- Legal fees are no longer exempt for 3-month backdating.
- Abolishes spousal refusal entirely.
- A homestead in Trust is no longer an exempt asset.
- Except for the Community Spouse Resource Allowance ($109,560) and Minimum Monthly Needs Maintenance Allowance ($2,739, HFS is no longer limited in how much it can seek when pursuing a support order against a community spouse.
- Reverts to the old limits on prepaid funeral contracts.
- Reduces the home equity exemption to the minimum allowed under federal law (base figure of $500,000, adjusted annually for inflation, rather than the $750,000 adopted in the DRA rulemaking).
- No exception for prepaid funerals for 3-month backdating.
Are you thinking of buying into a comfortable retirement community?
That is often a good idea but, think again carefully.
The new Illinois Medicaid law taking effect on January 1, 2012 dramatically change the treatment of entrance fees at Continuing Care Retirement CommunitiesContinuing Care Retirement Communities (CCRCs) are communities that provide a full continuum of care for its residents. They have flexible accommodations designed to meet their resident’s health and housing needs as their needs change over time. They offer independent living, assisted living and nursing home care, usually all in one location. As a requirement for admission to most CCRCs, residents are required to pay an entrance fee or a lump sum “buy-in” which, in addition to other things, guarantees the resident’s right to live in the facility for the remainder of their lifetime. In addition to the entrance fee, residents also pay a monthly service fee. The entrance fee is often, but not always, reimbursable (at least partially) if the individual moves from the facility, if they pass away while a resident at the facility, or if they otherwise terminate the contract. Many contracts also contain a provision wherein an individual is able to use a portion of their entrance fee toward their monthly resident charges if the resident exhausts his resources and becomes otherwise unable to pay. PRIOR LAW Prior to the new Medicaid law (the Deficit Reduction Act of 2005, hereinafter “DRA”), the entrance fee was generally not considered an available asset for Medicaid eligibility purposes. NEW LAW Under the new DRA, that took effect on January 1, 2012, a CCRC entrance fee is considered an available or “countable” asset if: (1) the contract provides the entrance fee may be used to pay for care should the resident run out of money and become unable to pay their monthly charge; or (2) the individual is eligible for a refund of any remaining entrance fee when the individual dies, leaves the community or otherwise terminates the life care contract; and (3) the entrance fee does not confer an ownership interest in the CCRC. Also, under the new law, CCRC’s are given the authority to include in their contacts a provision which requires residents to spend all of their resources on their care prior to applying for Medicaid benefits (essentially disallowing any Medicaid planning or asset protection once the contract is signed). Thus, when an individual applies for admission to a CCRC, the application may request full disclosure of an individual’s resources. Prior to the new law, regardless of the amount of resources an individual declared, the CCRC could not prohibit the individual from doing any long-term care planning or asset protection planning and then applying for Medicaid. PROBLEM CREATED BY NEW LAW Now CCRC’s can contractually require a resident to spend down all of the assets they declared at the time of admission before applying for medical assistance. This new provision will greatly limit the ability of CCRC residents to protect their assets once admitted to the community. Some residents may not care about the ability to protect their assets once they are admitted to the community. But for those of you that do care about protecting assets from being lost to the devastating cost of long-term care, the inability to plan with your remaining dwindling resources is a big deal! CONCLUSION It is a good idea to consult with an experienced elder law attorney prior to entering into a contract at a Continuing Care Retirement Community. This ensures that you understand how your entrance fee/”buy-in” agreement may financially and legally impact your long term care plan and any asset protection planning that you may have in mind. CCRC’s can do a nice job of providing care, but there is no substitute for getting the appropriate legal advice before you enter into a binding contract with anyone.
* “Extreme emotional disturbance.” (The American Heritage Dictionary of the English Language)
* “A mental state of extreme emotional disturbance, the feeling of being agitated; not calm.” (WorldNet 1.6)
* A stirring up or arousing; disturbance of tranquility; disturbance of mind that shows itself by physical excitement.” (Webster’s Revised Unabridged Dictionary)Most people can identify such a feeling in themselves and use appropriate coping mechanisms. But this can be impossible for people with Alzheimer’s disease. Often, they are unable to get in touch with, or express, their feelings. When they experience agitation, therefore, it is hard for those around them — caregivers, family members and others — to understand or offer help. We won’t go in-depth into it here, but the issue of medication should be mentioned. Medication could be responsible for sudden changes in mood or behavior, and that includes agitation. A new medication or a changed dose might be the source of new levels of agitation. Keep notes and discuss them with your physician. Do not think you have to wait for your next appointment, which could be weeks or months away. Call right away for assistance. Realize that both prescription and over-the-counter medications can be responsible for heightened levels of agitation. Always consult a doctor before starting, stopping or changing any medication.
- the ability to protect the assets inherited by a child from the creditors and predators of the child, such as divorcing spouses, business creditors, tort creditors, etc.;
- the ability to allow the management of the assets to continue under the supervision of the parents’ financial advisor who may have assisted the parents over the years in accumulating a critical mass of assets that can provide for many years of security for the children;
- the ability to meet the five-year lookback requirement of the new Medicaid laws;
- and, finally, the ability to prevent the children from squandering or losing the assets that the parents carefully accumulated during their lifetime.