Nursing Home Abuse
Massachusetts Nursing Home Abuse Lawyer
The toughest decision you may ever face may be to place your parent or spouse into a nursing home. No one wants to do that. But there may come a time when there is no choice – your loved one has developed Alzheimer’s disease, has had a stroke, or suffers from some other debilitating condition and requires full-time care that you simply can’t provide.
This step will raise all sorts of questions and self-doubt. Are you being selfish? Are you breaking your marriage vow to care for each other in sickness and in health? Your parent was always there for you – how can you walk away now when he or she needs you most? Will the move into unfamiliar surroundings further disorient your loved one? With the facility’s staff treat him or her with kindness and give good care? You have worked hard to find the best nursing home but what about the horror stories that you’ve read about abuse and neglect in nursing homes?
Can You Pay for Nursing Home Care Without Going Broke?
Stacked on top of these extreme emotional burdens is the crushing financial shock of the cost of long-term care. The late Claude M. Pepper, a U.S. congressman from Florida who was a leading advocate of senior citizens’ rights, observed that
“the single greatest fear of our senior citizens, and of all Americans, [is] that a long-term catastrophic illness may strike and, because of the absence of public or private coverage, they will become destitute.”
When a nursing home crisis hits, it is too late to worry about paying for a lengthy stay through long-term care insurance. Instead, the concern of the family will be how to pay for the nursing home. With the costs of nursing homes easily exceeding $4,000 or more per month, how long could your family pay for this care? How long would it take to dissipate the modest nest egg your parents or spouse worked so hard to build during their lifetimes? The sad answer: not long.
This financial devastation is unnecessary. You don’t have to continue paying nursing home bills until the money is gone. By planning ahead, or assisting your parents or spouse to plan ahead, you can help maintain your loved one’s dignity and preserve life-savings from being completely consumed by nursing-home costs.
The Medicaid Trap
Medicaid will cover long-term care in a nursing home. But there is a trap: to qualify for Medicaid, a person must either be poor or become poor. The technical term for this is “spend down.” Put into simple English, it means that a lower or middle income American who is not poor when entering the nursing home, soon will be.
The alternative to exhausting family savings to pay for catastrophic nursing home costs is to know the Medicaid laws. Arranging assets in a way allowed by the law to qualify for Medicaid is akin to arranging assets to qualify for income or estate tax savings. It is up to do you make your plans now to protect your life savings. As Congressman Borski said,
“If you have the misfortune of getting a long-term catastrophic illness in the United States of America, no one will help you. Not the United States Government and Medicare, not Medigap insurance policies and no on until you have exhausted all of your financial resources, until they ask you to become virtually penniless, until you lose your home, until you lose all of your money, and unfortunately until you lose all of your pride.”
Medicaid applications are extremely complex and they are applied differently in each state. There are different rules for married and nonmarried people (widows, widowers, or those divorced or never married). In fact the rules now permit a married couple to keep their home if one spouse enters a nursing home, plus a certain amount of cash. This article is not to burden you with all of the details of Medicaid qualification rules as they now stand. There will be other on-line resources cited below for you to learn more of the details. But it is important that you understand that you need to act now to formulate your protection plan.
Don’t forget to plan for the healthy spouse
So much attention is given to transferring assets and protecting property when the ill spouse enters a nursing home, that planning for the healthy spouse often is overlooked. In some situations, assets are transferred to the healthy spouse, who then unexpectedly predeceases the ill spouse. All of the couple’s assets then pass to the ill spouse, immediately disqualifying the ill spouse from Medicaid until the assets were spent down or some other allowable disposition of the assets can be made.
The first precaution is to prepare a durable power of attorney for the healthy spouse. This will allow for the completion of an asset preservation plan should the healthy spouse become incompetent.
Next the healthy spouse’s will must be reviewed. Most couples have wills leaving everything to the survivor. The will should be changed to either bypass the healthy spouse altogether, or to create a Special Needs Trust in the will to hold the couple’s property to pay for extra care of the ill spouse that would not be covered by Medicaid.
The couple needs to be sure that their home and other real property is not held as joint tenants. Unless the home is transferred into the healthy spouse’s name outright, the home that continued to be held jointly by husband and wife would pass to the ill spouse if he or she survived the health spouse. Again, that would cause instant Medicaid disqualification for the ill spouse, and throw the family’s plans into a tailspin.
Revisions to the will and estate plan of the healthy spouse will depend upon (a) the state of his or her health (b) whether he or she wants to provide for the institutionalized spouse who is on Medicaid, and (c) whether it makes sense to carry out a Medicaid plan for the health spouse.
- If the healthy spouse is in generally good health, or if not in good health but institutionalization is not likely, then a plan might include gifts to children, or using an irrevocable Medicaid trust, or both.
- If the healthy spouse is not in good health, then if the ill spouse has qualified for Medicaid, outright gifts to children in a way that will not disqualify the ill spouse may be called for.
- Finally, if the healthy spouse wants to provide for the ill spouse, it could be done through the irrevocable Medicaid trust after her death. The healthy spouse can also add a trust in his or her will (called a “testamentary trust”) for the ill spouse, but that will mean the healthy spouse must keep assets in his or her own name and so preclude doing his or her own Medicaid planning.
Time for Action
This article and the case studies included above should be considered a starting point for learning more about how you can plan to pay for the catastrophic nursing home costs without going broke. You should get counsel from an experienced Massachusetts nursing home abuse lawyer who handles situations like yours, because the laws are very complex, and every family’s circumstances are different.