How Do I Hire a Caregiver from an Agency?

Part One of AARP’s recent article entitled “How to Hire a Caregiver” explains that when you have a list of promising agencies, you should schedule a consultation.

It doesn’t matter if your family member is eligible for Medicare, Medicare’s Home Health Compare can be a terrific tool for finding and researching home health agencies in your area.

It provides detailed information on what services they provide and how patients rate them.

Working with an agency has its pros and cons. The pluses include the following:

Background checks. Caregivers must pass a background check.
Experienced caregivers. Agencies are likely to have a number of caregivers who cared for other seniors with the illness or condition affecting your loved one.
Backup care. If the primary aide is sick or doesn’t work out, an agency typically can quickly find a replacement.
Liability protection in the event that a caregiver is injured while at the home.
No paperwork. The agency takes a fee, pays the aide and does the payroll and taxes.

Here are some of the corresponding minuses of working with an agency:

Greater expense. You’ll pay more for an agency-provided caregiver.
Little choice. The agency chooses the worker, and he or she may not fit well with you or your family member.
Negotiation is limited, and individuals are generally more flexible about duties, hours and overtime than agencies.
There are agencies that don’t permit a part-time schedule.

In addition, you can contact an experienced elder law attorney and ask for recommendations.

Reference: AARP (Sep. 27, 2021) “How to Hire a Caregiver”

Can I Restructure Assets to Qualify for Medicaid?

Some people believe that Medicaid is only for poor and low-income seniors. However, with proper and thoughtful estate planning and the help of an attorney who specializes in Medicaid planning, all but the very wealthiest people can often qualify for program benefits.

Kiplinger’s recent article entitled “How to Restructure Your Assets to Qualify for Medicaid” says that unlike Medicare, Medicaid isn’t a federally run program. Operating within broad federal guidelines, each state determines its own Medicaid eligibility criteria, eligible coverage groups, services covered, administrative and operating procedures and payment levels.

The Medicaid program covers long-term nursing home care costs and many home health care costs, which are not covered by Medicare. If your income exceeds your state’s Medicaid eligibility threshold, there are two commonly used trusts that can be used to divert excess income to maintain your program eligibility.

Qualified Income Trusts (QITs): Also known as a “Miller trust,” this is an irrevocable trust into which your income is placed and then controlled by a trustee. The restrictions are tight on what the income placed in the trust can be used for (e.g., both a personal and if applicable a spousal “needs allowance,” as well as any medical care costs, including the cost of private health insurance premiums). However, due to the fact that the funds are legally owned by the trust (not you individually), they no longer count against your Medicaid income eligibility.

Pooled Income Trusts: Like a QIT, these are irrevocable trusts into which your “surplus income” can be placed to maintain Medicaid eligibility. To take advantage of this type of trust, you must qualify as disabled. Your income is pooled together with the income of others and managed by a non-profit charitable organization that acts as trustee and makes monthly disbursements to pay expenses on behalf of the individuals for whom the trust was made. Any funds remaining in the trust at your death are used to help other disabled individuals in the trust.

These income trusts are designed to create a legal pathway to Medicaid eligibility for those with too much income to qualify for assistance, but not enough wealth to pay for the rising cost of much-needed care. Like income limitations, the Medicaid “asset test” is complicated and varies from state to state. Generally, your home’s value (up to a maximum amount) is exempt, provided you still live there or intend to return. Otherwise, most states require you to spend down other assets to around $2,000/person ($4,000/married couple) to qualify.

Reference: Kiplinger (Nov. 7, 2021) “How to Restructure Your Assets to Qualify for Medicaid”

Can I Claim Grandfather’s Unclaimed Insurance Policy?

What if you recently discovered some old life insurance accounts being held by the state for your grandfather, who passed away in 1977.

It looks like the funds were never disbursed because the address was spelled wrong. As a result, the insurance accounts were considered unclaimed.

None of his children—including your mom—is alive today, and there are a number of adult grandchildren besides you.

How do you get your hands on this money? How is it disbursed?

Nj.com’s recent article entitled “I found two old life insurance policies. How can we collect?” says that insurance claims can be made at any time, even years after the death of the policy holder.

The first step is to make contact with the life insurance company that issued the policy.

The National Association of Insurance Commissioners has a website to help people locate insurance policies.

Even if the policy proceeds reverted to the state, you can still claim it through the Unclaimed Property Administration.

The National Association of Unclaimed Property Administrators, which is a network of the National Association of State Treasurers, says that about one in 10 people have unclaimed cash or property waiting for them.

Unclaimed or “abandoned” property is defined as property or accounts within financial institutions or companies with no activity generated (or contact with the owner) as to the property for one year or a longer period.

After a designated period of time—known as “the dormancy period”— with no activity or contact, the property becomes “unclaimed” and—by law—must be turned over to the state.

There are billions of dollars in unclaimed property that’s held by state governments and treasuries across the country.

As far as who would get your grandfather’s insurance policy proceeds, the distribution of the life insurance proceeds are governed by the contract of the life insurance policy.

Reference: nj.com (Nov. 18, 2021) “I found two old life insurance policies. How can we collect?”

What Taxes Have to Be Paid When Someone Dies?

The last thing families want to think about after a loved one has passed are taxes, but they must be dealt with, deadlines must be met and challenges along the way need to be addressed. The article “Elder Care: Death and taxes, Part 1: Tax guidance for administering a loved one’s estate” from The Sentinel offers a useful overview, and recommends speaking with an estate planning attorney to be sure all tasks are completed in a timely manner.

Final income tax returns must be filed after a person passes. This is the tax return on income received during their last year of life, up to the date of death. When a final return is filed, this alerts federal and state taxing authorities to close out the decedent’s tax accounts. If a final return is not filed, these agencies will expect to receive annual tax payments and may audit the deceased. Even if the person didn’t have enough income to need to pay taxes, a final return still needs to be filed so tax accounts are closed out. The surviving spouse or executor typically files the final tax return. If there is a surviving spouse, the final income tax return is the last joint return.

Any tax liabilities should be paid by the estate, not by the executor. If a refund is due, the IRS will only release it to the personal representative of the estate. An estate planning attorney will know the required IRS form, which is to be sent with an original of the order appointing the person to represent the estate.

Depending on the decedent’s state of residence, heirs may have to pay an Inheritance Tax Return. This is usually based on the relationship of the heirs. The estate planning attorney will know who needs to pay this tax, how much needs to be paid and how it is done.

Income received by the estate after the decedent’s death may be taxable. This may be minimal, depending upon how much income the estate has earned after the date of death. In complex cases, there may be significant income and complex tax filings may be required.

If a Fiduciary Return needs to be filed, there will be strict filing deadline, often based on the date when the executor applied for the EIN, or the tax identification number for the estate.

The estate’s executor needs to know of any trusts that exist, even though they pass outside of probate. Currently existing trusts need to be administered. If there is a trust provision in the will, a new trust may need to be started after the date of death. Depending on how they are structured, trust income and distributions need to be reported to the IRS. The estate planning attorney will be able to help with making sure this is managed correctly, as long as they have access to the information.

The decedent’s tax returns may have a lot of information, but probably don’t include trust information. If the person had a Grantor Trust, you’ll need an experienced estate planning attorney to help. During the Grantor’s lifetime, the trust income is reported on the Grantor’s 1040 personal income tax return, as if there was no trust. However, when the Grantor dies, the tax treatment of the trust changes. The Trustee is now required to file Fiduciary Returns for the trust each year it exists and generates income.

An experienced estate planning attorney can analyze the trust and understand reporting and taxes that need to be paid, avoiding any unnecessary additional stress on the family.

Reference: The Sentinel (Dec. 3, 2021) “Elder Care: Death and taxes, Part 1: Tax guidance for administering a loved one’s estate”

Can Elder Financial Abuse Be Stopped?

The numbers are chilling. One in ten Americans age 60+ has experienced elder abuse. One of the most common forms of elder abuse is financial, says a recent article from Forbes titled “What Is Elder Financial Abuse—And How Do We Prevent It?”

Financial elder abuse is defined as when someone illegally or improperly uses an elderly person’s money for their own use. Elderly people are easy victims for obvious reasons. They may be mentally vulnerable, suffering from Alzheimer’s or other form of dementia. They may also be lonely and find the company of a new “friend” is so delightful that it impairs their judgement.

Financial elder abuse occurs most often from adult children, but also in nursing homes and assisted living facilities. Be on the watch for those new friends who enter senior’s lives, especially if they seek to limit contact with family members.

Caregivers or nursing staff have access to resident’s possessions, including checkbooks, ATM cards and credit cards. Monitoring an aging parent’s bank accounts on a regular basis should be part of caregiving by adult children. Unusual transactions, large withdrawals or unlikely purchases by credit card should immediately be reported to their bank or credit card company.

Less obvious and harder to track, is when someone forces a nursing home resident to sign legal documents transferring ownership of homes, cars, bank accounts and even investment accounts. They may also be pressured into creating a new will.

Here are some red flags to watch for:

New names being added to bank accounts or on credit cards.
Finding unpaid bills, letters from collection agencies or past due notices from creditors, especially when the person has sufficient funds.
Relatives who suddenly show up and want to be involved with an aging senior, including estranged children.
The unexpected transfer of any kind of asset to someone who is not a family member.
Any change in habits concerning money, including someone who was never worried about money suddenly being concerned about paying bills.

The elderly are often scared to report being victimized. They may fear further loss of control over their lives or be embarrassed to have been scammed. If a caregiver is stealing, they may also be physically threatened, or frightened of losing their familiar care provider.

Talk to your estate planning attorney, speak with the local Adult Protective Services office, or contact the National Elder Fraud Hotline, if you are concerned about a loved one being financially exploited. If you believe a loved one is in physical danger, contact the local police. Don’t hesitate to ask for help.

Reference: Forbes (Nov. 9, 2021) “What Is Elder Financial Abuse—And How Do We Prevent It?”

What’s the Price Increase on Medicare Next Year?

Money Talks News’ recent article entitled “Traditional Medicare Premiums Will Soar in 2022” says that the rising costs include the:

2022 Medicare Part B standard premium: $170.10 per month, an increase of $21.60 from $148.50 in 2021. That’s compared with an increase of $3.90 per month one year earlier.
2022 Medicare Part B deductible: $233 per year, an increase of $30 from $203 in 2021. That’s compared with an increase of $5 one year prior.
2022 Medicare Part A inpatient hospital deductible: $1,556, an increase of $72 from $1,484 in 2021. That’s compared with an increase of $76 one year prior.

What this means is that Medicare costs will go up 2022 and will effectively reduce the 5.9% cost-of-living adjustment (or “COLA”) that increases retirees’ monthly Social Security benefit payments in the new year. For the average retiree, the 2022 COLA is about an extra $92 a month. These Social Security COLAs averaged 2.2% between 2000 and 2020 and annual increases in the Part B premium averaged 5.9% during the same period.

Here what Medicare Part A covers:

Inpatient hospital services
Skilled nursing facility services; and
Some home health care services.

Nearly all (roughly 99%) of Medicare beneficiaries don’t pay a premium for their Part A coverage due to how long they worked and had Medicare taxes withheld from their paychecks. Medicare Part B covers the following types of care:

Physician services
Outpatient hospital services
Certain home health services
Durable medical equipment; and
Certain other medical and health services not covered by Part A.

Part B premiums are based on income. Those with higher incomes pay higher Part B premiums — which will be anywhere from $238.10 to $578.30 for 2022, depending on income and federal tax-filing status.

Reference: Money Talks News (Nov. 15, 2021) “Traditional Medicare Premiums Will Soar in 2022”

How Can I Rescue My Retirement?

A 2019 survey by Global Atlantic Financial Group, which sells annuities, asked more than 4,000 Americans, pre-retirees and retirees, about their retirement savings. Of those surveyed, 55% said they had regrets. The top three were that they:

Did not save enough.
Relied too much on Social Security.
Did not pay down debt before retiring.

However, you can avoid some of this remorse, by taking steps now. Let’s look at how you can avoid those major retirement regrets.

Failing to save enough. A recent survey found that 62% of respondents were confident about their current financial health. However, when people looked ahead to their retirement finances, that changed. Part of the issue is planning. Only 18% of the Fidelity survey respondents had a financial plan for retirement. Without planning, it’s hard to know if you have enough saved. See how much you’ll be spending in retirement. Go through your expenses and increase your savings. The most common financial surprises for retirees are inflation and unexpected medical costs.
Depending too much on Social Security. Rather than looking at Social Security as your main source of income in retirement, view it as one of several legs of a stool. Social Security isn’t designed to provide all the necessities of life. It is supplemental. It is not intended to be replacement income. Your planning should include other resources, including:

Tax-advantaged retirement plans
Pensions
Taxable investment accounts
Personal savings
A health savings account
Income from businesses or properties.

Not paying off debt before you retire. For retirees on fixed incomes, debt makes it difficult to really enjoy retirement. Therefore, retire any debt you have before you stop working. You should systematically focus on one debt at a time, while making minimum payments on other debts. Get started by targeting the debt with the highest interest, or perhaps the one with the smallest balance. The goal is to be debt-free in retirement, so your financial resources can go toward helping you enjoy life. However, you shouldn’t concentrate too much on paying down debt and overlooking your retirement savings.

The best way to avoid retirement regret is planning. Start now and evaluate your situation. Then develop a retirement roadmap that helps you get from today to tomorrow.

Reference: Money Talks News (Oct. 13, 2019) “The 3 Biggest Regrets of Retirees — and How to Avoid Them”

What are Earnings Limits for Disability Retirees?

If you are 60 or older, there’s no restriction on the amount of income you can earn while receiving disability retirement.

However, if you’re under age 60, you can earn income from work while also receiving disability retirement benefits. Note that your disability annuity will cease, if the United States Office of Personnel Management determines that you’re able to earn an income that’s near to what your earnings would be if you’d continued working.

Fed Week’s recent article entitled “The Limits on Earnings for Disability Retirees” says that the retirement law has set an earnings limit of 80% for you to still keep getting your disability retirement. You reach the 80% earnings limit (or are “restored to earning capacity”) if, in any calendar year, your income from wages and self-employment is at least 80% of the current rate of basic pay for the position from which you retired.

All income from wages and self-employment that you actually get plus deferred income that you actually earned in the calendar year is considered “earnings.” Any money received before your retirement isn’t considered “earnings.”

The government says that income from wages includes any salary received while working for someone else (including overtime, vacation pay, etc.). Income from self-employment is any net profit you made from working or managing your own business—whether at home or elsewhere. Net profit is the amount that’s left after deducting business expenses and before the deduction of any personal expenses or exemptions as allowed by the IRS. Deferred income is any income you earned but didn’t receive in the calendar year for which you’re claiming income below the 80% earnings limitation.

If you’re reemployed in federal service, and your salary is reduced by the gross amount of your annuity, the gross amount of your salary before the reduction is considered “earnings” during the calendar year.

The following aren’t considered earnings:

Gifts
Pensions and annuities
Social Security benefits
Insurance proceeds
Unemployment compensation
Rents and royalties not involving or resulting from personal services
Interest and dividends not resulting from your own trade or business
Money earned prior to retirement
Inheritances
Capital gains
Prizes and awards
Fellowships and scholarships; and
Net business losses.

If you’re under age 60 and reemployed in a position equivalent to the position you held at retirement, the Office of Personnel Management will find you recovered from your disability and will cut off your annuity payments.

Reference: Fed Week (Nov. 4, 2021) “The Limits on Earnings for Disability Retirees”

What are Latest Trends in Senior Care Facility Design?

iAdvance Senior Care’s recent article entitled “The Newest Trends in Senior Care Facility Design” interviewed Christine Cook, NCARB, principal with the Dallas-based design boutique three. She explained that she’s seeing several new trends that are shaping the industry.

“Owners and operators are working to connect through lifestyle choices, in combination with a healthcare amenity, to reach the target pool of prospective residents. ‘Active aging’ and ‘purposeful lifestyles’ resonate favorably with both residents and their families. This shifts the perception away from residency as need-based or compelled to a feeling of joining the community by choice,” she remarked.

Other design trends include more tailored residential apartments and cottages. There is also an increased demand for amenities, both on-site and within walking distance.

“Also, it is foundational to ensure consistency of the design aesthetic and quality of materials across the continuum-of-care, from independent living to assisted living and memory care,” says Cook.

Cook also said that many existing communities are decreasing their skilled nursing offerings. They’re customizing assisted living and memory care environments, tailoring them to the residents’ needs. “Most new communities are not incorporating skilled nursing at all.”

The COVID-19 pandemic has also prompted an increased focus on cleanliness and practical material selection. “Escalating cleaning protocols are demanding increased attention to the selection of finishes,” says Cook.

“Materials must be durable and resilient, otherwise replacing them when they wear out will have to be cost-effective — think modular cabinetry or tile flooring. We have also had to address plans for processional arrival sequences at entryways, modifying and limiting them to ensure there will be no security breaches with respect to disease migration.”

She’s also seen an uptick in requests for no-touch access controls for resident and staff-only areas. Cook notes that there’s also a market preference for larger balconies and full-height windows to allow for more natural daylight. Designs that reinforce healthy connections to nature, like balconies doubling as outdoor great rooms, can prompt residents to be more inspired and engaged.

However, Cook says that owner-operators frequently describe two common challenges: Keeping occupancy rates high and attracting and retaining high-quality, mission-focused staff.

Cook thinks that several trends will continue to define the senior care market in the future. These include increased demand for pocket-park communities, which usually consist of 10 to 12 cottages that are organized around or near an activity center. These communities are often developed in association with a larger senior care community or health provider.

Reference: iAdvance Senior Care (Oct. 12, 2021) “The Newest Trends in Senior Care Facility Design”

How Do I Hire an Elder Law Attorney?

Elder law attorneys are lawyers who assist the elderly and their family members, and caregivers with legal questions and planning related to aging.

These attorneys frequently are called upon to assist with tax planning, disability planning, probate and the administration of an estate, nursing home placement, as well as a host of other legal issues, says Forbes’ recent article entitled “Hiring An Elder Law Attorney.”

In addition, there are some elder law attorneys who have the designation of Certified Elder Law Attorney (CELA), a certification issued by the National Elder Law Foundation. A Certified Elder Law Attorney must meet licensing and other requirements, including specific experience in elder law matters and continuing education in elder law. However, note that an elder law attorney does not need to have the CELA certification to be an experienced elder law attorney.

There are many elder law attorneys who specialize in Medicaid planning to help protect a senior’s financial assets, if they suffer from dementia or another debilitating illness that may require long-term care. Elder law attorneys also prepare estate documents, such as a durable power of attorney for health and medical needs and a living will. As you age, the legal issues that you, your spouse, and/or your family caregivers must address can also change.

If you are a senior, then you should have durable powers of attorney for financial and health needs, in the event that you or your spouse becomes incapacitated. You might also need an elder law attorney to help you transfer assets if you or your spouse move into a nursing home to avoid spending your life savings on long-term care.

Healthy people over 65 are in the best spot to do more than having estate planning documents prepared. That’s because they have the opportunity to develop a holistic strategy beyond the legal documents. This can give assurances that the family members and professionals they’ve assembled understand the principle of supported decision-making and how it will be implemented.

For example, an elder law attorney may focus on finding the least restrictive residential environment and making other health care and financial choices. An elder law attorney can also protect seniors with diminished capacity, who are being victimized by personal and financial exploitation.

An initial consultation with an elder law attorney will help determine the types of legal services they can offer, and the fees associated with these services.

Reference: Forbes (Oct. 4, 2021) “Hiring an Elder Law Attorney”

Estate Planning Blog Articles

Estate & Business Planning Law Firm Serving the Providence & Cranston, RI Areas

How Do I Hire a Caregiver from an Agency?

Can I Restructure Assets to Qualify for Medicaid?

Can I Claim Grandfather’s Unclaimed Insurance Policy?