Archive for the ‘Long Term Care’ Category

Is Your Estate Plan Up To Date?

Thursday, May 11th, 2017

By: Amy C. O’Hara, Esq., Littman Krooks LLP

In order to ensure your existing estate plan meets your objectives, it is imperative that it be reviewed at least every 3-5 years and updated when needed.  Here are some issues that might necessitate updating your estate plan:

  • You want to avoid probate;
  • You or a beneficiary become disabled or have a long-term illness;
  • Death of a beneficiary;
  • Marriage, divorce or remarriage;
  • Birth or adoption of a child;
  • Death or change of executor, trustee, and/o guardian;
  • A change in the distribution of your estate;
  • A significant increase or decrease in your net worth;
  • Retirement;
  • Expecting to change state of domicile; and
  • Finally, any time you feel uneasy about any of your documents, making changes and/or speaking with your estate planning lawyer to make you feel comfortable with them.

Never make any changes on your current estate planning documents.  Mark-outs, interlineations and other informal changes are of no effect and will not be honored during an illness or after your death.  It is important to meet with an experienced estate planning lawyer to ensure you estate plan is updated properly to protect you and your loved ones.

 

Learn more about our elder law  estate planning or Medicaid Planning services. Contact us with additional questions.  


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NYC Program Helps Seniors with Home Repairs

Friday, May 5th, 2017

Seniors who own their own home in New York City and need help paying for repairs may qualify for the Senior Citizen Home Assistance Program (SCHAP).

The SCHAP program is administered by the city’s Department of Housing Preservation and Development (HPD), in partnership with the Parodneck Foundation. Qualifying low- and moderate-income seniors can receive low-interest repayment loans or deferred no-interest loans to prevent physical deterioration of their home or to improve living conditions. The maximum loan amount is $40,000 for single-family homes or $30,000 per dwelling unit for two- to four-family homes.

Seniors may qualify if they have owned their home within the five boroughs of New York City for at least two years, and are 60 years old or older. Income guidelines apply, and the home must have liability and property insurance.

In the case of deferred, interest-free loans, there are no monthly payments, and fees plus ten percent of the loan are forgiven after the first year. The loan is payable in full if the house is sold, but if the borrower still resides in the home after 30 years, the balance of the loan is forgiven. In the case of low-interest repayment loans, the borrower is charged with 0-3 percent interest and repays the loan over 30 years.

The SCHAP program has been in operation since 1986, and has assisted more than 1,000 senior homeowners. In addition to affordable loans, the program also offers extensive technical assistance to qualifying seniors.

To learn more about the SCHAP program, including application requirements and the loan process, contact the Parodneck Foundation at 212-431-9700, extension 313, or visit: parodneckfoundation.org/schap.

 

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Nursing Home Residents Will Soon Have Greater Rights

Tuesday, November 22nd, 2016

Update (12/1/2016): “The rule was supposed to take effect Nov. 28, but the American Health Care Association, an industry group that represents most nursing homes in the U.S., filed a lawsuit in October to block the rule, which it called “arbitrary and capricious.” To read more, click here.

 

A rule change by a federal agency will provide nursing home residents with major new legal protections by preventing facilities from forcing disputes into arbitration.

littman krooks long-term-careThe Centers for Medicare and Medicaid Services (CMS), part of the Health and Human Services Department, issued a rule preventing nursing homes from requiring that residents resolve disputes in arbitration rather than through a lawsuit. The rule applies to all facilities that receive federal funding, protecting the rights of 1.5 million residents. The arbitration ban is one of several new nursing home regulations promulgated by CMS, including new standards for nutrition and infection control.

Many families must make the decision about a nursing home under time pressure and in emotional turmoil, and they often are not able to consider the implications of all the contract terms. Nursing home contracts often contain fine print requiring that disputes be resolved through arbitration, taking away the right to sue for elder abuse, neglect and even wrongful death.

The nursing home industry said that the rule change, “clearly exceeds the agency’s authority.” Arbitration has reduced legal costs for nursing homes, but advocates for seniors say that it has prevented residents and their families from getting justice. Officials in 16 states and the District of Columbia had urged government action, arguing that private arbitration kept patterns of abuse hidden.

The new rule goes into effect on Nov. 28. It does not apply to contracts signed prior to that date, but current nursing home residents or their families can review their contracts and attempt to renegotiate or choose to move to another facility. After Nov. 28, nursing homes may still ask for a dispute to be settled through arbitration, but residents and their families have the right to file a lawsuit instead.

 

Join us for a free workshop on estate planning, “Plan for Your Future and Avoid Guardianship” on December 7, 2016 at the Greenburgh Library from 10:00 AM-12:00 PM. Registration is required because seating is limited. For more information or to register, click here.


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Westchester to Receive $3.3 Million Grant for In-Home Senior Services

Tuesday, September 27th, 2016

Governor Andrew M. Cuomo recently announced that the Westchester County Department of Senior Programs and Services will receive a $3.3 million grant for in-home services for seniors.

Gov. Cuomo said that the funding would help older New Yorkers continue to live in their homes with dignity and would improve their quality of life.

New York State’s county-based Area Agencies on Aging will receive a total of $50 million through the Expanded In-Home Services for the Elderly Program to help seniors remain in their homes and communities. The program is intended to maximize independence, providing the assistance that seniors need in order maintain a high quality of life in their communities. This may prevent the need for more expensive care, the cost of which is often borne by Medicaid.

The services are designed to help lower income seniors who may have functional impairments and need help with activities of daily living. The in-home services program provides non-medical supports such as assistance with cooking, shopping and getting bills paid.Littman Krooks Elder Law

State Senator Sue Serino, chain of the Senate Standing Committee on Aging, said that both seniors and the community at large benefit when people are able to age in place. When seniors maintain their independence costly nursing home placement is prevented. The program is expected to benefit nearly 70,000 New York seniors.

To be eligible, seniors must not be eligible for similar services such as Medicaid, must be 60 years of age or older and must be able to reside safely in the community. It is not necessary to show that there is a medical need for the services.

 

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Medicaid Asset Transfers: What Are The Rules?

Tuesday, June 21st, 2016

For many families, paying for a loved one’s extended stay in a nursing home would be difficult without the help of Medicaid. However, in order to qualify for the program, a person’s income and assets must fall within certain limits.

Federal rules state that to qualify for Medicaid nursing home coverage, a person must have no more than $2,000 in “countable” assets. However, New York State has more generous rules, so for New York residents in 2016 the limit is $14,850 for a single person. If a married person needs nursing home care, there are protections for a spouse who remains outside. In this situation, the community spouse has a maximum threshold of &74,820 to $119,220 ($14,850 for the institutionalized person and $119,220 for that person’s spouse). Certain types of resources are exempt, such as up to $828,000 of equity in a home and one motor vehicle.

Littman Krooks Elder LawIf you have countable resources above the limits, you may be told that you need to “spend down” your assets, paying for nursing home care yourself, until you reach the resource limits, at which point Medicaid begins covering the cost. This is what happens in many cases. In other cases, a family may anticipate the need for long-term care and wish to transfer assets to the next generation ahead of time, in order to preserve the family’s resources while still qualifying for Medicaid. This is an excellent strategy, as long as the Medicaid rules are followed.

Medicaid has a five-year “look-back” period for transfers of assets. A person applying for Medicaid must disclose all financial transactions for the previous five years. During this time, any transfers of assets for less than fair market value may prevent the person from being eligible for Medicaid. (However, in New York State, the asset transfer rules do not apply for recipients of Medicaid for home care services.) In addition, invalid transfers may result in a costly penalty period during which ineligibility may continue even after assets are spent down.

To avoid ineligibility and penalties, it is important to plan ahead. Transfers made more than five years in advance are not affected by the rules. There are also important exceptions to the asset transfer rules as well as legal strategies including certain trusts that can help preserve assets while ensuring eligibility. As you can see, Medicaid planning is very complex and it is essential to have help from a qualified elder law attorney.

 

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Seniors & Mental Health: Is it Mental Illness or Aging?

Sunday, May 22nd, 2016

Seniors are more at risk for mental illness than the general population. According to the Centers for Disease Control and Prevention (CDC), about 20 percent of people age 55 and older experience some kind of mental health concern. Not only are more seniors affected by mental illness, nearly one in three affected older adults does not receive treatment. By learning more about this often-misunderstood problem and watching for warning signs, we may be able to help elders in need get treatment.

Littman Krooks Elder LawMost people are aware that seniors are more at risk for Alzheimer’s disease and other cognitive impairment. About 11 percent of seniors have Alzheimer’s disease, but it is crucial to understand that cognitive decline is not a normal part of aging. Therefore, changes such as increased forgetfulness, confusion or disorientation should be taken seriously. With a prompt diagnosis, seniors can benefit from treatment earlier, and any necessary changes to their living environment can be made in order to keep them safe.

Seniors are also at risk for depression and mood disorders. According to the CDC, in a 2006 survey, 10.5 percent of people age 65 and older said they had received a diagnosis of depression at some time in their lives, and 5 percent had current depression. Another 7.6 percent received a diagnosis of an anxiety disorder at some time in their lives. Anxiety disorders can include a variety of problems, such as phobias, post-traumatic stress disorder and obsessive-compulsive disorder, including hoarding syndrome. Many seniors fail to seek treatment, in part because some people mistakenly believe that depression is a condition natural to aging.

Mental health concerns can have consequences beyond the symptoms of the condition itself. Untreated mental illness can lead to social isolation, take away from seniors’ independence, and cause physical problems and additional medical concerns. That is why it is important for seniors to take preventive measures, and for their loved ones to be aware of warning signs.

Studies have shown that preventive measures can alleviate mental health problems. The risk of depression and anxiety can be lowered as a result of better physical health. Simple exercise three times a week can be even more effective than prescription medication. Research also indicates that keeping the mind active, through social activities, games and puzzles, and communication with friends and family, can decrease the risk of mental health disorders.

Loved ones and caregivers should watch for changes that may indicate mental health concerns for seniors.

Warning signs include:

  • social withdrawal,
  • a depressed mood that lasts longer than two weeks,
  • memory loss,
  • confusion,
  • feelings of worthlessness or guilt,
  • unexplained physical changes, such as in dress, weight or hygiene.

If any of these symptoms appear, discuss them with the family doctor. Treatment such as counseling or psychiatric care can help seniors get on the right track to healthy aging.

 

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NYC Restores Assistance For Seniors and People with Disabilities

Thursday, April 21st, 2016

The New York City Department of Finance has agreed to a settlement that will reinstate or recalculate the previously frozen rent rates of widowed seniors who had been surprised by steep rent increases after the death of their spouses.

senior couple planningA 2014 rule change by the New York City Department of Finance instituted a new requirement that a spouse or disabled adult wishing to take over a Disability Rent Increase Exemption (DRIE) or Senior Citizen Rent Increase Exemption (SCRIE) from a deceased head of household file an application within 60 days of the death. According to the lawsuit, households receiving the benefits were not given notice of the new rule. As a result, many recently widowed seniors were hit with alarming rent increases.

In March, a settlement was reached awarding damages and legal fees to the plaintiffs and putting an end to the 60-day deadline. The deadline for benefits takeovers is now six months after the death of the head of household or 90 days after receiving notice, whichever is later. The Finance Department also agreed to send information to tenants in seven languages. Read about SCRIE or DRIE.

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Proposed FINRA Rules Will Help Prevent Financial Elder Abuse

Monday, November 16th, 2015

Under new rule proposals soon to be released by the Financial Industry Regulatory Authority (FINRA), financial advisers would be able to delay disbursing funds from the accounts of senior investors if they believe financial elder abuse may be taking place.

Littman Krooks Elder LawOne of the proposed rules would allow financial advisers to wait up to 15 days to disburse funds from senior investors’ accounts if they reasonably believe that financial exploitation is occurring. The proposed rule defines a senior investor as a person who is age 65 or older, or an investor who may be vulnerable for other reasons. The rule would allow advisers to reach out to a person designated as a trusted contact.

A related proposal would require financial advisers to make a reasonable attempt to get contact information for a trusted person on senior investors’ accounts. Under the current proposal, if a senior investor declines to provide such information, the adviser is still permitted to open the account.

The proposed rules would require that if an adviser paused disbursements on a senior investor’s account because of suspected financial elder abuse, the adviser would be required to notify the trusted contact. However, if the trusted contact is the person suspected of committing the exploitation, then the adviser could notify another family member or other responsible party.

The proposed FINRA rules are similar to rules proposed by the North American Securities Administrators Association (NASAA) recently. The NASAA rules allow for a 10-day hold on disbursements when abuse is suspected, and provides for qualified immunity from civil or administrative liability for firms that report suspected financial exploitation of seniors.

 

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Making Decisions on Senior Housing

Tuesday, September 15th, 2015

When an older person needs care and can no longer live with full independence, the senior and his or her family are faced with a number of decisions to make. There is often a range of choices available such as assisted living, in-home care, or a skilled nursing facility, and the task of deciding what is right for the individual senior can seem overwhelming.Littman Krooks Elder Law

The decision may be difficult, but families do not have to face it alone. With Americans age 85 and older the fastest growing age group, millions of Americans are now struggling with this very issue, and there are a number of specialists that are available to assist them.

The exact type of assistance that is required depends on the needs of the individual senior and the family’s situation. Families may need to seek guidance from their family doctor, a financial planner, or an elder care specialist. Crucial assistance can be provided by an elder law attorney, who can provide services such as drafting documents that give power of attorney to a trusted family member so that medical and financial decisions can be made if the senior loses the capacity to make them.

A key factor in making a good decision on senior housing is advance planning. Too often families end up making a decision because of a crisis such as a health issue that has taken a turn for the worse. However, in many cases, the need for care can be predicted and planned for. If the family waits for a crisis to develop, they may not have time to consider all the options.

Ideally, the choice of a housing situation for a senior will come out of a series of family discussions that incorporate the senior’s needs and desires, the available options, and the family’s financial situation. Taking the time to consider the options, and seek expert counsel, can allow a family to craft a unique solution for the individual’s unique needs.

 

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Learn the Facts About Medicare, Medicaid and Long-term Care

Tuesday, July 14th, 2015

More than 40 million seniors rely on Medicare for their everyday health insurance needs, and many mistakenly assume that Medicare will also cover long-term care if it is needed. In fact, there are specific limitations to Medicare coverage for long-term care, and such care is often covered instead by Medicaid, which has eligibility requirements. Therefore, it is important to understand how these two public benefit programs affect long-term care expenses.

Littman Krooks Elder Law

Medicare pays for health care for people age 65 years and older or with certain disabilities. Under certain conditions, Medicare will pay for short-term stays in skilled nursing facilities, hospice care, or home health care. Generally, Medicare focuses on medically necessary care such as doctor’s visits and hospital stays, rather than personal care services associated with long-term care.

Until recently, there was an unevenly enforced “improvement standard,” by which Medicare beneficiaries were denied coverage if their condition was no longer improving. However, the settlement of Jimmo v. Sebelius, a 2013 lawsuit, clarified that no such “improvement standard” can be enforced, and people with chronic conditions can continue to be eligible for Medicare to pay for their medical treatment.

Nevertheless, Medicare generally does not provide for room, board and custodial care such as that offered in a skilled nursing facility. Therefore, people needing such care usually use personal resources, long-term care insurance, and Medicaid. Medicaid has income and asset eligibility requirements, and many seniors will have to spend down some assets to qualify. The financial requirements for Medicaid can be complicated, and the advice of an experienced elder law attorney can be invaluable in planning for long-term care.

 

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