April 18, 2014

Good News for NY Medicaid System - Agreement Reached with Federal Government

Uncertainty reigned over the last few months regarding the budget situation for the New York Medicaid system. Fortunately, an agreement has been reached which should provide more long-term stability and the ease the minds of both policymakers and NY residents alike.

The underlying problem was claims by the federal government that over a period of years New York engaged in improper billing practices. The mistakes led to billions of dollars being paid to the state that should not have been paid. After discovering the problem, federal officials initially claimed that the money needed to be re-paid. All told, this would amount to nearly $15 billion being drained from state coffers that otherwise would provide support to local residents. No matter which way you slice it, losing those funds would hurt New York Medicaid participants, including seniors.

Settlement Agreement
Fortunately, a settlement has been reached that will spare the state the burden of repaying those billions. Per the terms of an agreement with federal officials. New York will be able to reinvest the money back into the NY Medicaid system that otherwise would have gone back to the federal government.

The terms of the agreement show that the money will be used in various ways, including developing long-term reforms in the program. The resources will help struggling hospitals, various health care providers, and other Medicaid participants.

A tentative deal of this nature was reached earlier this year, but it was finalized only this week. The deal allows the state to save $8 billion in the first year, with savings continued over the next five years totaling $17 billion. To put that into perspective, the entire New York Medicaid program currently costs about $58 billion each year--more than any other state in the country.

Get Legal Help
The financial health of this vital program is of obvious importance for many New Yorkers. That includes seniors and their family members who rely on the New York Medicaid system for long-term care in nursing homes and via at-home caregivers. The support that is provided to seniors is ultimately dependent on available financial resources, and so this agreement is welcome news.

If you have questions about applying for Medicaid in New York and saving assets during the process, seek out legal professionals. The NY Medicaid attorneys at our firm have helped thousands of local families navigate the process, secure benefits, and protect property in the process.

April 16, 2014

The Mickey Rooney Example: Be Clear About Funeral & Burial Plans

Legendary actor Mickey Rooney died earlier this month at the age of 93. Over the later course of his life, Rooney offered many important lessons related to elder law estate planning. For one thing, he was a vocal advocate against senior financial exploitation. In 2011 he testified before a U.S. Senate committee that was analyzing the various aspects of elder abuse. Rooney told the committee that he was emotionally and financially abused at the hand of his step-children (the biological children of his estranged wife).

At that hearing, Rooney echoed the thoughts of many New York seniors who were in the same situation, explaining, "For years I suffered silently. I didn't want to tell anybody [...] Even when I tried to speak up, I was told to shut up and be quiet."

Fighting Continued After Death
As his Senate testimony evidenced, there was significant feuding and disagreement within the Rooney family. Those fights continued this month after the icon's passing. Reports note that Rooney's wife wasn't told of his death personally--learning about it on the news. Disagreement then broke out regarding burial. The wife apparently was not allowed to see Rooney in the funeral home or have any say in the burial plans.

Mickey's wife allegedly wanted her husband buried near one of their old homes, where they owned land. However, the temporary executor of Rooney's estate fought the move and instead recently explained that Rooney would be buried in the well-known "Hollywood Forever Cemetery" alongside many other entertainment stars.

It is unclear exactly what Rooney himself wanted. But, per the terms of his will, the trustee (and ultimate executor of the estate) ultimately was able to make the final decision.

Be Explicit About Funeral Wishes
Mickey Rooney's struggles later in life often many lessons for those seeking to avoid family feuding in their golden years. Notably, it is critical to be specific about funeral and burial wishes--and put steps in place so that those desires are legally carried out. After a passing Some general tips to consider:

***It may be beneficial to buy burial plots or other items ahead of time. It can be difficult for family members to make these decisions and purchases in the short time available after a death.

***Alternatively, ensure that you are familiar with what happens to pre-paid funds and know exactly what you are getting. These can be complex arrangements, and it is important to get full value for your investment.

***Share your wishes with various family members, your attorney, and others. Avoid telling just one person.

***Put your wishes in writing. The more specific you are, the more likely that matters will proceed exactly as you intend.

Contact an elder law estate planning lawyer for help on these issues in New York.

April 15, 2014

Science of the Brain & Elder Financial Exploitation

Advances in brain research are shedding new light on how our minds function. This includes understanding how we process decisions related to finances as well as how our decision-making changes as we age. Taken together, the new knowledge offers an important affirmation of the need to guard against senior financial exploitation and mismanagement.

The Science of Emotions
A Wall Street Journal story this week explained new neuroscientific findings that show a shift in mental activity as brains age. Specifically, older minds focus more than younger ones on blocking out negative emotions and experiences while maximizing positive emotions and interactions. This is referred to as "socioemotional selectivity."

On one hand, this shift is helpful in providing more general happiness and comfort for older individuals--a better ability to "not sweat the small stuff." At the same time, the selectivity also works to blind some seniors to warning signs of abuse, mistreatment, or exploitation by others.

Beyond Dementia
One critical aspect of the latest research is that the vulnerabilities in seniors apparently exist well outside of traditional "dementia" issues. In other words, even seniors who are highly intelligent and financially aware, with no signs of past cognitive challenges, may still be more vulnerable to financial errors or abuses.

A neuroscientific study at Yale University recently compared the actions of younger and older investors. They found that investors over the age of 65 (with all other factors held constant) "showed striking and costly inconsistencies' in their financial actions. Of course, this is not to suggest that anyone over 65 years old is incapable of managing their money prudently or avoiding scammers. However, the general arc of the research is a reminder that there are very real and deep brain processes that affect these matters.

What's more is that very few individuals appreciate that these risks exist--often leading to avoidance of planning to account for potential problems in the future. After all, middle-aged individuals who are firing on all cylinders in their financial life almost never believe that they will eventually lose their wits. At the same time, because the decline happens very subtly, most are unable to identify that they may have a problem until they have already been struggling for some time. As the WSJ story succinctly explains, "Just when they are the most capable of planning ahead for a time when their judgment might fail, investors are at an age when they're unlikely to believe that they actually need to plan ahead."

For help with long-term elder law estate planning throughout New York, please contact our legal team today.

April 10, 2014

New Report Explores State of Medicaid Following Affordable Care Act

As the first wave of healthcare insurance enrollment ends as part of the Affordable Care Act, observers are quick to comment on the changes enacted by the law. In addition to millions who took advantage of insurance sold in private marketplace exchanges, there has also been a significant increase in Medicaid participants--both in New York and nationwide.

According to a New York Times report last week, across the country there are now over 62 million Americans receiving some Medicaid support. The increase is more targeted in states like New York that specifically took advantage of options in the Affordable Care Act that allow for expansion of the program.

Importantly, much of the discussion about healthcare exchanges and Medicaid expansion refer to general health insurance coverage--not necessarily care that includes long-term support for the elderly.

However, there is one aspect to the expansion that will have ripple effects on all future Medicaid policy discussions--data collection. In the past, the data collection procedures for these programs slow in coming and often incomplete. As a result, policymakers considering various changes to the overall program were working off generalities or outdated information. Researchers note that, the U.S. Department of Health and Human Services typically took over two years to publish data on enrollment.

But a component of the Affordable Care Act called for a far more streamlined procedure which has made data collection easier. As a result, we are getting accurate enrollment numbers now, years earlier than in the past. This ultimately may influence future Medicaid policy. Researchers and policy experts may better understand the specific needs of participants--like a growing long-term care shortfall--and respond accordingly.

Need Help Applying for Medicaid in New York?

Many local families are understandably confused by the New York Medicaid application and qualification process. The expansion of the program in recent years, coupled with "crackdowns" in order to save funds, paints a complex picture of the system. It is often not clear to New York residents what they need to do to qualify for support, and, once enrolling in Medicaid, what specific benefits they can expect to receive.

All of this is made more complicated in certain unique situations, particularly those involving seniors seeking Medicaid for help with long-term care. Seniors are more likely to have assets--like a family home--that they wish to protect and pass on to adult children. Because Medicaid is a financial need based program, families need to take special steps to protect assets from being "spent down" to qualify for the program.

An elder law attorney can explain what makes sense in your specific situation and help carry out that plan. Contact the NY Medicaid attorneys at our firm today to get started. Timing is critical in these matters, and the earlier you plan for this need, the better.

April 7, 2014

Guardianship Law To Go in Effect in New York

"Granny Snatching" is probably not a term you are familiar with hearing. But, believe it or not, over the years elder law advocates have popularized the concept to explain a problem affecting fights over guardianship of seniors. Specifically, granny snatching refers to a problem where a elder guardian (usually close friend or family member) suddenly loses their rights when the senior moves into a different state than the one where guardianship was established.

This situation can exacerbate family feuding and increased elder abuse risk. That is because the jurisdictional matter opens the door for one relative (who does not have legal guardianship) to physically move the senior elsewhere. The former legal guardian then faces significant challenges being reunited with their loved one because the new state's failure to recognize their authority.

Currently, this is a risk for all families that move into (or out of) New York. Per existing state law, a guardian needed to bring new guardianship proceedings upon moving into the state. At the same time, New York residents that move elsewhere risked having their guardianship ignored by the new state. This poses very real administrative problems for seniors most in need of help with various day-to-day financial and well-being issues.

Fixing the Problem
Fortunately, most of that will soon change as a new state law addressing the situation will go into effect on April 21st. Last year, Governor Cuomo signed into law changes to Article 83 of the state's Mental Hygiene Law. This takes the form of the state's adoption of the Uniform Guardianship Protective Proceedings Jurisdiction Act (UAGPPJA). While the acronym is quite a mouthful, it stands as an important step forward to help streamline court proceedings and protect families no matter where their lives may take them.

The exact changes in state procedures are a bit complex. However, the underlying issue is to simplify multi-jurisdictional dispute matters. Notably, under the law, New York will recognize a "home state" jurisdiction from elsewhere so long as the individual lived in that former state for six consecutive months prior to filing the guardianship petition. New York will also work more closely with the home state on different procedures, ultimately simplifying the process for new residents. In addition, by joining onto the UAGPPJA, New York residents who move elsewhere will hopefully face a more effective legal process in the new location.

For help with elder law issues in New York, contact our legal professionals today for tailored guidance.

April 4, 2014

Alzheimer's, Medical Testing, & Long-Term Care Insurance

Rather extraordinary claims were recently made by researchers in a Nature Medicine article that may forever change the long-term care planning landscape.

Scientists from Georgetown University are claiming to have developed a blood test that can determine whether an individual will develop dementia symptoms within two or three years. Their findings suggest the test is 90% accurate. While few are questioning the researchers methods, it is still to early to know if the results will hold up in future studies. This initial group consisted of only 525 total participants (all over age 70), with only 28 of that group ultimately developing symptoms. More efforts are already underway to test larger groups and potentially verify the results.

While this test offers nothing in the way of a direct cure to prevent Alzheimer's or minimize symptoms, it still may eventually lead to treatments. That is because some research argues that all previously attempted therapies failed because they were only begun after someone showed the symptoms--at which point it may have been too late. However, if this test proves accurate, then treatments can begin earlier that may actually be effective.

Long-Term Care Insurance
Beyond the specific medical importance of the testing, the ability to detect dementia years in advance can have significant effects on planning. That is because having a better idea of challenges that you may face in the future can be reflected in the specific steps taken to prepare for long-term care.

Last week, for example, Forbes published a story that suggested screening for Alzheimer's may drastically change the way long-term care insurance is priced and/or used. That is because the insurance is based on the uncertainty of the future. All residents are advised to use long-term care insurance to ensure that support will be available, even if they end up not needing it. The costs of long-term care insurance can already be high for some (particularly for those who do not purchase it while relatively young and healthy).

But if individuals know in advance what their future is likely to hold, then it may be far harder to find affordable insurance. This is the same general problem as the 'pre-existing condition' issue that affected traditional health insurance.

These early advances only allow detection a few years out, and so it may not affect most long-term care insurance purchasers who do so (ideally) many years or decades before needing coverage. However, as the science advances and diagnosis occurs far earlier, then it is possible for these tests to fundamentally alter insurance and planning.

For help putting a long-term care plan in place throughout New York please contact our legal team today.

April 1, 2014

Outrage After Seniors Kicked Out of New York Nursing Home

Elder care advocates are understandably up in arms following reports about questionable evictions from a Brooklyn facility catering to seniors. The sad situation is a reminder of the continuing struggles faced by so many local families in their quest for quality, reliable long-term care and support. It is also a troublesome sign that most communities remain drastically unprepared to provide the aid that will be needed in coming decades as the New York population ages.

NY Nursing Residents Evicted After Facility Closure
As reported by the NY Daily News last month, a group of over 100 Brooklyn seniors are currently scrambling to find alternative living arrangements following the announcement of the sudden closure of the Prospect Park Residence. The Park Slope facility has been a home for senior for over 15 years. But that will end in May, as the facility is slated to shut its door by the beginning of June.

The news was apparently a shock to residents, their family members, and even employees of the facility. The nursing home's owner explained that finances were the cause of the closure, citing inadequate compensation and tax increases. Perhaps contributing to the closure were other caregiving problems faced by the home in recent years. A 2010 lawsuit claimed that the facility's poor care led to a resident death. Just last year, another suit claimed that the facility was improperly licensed and that negligence led to at least three deaths of residents with dementia.

Public Outcry
As soon as news of the sudden closure was made public, there was a local outcry. Several area elected officials issued a joint statement slamming the move as "cruel, heartless, and unacceptable."

The Capital later reported that the evictions recently caught the eye of the New York Attorney General who is "engaged" in the matter, presumably to find a solution. Attorney General Schneiderman explained, "It is very hard to argue that it is reasonable conduct to tell vulnerable seniors you have 90 days to get out of your home."

Despite the clear public engagement on the issue, it remains unknown whether there is any alternative to closing the facility. In fact, the NY Department of Health already approved the closure plan.

As the seniors living at the Prospect Park Residence learned all too harshly, the future is never certain. While taking time to plan ahead for that uncertainty can never eliminate all risk, preparation does go a long way. Contact our elder law estate planning attorneys today to see how we can help provide peace of mind.

March 31, 2014

Be Careful with Reverse Mortgages

We have all seen the commercials. An attractive older man or woman explains a
"magical" financial tool that helps senior citizens receive money they need for long-term care while remaining in their own home. The tool is known as a "reverse mortgage," and it allows a homeowner to borrow money against the home's value that does not need to be repaid until the senior moves or dies. It is only available to those over 62 and marketed as a helpful device for seniors in need of immediate funds.

Be Skeptical
However, as more and more seniors and their families are discovering, the reverse mortgage comes with many pitfalls that may cause far more harm than good. It is critical not take out one of these mortgages without knowing how it will affect your long-term plan and potential heirs.

A growing problem involves the aggressive tactics that lenders may use following a senior's death in order to recover funds. Adult children are frequently mired in bitter feuds with companies to pay back the loan while trying to keep the family home and avoiding foreclosure.

As a New York Times story mentioned last week, there are growing concerns that lenders are not abiding by federal regulations when dealing with heirs during the collection process. Under federal law, these lenders are required to offer survivors two options to re-pay--either the total amount owed on the loan, or 95% of the current home value. Depending on the housing market, the home value option may be far lower than the outstanding loan amount.

Lenders are required to give families a month to determine how they would like to cover the obligation. Families must also be given up to six months to arrange for financing. Yet, there are countless stories of adult children receiving foreclosure notices within days of their parents passing. Some lenders are acting aggressively in collections, not giving borrowers time to properly learn about their options and make prudent choices.

Receive Comprehensive Advice
If it seems too good to be true, it probably is. Financial decisions should never been made quickly or based on overly optimistic promises from any one provider. Unfortunately, some businesses are willing to exploit the confusion and fear that surround so many of these issues in order to increase profits.

Elder law estate planning attorneys are bound by professionals rules to act only in the best interest of their clients. Do not make critical decisions about retirement planning, inheritance, or similar matters without consulting a professional who you know is looking out solely for your best interests.

March 26, 2014

Push for More Funds to Combat New York City Elder Financial Abuse

It is somewhat cliche to claim that a social problems is under-appreciated or misunderstood. But if any issue fits that bill, then it is senior financial exploitation. According to many reports of the problem, odds suggest that virtually all New Yorkers know someone who is affected by this problem--though the senior may never report the mistreatment. According to most estimates, every year a staggering $3 billion is lost by seniors who are exploited financially. This is not an isolated problem. If affects seniors of all income levels and in various living situations.

The New York City Council's Committee on Aging chairperson explained recently that elder abuse is "a nearly silent epidemic due largely to underreporting and lack of public awareness.'

A Push for Protection
Considering the scope of the abuse, it is no surprise that elder care advocates are pushing for additional support to combat the problem. As the Epoch Times reported last month, many of those advocates are calling for increased public funding to better protect particularly vulnerable seniors.

As a recent NY City Council meeting, representatives from at least twelve senior support groups called for increased funding for elder abuse prevention programs. In the current year, about $800,000 was allocated for these programs. However, considering the widespread nature of the problems, the groups are asking for more support. This is particularly important in NY, because we have the third largest number of senior residents of any state in the country. Changing demographics are set to increase the population even more in the coming decades.

The exploitation does not just affect the pocketbook. Reports indicate that seniors harmed by financial abuse and mistreatment are 300% more likely to die within a few years of the harm when compared with their unaffected peers. In other words, financial exploitation has an extreme effect on a senior's overall well-being, and it is a problem that can ruin one's last years.

Get Help
Make no mistake, elder financial exploitation is a serious crime that can turn one's golden years into a nightmare. While it is impossible to guarantee that you or a loved one will never be affected, prior planning can go a long way to minimize the risk. Those affected often do not have full elder law estate plans in place. In addition, victims frequently have no professional oversight of their affairs, making it easier for problems to go undetected for an extended period of time. In most cases, stolen funds are spent immediately, meaning that it is rare for a victim to ever recover lost money, even after the problem is identified.

For help with creating a long-term financial protection plan, contact experienced professionals today.

March 24, 2014

Back to the Basics: NY Medicaid Eligibility & Protecting Assets

The New York Medicaid program is a critical lifeline for millions of residents. Unfortunately, many remain confused by some of the complex details. It is common to have only a fragmented understanding of how Medicaid works from random discussions with friends and neighbors or by hearing snippets of news clips discussing the program.

One of the most misunderstood aspects of the system is the "spend down" requirement. Medicaid is a need-based program, and so qualification requires one to have assets below a very low threshold. But that does not mean that everything you own will be lost before qualifying for Medicaid.

Medicaid Misunderstandings.
Some of the most common questions asked by New York residents regarding the "spend down" requirement include:

Do all of my assets need to be disposed of before qualifying?

Not all assets are counted in Medicaid applications. Specifically, when an applicant is still married and there is a "community spouse" (who still lives at home), then various assets can be kept. This usually includes: a home (up to $750,000), as much as $110,000 in other resources, a car, various household furniture and effects, some retirement accounts, and a few other assets.

These rules are different if the applicant is not married, as single residents have far fewer exemptions. However, there are a few other options depending on one's circumstances. For example, a family home can be preserved if an adult child was also living in the home for two years and providing care to the senior.

Should I transfer assets to another family member's name?

Very simple attempts to get around the spend down requirement are usually not wise moves. That is because there is a "look back" period where transfers are analyzed. Essentially, all assets given away within five years will trigger a divestment penalty that prevents one from qualifying for Medicaid for a set period of time.

Is my spouse required to spend down assets as well?

In general, both spouses assets will be considered during the application process, regardless of which spouse is named as owner. However, as mentioned above, a community spouse is given leeway with exempt assets. The program is not designed to force a healthy spouse to lose everything in order to secure program support for an ailing partner. However, depending on the size of a family's assets, without planning, a couple may still need to spend significant resources to qualify.

Can a trust protect assets?

When planning ahead for potential Medicaid support, there are many strategies that can be employed to protect assets. Most notably, assets can be moved into a Medicaid Asset Protection Trust (MAPT) with the income from the trust going to you or your spouse. The benefit of the MAPT is that is can protect assets above and beyond any exemption while still allowing individuals to qualify for Medicaid. Importantly, assets in a MAPT are still subject to scrutiny based on the five year look-back period. In other words, it is important to create a MAPT as early as feasible.

The advice of counsel is critical when making these plans. The rules change frequently, vary from state to state, and your needs hinge on specific factors about your own situation (your marital status, current health, types of assets owned, etc.). Contact an elder law estate planning attorney to ensure you act prudently to protect your assets while ensuring care is available down the road.

March 21, 2014

Good News Following Ulster County Nursing Home Sale?

The face of New York nursing home care has been changing in recent years. The traditional model of individual counties throughout the state owning and operating facilities to provide care to ailing seniors is being phased out in may places. Instead, the counties are selling the homes to private companies to operate. The moves are spurred in almost all cases by financial realities--the facilities are too expensive for the county to operate.

Understandably, elder advocates worry about the effect of the change on senior care. In the past, some analyses have suggested that privately-run nursing homes, on average, show more "deficiencies" than their public counterparts. The assumption is that private homes are motivated by profit and more willing to cut resources to residents and refuse to pay wages for the best caregivers in order to boost their bottom line.

But is is important to remember that no two homes are identical, and "averages" do not mean that all privately run homes are rampant with neglect and need to be avoided. Early reports out of Ulster County, for example, offer a hopeful reminder that quality decreases may not automatically follow private nursing homes sales.

So Far, So Good
As reported by the Oneida Dispatch, many residents of the Golden Hill Health Care Facility are happy with the operation at the facility since it was sold to a private company six months ago. The head of the Residents' Council explained that, since the change, more staff members had been hired, including physical and occupational therapists. In addition, the resident suggested that other aspects of the operations, from the food to building cleanliness, had improved since the take-over. According to the most recent state on-site review of the home (in September) the facility was in full compliance with state and federal caregiving requirements.

There was aggressive push-back when the county board was debating the sale in 2011 and 2012, based mostly on concerns about potential decrease in quality of care. Advocates for the county-employees at the facility argue that it is still too early to tell whether the long-term care at the facility will be affected by the change.

It is impossible to draw general conclusions about care quality from a single New York nursing home. But this situation is a helpful reminder of the fact that quality varies considerably from facility to facility. Not all private homes are bad, and not all public facilities are superior. Those making choices are urged to be diligent in reviewing their caregiving options.

Get Help
If you have questions about selecting a nursing home or applying for Medicaid in New York in order to pay for nursing home care, please contact our elder law attorneys today to see how we can help.

March 20, 2014

More Problems with New York Medicaid Overpayments

We are in the midst of significant changes to the New York Medicaid system. The critical state-federal program serves as a lifeline for many residents--including those in nursing homes. As part of President Obama's healthcare overhaul, Medicaid is expanding, opening opportunities to more residents than ever before. New York has been cited as a model for that expansion, as our state has the most robust system in the country.

At the same time, however, with expansion comes increased scrutiny on exactly how each Medicaid dollar is spent. Both state officials and federal regulators are focusing on cutting out fraud and otherwise maximizing the value of funds. While this may seem like only a concern of policymakers, these changes will also trickle down and directly affect New York residents who rely on the system. As oversight changes, there may be alterations to the Medicaid application process and new rules about what benefits a resident can receive as part of the system.

More Overpayments
Last week federal officials released a report which suggests that New York was given $320 more in federal Medicaid payments that it was actually entitled. The problem apparently goes back several years and stems from the billing practices at state-run facilities for the disabled. The U.S. Department of Health and Human Services inspector general's report notes that the facilities were billing at nearly doubly the appropriate rate.

This problem was first identified in 2012, and state officials have already implemented various changes in order to address the issue. For example, a new payment system was created and applied retroactively. New payment plans are being negotiated with federal officials.

On top of that, mirroring general trends in elder caregiving, state reliance on institutions for disability care is decreasing. Consider that in 1990 there were around 27,000 developmentally disabled residents in state-run facilities--today there are less than 1,000. Instead, individuals in need of this support are being moved to community care and group homes.

Federal officials note that more audits of the NY Medicaid system are on the way. The audit manager specifically indicated that an analysis of community support programs offered by Medicaid will be looked at next to ensure all funds spent are being used as intended.

NY Medicaid Attorneys
Navigating the Medicaid maze is a daunting challenge. Fortunately, elder law attorneys can help you put a plan in place to prepare for potential Medicaid enrollment and save assets in the process. Contact a professional today to see how we can help.

March 19, 2014

Tax Time Tip - Declaring a Parent as a Dependent

Late March is best known for many as the time of year that they fervently fill out their "March Madness" college basketball bracket in hopes of winning the office pool or family competition. For others, however, this marks the time when the procrastination ends and you finally get around to filing your taxes. With less than a month left before the classic April 15th deadline, if you have not done so already, it is time to start gathering paperwork and getting the task out of the way.

Elder Care & Taxes
Tax issues are notoriously complex and confusing. And considering the thousands of pages that make up the Tax Code, New York residents can be forgiven for not committing the details to memory or spending their free-time analyzing the issues. Yet, one general tip that most are aware of is the need to claim all possible deductions in order to lower your overall tax burden.In that regard it is important not to forget the way that elder care intersects with your taxes.

Consider a common scenario in many local households--an elder parent lives with and receives some basic support from their adult children. In those situations, the IRS may allow the caregiving-children to claim the parent as a "dependent" for tax purposes--similar to the way that children are categorized.

According to IRS rules, elder parents can be claimed as depending so long as they meet certain criteria, including:

***The parent is not filing jointly with another (i.e. married spouse)
***The children provide at least 50% of their parent's support for the previous year. This may include housing costs, medical care, food, transportation, and similar costs.
***The parent's taxable income must be less than the IRS personal exemption level (a few thousand dollars). Most Social Security payments would not count toward this figure, and so it only refers to extra money that they are earning (i.e. a part-time job)

But it is important to think carefully about the overall effect of this step. That is to ensure that claiming one as a dependent does not affect the senior's Social Security or Medicaid eligibility. If done properly, claiming a parent as a dependent should not impact use of those federal programs. However, the details can be quite complex, and so it is best to have the counsel of experienced elder law attorneys before make any specific decisions.

For help with many different elder law issues in New York--from applying for Medicaid to securing long-term care insurance--be sure to contact an experienced attorney today.

March 13, 2014

New Tests to Predict Onset of Dementia

Elder care is not one-size-fits-all. There are a wide range of different needs for seniors, from simple help with travel to extensive, around-the-clock medical support. Fortunately, more and more experts are working to accommodate many different needs, providing the ideal fit for residents that preserves individuality and freedom as much as possible.

One particular strand of elder care that has received more focus in recent years is support for those with cognitive ailments--like dementia and Alzheimer's. Residents with these memory challenges face particular vulnerabilities. Even the more all-encompassing caregiving options (like a move into a nursing home) may not provide the best fit for these residents. The need for solid elder care planning is particularly important for those at risk of dementia, to ensure that proper care is available if necessary. Unfortunately, many do not identify their condition until it is too late.

But how do you know if you are at risk of dementia?

Interestingly, researchers are working to answer that question now, coming up with ways to identify the signs far earlier, giving resident more time to prepare.

Earlier Dementia Diagnosis
As discussed in a Scientific American article, a definitive diagnosis for a condition like Alzheimer's used to require a brain autopsy. However, advances in brain imaging have allowed professionals to examine the brains of living patients more closely. The signs of dementia, like plaque and brain tangles, can be spotted earlier.

Researchers are now taking the improvement to the next level, beginning clinical trials to examine brains and, hopefully, identify the signs of Alzheimer's years before the symptoms actually appear. The ultimate goal is for the general tests to be added to the list of diagnostic regimes that all residents of a certain ask are counseled to take.

These developments are good news for all local residents. The earlier the identification of cognitive ailments, the better chance that there will be time to put an elder law estate plan in place to prepare for whatever the future holds.

But the possible benefit involves more than just planning. It may also help guide experts toward a cure. As it currently stands, the dementia is usually only identified when it is too late for any drug treatments to work. However, if the signs can be spotted years before symptoms appear, then drugs may be able to help fight back against the nerve cell damage in the brain, prolonging one's life free of the condition.

March 11, 2014

Do Even "High Ranking" New York Nursing Home Neglect Residents?

Nursing home horror stories abound, and everyone has likely heard some tale of seniors suffering neglect at a New York long-term care facility. It is for that reason that elder care advocates always suggest doing your homework before making a final decision about where to receive skilled nursing care.

One of the most well-regarding nursing home ranking system is the federal "Nursing Home Compare" website. The site lists most nursing homes and gives them a star rating, from one to five. The rating is based on health inspections, staffing levels, and various quality measures. As a general guide, browsing the rankings of all local New York homes is a very helpful way to get an idea of home performance.

However, can the star system be relied upon exclusively? Is admission to a home with four or five stars a guarantee that the care provided will be proper?

Not quite.

Beyond the Rankings
Unfortunately, neglect and mistreatment of residents occurs even at homes that seem to perform well on rankings. For example, recent reports out of the Medford Multicare Center for Living are startling and a vivid reminder of the problems rampant in many long-term facilities.

Last month, the New York Attorney General's Office filed suit against the home making allegations of chronic abuse and mistreatment of residents, with at least one resulting in death. Uniquely, the mistreatment has led to criminal charges (usually only civil suits are filed). At least seven employees at the facility are accused of crimes related to covering up some of the problems.

What is particularly alarming is the fact that as recently as last year Medford received four out of five stars on the Medicaid ranking system. This places the firm above average when compared with others. If Medford is above average, one shudders to think of what goes on at other facilities. Observers point out that the situation is a clear sign that ranking systems are inherently flawed in that they rely significantly on self-reporting. In addition, annual inspections may be lax, further distorting the reliability of these indicators

Do Not Rely on Others
One clear takeaway of this situation is the need for particularly careful analysis of nursing homes before making a selection, including on-site visits, discussions with staff, and talks with current residents.

Beyond that, however, an even more preferable situation is to avoid the need to move into a nursing home in the first place. Various options are available for many residents to receive alternative care. From long-term care insurance to special Medicaid programs, securing at-home support is usually the best option for New York residents. An elder law attorney can explain what steps you can take now to best position yourself to receive your preferred care if the need arises.