Planning for Life

US Agency Strengthens Protections for Nursing Home Residents

Posted by Elizabeth Stepakoff on October 28, 2016

By Rebecca J. Benson

The Center for Medicare and Medicaid Services (CMS) has announced its first comprehensiveAgingWaiver-resized-600.jpg overhaul of nursing home rules in over 20 years. CMS first promulgated nursing home regulations in 1989 and 1991 to implement the landmark Nursing Home Reform Law of 1987. CMS stated that the new regulations were necessary to reflect innovations in resident care and quality assessment practices, and to address the fact that the population of long-term care facilities has become more diverse and more clinically complex.

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Topics: long-term care planning, nursing homes

CMS Protects Nursing Home Residents’ Right to a Jury Trial

Posted by Rebecca J Benson on October 17, 2016

Frail nursing home residents and their stressed family members are routinely asked to sign a stack of densely-printed documents at the time of admission, without adequate time to review them or consult with counsel. They often do not realize that the agreements include binding arbitration provisions. Although this might sound benign, arbitration requires a waiver of the fundamental constitutional right to a jury trial, even if the resident later suffers serious injury, medical malpractice, or wrongful death. 

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Topics: long-term care planning

MassHealth Planning and Real Estate

Posted by Harry S. Margolis on October 11, 2016

I. MassHealth Eligibility and the Family Home

A. Long-Term Care Planning

For all practical purposes, in the United States the only "insurance" plan for long-term institutional care is Medicaid (called “MassHealth” in Massachusetts). Medicare only pays for approximately 20 percent of nursing home care in the United States. Private insurance pays for even less. The result is that most people pay out of their own pockets for long-term care until they become eligible for MassHealth. While Medicare is an entitlement program, MassHealth is a form of welfare -- or at least that's how it began. So to be eligible, you must become "impoverished" under the program's guidelines.

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Topics: MassHealth, long-term care planning

Using Annuities in MassHealth Planning for Nursing Home Residents

Posted by Harry S. Margolis on October 4, 2016

By Harry S. Margolis

Immediate annuities have long been used in long-term care planning as a means of transforming assets that are countable against the limits for MassHealth eligibility into an income stream that does not affect eligibility. This primarily benefits spouses of nursing home residents, but can be used for single nursing home residents as a form of “arbitrage,” in effect to pay the MassHealth rather than the private-pay rates charged by nursing homes. 

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Topics: long-term care planning, MassHealth, MassHealth planning

How one couple prioritized conflicting estate planning goals

Posted by Harry S. Margolis on September 8, 2016

By Harry S. Margolis

My new clients were an older couple, the wife healthy and the husband, unfortunately, suffering from a progressive neurological disease which confined him to a wheelchair. He needed physical help at the start and end of each day and the level of help, and its cost, was likely to grow as his disease progressed. The couple had their main home in Massachusetts, plus a vacation home in New Hampshire. They had sufficient income and savings to cover their current living expenses, but they could be depleted if the husband needed extensive care over a long period of time. Much of their savings was in tax-deferred retirement accounts.

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Topics: Estate Planning, long-term care planning

Are You Saving to Leave an Inheritance? Why?

Posted by Harry S. Margolis on August 29, 2016

By Harry S. Margolis

Do you hope to leave your children an inheritance? If so, what sacrifices are you willing to make to assure that you do so. Are you working longer or scrimping on spending for yourself? If so, why? Haven't you raised your children and perhaps paid expensive college tuitions? Shouldn't they be able to stand on their own two feet?

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Topics: Retirement Planning, MassHealth planning, long-term care planning

At What Age Should You Do Long-Term Care Planning?

Posted by Harry S. Margolis on April 12, 2016

By Harry S. Margolis

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Topics: long-term care planning, long-term care insurance, MassHealth

Another Trust Bites the Dust, or Why You Should Review Your Plan Periodically

Posted by Harry S. Margolis on April 5, 2016

By Harry S. Margolis

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Topics: trusts, MassHealth planning, long-term care planning, MassHealth

The Top 10 Blog Posts of 2015

Posted by Harry S. Margolis on February 16, 2016

By Harry S. Margolis

While two of our blog posts on life estates and durable powers of attorney (see the links on the right) get far more traffic than all others (they must have gotten greenlighted by Google in some fashion), following are the most popular articles we posted in 2015.

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Topics: MassHealth planning, long-term care planning, MassHealth, Estate Planning

8 More Ways to Protect Your Home from MassHealth Estate Recovery: Part 2

Posted by Harry S. Margolis on February 9, 2016

By Harry S. Margolis

In an earlier blog post, I discussed planning steps you can take to protect your home if sometime in the future you were to need MassHealth covered long-term care. The four steps I described all need to be taken at least five years before you apply for MassHealth. But what do you do if you can't wait five years, if you or a loved one already needs assistance or the writing is on the wall?

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Topics: MassHealth planning, long-term care planning, MassHealth

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