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Last week we published a blog on the special Medicaid laws that protect spouses. As we mentioned, Georgia laws and regulations apply different asset limits, allow for spousal diversions, and delay Medicaid estate recovery for married couples when one spouse is in the nursing home. These rules allow for a well spouse to not be impoverished while caring for an ill spouse.

All too often, though, these rules are misunderstood.

And when these rules are misunderstood, families make poor decisions about their loved one’s long-term care. We often hear from spouses who do not understand the Medicaid rules, who think their only option is to bring their ill spouses home even when they doubt their ability to care for them.

Focus on the care first—get the right care for your loved one.

The decision to remove a loved one from nursing home care should not be a financial decision. If someone truly needs the 24/7 skilled care from a nursing home, that care can likely be paid for through Medicaid. That being said, we always prefer that older adults receive care in the least restrictive environment, such as at home, in a personal care home, or in an assisted living community. For some, though, nursing homes offer the best and safest care.

Seek professional advice on Medicaid eligibility.

The rules for nursing home Medicaid in Georgia are complicated and ever-changing. How Medicaid estate recovery works, how patient liabilities are determined, and how assets are counted confuse even the savviest individuals. If you are considering nursing home care for a loved one, please be sure to speak with a knowledgeable, experienced Certified Elder Law Attorney about your loved one’s rights to Medicaid.

Hurley Elder Care Law offers a complimentary phone consultation. Our Certified Elder Law Attorneys can assist you and your family with the nursing home Medicaid process. Please contact us at 404-843-0121 or here.

The post Medicaid Misinformation Creates Poor Long-Term Care Decisions appeared first on Hurley Elder Care Law | Georgia's #1 Certified Elder Law Attorney.

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Georgia nursing home Medicaid continues to confuse families and professionals. One of the most confusing aspects is how the rules apply to a nursing home resident that is married vs. single.

Nursing home Medicaid laws are different for single individuals than for married individuals. In many ways, Medicaid laws are more generous for those with a spouse still at home. In general, the rules usually allow a married individual to get on Medicaid without spending all of his/her assets and income.

In an effort to protect the well spouse, Georgia laws and regulations apply different asset limits, allow for spousal diversions, and delay Medicaid estate recovery for married couples when one spouse is in the nursing home. Medicaid does not want the well spouse to be impoverished by his/her ill spouse’s nursing home costs.

Different Asset Limits for Spouses

Married couples can keep up to $128,420 in assets and still qualify for Medicaid. Compare this to the individual asset limit of $2,000. In addition to this increase in asset limits, Medicaid allows for transfers of assets to occur between spouses penalty-free. So, a nursing home spouse can transfer all of his/her assets to the community spouse without worrying about the dreaded look-back period.

Whether single or married, a nursing home resident can apply for Medicaid while still owning a home and a car. He/she can also have a qualified retirement plan and up to $10,000 in a prepaid burial plan. These are all considered to be exempt assets.

Spousal Diversions and Income Limits for Spouses

When looking at income, Medicaid only looks at the nursing home resident’s income. The well spouse’s income is not considered for Medicaid eligibility. If, however, the well spouse makes less than $3,160.50 in monthly income, he/she may be entitled to keep a portion of the nursing home spouse’s income in order to bring him/her up to the $3,160.50 amount. 

Many of our married clients are concerned that all of their spouse’s income will go to the nursing home if they need nursing home care. Our average clients make $3,500/month in income (the husband has about $2,750 and the wife $750). Georgia allows the well spouse to have a monthly maintenance needs allowance of $3,160.50. So, for either spouse in this situation, the husband or the wife would get to keep a portion of their nursing home spouse’s income. The wife would keep $2,410.50 of her husband’s income; and the husband would keep $410.50 of his wife’s income.

Delayed Medicaid Estate Recovery for Spouses

Lastly, Medicaid allows spouses to avoid or delay Medicaid estate recovery. As we mentioned above, spouses are allowed to transfer assets to their community spouse without worrying about a transfer penalty or being subjected to the look-back period. Doing so may help a family avoid Medicaid estate recovery altogether.

If a family does not take steps to avoid estate recovery, the state does allow the process to be delayed for married couples. Medicaid will avoid placing a lien on the house until after the community spouse also dies. So, if the nursing home spouse dies first and owes money to the state, the state will not seek reimbursement until the other spouse also dies. In this way, Medicaid estate recovery is delayed for married beneficiaries.

In most cases, being married can help an individual to qualify for nursing home Medicaid in Georgia while not depleting his/her assets entirely. The laws can be confusing, and mistakes can be costly. If you are curious about how Medicaid eligibility rules can apply to you, please call our office for a complimentary phone consultation at 404-843-0121 or contact us here.

The post Medicaid Law’s Special Protections for Spouses
 appeared first on Hurley Elder Care Law | Georgia's #1 Certified Elder Law Attorney.

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Georgia nursing home Medicaid continues to confuse families and professionals. One of the most confusing aspects is how the rules apply to a nursing home resident that is married vs. single.

Nursing home Medicaid laws are different for single individuals than for married individuals. In many ways, Medicaid laws are more generous for those with a spouse still at home. In general, the rules usually allow a married individual to get on Medicaid without spending all of his/her assets and income.

In an effort to protect the well spouse, Georgia laws and regulations apply different asset limits, allow for spousal diversions, and delay Medicaid estate recovery for married couples when one spouse is in the nursing home. Medicaid does not want the well spouse to be impoverished by his/her ill spouse’s nursing home costs.

Different Asset Limits for Spouses

Married couples can keep up to $128,420 in assets and still qualify for Medicaid. Compare this to the individual asset limit of $2,000. In addition to this increase in asset limits, Medicaid allows for transfers of assets to occur between spouses penalty-free. So, a nursing home spouse can transfer all of his/her assets to the community spouse without worrying about the dreaded look-back period.

Whether single or married, a nursing home resident can apply for Medicaid while still owning a home and a car. He/she can also have a qualified retirement plan and up to $10,000 in a prepaid burial plan. These are all considered to be exempt assets.

Spousal Diversions and Income Limits for Spouses

When looking at income, Medicaid only looks at the nursing home resident’s income. The well spouse’s income is not considered for Medicaid eligibility. If, however, the well spouse makes less than $3,160.50 in monthly income, he/she may be entitled to keep a portion of the nursing home spouse’s income in order to bring him/her up to the $3,160.50 amount. 

Many of our married clients are concerned that all of their spouse’s income will go to the nursing home if they need nursing home care. Our average clients make $3,500/month in income (the husband has about $2,750 and the wife $750). Georgia allows the well spouse to have a monthly maintenance needs allowance of $3,160.50. So, for either spouse in this situation, the husband or the wife would get to keep a portion of their nursing home spouse’s income. The wife would keep $2,410.50 of her husband’s income; and the husband would keep $410.50 of his wife’s income.

Delayed Medicaid Estate Recovery for Spouses

Lastly, Medicaid allows spouses to avoid or delay Medicaid estate recovery. As we mentioned above, spouses are allowed to transfer assets to their community spouse without worrying about a transfer penalty or being subjected to the look-back period. Doing so may help a family avoid Medicaid estate recovery altogether.

If a family does not take steps to avoid estate recovery, the state does allow the process to be delayed for married couples. Medicaid will avoid placing a lien on the house until after the community spouse also dies. So, if the nursing home spouse dies first and owes money to the state, the state will not seek reimbursement until the other spouse also dies. In this way, Medicaid estate recovery is delayed for married beneficiaries.

In most cases, being married can help an individual to qualify for nursing home Medicaid in Georgia while not depleting his/her assets entirely. The laws can be confusing, and mistakes can be costly. If you are curious about how Medicaid eligibility rules can apply to you, please call our office for a complimentary phone consultation at 404-843-0121 or contact us here.

The post Medicaid Law’s Special Protections for Spouses
 appeared first on Hurley Elder Care Law | Georgia's #1 Certified Elder Law Attorney.

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After years of a stagnant personal needs allowance (it was stuck at $50/month for many years), Georgia has made increases two years in a row. In 2018, Georgia increased the personal needs allowance to $65. This year, Georgia has increased the amount to $70. This new personal needs allowance went into effect on Monday, July 1, 2019 (the start of our new fiscal year).

The personal needs allowance is the amount of money that a nursing home resident receiving Medicaid benefits can keep from their monthly income.

Medicaid is a means-tested health insurance program for those with limited income and assets (for a complete discussion on those limits, please click here). Most nursing home Medicaid recipients have to pay some or most of their income to the nursing home as part of their cost share.

They are, however, entitled to keep a small portion of their income for their own needs. This year, Georgia has decided that nursing home residents can now keep $70 of their income to buy what the nursing home does not provide.

If you have any questions about Medicaid, please contact our office through our website or by calling us at (404) 843-0121.

The post Georgia’s Personal Needs Allowance Increases to $70 appeared first on Hurley Elder Care Law | Georgia's #1 Certified Elder Law Attorney.

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For most aging adults, family members act as the health care and financial agents. Most of us have a spouse, adult child, sibling or other family member who is able and willing to be our agent(s).

More and more frequently, however, we are hearing from elder orphans—or those who have no adult children, spouse or companion to rely on for company, assistance or input.

Nearly 1/3 of all 45-to-63-year-olds are single (either never married or are now divorced). There is also a growing number of “solo-agers,” or older adults without children, living alone. Currently, about 29% (13.3 million) of non-institutionalized older persons live alone. The majority of those are women (9.2 million, vs. 4.1 million men).

There are limited options for seniors without family.

Our long-term care world is set up to help those with involved family members. Hospitals, doctor’s offices, home health, hospice, assisted living communities, and nursing homes expect each patient or resident to have an involved family member to make decisions, arrange transportation, offer support, or provide medical and personal care on a 24/7 basis if needed.

When completing estate planning documents, most have family members to name as surrogate decision-makers.

We encourage every older adult to complete an advance directive, power of attorney for health care, and will and/or trust. Each of these documents require a named surrogate decision-maker. A financial agent is needed in the POA; a healthcare agent in the advance directive; an executor in the will; and a trustee in the trust.

For those without family and friends, professional agents can be hired.

Hurley Elder Care Law recently announced our new service: the Aging Ally. The Aging Ally is a service offered by Hurley Elder Care Law to help older adults in Georgia age with a safety net. Intended to provide extra support to older adults who do not have a designated healthcare and/or financial agent, Hurley Elder Care Law can now step into that role, becoming a hired advocate and decision-maker when necessary.

Our team of professionals can become the client’s healthcare and/or financial agent, providing decision-making services, oversight of healthcare and financial affairs, and protection of financial and physical well-being.

Someone may be a good fit for the Aging Ally Services if:

He is unmarried or widowed with no children.
She is aging without the support of family members.
Any adult children are spread out across the country and not readily available.
Any adult children are uninvolved or estranged.
He prefers enlisting a neutral party in order to keep peace and tranquility within the family.
She is concerned about burdening her family with the responsibility of care.
He has outlived his relatives and friends.
Her spouse is in poor health, and she is concerned about his well-being if she were to die before him.
He is concerned that heirs would consider their needs before his when making decisions about care.
She feels overwhelmed by the process of planning for future care needs and would like assistance from a comprehensive firm that has over 100 years of combined experience.

The Aging Ally Services include many tailored services.

After a thorough assessment, we customize each plan so that we have the level of involvement that is needed in any given situation. This is not a one-size fits all program. We want to find the right size for you and your specific needs. The Aging Ally Services can include:

-Estate Planning (e.g., updated Advance Directives, Powers of Attorney, Wills, and/or Trusts);
-Asset Protection Planning to maximize our client’s resources;
-Care Coordination Services (an initial assessment and on-going involvement by our licensed staff);
-Surrogate Decision-Making, if/when needed by our team;
-Hiring and Oversight of Other Helping Professionals (e.g., CNAs, Geriatric Care Managers, etc.);
-Bill Paying, if/when needed;
-Long-Term Care Placement in the least-restrictive environment that meets both financial and medical needs;
-and more…

If you are interested in learning more about Hurley Elder Care Law’s Aging Ally Services, please contact our office in order to make an appointment with one of our Certified Elder Law Attorneys (CELA). We begin each relationship with a phone call and an in-person assessment with our team.  You can reach us at (404) 843-0121 or through our website.

The post Hiring a Professional to be Your POA appeared first on Hurley Elder Care Law | Georgia's #1 Certified Elder Law Attorney.

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Your estate planning documents should be updated regularly. They are not meant for you to “set it and forget it.”  We recommend that everyone follow the following rule of thumb for updating their advance directives: Whenever there is a new decade, death, diagnosis, divorce, decline, or change in domicile, it’s time to update your estate planning documents.

Whenever one of these things happen in your life, you should update, or at least review, your advance directive:

Decade – At each 10-year birthday (i.e., 40, 50, 60, 70, 80, 90)
Death – When there’s been a death in your family or support system.
Diagnosis – If a serious medical problem arises for you or one of your named agents.
Divorce – If your spouse was named as agent of your directive.
Decline – If your or your agents’ health declines rapidly or if you lose functioning.
Domicile — If there is a change in your living situation (e.g., if you move, if someone moves in with you, etc.)

This is not welcome news for many, but it is best practice.

Last month, someone asked me why her mom is required to update the power of attorney she created in 1995. She was insisting that the documents were still good and that she did not want to spend the time, money, and energy to put new documents in place.

I get it. I can think of at least 200 tasks that would be easier and more pleasant to do besides sign a new power of attorney and new will. Old documents are still valid, but they may not reflect what the person wants, the appointed agents and/or beneficiaries may not be alive, and the document may not comply with current state laws. So, even though you do not have to update old documents, you should. Or you should at least have an elder law attorney review your current documents.

If you need to update your current estate planning documents because one of the six Ds listed above has happened (or if you just want your documents reviewed by one of our Certified Elder Law Attorneys), please contact our office through our website or by calling us at (404) 843-0121.

The post How Often Should You Update Your Documents? appeared first on Hurley Elder Care Law | Georgia's #1 Certified Elder Law Attorney.

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At least once a week we hear from a family member who has been told that her dad’s power of attorney has expired. In an effort to protect an account holder’s assets, many financial institutions will refuse to accept a power of attorney. They fear fraud and exploitation, so they will often create artificial barriers to accepting an account holder’s POA.

This is often infuriating and confusing to the named agent who is probably already facing a stressful and overwhelming situation. So, one of the common tactics financial institutions use to turn away acting financial agents is to claim that the POA is “stale,” “expired,” or “too old.”

Let’s be clear: there is no Georgia statute that forces a power of attorney to have a set expiration date.

There is no magical number of years that a power of attorney must have been written within in order to still be good. So, when you hear:

“Your power of attorney is over five years old, we can’t use it.”
“This POA was written in 2010—it’s not good anymore.”
“His power of attorney is stale.”

Know that this is a false claim. Push back. Ask to speak to a manager. Ask to speak to one of the financial institution’s attorneys. Because here is the truth:

Most powers of attorney are good until the creator of the POA dies.

The power of attorney document will say within it when it expires or when it is no longer effective. There is a slim chance that the document may set an expiration date. Most, however, state that the document is good until the person’s death.

If you have any questions or concerns about the powers of attorney or if you just want your documents reviewed by one of our Certified Elder Law Attorneys, please contact our office through our website or by calling us at (404) 843-0121.

The post Has your Power of Attorney expired? appeared first on Hurley Elder Care Law | Georgia's #1 Certified Elder Law Attorney.

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Because a Power of Attorney enables your agent to act on your behalf for all financial matters, it is extremely important that you choose an agent that you trust.  Effectively, you are giving someone else the power to spend your money, sell your property, and take out new lines of credit in your name.

Choose someone who is trustworthy, has integrity, and is good with money.

Your financial agent has a fiduciary obligation to do what is in your best interest, but it is very difficult to get money back from bad agents once they have stolen your assets. Many people put off signing a power of attorney because they fear being taken advantage of or fear their control being taken away from them too soon. These are real concerns, and you should never sign a power of attorney without some deep consideration about your options and potential consequences.

Choose someone carefully, but do not drag your feet.

Although it may be tempting to put off this important piece of estate planning, most of us over the age of 18 should have a power of attorney in place. And luckily, Georgia passed a law in 2017 that provides us all with greater protections when it comes to powers of attorneys.  This law, known as the Uniform Power of Attorney Act, gives us more prosecuting powers when it comes to bad financial agents.

Choose successive agents.

The power of attorney allows you to name a primary financial agent as well as successor agents. These successor agents can act if your primary agent resigns, dies, becomes incapacitated, is no longer qualified to serve, or has declined to serve.  It is important to name successor agents in the unfortunate event that your primary agent cannot serve when you need him/her.

In addition to successor agents, you can name co-agents. Co-agents can have equal authority and can act independently if you choose for them to do so. Co-agents can also be required to act in tandem, only being able to make decisions if both co-agents agree on the decision. This is one way of protecting yourself from bad agents–make two people be held accountable to one another for any decision that is made about your finances.

Co-agents that have to act in agreement may provide a safeguard, but this situation may also hold up important, time-sensitive decisions that must be made on your behalf. We only recommend co-agents for situations in which no completely trustworthy agent can be named. We occasionally have older adults who want to name two siblings as co-agents just because they don’t want to make one child upset over not being chosen as the financial agent. This rationale, truly, is not a good enough reason to go through the hassles of having co-agents that must act together for every decision. Likewise, having co-agents that have shared authority can make financial decisions a mess. When actions are not communicated, finances can become chaotic.

Consider hiring a professional to act as your agent.

There are professionals that can be hired to act as your financial agent. These attorneys, bankers, daily money managers, etc., can be named as your agent and receive compensation for ever acting in that role on your behalf. For those without accessible, dependable, trustworthy family or friends, hiring a professional that is experienced, credible, and insured can be a great option.

Hurley Elder Care Law has recently added Aging Ally services. The Aging Ally is a service to help older adults in Georgia age with a safety net. Intended to provide extra support to older adults who do not have a designated healthcare and/or financial agent, Hurley Elder Care Law can now step into that role, becoming a hired advocate and decision-maker when necessary.

If you have any questions or concerns about the powers of attorney or the aging ally program, please contact our office through our website or by calling us at (404) 843-0121.

The post Choosing the Best Agent for Your Power of Attorney appeared first on Hurley Elder Care Law | Georgia's #1 Certified Elder Law Attorney.

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If you are caring for a disabled or aging loved one, you are likely anticipating a medical crisis to eventually happen: The dreaded call from a neighbor or hospital; a late night call from your loved one; coming home from work to find your loved one on the floor!

Many of us think we’re prepared, but are we?

You have likely completed an advance directive, had some cursory talks about end-of-life care, and feel pretty confident in your ability to handle the emergency. Or maybe you know that you are ill-prepared for the future but feel too overwhelmed to plan. Let’s take a quick quiz.

Can you answer these questions?

Where is your loved one’s advance directive?
What are his/her doctors’ names?
Can you list all medications and drug allergies?
What are his/her major medical problems?
What is your loved one’s surgical history?
Where are the insurance cards and policies kept (including health, life, and long-term care insurance)?
Would he/she want a feeding tube, ventilator, CPR, etc.?
How does your loved one feel about life-sustaining treatment?
How does he/she feel about quality of life vs. quantity of life?
Is Aging In Place important to your loved one? Or is community living an option?

Maybe we can never fully be prepared for a medical crisis, but being able to answer these 10 questions can help you immensely. As you navigate through a healthcare crisis, you will interact with providers and experts that can help you and your loved one. They have to be able to make good assessments, and they will rely on you providing them with accurate, complete information.

Where do you start?

Last week’s blog covered “How to Talk to Your Loved Ones about End-of-Life Wishes.” There was some great information packed in that blog about how to start the conversation as well as resources. Start by reading (or re-reading) that blog, and then start asking your loved ones questions.

Should you hire an expert?

You can always reach out to a professional (e.g., an elder law attorney, geriatric social worker, or geriatric care manager) to facilitate these discussions and to help create a plan. Often, the presence of a neutral, knowledgeable professional can defuse worries and eliminate barriers. If your loved one is not willing to talk to you, they might talk to a professional. Many adult children have been surprised by their parents’ openness and agreeability when working with our team.

We have helped many families navigate these crises. Many of them had no plan, and their journey was so much harder. We are passionate about helping families plan for the unknown. If you have any questions or concerns about advance care planning, please contact our office through our website or by calling us at (404) 843-0121.

The post Quiz: Are You Truly Prepared for Your Loved One’s Medical Crisis? appeared first on Hurley Elder Care Law | Georgia's #1 Certified Elder Law Attorney.

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Many of our clients have touched my life, changed how I practice, and informed my approach. There is one client in particular that I will never forget. He was 99 years old and came to our office for estate planning. He had just moved to Georgia from South Carolina to be closer to his daughter after his wife died.

When we got to the advance directive, I asked my client about his treatment preferences. After he answered, I quizzed his daughter about any significant changes in his wishes. A sudden change in wishes should be discussed and questioned to rule out any undue influence, misunderstandings, or capacity issues.

“Your father just indicated that he would not want CPR if his heart were to stop and would not ever want a feeding tube. Is this in line with what your previous conversations and what he has stated before?” I asked.

“Well, I’m not sure–we’ve never talked about this before,” she replied.

I was dumbfounded.  This family had avoided any meaningful conversation about end-of-life wishes and estate planning concerns for a very long time, and they were lucky to have never experienced a crisis prior to this conversation.

I still am not sure how a man reaches age 99 without ever having told his family his opinions about his healthcare wishes or his final plans. Perhaps he and his wife had decided to only talk about that in private with each other.

For most families, this conversation comes up at some point (at least in brief conversations like, “Do not ever keep me alive if I get sick like they did to Nancy down the street after her stroke.”); but even for those families that have talked about end-of-life wishes at all, very few have talked about these issues in-depth.

Ask your loved ones about their wishes, and then ask more questions.

When you are suddenly called upon to make decisions for your loved one’s medical care, it is crucial that you know what your loved one would want. Knowing how they feel about life-extending care and where they fall on the quality vs. quantity of life continuum matters.

It may seem morbid to bring up. Some older adults wittily reply with a “What? Are you trying to kill me?” response, but most older adults express relief and gratitude for the opportunity to discuss their end-of-life wishes and treatment preferences. And even if the conversation is uncomfortable, that pain pales in comparison to the pain of making major medical decisions for someone that you had never talked to about end-of-life wishes.

Prepare for the conversation.

Lucky for all of us, there are some great resources on how to have this conversation with your loved ones. In our last blogs, we shared information on Advance Directives, PREPARE for Your Care, the Five Wishes, and Critical Conditions. You can use any of these to guide you through the conversation, focusing on completing the document together instead of having an open-ended conversation. This task-focused approach may be less intimidating for some.

It hardly matters exactly how you have the conversations with your loved ones—it’s just important that you have them. You can always reach out to a professional (an elder law attorney, geriatrician, or geriatric social worker) to facilitate the discussion.

We are passionate about all Georgians completing an advance directive for healthcare. If you have any questions or concerns about the Georgia Advance Directive, please contact our office through our website or by calling us at (404) 843-0121.

The post How to Talk to Your Loved Ones about Their End-of-Life Wishes appeared first on Hurley Elder Care Law | Georgia's #1 Certified Elder Law Attorney.

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