Nursing Home Care Costs Are Only Slightly Higher in 2016

Money exchangeThe median cost of a private nursing home room in the United States has increased slightly to $92,378 a year, up 1.24 percent from 2015, according to Genworth’s 2016 Cost of Care survey, which the insurer conducts annually. Genworth reports that the median cost of a semi-private room in a nursing home is $82,125, up 2.27 percent from 2015. The rise in prices is modest compared to the 4.2 percent and 3.8 percent gains, respectively, in 2015.

The price rise was even lower for assisted living facilities, where the median rate ticked up only .78 percent, to $3,628 a month.  The national median rate for the services of a home health aide was $20 an hour, the same rate as 2015, and the cost of adult day care, which provides support services in a protective setting during part of the day, actually fell from $69 to $68 a day. 

Alaska continues to be the costliest state for nursing home care, with the median annual cost of a private nursing home room totaling $297,840. Oklahoma again was found to be the most affordable state, with a median annual cost of a private room of $60,225, which did not increase in 2016.

While prices may not have increased drastically from last year, the survey found that Americans underestimate the cost of in-home long-term care by almost 50 percent. Thirty percent believe it will be less than $417 a month. In fact, an in-home aide working 44 hours a month would cost $3,861, according to Genworth. For more information, click here.

The 2016 survey was based on responses from more than 15,000 nursing homes, assisted living facilities, adult day health facilities and home care providers. The survey was conducted by phone during January and February of 2016.

For more on Genworth’s 2016 Cost of Care Survey, including costs for your state, click here.

For more articles on senior living, including alternatives to nursing homes, click here.

 

Can Social Security Benefits Be Garnished to Pay Debts?

gavelIf you don’t pay your debts, creditors can get a court order to garnish your wages, but what if your income comes from Social Security? The answer is that it depends on the kind of debt.

For most types of debt, including credit cards, medical bills, and personal loans, Social Security cannot be garnished to pay the debt. If you owe money to a creditor, the creditor can go to court and get an order to take money from your bank account. If your Social Security check is directly deposited in the bank, the bank is required to protect Social Security benefits from garnishment. When a creditor tries to freeze a debtor’s bank account, the bank is required to look at the debtor’s previous two months of transactions to determine if the debtor received any Social Security benefits by direct deposit. For example, if you receive $1,500 a month in Social Security, the bank is required to allow you to use up to $3,000 in your account.

If you receive a Social Security check and deposit it in the bank yourself, the bank can freeze the entire amount in the account. You would be required to go to court and prove the money in the account came from Social Security.

There are certain debts, however, that Social Security can be garnished to pay for. Those debts include federal taxes, federal student loans, child support and alimony, victim restitution, and other federal debts. If you owe federal taxes, 15 percent of your Social Security check can be used to pay your debt, no matter how much money is left.

For student loans and other non-tax debts, the government can take 15 percent of your Social Security check as long as the remaining balance doesn’t drop below $750. There is no statute of limitations on student loan debt, so it doesn’t matter how long ago the debt occurred.  (In fact, student loan debt may be the next crisis facing elderly Americans. In 2015, bills were introduced in the House and Senate, HR 3967 and S 2387, to stop the government from garnishing the wages of elderly and disabled Social Security recipients.)

The rules for child support and alimony vary depending on the law in your state. The maximum amount that can be garnished is 50 percent of your Social Security benefit if you support another child, 60 percent if you don’t support another child, or 65 percent if the support is more than 12 weeks in arrears.

These rules do not apply to Supplemental Security Income (SSI). SSI is protected from garnishment even if the creditor can garnish regular Social Security. Social Security Disability Insurance can be garnished in the same way that Social Security is garnished.

If you feel your Social Security is being improperly garnished, contact your lawyer. 

For more information about Social Security, go here: http://www.elderlawanswers.com/social-security.

Medicare Now Covers Conversations About End-of-Life Care

Doctor-patient consultationMedicare beneficiaries may now discuss options for care at the end of life with their health care providers. 

Beneficiaries of course were already free to talk about advance care planning with their doctors or other qualified health professionals, but the practitioners could be reimbursed for such discussions only during a patient’s “Welcome to Medicare” visit, a time when the topic may not seem very relevant. As of January 1, 2016, Medicare will pay physicians for speaking at any time with Medicare beneficiaries and their families about different options for care and treatment at the end of life. 

These purely voluntary conversations will help enable patients to end their lives on their own terms. Patients are often unable to express themselves when a crisis is at hand and a decision needs to be made about how much or little care they want when facing a terminal illness. According to the Kaiser Family Foundation, one-quarter of Medicare’s budget is spent on patients in their last year of life.  For many patients, life-prolonging medical procedurs are unwanted and unwelcome.  A 2011 study found that when medical personnel know what kind of care a patient wants at the end of life, Medicare can be spared significant sums and the patient is more likely to die at home rather than in a hospital in some areas.

Now that discussions about advance care planning are a regular Medicare benefit, seniors and other Medicare beneficiaries will be able to learn about health care options that are available for end-of-life care, such as advance directives, palliative care and hospice care.  They can then determine which types of care they would like to have, and share their wishes with their practititioners and family.  After sufficient conversations with their doctors and other health professionals, the beneficiaries may be ready to execute legal documents, such as advance directives or “POLST” forms, and name a health care proxy to ensure that their wishes will be carried out. Studies have found that 40 percent of people over age 65 have not written down their wishes for end-of-life treatment. 

An early version of the Affordable Care Act (aka “Obamacare”) would have allowed Medicare to pay for these patient discussions, but former vice presidential candidate Sarah Palin and other opponents of health reform characterized them as government “death panels,” and the provision never made it into the final health care legislation. The Obama administration tried again in 2011, enacting a Medicare regulation that would have reimbursed doctors for discussing end-of-life planning with patients during their annual checkups, but quickly reversed course and withdrew the regulation, apparently fearing that it would revive the specter of  “death panels” at a time when the health reform law was under fierce attack from Republicans. 

Under the new regulations, the advance care planning discussions can take place during the annual wellness visit or at a separate appointment.  They are a reimbursable benefit under Medicare Part B and there will be a copayment if the conversation is not part of the annual wellness visit.

Talk to your elder law attorney about drawing up the documents to help ensure you receive the end-of-life medical treatment you want — no more and no less.

 

The Hardship Exception to the Medicaid Penalty Period: Rare But Possible

Money exchangeIf you transfer assets within five years of applying for Medicaid, you will likely be subject to a period of ineligibility. There is an exception, however, if enforcing the penalty period would cause the applicant an “undue hardship.” This exception is difficult to prove and rarely granted, but it may be possible in certain circumstances.

Under federal Medicaid law, the state Medicaid agency must determine whether a Medicaid applicant transferred any assets for less than fair market value within the past five years. If there are any transfers, the state imposes a penalty period, which is a period of time in which the applicant will be ineligible for Medicaid benefits.

A Medicaid applicant can fight the penalty period by arguing that enforcing the penalty period will cause the applicant an undue hardship. Federal law provides that an undue hardship exists if the penalty period would deprive the applicant of (1) medical care necessary to maintain the applicant’s health or life or (2) food, clothing, shelter, or necessities of life. The burden is on the applicant to prove that hardship exists. A nursing home can also pursue a hardship waiver on behalf of a resident.

Proving an undue hardship is difficult because the applicant needs to show that he or she can’t afford nursing home care during the penalty period and that without nursing home care, the applicant’s health will decline. In addition, states are free to define “hardship” as they see fit and courts vary on how they enforce the hardship exception. For example, in Matter of Tarrytown Hall Care Ctr. v McGuire (N.Y. Sup. Ct., App. Div., 2nd Dept., No. 2849/12, April 16, 2014), a New York appeals court ruled that an undue hardship exception applied even though the nursing home did not attempt to evict the applicant because she was insolvent and unable to recover the assets, and because no other nursing home would accept her. On the other hand, in R.P. v. Division of Medical Assistance and Health Services (N.J. Super. Ct., A.D., No. A-6148-11T3, Oct. 22, 2013), a New Jersey appeals court ruled that a Medicaid applicant whose son had transferred the applicant’s assets to himself was not entitled to an undue hardship exception because the applicant had not proven his health or life were endangered.

If you believe you are entitled to an undue hardship waiver, contact your attorney.

For more information about Medicaid, click here

 

Get Help With Receiving Your Texas Veterans Benefits

Are You Trying To Get The Texas Veterans Benefits You Deserve?

Don’t Wait Any Longer!
Let Us Help You Get Your Deserved Denton County Texas Veterans Benefits

After all they have done for our country, the least we can do is offer benefits for veterans that will help make their lives a bit easier.

Many of our nation’s veterans have seen and experienced terrible things they only wish they could forget. In addition, many suffer from irreversible injuries and are in need of additional support. Yet, for some reason, many of these brave people are still struggling to get the Texas veterans benefits they so rightly deserve.

If you are someone that is trying to get the Denton County Texas veterans benefits you are owed, you might need to seek the assistance of a professional attorney. With the help of Richard M. Barron, you can finally start receiving the Collin County Texas veterans benefits you were promised. These benefits include…

Veterans aid and attendance
Veterans pension

Sadly, many people are unaware of the Texas veterans benefits that they have the right to receive. Why are these benefits for veterans kept so quiet? The answer is simple: money. After all, it saves the state money if it doesn’t have to pay out benefits.

Richard M. Barron finds this to be unacceptable. You gave up years of your life and sacrificed yourself for the good of the country. You deserve to be cared for in return.

Richard M. Barron will help you receive the benefits you are entitled to. Give us a call at 800-939-9093 or email us at rbarron@texaselderlawattorney.com to learn how you can get the support you need today.

Revoking a Power of Attorney

power of attorneyIf for any reason, you become unhappy with the person you have appointed to make decisions for you under a durable power of attorney, you may revoke the power of attorney at any time. There are a few steps you should take to ensure the document is properly revoked.

While any new power of attorney should state that old powers of attorney are revoked, you should also put the revocation in writing. The revocation should include your name, a statement that you are of sound mind, and your wish to revoke the power of attorney. You should also specify the date the original power of attorney was executed and the person selected as your agent. Sign the document and send it to your old agent as well as any institutions or agencies that have a copy of the power of attorney. Attach your new power of attorney if you have one.

You will also need to get the old power of attorney back from your agent. If you can’t get it back, send the agent a certified letter, stating that the power of attorney has been revoked.

Because a durable power of attorney is the most important estate planning instrument available, if you revoke a power of attorney, it is important to have a new one in place. Your attorney can assist you in revoking an old power of attorney or drafting a new one.

What Is Required of an Executor?

filesBeing the executor of an estate is not a task to take lightly. An executor is the person responsible for managing the administration of a deceased individual’s estate. Although the time and effort involved will vary with the size of the estate, even if you are the executor of a small estate you will have important duties that must be performed correctly or you may be liable to the estate or the beneficiaries.

The executor is either named in the will or if there is no will, appointed by the court. You do not have to accept the position of executor even if you are named in the will.

The average estate administration takes one year, though you won’t need to work full time on it. Following are some of the duties you may have to perform as executor:

  • Find documents. If there is a will, but you don’t already know where the will is or the will hasn’t already been brought to court, you may need to find it among the deceased’s belongings. If all you have is a copy of the will, you may need to get the original from the lawyer who drafted it. You will also need to get a copy of the death certificate.
  • Hire an attorney. You are not required to hire an attorney, but mistakes can cost you money. You may be personally liable if something goes wrong with the estate or the payment of taxes. An attorney can help you make sure all the proper steps are taken and deadlines met.
  • Apply for probate. If there is a will, the court will grant you letters testamentary. If there is no will, you will receive letters of administration. This will officially begin your work as the executor.
  • Notify interested parties. Notify the beneficiaries of the will, if there is a will, as well as any potential heirs (such as children, siblings, or parents who may or may not be named in a will). In addition, you will have to place an advertisement for potential creditors in a newspaper near where the deceased lived.
  • Manage the deceased’s property. You will need to prepare a list of the deceased’s assets and liabilities, and you may need to collect any property in the hands of other people. One of the executor’s jobs is to protect the property from loss, so you will need to assure the property is kept safe. You will also need to hire an appraiser to find out how much any property is worth. In addition, if the estate includes a business, you may have to make sure the business continues to run.
  • Pay valid claims by creditors. Once the creditors are determined, you will need to pay the deceased’s debts from the estate’s funds. The executor is not personally liable for deceased’s debts. The estate usually pays any reasonable funeral expenses first. Other debts include probate and administration fees and taxes as well as any valid claims filed by creditors.
  • File tax returns. You need to make sure the tax forms are filed within the time frame set under the law. Taxes will include estate taxes and income taxes.
  • Distribute the assets to the beneficiaries. Once the creditors’ claims are clear, the executor is responsible for making sure the beneficiaries get what they are entitled to under the will or under the law, if there is no will. You may be required to sell property in order to fulfill legacies in a will. In addition, you may have to set up any trusts required by the will.
  • Keep accurate records. It is very important to keep accurate records of everything you do. You will need to create a final accounting, which the beneficiaries must review before the distribution of the estate can be finalized. The accounting should include any distributions and expenses as well as any income earned by the estate since the deceased died.
  • File the final accounting with the court. Once the final accounting is approved by the beneficiaries and the court, the court will close the estate. File a final report with the court and close the estate.

All this can be a lot of work, but remember that the executor is entitled to compensation, subject to approval by the court. Keep in mind that the compensation is counted as income, so you will need to declare it on your income taxes.