Client's Age: 67
County: Mason
Client's husband passed away several months ago, and her household income plummeted. Her monthly mortgage payment is more than her entire monthly income, but she has been making the payment with the life insurance benefit. The insurance has run out and she wanted to know what to do. We examined her finances, including her assets, debts, income, expenses, and explained that she could not afford to live in that house anymore since her mortgage balance was substantially higher than the home's fair market value and couldn't be effectively refinanced. We helped her get connected with affordable housing options and explained the foreclosure process.
Monday, April 30, 2007
Case of the Week 4/20/07
Client's Age: 82
County: Pocahontas
Client is a nursing home resident whose physician has determined he lacks the capacity to make his own healthcare decisions. His estranged wife has Medical Power of Attorney for him, he is considering divorce, and he doesn't want her to have that authority anymore. We explained to C that divorce would automatically legally revoke her authority for him under the MPOA, and in the mean time if his physician determines that he has the capacity to at least choose his medical decisionmaker, he could revoke the MPOA and execute a new one. Or if the physician determined the estranged wife were incapable of properly acting as his MPOA representative, he could appoint a healthcare surrogate for client.
County: Pocahontas
Client is a nursing home resident whose physician has determined he lacks the capacity to make his own healthcare decisions. His estranged wife has Medical Power of Attorney for him, he is considering divorce, and he doesn't want her to have that authority anymore. We explained to C that divorce would automatically legally revoke her authority for him under the MPOA, and in the mean time if his physician determines that he has the capacity to at least choose his medical decisionmaker, he could revoke the MPOA and execute a new one. Or if the physician determined the estranged wife were incapable of properly acting as his MPOA representative, he could appoint a healthcare surrogate for client.
Tuesday, April 17, 2007
Change in the NH Medicaid penalty for uncompensated transfers of assets
The monthly private-pay nursing home care rate is part of what DHHR uses to determine how long your penalty will be for certain uncompensated transfers of assets if you apply for nursing home Medicaid. That figure has been increased to $5,087 as of March 1, 2007 www.wvdhhr.org/bcf/policy/imm/IMManualChanges/451/ch17_10.pdf
For several years (approximately 8?) the figure has been the very low $3,380. This is an improvement for long-term Medicaid beneficiaries and their families because it will reduce the length of penalties for the kinds of uncompensated asset transfers (a legal term for something most people would call gifts) that get penalized. For example, if you gave your granddaughter $7,000 to help her pay her college tuition, and needed Medicaid to pay for your nursing home care within 3 years (soon to be 5 years, more on this later), that could have gotten you a 2 month penalty using the old rate. It could only get you a 1 month penalty under the new rule, as DHHR divides the value of the gift by this new monthly private-pay nursing home rate.
But WV still has not promulgated regulations to implement the federal Medicaid changes under the Deficit Reduction Act 2005 (DRA). Those changes, whenever they are made, will likely make the penalties even harsher again, as they eliminate the practice of rounding down to the nearest whole number of months, lengthen the look-back period for penalizing transfers from 3 years to 5 years, and begin the penalties from the time you are in the NH and need the benefits rather than from the time of the transfer.
For several years (approximately 8?) the figure has been the very low $3,380. This is an improvement for long-term Medicaid beneficiaries and their families because it will reduce the length of penalties for the kinds of uncompensated asset transfers (a legal term for something most people would call gifts) that get penalized. For example, if you gave your granddaughter $7,000 to help her pay her college tuition, and needed Medicaid to pay for your nursing home care within 3 years (soon to be 5 years, more on this later), that could have gotten you a 2 month penalty using the old rate. It could only get you a 1 month penalty under the new rule, as DHHR divides the value of the gift by this new monthly private-pay nursing home rate.
But WV still has not promulgated regulations to implement the federal Medicaid changes under the Deficit Reduction Act 2005 (DRA). Those changes, whenever they are made, will likely make the penalties even harsher again, as they eliminate the practice of rounding down to the nearest whole number of months, lengthen the look-back period for penalizing transfers from 3 years to 5 years, and begin the penalties from the time you are in the NH and need the benefits rather than from the time of the transfer.
Case of the Week 4/13/07
Client's Age: 63
County: Putnam
Client had a fairly unusual circumstance, of having her home deeded in both her and her ex-husband's name, though they had been divorced for over 25 years. Now ex-husband may need nursing home Medicaid benefits, and client was worried about the state taking the home because his name was still on it. We examined her circumstances and explained that if the deed were joint/survivor and he died first, Medicaid estate recovery would not attach because the home would not pass through ex-husband's probate estate. But if client died first, ex-husband would become sole owner and Medicaid estate recovery could attach. "Thank you so much, I wish I'd known about you years ago, I've gotten more from you today than 8 yrs of asking."
County: Putnam
Client had a fairly unusual circumstance, of having her home deeded in both her and her ex-husband's name, though they had been divorced for over 25 years. Now ex-husband may need nursing home Medicaid benefits, and client was worried about the state taking the home because his name was still on it. We examined her circumstances and explained that if the deed were joint/survivor and he died first, Medicaid estate recovery would not attach because the home would not pass through ex-husband's probate estate. But if client died first, ex-husband would become sole owner and Medicaid estate recovery could attach. "Thank you so much, I wish I'd known about you years ago, I've gotten more from you today than 8 yrs of asking."
Case of the Week 4/6/07
Client's Age: 65
County: Taylor
Client and her now-deceased husband had put their home in their daughter's name to protect it for client from her husband's son from a former marriage. Now she is having disputes with her daughter and wants to put the house back in her own name. We explained that once the deed was made to the daughter, the property became daughter's (subject to the life estate client retained). Client cannot force daughter to give it back, though we explained client has the exclusive right of possession of the property during her lifetime.
County: Taylor
Client and her now-deceased husband had put their home in their daughter's name to protect it for client from her husband's son from a former marriage. Now she is having disputes with her daughter and wants to put the house back in her own name. We explained that once the deed was made to the daughter, the property became daughter's (subject to the life estate client retained). Client cannot force daughter to give it back, though we explained client has the exclusive right of possession of the property during her lifetime.
Case of the Week 3/30/07
Client's Age: 75
County: Lincoln
Client lives alone with her two cats, and the cats both seemed sick. She heard about the recent large-scale cat food recall for food contaminants that were life-threatening for the animals. Once we determined which brands and types of cat food she had given them, we reviewed the recall website and determined that none of the foods her cats ate were on the long recall list. She was relieved.
County: Lincoln
Client lives alone with her two cats, and the cats both seemed sick. She heard about the recent large-scale cat food recall for food contaminants that were life-threatening for the animals. Once we determined which brands and types of cat food she had given them, we reviewed the recall website and determined that none of the foods her cats ate were on the long recall list. She was relieved.
Case of the Week 3/23/07
Client's Age: 69
County: Clay
Client, a widow who recently moved from another state to WV to be near his son, has been diagnosed with early Alzheimers. He called us with a variety of legal questions as he is trying to get his affairs in order as he anticipates his future mental incapacity. He had been told to transfer his assets to his son to qualify for long-term care Medicaid. That is a popular legal myth that actually can cause you significant harm because of the penalties for uncompensated transfers of assets. We explained in detail long-term care Medicaid eligibility, spend-down, uncompensated transfers of assets impacts, and estate recovery, and applied those concepts to his particular circumstances so he can plan effectively.
County: Clay
Client, a widow who recently moved from another state to WV to be near his son, has been diagnosed with early Alzheimers. He called us with a variety of legal questions as he is trying to get his affairs in order as he anticipates his future mental incapacity. He had been told to transfer his assets to his son to qualify for long-term care Medicaid. That is a popular legal myth that actually can cause you significant harm because of the penalties for uncompensated transfers of assets. We explained in detail long-term care Medicaid eligibility, spend-down, uncompensated transfers of assets impacts, and estate recovery, and applied those concepts to his particular circumstances so he can plan effectively.
Case of the Week 3/16/07
Client's Age: 69
County: Ohio
Client has 4 credit card debts with which she has been struggling to keep up payments, plus medical debt, she's in arrears with her utilities, and has a mortgage and car payment. After carefully reviewing her assets, income sources, debt, and expenses, we explained that she is largely collection-proof, except for a small private pension that is a relatively small portion of her monthly income. We helped her understand the different legal rights she has related to the different kinds of debts and bills she has, and helped her understand that her mortgage and utilities should always be a priority over her unsecured debt. We also explained how to write cease letters to her creditors, and encouraged her to call back if she ever got sued or reached a point where her mortgage and living expenses (excluding payments toward unsecured debt) became unaffordable.
County: Ohio
Client has 4 credit card debts with which she has been struggling to keep up payments, plus medical debt, she's in arrears with her utilities, and has a mortgage and car payment. After carefully reviewing her assets, income sources, debt, and expenses, we explained that she is largely collection-proof, except for a small private pension that is a relatively small portion of her monthly income. We helped her understand the different legal rights she has related to the different kinds of debts and bills she has, and helped her understand that her mortgage and utilities should always be a priority over her unsecured debt. We also explained how to write cease letters to her creditors, and encouraged her to call back if she ever got sued or reached a point where her mortgage and living expenses (excluding payments toward unsecured debt) became unaffordable.
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