these annuities and how they work within the framework of an application for Medicaid vendor nursing care benefits with the Missouri Family Support Division.<br />
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Please understand that while a financial advisor may understand the product itself, he or she does not understand how the annuity works within the context of an application for Medicaid benefits. Consequently, it is very important to discuss these products with an elder law attorney that is familiar with the Missouri Medicaid system and with how it treats these products.Nathan J. Forck, Attorney at Lawhttp://www.blogger.com/profile/06304074249483162612noreply@blogger.com2tag:blogger.com,1999:blog-436663195658978893.post-4235672932352581992012-02-29T11:39:00.004-08:002012-03-09T11:43:45.886-08:00Upcoming Seminars: March and April<h2><u>March 20, 2012</u> <br />
12:00-1:30 PM<br />
<span style="color: red;">Lunch and Learn </span><em><u>Basics of Medicaid and Veteran's Aid in Attendance Eligibility</u></em></h2><h2><br />
Millard Family Chapel<br />
540 South Summit Drive<br />
Holts Summit, MO<br />
<u>RSVP</u>: Mark (573) 680-7880<br />
<br />
<u></u></h2><h2><u>March 29, 2012</u>6:00-8:00 PM<br />
<em><u>Estate Planning and Medicaid Eligibility</u></em></h2><h2>Crestview Home<br />
1313 South 25th Street<br />
Bethany, MO<br />
RSVP: Sherry (660)425-3128</h2><h2> </h2><h2><u>March 22, 2012</u></h2><h2>6:00 pm - 8:00 PM<br />
<em><u>Estate Planning and Medicaid Eligibility</u></em></h2><h2>Frene Valley Health Center<br />
1800 Wein <br />
Hermann, MO<br />
<u>RSVP</u>: Jenny (573) 486-3155<br />
<br />
<u></u></h2><h2><u></u> </h2><h2><u>April 24, 2012</u></h2><h2>12:15-1:00 PM<br />
<em><u>Basics of Medicaid Eligibility</u></em></h2><h2>Senior Center @ the Mall<br />
3600 Country Club Drive<br />
Jefferson City, MO<br />
<br />
<u></u></h2><h2><u></u> </h2><h2><u>April 26, 2012</u></h2><h2>12:15-1:00 PM<br />
<em><u>Basics of Veteran's Aid in Attendance Eligibility</u></em></h2><h2>Clarke Senior Center<br />
1310 Linden Drive<br />
Jefferson City, MO</h2>Nathan J. Forck, Attorney at Lawhttp://www.blogger.com/profile/06304074249483162612noreply@blogger.com0