In the event of illness or incapacitation, most individuals have an idea as to how health matters and property distribution should proceed. However, delegating complete authority over your estate administration to one individual to serve as Trustee, Personal Representative (formerly Executor in Massachusetts), and agent under a Health Care Proxy and financial Power of Attorney can be a significant and oftentimes difficult decision. Personal integrity, familiarity with the needs of your estate, financial knowledge, competency, and willingness to take on such responsibilities are the more obvious qualifications of a Personal Representative, but there other important considerations. [Read more…]
I Take Care of My Mother. Can I Legally Get Paid for That?
As the number of family members providing care for aging parents increases, the solutions to find help with loss of income because of time off from employment for caregiving has become a major concern for many. The demands on both the time and energy needed to provide the needed care can make it impossible to maintain both a full time job with full time caregiving. [Read more…]
Fall Prevention in the Aging Population
From time to time I like to feature local experts with tips and advice for improving senior’s lives. This week’s blog is written by my colleague, Dr. Don Pelto of Central Massachusetts Podiatry. Dr. Pelto specializes in many foot ailments and writes about how you can be proactive by avoiding falls among elders. [Read more…]
Grandparents Raising Grandchildren – Legal Options and Financial Support
With the decline of the traditional nuclear family, individuals over 50 are increasingly vested with responsibility for the caretaking of young children and adolescents. Financial problems are the primary cause of seniors having to assume more “traditional” child-rearing duties. Whether due to a divorce, military service, substance abuse, mental illness or other secondary issues, some adults may be unable or simply unwilling to be good parents themselves. [Read more…]
What Really Happens to Your Estate if You Die Without a Will in Massachusetts?
Dying without a Will is called dying “intestate”. What this means is that your intentions as to who inherits your assets, who administers your estate, and who acts as guardians for any young children are determined by the Commonwealth of Massachusetts. It is often said that if you don’t have an estate plan, the Commonwealth has one for you. And as of January 2nd, 2012, the Commonwealth has an updated plan for you! That’s when the last phase of the Massachusetts Uniform Probate Code (MUPC) takes effect. [Read more…]
Marrying Later in Life: Do I Need a Prenup?
Welcome to the new singles scene. With the average life expectancy in the United States about 78 years old, people are living longer and healthier lives than ever before and more and more seniors are falling in love. However, what can be a thrilling and romantic time for an older couple can also be an anxious time for family members that have expectations regarding inheritance. It is worth noting that once married, a spouse will automatically inherit, at the very least, a portion of deceased partner’s estate, unless measures are taken to avoid this. [Read more…]
Protecting the Family Cottage from a Medicaid (MassHealth) Spend Down Through an Irrevocable Trust
An irrevocable trust is an excellent tool when preplanning for Medicaid benefits. Anything that is put into the irrevocable trust is protected from a Medicaid spend-down if five years pass from the date of the transfer. [Read more…]
When Should I Update My Estate Plan?
An estate plan that was suitable a few years ago may no longer be suitable today. One should look to update their estate planning every three to five years or even sooner if you experience a dramatic change in life circumstances. [Read more…]
Legislature Set to Abolish 10-Day Bed-Holds for Nursing Home Residents Temporarily Discharged or Under Hospitalization
For many years, the Massachusetts Legislature has provided funding for MassHealth to keep a nursing home resident’s bed empty for up to ten days during a period of hospitalization or temporary discharge- “bed-hold”. In 2010, the benefit was used in Massachusetts 28, 854 times. However, the State Senate recently concluded that Massachusetts cannot afford to maintain this policy.
The MassHealth bed-hold-policy now permits an individual in receipt of MassHealth to leave a nursing home to seek outside medical treatment or time with family and friends for a period of ten consecutive days without incurring any private pay cost. The policy also assures that if a MassHealth recipient returns to a long-term care facility within ten days, their own bed and room will be held free until their return.
Cuts would most significantly affect persons suffering from dementia and other cognitive impairments. For these individuals, a certain routine and comfort with the attending staff and surrounding residents are particularly significant. People with advanced dementia may suffer fright, disorientation and distress with any move – they have lost their home and may have trouble processing why.
Young people in nursing homes would also be seriously affected. The Boston Globe remarked on the case of a 31-year-old man who needs round-the-clock care after being permanently disabled in a car accident. Without bed-hold funds he will be unable to attend a summer camp without losing his place.
Although the Patrick administration has publicly declared that an average of 10 empty beds are present in a facility on any given day, so that a nursing home is usually able to retain an individual’s bed following a hospitalization or temporary illness, residents that live in homes specializing in a specific type of care face a greater amount of competition for beds.
Significantly, the financial limit for a single MassHealth recipient is $2,000. Given that private nursing home rates differ between $250-$350 per day, if recipients want their bed to be held by the facility, they will be expected to pay out of pocket.
The current MassHealth bed-hold policy also provides for non-medical leaves of absence for up to 10 days per year. Generally, this allows a recipient to leave a nursing home to attend family gatherings without putting his or her bed in jeopardy. Eliminating the bed-hold policy would force individuals to pay privately for their beds if they wish to temporarily leave the facility for a wedding or holiday function.
Disallowing residents the financial freedom to attend such events would undoubtedly result in compounded isolation from family members and the outside world.
Fortunately, advocates for upholding the MassHealth bed-hold policy have persuaded the postponement of the elimination of the policy from July 8, 2011 until July 22. Elder law advocates seek to secure the signatures of as many legislators as possible in opposition to the policy to dissuade the Executive Office of Health and Human Services Secretary, Judy Ann Bigby, from abolishing existing policy. If you are interested in fighting to maintain the 10 day bed-hold policy, contact your local legislature.
What Do You Mean Medicare Won’t Pay for Dad’s Nursing Home Stay?!
A three-day hospitalization often serves as a gateway for a senior citizen’s transition into a skilled care facility. When the patient is discharged to a skilled care facility for occupational, physical, or speech therapy, the patient’s health insurance (Medicare) will continue to finance treatment for up to 100 days per stay (as long as the person continues to benefit from rehab). Medicare coverage ultimately ends, and when it does, the patient must pay from income, savings, long-term care insurance, Medicaid, or a combination of these resources. [Read more…]
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