Planning for Life

Obesity Decline a Good Omen for Elder Care

Posted by Harry S. Margolis on July 28, 2015

By Harry S. Margolis

Years ago, I interviewed Dr. Robert Butler, the father of gerontology, for a podcast series I had at the time. With complete self-interest, I asked how he thought Baby Boomers would fare as they aged, fully expecting a bright future as the result of our athleticism and the benefits of good health care. I was surprised at his response that Baby Boomers as a group could look forward to a miserable old age due to obesity.

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Topics: long-term care planning, baby boomers

Using Immediate Annuities in MassHealth Planning for Single Nursing Home Residents

Posted by Harry S. Margolis on April 28, 2015

By Harry S. Margolis

Last week, I blogged about how immediate annuities might be used by spouses of nursing home residents to preserve their assets and qualify the nursing home spouse for MassHealth coverage. Immediate annuities are also used by unmarried or widowed nursing home residents, but with less favorable results. In effect, they permit the nursing home resident to pay the MassHealth rate rather than the private-pay rate. Use of immediate annuities is based on the following rules and facts:

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Topics: MassHealth planning, long-term care planning

Census Bureau Issues Revealing Report on Older Americans

Posted by Harry S. Margolis on April 14, 2015

By Harry S. Margolis

The U.S. Census Bureau has issued a report on the 65+ in the United States: 2014 that paints an interesting picture of the changing demographics of the nation as a whole and of older Americans in particular. Here are some of the highlights:

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Topics: growth of elderly population, long-term care planning

How Much Does MassHealth Pay Nursing Homes?

Posted by Harry S. Margolis on January 20, 2015

By Harry S. Margolis

Families of nursing home residents often want to know what MassHealth is paying for the care of their loved ones. This can be difficult to determine because the rates are different for each facility and for each patient, depending on his or her level of care. But it's important because MassHealth often has a right to recover its expenses at the death of the nursing home resident in the form of a claim for estate recovery against a home, as the beneficiary of an annuity, or under the terms of a (d)(4)(A) or (d)(4)(C) trust.It helps to know what to expect.

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

Why is Long-Term Care Planning So Complicated?

Posted by Harry S. Margolis on December 23, 2014

By Harry S. Margolis

I've been thinking about why long-term care planning is so complicated. The reason is that the future can take so many paths, from no need for care to a long-term nursing home placement, with one or more stops in between. The difficulty of predicting how we will fare is compounded when considering planning for a couple rather than for a single individual.

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Topics: long-term care planning, nursing homes

Are We Elder Law or Elder Care Attorneys?

Posted by Harry S. Margolis on November 4, 2014

Since the National Academy of Elder Law Attorneys (NAELA) was founded more than 25 years ago, lawyers who work with seniors have been trying to brand themselves as "elder law" attorneys. Despite this effort, more and more often I hear us referred to as "elder care" attorneys. "Elder law attorneys" still gets almost four times as many results in Google than "elder care attorneys," but that doesn't seem like a lot when there has been no effort made to promote the second term, though the results overlap significantly.

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Topics: long-term care planning

But Not All MassHealth Trust Cases Go the Right Way

Posted by Harry S. Margolis on October 14, 2014

We recently reported on a superior court decision upholding an irrevocable trust designed to shelter assets as part of long-term care planning. (Click here to read the blog post.) Unfortunately, we have become aware of another decision upholding one of MassHealth arguments against irrevocable trusts, one we felt was so contrary to established trust law that no court would ever go along with it.

In Rita E. Sands vs. Commonwealth of Massachuesetts, Executive Office of Health and Human Services, Office of Medicaid (Suffolk Sup. Ct. CA No. SUCV 2013-3537-A, April 28, 2014), Judge Douglas H. Wilkins holds that all of the funds in an irrevocable income-only trust are available to the trust's grantor because the trustee may purchase an annuity, thus converting unavailable principal to available income.

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Topics: long-term care planning

MassHealth Reversed in Another Trust Case

Posted by Harry S. Margolis on October 10, 2014

Over the last couple of years, MassHealth has been rejecting irrevocable trusts containing terms that it had accepted up until recently. Since many seniors use irrevocable trusts to shelter assets as part of long-term care planning, this has resulted in much uncertainty and cost due to the need for administrative and court appeals. Fortunately, as more cases have gone through the lengthy appeal process litigants are having increasing success in defending the trusts. We can report that my partner, Jeffrey A. Bloom, recently was successful in defending our standard irrevocable trust instrument at an administrative fair hearing.

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

Health Care Agents Cannot Bind Nursing Home Residents to Arbitration

Posted by Rebecca J Benson on September 9, 2014

The Massachusetts Appeals Court has ruled that an agent named in a health care proxy lacks authority to agree to arbitration on behalf of a nursing home resident in a wrongful death case. Barrow v. Dartmouth Nursing Home (Mass App. Court No. 13P-1375, August 18, 2014). The Court noted that the Supreme Judicial Court had recently defined the standards for authorizing arbitration agreements and distinguished them from other forms of agency authority, including those governing health care proxies and the signing of ordinary nursing home admission agreements. Johnson v. Kindred Health Care (Mass., No. SJC-11335, Jan. 13, 2014); and Licata v. GGNSC Malden Dexter LLC (Mass., No. SJC-11336, Jan 13, 2014) (Click here to learn more about the agreements).

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Topics: nursing homes, Estate Planning, long-term care planning

Should You Use a Lawyer or LegalZoom for Your Estate Plan?

Posted by Harry S. Margolis on August 20, 2014

While the goals of attorneys and their clients are supposed to be aligned, often they are not, or at least not completely. I've been thinking about what this means in the field of estate planning and how we can better serve our clients.To lay the groundwork, here are the premises I'm working with:

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Topics: long-term care planning, second marriage, Estate Planning

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