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asset protection

What are the options to protect our home?

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The Home Equity Rule

The home is the major asset for most Americans. In addition to its financial significance, it often has emotional significance as the place that parents have raised their children and lived for many decades. They have paid mortgages for up to 30 years and often built, repaired, maintained, and improved the properties themselves.

Medicaid law recognizes the special character of homes, in many states exempting them entirely as countable assets. Congress, however, through the Deficit Reduction Act has limited this exemption to the first $688,000 of equity unless a spouse or minor or disabled child is living in the house. States have the option of increasing the exemption to $1,033,000. This has added to the planning that clients with high-value homes should consider.

The Medicaid Payback Lien

In addition, while the house itself may be protected in terms of Medicaid eligibility, it is not protected from a claim for estate recovery upon the nursing home resident’s death. And the proceeds of the sale of the home are not protected if it is sold during the nursing home resident’s life.

One option for the house is aimed at the healthy spouse of someone who is likely to need nursing home care in the future. It simply states that the house is protected, but that it should be placed in the healthy spouse’s name in order to give him or her control and protect against estate recovery in the event he or she predeceases the nursing home spouse.

The House

Protecting the equity of a home is a universal goal for most families.

The house is a unique asset under the Medicaid rules. It is considered a “noncountable ” resource as long as you or your spouse lives there or states an intent to return there to live. This means that the applicant for Medicaid may continue to own a house, no matter what the value, if he or she claims the house as his or her residence, regardless of whether he or she has any realistic prospect of returning home. However, if the house remains in the Medicaid recipient’s estate, after his or her death the state has an automatic claim on the house to the extent of its expenses for the care of the Medicaid recipient. This estate recovery can be protected against by keeping the house outside of the Medicaid recipient’s probate estate.

The first step is to put the house in community spouses, the spouse not in the nursing home, name alone. This gives them complete control over the house and keeps it out of the institutionalized spouses, the spouse in the nursing home, probate estate. There is no penalty for transfers between spouses. Then, you can consider taking other steps to protect the house in case the community spouse ever require long-term care.

So how do you keep the house out of your probate estate so that the state has no access to it, and in your federal taxable estate so that it gets the stepped-up basis? There are two ways to do this. Both cause the house to pass automatically to your beneficiaries without going through probate.

  1. The Life Estate. One planning technique is for you to give the house to your children while retaining a life estate for yourself. This means that you retain current ownership of the property, while your children automatically have ownership after your death. You would be responsible for upkeep of the house and would receive any rental income. The advantage of this method is that it is relatively simple to put into effect. You simply deed the remainder interest to your children. You would also have to file a federal gift tax return, but no tax would be due at this time.
    There are some disadvantages to this approach. First, you give up some control of the house, since your children will have an ownership interest. They would have to sign any deed if you were to sell or mortgage the property or change your mind about who it should go to. If the house were sold during your lifetime, a portion of the proceeds would go to you and the balance to your children, the amount of each share depending on your age at the time of the sale. Finally, you would be ineligible for Medicaid for the five years following the transfer of the remainder interest to your children, though if worse came to worst, your children could deed back to you their interest in the house and thus “cure ” this transfer penalty.
  2. The Irrevocable Trust. The second method of keeping the house in your taxable estate but out of your probate estate is to place it in an irrevocable trust. After you do so, you cannot change your mind. Once the house is in the trust, it is there for good. If the trustee decides to sell the house, the proceeds of the sale must remain in the trust. Although this protects the cash proceeds, it limits your access to them. This would be an effective transfer at the time of creating the trust, causing your ineligibility for Medicaid for the subsequent five years. You would not have the same option to “cure ” the transfer that you would with the life estate. Though there are restrictions, there are also significant benefits to this trust. If drafted as a grantor trust, the creators of the trust would still be eligible for capital gains exclusions and the beneficiaries would receive a step-up in basis. Though no state will ever allow principal to be distributed from the trust to the grantors, many states will allow principal to go to children or heirs of the grantors – allowing for access to the principal that could be gifted from the children back to the grantors. Finally, trustees can sell real estate without risk of the proceeds being deemed countable resources.

Caretaker Child Exception

You can receive Medicaid coverage while still keeping an ownership interest in your home. However, at your death the state will have the right to recover from your probate estate—essentially your home—whatever it pays out for your care. Your home could escape this claim if it were transferred to one or more of your children. A problem with doing this is that under the general transfer penalty rule, you would be ineligible for Medicaid benefits for up to 60 months following the conveyance.

However, an exception to the transfer penalty allows a Medicaid applicant to transfer his or her home to a qualified caregiver child. The law defines a caregiver-transferee as a child of the Medicaid applicant “who was residing in the applicant’s…home for a period of at least two years immediately before the date of the applicant’s…admission to the institution, and who (as determined by the physician) provided care to the applicant…that permitted him or her to reside at home rather than in an institution. ” In order to qualify under this exception, an applicant should be prepared to submit a certification by his or her attending physician which basically states that, but for the caregiver, the applicant would have had to move to a nursing home.

An important exception to Medicaid transfer penalties is for transfers into trust for anyone who is disabled and under the age of 65. Prior to that, transfers directly to the disabled child of a Medicaid applicant were not penalized. But in many cases, it was inappropriate to give funds to a mentally retarded or mentally ill child. At least some states strictly construed the exception to bar the funding of trusts for such children. OBRA ’93 corrected that narrow thinking and broadened the exception to include trusts for anyone under age 65 and disabled, whether or not he/she is a child of the Medicaid applicant. This form describes this planning option. You will need to check with your state Medicaid agency to determine how it construes the requirement that the trust be “solely for the benefit “ of the disabled individual. Some states require that no remaindermen be listed on the trust, that instead it be payable to the disabled beneficiary’s estate on his or her death, or that a (d)(4)(A) trust be used for this purpose.

Exceptions to the Transfer Penalty

Transferring assets to certain recipients will not trigger a period of Medicaid ineligibility. These exempt recipients include:

  1. A spouse (or anyone else for the spouses benefit);
  2. A blind or disabled child;
  3. A trust for the benefit of a blind or disabled child; or
  4. A trust for the benefit of a disabled individual under the age of 65 (even for the benefit of the applicant under certain circumstances).

Special rules apply with respect to the transfer of a home. In addition to being able to make the transfers without penalty to one’s spouse or blind or disabled child, or into trust for other disabled beneficiaries, the applicant may freely transfer his or her home to:

  1. A child under age 21;
  2. A sibling who has lived in the home during the year preceding the applicant’s institutionalization and who already holds an equity interest in the home; or
  3. A “caretaker child, ” who is defined as a child of the applicant who lived in the house for at least two years prior to the applicant’s institutionalization and who during that period provided such care that the applicant did not need to move to a nursing home.

A transfer can be cured by the return of the transferred asset in its entirety. And in some instances the applicant for benefits may be eligible for a “hardship ” waiver.

Still have questions as to how to protect your home? Call us for a no obligation consultation.

Choosing the Right Nursing Home

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What Nursing Home Is Right For My Loved One?

When families are advised that their loved one will need skilled nursing care, one of the first questions they will ask is are there any facilities that we recommend. There are a lot of factors that go into deciding if a particular facility is right for your family member. Some of those factors to consider are:

  • Proximity to where advocates and family members reside – having family visit regularly and being engaged in the care and services provided to their loved ones is critical to ensure they receive the best possible care
  • Understanding the level of care needed: certain facilities are geared toward particular conditions. Understanding a facilities specialty, if any, is important to determining if there is a fit.
  • Know how you are going to pay for the care. Once the family members Medicare benefits are exhausted, and you still require skilled nursing, understanding how to pay for the care needed and developing a path to Medicaid which will help subsidize the cost of nursing home care is critical.
  • Private Pay versus Medicaid – when visiting a facility, know what forms of payment they accept. The overwhelming majority accept Medicaid but a few do not. Follow the link in this article to find out if your facility accepts Medicaid.

Understanding The Different Levels of Care

A Nursing Home (NH) is a facility that provides 24 hour 7 day a week medical care and supervision.

A Skilled Nursing Facility (SNF) provides skilled nursing (examples: wound care, pain management, or bowel/bladder training),  and physical, occupational or speech therapy services. A SNF may also be referred to as a sub-acute rehab. Medicare may cover up to 100 days in a skilled nursing facility if you have met very specific Medicare eligibility guidelines.

Medicare does NOT cover ongoing long-term Nursing Home care. You may require additional care after your Medicare coverage ends. You may choose to pay the nursing home privately, use long-term care insurance or apply for state Medicaid.

A nursing home may also provide long-term care.

Ranking All Rhode Island Nursing Homes and What Payment Options They Accept

Since 2002, Healthcare Quality Reports has published information on the quality of care administered by nursing homes, including data on resident and family satisfaction and care outcomes. If you know in advance that you or a family member will need nursing home care, this information can help you compare nursing homes and choose among them. You can also visit nursing homes or ask friends and family for their thoughts and experiences.

The RI Department of Health’s Healthcare Quality Reporting Program has developed a Nursing Home Summary Report to help you compare Nursing Homes and choose among them. To find the most recent LIST OF NURSING HOMES and REPORT CARD click here. 

The PDF that the above link takes you to assembles many of the key pieces of information that any family will need when making an initial assessment of What Nursing Home is Right For My loved one!

Still have questions about how to proceed? Call me at 401-600-0143 for a no obligation consultation.

ELDER LAW - ASSET PROTECTION

Helping families help their loved ones.

What is the Caretaker Child Exception?

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Caretaker Child Exception

You can receive Medicaid coverage while still keeping an ownership interest in your home. However, at your death the state will have the right to recover from your probate estate—essentially your home—whatever it pays out for your care. Your home could escape this claim if it were transferred to one or more of your children. A problem with doing this is that under the general transfer penalty rule, you would be ineligible for Medicaid benefits for up to 60 months following the conveyance.

Children who care for their parents can take advantage of provisions in the Medicaid Regulations

The Caretaker Child Exception to the transfer penalty can be a valuable tool to preserve the home of parents.

However, an exception to the transfer penalty allows a Medicaid applicant to transfer his or her home to a qualified caregiver child. The law defines a caregiver-transferee as a child  of the Medicaid applicant “who was residing in the applicant’s…home for a period of at least two years immediately before the date of the applicant’s…admission to the institution, and who (as determined by the DHS) provided care to the applicant…that permitted him or her to reside at home rather than in an institution. “ In order to qualify under this exception, an applicant should be prepared to submit a certification by his or her attending physician which basically states that, but for the caregiver, the applicant would have had to move to a nursing home.

If you can get the necessary certification, and if you would feel comfortable with the property in your caretaker’s name solely, it is recommend that you transfer your interest in your home to your caretaker child. No transfer penalty would be triggered and, in addition, the unit would not be subject to any reimbursement claim by the state. Once the transfer is made, your caretaker child would be free to sell the house or simply rent it out. If you choose to transfer the house to your caretaker child, you should discuss the form of conveyance—trust, life estate, or outright ownership—and the tax consequences to each approach.

If you decide to make the transfer, you will have the option of doing so after you qualify for Medicaid, or before you submit the application. To make the transfer before you have qualified for Medicaid may prolong the application process. For that reason, it may be easier to make the transfer after you have been determined eligible for Medicaid. However, we have submitted applications where the home was transferred before and after and all were approved.

Want to discuss how to take advantage of the Caretaker Child Exception with your family? Call us to schedule a no obligation consultation.

FRAUD: The “F” Word of Estate Planning

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Fraud is a label to run from – not walk from

As an attorney that practices in areas of law that have both local and national scope – reading and reviewing scholarly writings and recent case decisions is critical to staying current. From these readings, we come to learn and respect the work done by other attorneys and how they are best representing their clients and their interest.

One such article came across my desk entitled “Medicaid Planning Technique Didn’t Work Exactly as Intended” a link to the full article can be found HERE.

The article examines what could be best described as a case study of one attorneys recommendations to a client who was retained to assist the family with Medicaid planning and qualification. As the title infers, the plan did not work out as explained and the clients goals and objectives were not carried out with the suggested plan proposed and enacted by the attorney. Fraud ruins any thought of a clever estate plan – and once that genie is let out of the bottle – it is hard to get it back in.

If it seems too good to be true – it probably is

The case is a lesson for both client and attorney. Just because you can do something – does not always mean you should. Deciding on an estate plan with the goal of qualifying for Medicaid benefits is something that must weigh all of the factors and rules. Knowledge of family dynamic, conflicts, tensions, and history are as important as understanding the rules of Medicaid eligibility, assets and income.

Fraud is a badge that does not wash off easily. Having to defend yourself or others from being accused of absconding with the assets of an elderly loved one is not something anyone wants to envision. There are legal consequences – which translate into strained relationships and possibly property and certainly financial penalties with the ultimate loss of liberty.

The author of the article makes the following suggestions when selecting an elder law attorney to work with:

  1. Be careful about selecting your lawyer. Do you want someone who really knows estate planning and/or Medicaid planning? Check out their reputation, their online information, and recommendations from friends and colleagues. Did you meet the lawyer at a promotional seminar at the public library or a local restaurant? Make sure you’re not being sold something you don’t really want or need.
  2. Does a particular Medicaid planning technique sound almost too good to be true? Be suspicious and ask for input from others.
  3. When a lawyer agrees to meet with you and your family member together, that suggests something troublesome. We are supposed to represent just one person, not a whole family. Recognize that your interests and those of your family member might differ, and respect the lawyer’s efforts to maintain that separation.
  4. Recognize that even though an idea — and particularly a Medicaid planning technique — might work, it might also have unintended secondary effects.

 

Medicaid Eligibility Update

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Rhode Island has updated its rules to become Medicaid eligible.

If you are a Rhode Island resident and you are seeking Medicaid benefits, you should be aware of some recent changes approved by the Rhode Island Department of Human Services as to your eligibility under the program. Final rules are expected to be published and release shortly but here is a recap of the expected changes:

  1. Income cap of $9,581 meaning that if the applicant has more than $9,581 in income, then they can never become eligible for Medicaid, nor can they start the penalty period.  If they have income under $9,581 but greater than $6,700 and they want to start a penalty period, they can do so but cannot get community Medicaid benefits, like Rx copays and doctor bills.   If their income is under $6,700, then nothing changes.    This went into effect in September and is effective for applications for eligibility delivered after 10/1/18.   50-00-2.4

    Changes Are Coming

  2. Long term care insurance is not considered countable income for purposes of the above income cap.   However, once on Medicaid, it would need to be spent as part of the patient share.    50-00-6.5.2(B)
  3. Burial Funds & Irrevocable Funeral Contracts have new limits which are helpful and could affect clients.  The new cap on Irrevocable funeral contracts is $15,000 and anything over that would be considered a countable asset.   40-00-3.5.5 A(1)(f)
  4. Life insurance is now exempt up to $4,000 of cash surrender value, with anything over being countable.  40-00-3.5.5 A(1)(h)
  5. Retirement Funds now have a new definition, but as long as they are income producing and the client gets at least the RMD, then they should still be fine. 40-00-3.5.5 A(2)(g)
  6. Penalty Divisor is $9,581 since mid September.

Like any social program, the figures and rules for eligibility are constantly revisited and updated based on changes in federal law, budgets, and program changes and advances. Staying current on the latest rules is the challenge.

If you or a loved one is facing serous medical issues requiring skilled nursing care, the Medicaid program will help pay for those costs for applicants who have assets and income within program limits. Contact us to discuss your estate plan and if your estate plan should be revised so as to become eligible for these valuable benefits.

Why Medicaid Planning should be on your mind!

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There are many reasons, but most are due to:

(1) Americans are living longer;thinking about medicaid

(2) it is costing a lot more than expected for them to live; and

(3) long term care is not solely a “senior” issue:

  • By 2025, for every 100 middle aged individuals, there will be 253 seniors;
  • There is a 70% probability that an individual over age 65 will become cognitively impaired or unable to complete at least two activities of daily living-including dressing, bathing or eating over his or her lifetime.
  • On the aggregate, of those who enter a nursing home, 50% will stay an average of 2.5 years; 10% will stay there five years or longer.
  • Currently, individuals over the age of 50 control 75% of the nation’s wealth and half the discretionary income.
  • 40% of people who need long term care are working-age adults between 18 and 64

Although we are living longer, “living longer” is not always synonymous with “living better.” The longer we live, the more likely it is that at some point in our lives, we will need someone to help take care of us.

Insurance and other financial services companies, following these trends, realize the enormous importance of the “senior” market. “Senior” is a difficult term to define since people polled at various points in their lives who were asked to define “senior” varied greatly in their response. Those in their 20’s and 30’s tend to define senior as an individual 65 or over. People in their 40’s and 50’s often describe seniors as those in their late 60’s or 70’s. The 60 and 70 year olds questioned defined seniors as those in their 80’s and 90’s.

In spite of the fact that many seniors would be considered by many as “wealthy,” long term care costs are enormous and a lifetime of savings can be quickly exhausted when long term health care becomes necessary.

  • 70% of single people who enter a nursing home are impoverished within one year.
  • 50% of all couples are impoverished within one year of one spouse entering a nursing home.
  • Private rooms in a nursing home in 2015 cost an average of $113,150 per year ($310 per day) from a high of $443 per day to $190 per day in the Providence-Warwick area.

THE WORST CASE SCENARIO

What would you do if you were suddenly faced with an additional yearly expense of $113,150 or more? (This could double for a couple both of whom needed care simultaneously) How would this impact on your retirement planning? How long could you afford these costs? How would this additional expense affect the estate you wish to leave behind? How can we assure that you maintain your financial security and independence?”

Medicaid Planning and possibly Long term care insurance for those who qualify and can afford the policies are a partial answer to some of these troubling questions. Although it is estimated that in 2010 seven to nine million people had already purchased private long term care insurance, that number comprises only about one quarter of the 37 million Americans over age 65. The reason few obtain this insurance links back to the cost associated with the policies, the ready availability of them and the overall concern with their long term existence, meaning, will the policy be there when I need it?

Medicaid Planning as this site is dedicated to discussing and explaining, is an option for those who do not qualify or cannot afford a Long Term Care Policy, yet still seek to protect the assets they have earned during their lifetime.

Schedule a free consultation with our office to discuss what Medicaid Planning would entail for you.  

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6 Major Reasons For Planning Your Estate

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Estate and asset protection planning provides solutions to the following types of concerns:

Estate_planning

How will I avoid the cost and inconvenience of probate for my spouse and children?

If you have ever been confronted with needing to administer an Estate for a loved one who died without a will or estate plan, they quickly realize the time and expense associated with the probate process.  For many clients, the best solution is a revocable trust, often referred to as a living trust. This document when funded will enable you to avoid the probate process.

 

If I can’t make legal, financial, or healthcare decisions for myself, how can I be sure my wishes are carried out?

Again, a revocable trust may provide the answer. In addition, every client needs a durable power of attorney and a health care proxy appointing a trusted individual to make financial and health care decisions for you when you no longer can yourself.

 

How can I make sure my wealth and possessions end up in the right hands when I’m gone?

Wills and trusts are vehicles for passing on your assets to those you choose. Many clients are concerned about funds they leave to their children being at risk of their children’s creditors, spouses upon divorce, or simply bad decisions their children may make. For them, a family protection trust can provide the protection they seek. In addition, proper planning will prevent the payment of unavoidable estate taxes upon your death.

 

My spouse needs more care than I can give. Will we lose everything to pay for care, or are there options?

Not if you plan properly, the earlier, the better. There are a number of planning options available to spouses of nursing home residents to protect their financial well-being while qualifying their ill spouse for Medicaid coverage of nursing home fees.

 

My child is disabled. How can I provide for her future?

We have helped many parents of children with special needs plan for their children through the creation of a special needs trust funded with life insurance.

 

What legacy will I leave?

Your greatest legacy of course is the children and grandchildren you raise, if any, and the memories you leave with your family, friends, and work colleagues. However, support of charities and an estate plan that provides for your family and smoothly passes on what you leave behind will also contribute greatly to the legacy you leave and your family’s welfare for decades to come.

Contact us today for more information 401.648.7000

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