Social distancing and restrictions on entering skilled nursing facilities continue to be in place across the nation. We know, as elder law attorneys, this can make it more challenging to be able to interact with your loved ones who may currently reside inside of them. We also know that this inability to interact personally may also cause you additional stress since you may not be able to physically “see” your aging loved one.
The first step to alleviate this concern and to also help your loved one, starts with making a plan. What should you plan for?
Plan to communicate with your loved one and the care team.
Plan to be involved, and stay involved.
Plan to be available to answer any questions for your aging loved one.
Plan to be available to advocate for your aging loved one.
We know you may have questions on how to best tackle this responsibility, especially in light of the ongoing issues from the pandemic.
1. Be in frequent communication. Communication is critical right now. Whether it is with your loved one or not, the nursing home needs to know that you are involved. Of course, you want to participate with your loved one who is in the facility but it is equally important to speak with his or her care team. The care team may involve doctors, nurses, and therapists, as well as other specialists. Make contact and ask to be provided with an update at least weekly, if not more frequently.
2. Participate in meaningful conversations. If you are able to communicate with your aging loved one, try to make your interactions as meaningful as possible. Social distancing and visitation restrictions can make this more challenging, but there are ways to stay connected. In addition to phone calls, consider video chats like FaceTime or Facebook Messenger so your loved one can see you and your family. Also, during this time you can share photos and scrapbooks as well.
3. Advocate from anywhere. Remember that your aging loved one may need you more than ever right now. The lack of being able to go into a facility in person should not prevent you from speaking with him or her. Discuss with your loved one, if possible, and the facility what are the best ways for you to be involved.
We know this blog may raise more questions than it answers. Do not hesitate to contact us at any time to help you answer them. We are here to help you and your loved ones as you face these challenges.
Tom knew his dad, Frank, was having a little trouble taking care of himself at home. He dreaded the idea of putting his father in a nursing home, even though he knew of several wonderful homes nearby. Frank wanted to remain independent at home for as long as possible. One day, however, Frank’s doctor told Tom that Frank should have supportive devices, special transportation, assistance with taking medication, and help with his daily activities. As Tom helped his dad deal with the changes in his life, he learned that Medicaid can help every step of the way. The first step was finding out that nursing care was needed.
Step two is finding out how Medicaid can help your loved one stay at home. Keep in mind that some Medicaid programs cover home health and institutional care.
Home-Based Long-Term Care
Medicaid is a federally-funded, state-run program that provides healthcare to qualified individuals. However, Medicaid is not just one program. Instead, various programs are offered to help different segments of our society. People like Frank need advanced care but may be eligible for Medicaid programs that meet their medical, nursing, and social needs without leaving home. Medicaid home health programs include:
Home Health Care. Eligible people of any age, including elderly, may be qualified to receive Medicaid home care
Home and Community-Based Waivers. Eligible Medicaid recipients must be at risk for moving to institutional care, yet willing to receive that care at home.
At some point, people may be ready for step three.
Transitioning to Institutional Care
Moving from home to nursing home can be difficult. Medicaid programs offer services and financial aid to make the move a little easier.
Medicaid for the Elderly and Disabled (E&D). The services offered through E&D assist people who live at home and in nursing homes, hospital, and other residential facilities.
Medicaid in the Nursing Home (Institutional Medicaid). This program provides coverage of institutional care for people who qualify.
Medicaid For the Various Phases of Life.
In addition to programs that help people move to an institutional setting, Medicaid also offers a program to help people move out of nursing homes. Gateway to Community Living offers services and support for qualified individuals who wish to move from an institution to a home setting.
Contact Bill Miller at 256-251-2137 to schedule an appointment. The attorneys at Miller Estate and Elder Law can help with applying for Medicaid. Even better, we can help you with Medicaid planning to increase your chance of getting Medicaid and keeping as much property as possible. Though our office is now located at 818 Leighton Avenue in Anniston, we serve clients in Gadsden, Hoover, Talladega, Vestavia Hills, and surrounding areas.
Giving away assets to qualify for Medicaid is a strategy that many people use when they are concerned that they might be going into a nursing home because they think it will help them qualify for Medicaid more quickly. Unfortunately, giving away assets usually involves way more risks and harm than good.
Medicaid has a 60 Month Look Back
Medicaid has a 60 month look back from the time you file your Medicaid application. Therefore, if you’ve given away any assets within the 60 months prior to filing your application, Medicaid is going to penalize you for those giveaways and you won’t qualify. The penalty is based on how much money you gave away during the 60 months prior to the application. The penalty is calculated by taking the amount given away and dividing that by a monthly divisor which is set by Medicaid each year. For example, if you have given away $64,000 within the past 60 months and the Medicaid penalty divisor is $6,400, Medicaid will impose a 60 month penalty.
There are More Risks Than Rewards When You Give Assets Away
The other problem with giving away assets is that once you give them away you no longer have control over them. Whoever you give the assets to has potential creditors and predators and your assets are now subject to those creditors. Most people say well, my son or my daughter would never do anything with my assets. However, what if they get sued? What if they get a divorce? What if they have to file bankruptcy?
Once you give your assets away to that person, then your assets are now subject to their bankruptcy filings, divorces, lawsuits, etc. I’ve seen more people than I can count unfortunately who used this strategy and had to go into a nursing home and the assets were no longer there and they couldn’t get the care that they needed. While there are strategies to protect assets from long term care costs, giving them away to relatives is not something that I recommend. There are better ways to accomplish the same objective without the risks.
One of the most frequently asked questions I get as an Elder Law attorney is “Will the Government Pay for My Nursing Home Expenses?” There are government programs that will pay or help pay for long term nursing home care but Medicare is not one of them. Medicaid does pay for nursing home care but there are very strict income and asset limits to qualify. The biggest and most costly mistake that people make is not getting information about how they can qualify for Medicaid. Watch this video to learn more. If you have a loved one in a nursing home or going to a nursing home, let us help you. Give us a call at 256 251-2137.
Frank and Delia were getting older, as most people do. Their life together had included raising three children and providing support for their parents before they passed away. Because of how much care their parents needed at the end of their lives, Frank and Delia were concerned about their own future medical care. They decided to be proactive and start to plan for long-term care situations now.
Long-Term Care Options
People faced with a need for increased levels of care have several options:
In-home. Aides may come in with meal preparation, cleaning, medication management, and personal hygiene.
Assisted Living Facilities. The residents live in separate apartments, but limited nursing care is provided.
Nursing Homes. Skilled nursing facilities typically offer 24/7 care for patients that need it.
As you start your plan for long-term care, consider the following:
Research Current Availability and Cost
It may be years before you need long-term care. However, you can start looking at what might be available.
The least expensive option is usually at-home care. In the Anniston area, the average monthly cost was $2,955 for homemaker services in 2018. Perhaps you have family members who can help you stay home as long as possible and reduce the cost of care.
In Anniston, the average monthly cost for assisted living facilities in 2018 was $3,566. If you don’t need memory care or 24/7 nursing, this might work. Check with family members, friends, and friends-of-friends who live in and can recommend assisted living accommodations.
As you might expect, the highest cost will be for nursing home care. Average 2018 cost in Anniston was $6,175 for a semi-private room and $6,449 for a private room. See what nursing homes are nearby. In addition to word of mouth, you can check the Alabama Department of Public Health website for lists of nursing homes with violations.
Once you have some ideas of available care, you can plan how to pay for it.
Methods of Payment
Generally, you will find there are three ways to pay:
Self-Pay. Your life savings may be used to pay for expensive long-term care.
Long-Term Care Insurance. Although this type of insurance can defray the high cost of long-term care, the premiums may be too high. It’s also important to buy the policy well before you need it.
Medicaid and Other Government Benefits. You may be able to tap into Medicaid to pay for part or all of your long-term care . . . if you qualify. Eligibility rules are strict. If there’s a possibility you will need Medicaid, consult with an attorney now.
Talk to an Experienced Attorney about How to Plan for Long-Term Care
There’s a good possibility that you or one of your loved ones will need some form of long-term care. Doesn’t it make sense to plan for it now?
For a free consultation with Bill Miller, an experienced Alabama attorney, contact us at 256-472-1900. Miller Estate and Elder Law is now located at 818 Leighton Avenue in Anniston, but we serve clients in Gadsden, Hoover, Talladega, Vestavia Hills, and surrounding areas.
Also, free copies of the following guides are available on our website: Medicaid Planning in Alabama: What You Need to Know and Don’t Go Broke Paying for Long-Term Care.
Hearing a doctor say that your loved one needs skilled nursing care, 24/7, can be a real shock. Chances are, you have not given much thought to planning for long-term care. If you have just learned that your dad or mom needs 24/7 care – or think this may happen in the future – continue reading to learn more about what you can do to help.
The Realities of 24/7 Care
If your mom needs 24/7 care, you are not alone. In fact, the following statistics tell an interesting story about long-term care:
52% of people age 65 right now will need long-term care at some point.
47% of men and 58% of women age 65 or older face long-term care.
Some people will need skilled nursing care for years. The cost of 24/7 care can be staggering. In Alabama, the monthly costs for long-term care in 2018 were:
$3,241 for homemaker services or a home health aide
$3,271 for an assisted living facility
$6,279 for a semi-private room in a nursing facility
$6,661 for a private room in a nursing facility
What can you do to help someone who needs 24/7 care?
Applying for Medicaid
Once you find a good nursing home, you need to figure out how to pay for it. This can be tricky. There are basically three ways to pay for long-term care: self-pay, long-term care insurance, and Medicaid.
You may need the Medicaid money now but don’t know how to get it or even if you will be eligible.
Medicaid offers a number of programs to provide medical care for people with limited assets and resources. To qualify, the application will need to meet certain asset and resource tests. For example, someone who needs 24/7 care must not earn more than $2,250 per month or have more than $2,000 in resources.
Applying for Medicaid can be frustrating and time consuming, in part because of the amount of supporting documentation. In addition, Medicaid case workers will review the applicant’s finances for a 60-month period prior to the application date. Certain transactions made during that time may disqualify the applicant from or delay benefits.
Medicaid Is Complicated. We Can Help.
It’s possible – and highly recommended – to plan ahead for incapacity and long-term care. Estate
planning can help, especially if Medicaid planning is included.
For a free consultation with an experienced Alabama estate planning attorney, contact Bill Miller
at 256-472-1900. Miller Estate and Elder Law is now located at 818 Leighton Avenue in
Anniston, but we serve clients in Gadsden, Hoover, Talladega, Vestavia Hills, and surrounding
areas.
