Archive for the ‘Long Term Care’ Category

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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Comparing Different Options in Life Insurance

Wednesday, March 18th, 2015

Certain forms of life insurance can be used as an investment and estate planning tool as well. Understanding the different options, term life insurance and permanent life insurance, can help to protect your family’s economic security in the event of an unexpected death.

Term life insurance
Term life insurance is pure risk protection, and it is what many families consider to be essential. The premium is paid for a certain term, or number of years, and the death benefit is paid out only if the insured person dies before the term ends. Term life insurance is much less costly than permanent life insurance, for the simple reason that the insurance company expects to only have to pay out the death benefit for about five percent of policies.

Within term life insurance, a common type is guaranteed level premium term life insurance, in which the annual premium remains the same for the entire term of 10, 15, 20 or 30 years. Insurance companies may also offer return premium term life insurance. With this type, some of the premiums paid are returned if the policyholder outlives the term, minus fees that the insurance company retains. This type of term life insurance is more expensive.

Permanent life insurance
With permanent life insurance, there is no fixed term, and the policy is in place for the insured person’s entire life. As long as the premiums are paid, then a death benefit will be paid when the person dies. Because the insurance company knows it must pay out a benefit, the premiums it charges are much higher than for term life insurance.

Permanent life insurance is typically comprised of an insurance portion and a savings or investment portion. The insurance company invests part of the premiums paid, and the policy builds up a cash value on a tax-deferred basis. The policyholder can usually borrow against the cash value.

The basic form of permanent life insurance is known as whole life insurance. A more flexible form is known as universal or adjustable life insurance. With a universal life insurance policy, one may choose to pay premiums at different times and increase the death benefit. One may also select a fixed death benefit, or an increasing amount equal to the face value of the policy plus the cash value amount.


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Age-Related Financial and Planning Milestones that People Will Encounter in their Sixties

Friday, March 28th, 2014

As one nears retirement age, a number of important financial planning milestones begin to approach. It can be difficult to keep them all straight. Here is a timeline of what happens when:

  • At age 59 1/2, people can begin to make withdrawals from 401(k)s, traditional IRAs and similar retirement savings accounts, without an additional tax penalty of 10 percent. (Withdrawals are still taxed as income in any case.) Of course, just because one can begin to make withdrawals at this age does not mean one necessarily should.
  • At age 60, if one’s spouse has died, then one can begin to collect a Social Security survivor benefit. This is also true if an ex-spouse has died, if the marriage lasted at least 10 years and the survivor did not remarry.
  • Upon reaching age 62, people can take the option of early Social Security retirement benefits. Keep in mind that starting one’s benefits early results in lower payments, and it is usually better to wait a few years to receive a larger benefit. If one is eligible for a pension, these benefits also often kick in at this age.
  • At age 65, one becomes eligible for Medicare. There is a seven-month window around one’s 65th birthday to sign up for Medicare benefits and avoid a surcharge.
  •  Age 66, for most baby boomers, is full retirement age for the purposes of Social Security retirement benefits. Additionally, at this age, someone who chose early benefits can now suspend benefits in order to build up delayed retirement credits.
  •  Upon reaching age 70, there is no further advantage to delaying taking Social Security retirement benefits. People who wait until this age to begin receiving benefits maximize their monthly payments.
  • At age 70 1/2, required minimum distributions begin for 401(k)s and IRAs. A certain amount must be withdrawn from these accounts each year, based on the total value of all such accounts.

By paying close attention to these milestones, one can complete a more precise budget, an important part of retirement planning.


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Further Thoughts on Long-Term Care Insurance

Monday, March 17th, 2014

Our recent post (see below) entitled, “Is Long-Term Care Insurance Worth the Cost?” has generated a lot of discussion.

We’d like to clarify a few points:

  • Long Term Care (LTC) insurance pays for expenses associated with chronic illnesses, such as home care, assisted living and nursing homes. On a long-term basis, these expenses are not covered by Medicare, which covers mainly short term rehabilitation.
  • In many cases, long-term care insurance enables policy holders to protect their financial assets.
  • Premiums for LTC insurance are based on a variety of factors, including the person’s age, health, medical history and policy benefits.  The earlier you buy, the less expensive the policy will be.

Whether and when a particular individual should purchase a LTC policy is a complex issue and the answer to the question posed in the original post can differ by individual, age, family situation, income and assets.  There really is no bright line test. LTC insurance should be considered by all as part of the estate planning process.

Before purchasing a LTC  policy:

  • Familiarize yourself with the benefits as well as the limitations
  • Have a thorough understanding of your financial situation and goals

Work with a reputable agent who specializes in LTC insurance.  In addition, speak to an elder law attorney and discuss the terms of the policy, the costs, the associated benefits as well as the financial strength of the insurer.


Is Long-Term Care Insurance Worth the Cost?

As the cost of a nursing home stay has increased, so has the cost of long-term care insurance, causing many seniors to reassess the value of such insurance.

Many people’s financial planning for retirement includes a combination of Social Security retirement benefits, other sources of income such as a pension, and savings and investments. On the expenses side, many costs are stable and predictable, with one serious risk being the need for nursing care for a long period of time. Since the annual cost of care in an Alzheimer’s unit can reach $100,000 or more, it is no wonder that many consider long-term care insurance. However, it is important to think about whether such protection is right for you.

First, keep in mind that many nursing home stays are not covered by such policies. Most long-term care policies do not cover the first 90 days, and two-thirds of nursing home stays are for less than 90 days, so insurance will not help at all in these cases. In the case of an extended stay, many policies will cover only a certain dollar amount and only for the period of time covered, often three years.

For many seniors entering a nursing home for an indefinite stay, Medicare will provide for the cost, with assets being used to offset the cost until they are exhausted, when Medicaid will kick in. Therefore, for a single person with no heirs, long-term care insurance may not be necessary. For a married couple, if one spouse requires an extended stay in a nursing home, the healthy spouse may keep the house, one vehicle, and assets of about $116,000 (the amount varies by state), and still qualify for Medicaid for the nursing home expenses.

One view is that long-term care insurance may be unnecessary either if a couple’s assets are less than $116,000 exclusive of the home and one vehicle, such that they will be eligible for Medicaid, or if assets are above about $700,000, in which case the couple can probably self-fund a nursing home stay. Within that window between roughly $116,000 and $700,000, long-term care insurance may be useful.


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How Divorce and Remarriage Affect Social Security Retirement Benefits

Tuesday, March 11th, 2014

People considering divorce as their 10-year wedding anniversary approaches should know that delaying the split until after the decade mark can result in higher Social Security retirement benefits for a spouse with a lower earning record.

Taking the example of a divorced couple where the ex-husband had a higher earnings record, if the couple was married for 10 years or more, then the ex-wife can receive higher benefits based on his record, provided she is age 62 or older and has not remarried.

Even if the ex-husband has not applied for retirement benefits, the ex-wife may receive benefits based on his record, provided they have been divorced for more than two years. If the woman remarries, then she would no longer be able to collect the benefits unless the later marriage

Recent years have seen a rise in both marriages and divorces later in life, and statistics suggest that divorcing couples may take retirement benefits into account, as there is a measurable increase in divorce after the 10-year mark. As might be expected, the effect is most pronounced for couples nearing retirement age. A recent study found that for people 55 and older, there is an 11.7 percent increase in the likelihood of divorce at about the decade mark. For couples age 35 to 55, that drops to a 6 percent increase in likelihood of divorce at 10 years, and for people under age 35, there is almost no effect.

Other researchers are skeptical that many people take retirement benefits into account in their divorce decisions, pointing to studies that show that only 13 percent of people are very knowledgeable about how Social Security benefits are calculated.

Whether divorcing couples currently consider retirement benefits in timing their divorce, many advisers agree that they should. Divorcing just short of the 10-year mark could result in thousands of dollars in lost benefits, so it may be worthwhile for some to delay the process.

Financial considerations are often part of making decisions about divorce, so it is important to be aware of how Social Security benefits can be affected.


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NY Connects: Long Term Care

Wednesday, February 12th, 2014

Choosing the right long term care services and supports can be difficult. If you are looking for long term care in New York State, you should be aware of NY Connects: Choices for Long Term Care. This is a free, state-funded service that can provide you with personalized information over the telephone about options such as assisted living residences, nursing homes, senior centers, adult day care, home care, hospice care, transportation, paying for medicine, and many other similar concerns.

Speaking with a NY Connects counselor can be very helpful if you know you need assistance but are not sure what kind of help is available or which long term care option is best for your situation.

The service is available whether you are eligible for a government program, using insurance, or paying for services yourself. Calls are confidential and are answered by trained specialists. Help is available in several different language, and TTY is available for the hearing impaired.

In Westchester County, NY Connects Can be reached at 914-813-6300. More information is available at


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Leaving Unequal Inheritances to Children Can Cause Problems

Wednesday, January 22nd, 2014

Many people creating or updating an estate plan are blessed with children and grandchildren, and enough assets to leave them a significant inheritance. However, deciding how to provide for future generations can lead to conflict, and much of that conflict stems from unequal treatment of children, whether it is intended or not. Here are a few pitfalls to avoid.

In some families, especially in previous generations, it was common to treat sons and daughters differently in regards to inheritances. A family business might be left to sons, while another asset such as a trust may have been created to provide for daughters. Needless to say, this can cause resentment and disputes. In modern times, such gender distinctions are less common. However, parents creating an estate plan often still choose to treat some children differently.

Parents sometimes consider providing for their adult children differently based on each child’s family income and assets. While this may seem like fairness, it is likely to cause resentment. It is, of course, one’s right to distribute one’s assets according to one’s wishes. However, parents may want to consider simply dividing their assets equally among their children. This simple solution can head off arguments and hurt feelings.

Distribution of assets to one’s children and grandchildren during one’s lifetime may be unequal for valid reasons. Paying for college may entail a greater cost for one child than for another. Helping to provide for grandchildren may mean that one’s adult children with more children of their own receive more help. These matters are best approached with openness and an attempt at fairness, keeping in mind individual circumstances.

When it comes to planning one’s estate, there may be a temptation to either mirror those inequalities by leaving more to adult children with more children of their own, or to make up for them by leaving something additional to one’s other children. However, the best approach may be the simplest: dividing one’s estate equally among one’s adult children, and providing that in the case of an adult child who has passed away, that any grandchildren receive that child’s share of the estate.

Passing on a family business may seem like a special case, but it need not be. If one or more adult child has had a special role in a family business, then that role will likely continue. Ownership of a family business may still be passed on to all adult children equally, with a child who has worked in the business continuing to be compensated for his or her work. Alternatively, a child who works in the business can receive ownership shares during the parents’ lifetime, so that the remaining family shares are distributed equally upon the parents’ death.

Passing on an inheritance to one’s children should be a cause for celebration rather than disputes. Making distributions as equal as possible is one way to keep it that way.



Different Types of Assisted Living Facilities Meet Different Needs

Tuesday, December 17th, 2013

Assisted living facilities are residences for senior citizens where help is provided with daily living activities, as needed. This can include making doctor’s appointments and taking medication, as well as bathing, dressing and grooming. Meals and housekeeping are also provided at such facilities. In the state of New York, all types of assisted living residences are licensed as adult care facilities by the Department of Health. However, there are different types of adult care facilities, which may also be called enriched housing programs or adult homes.

First, all adult care facilities are distinguished from nursing homes in that they are for people who do not need round-the-clock medical services or skilled nursing. People who need for medical staff to be present on a continuous basis are better served by a nursing home.

The two kinds of adult care facilities in New York, enriched housing programs and adult homes, both offer long-term care in a residential setting, including meals, laundry, housekeeping, supervision and assistance with personal care and medication. One major difference is that the law has stricter supervision requirements for adult homes, although a number of enriched housing programs may offer the same level of supervision. In addition, enriched housing programs usually provide apartment-style residences, while adult homes generally provide private rooms or two-person rooms.

The same types of service provided in enriched housing programs and adult homes may also be provided by assisted living residences and assisted living programs. In order to refer to themselves as providing “assisted living,” these facilities must meet additional requirements of providing certain disclosures and rights for residents. The goal of assisted living facilities is to provide the care necessary to allow individuals to live as independently as possible, emphasizing personal dignity and freedom of choice.

Finally, an assisted living residence that offers aging-in-place services and obtains additional certification may be designated an enhanced assisted living residence. A special needs assisted living residence is an assisted living residence that provides specialized care and meets additional certification requirements.

For more information, refer to the New York State Department of Health’s website on assisted living, available at