Very few people look forward to living in a nursing home the last years of their lives. There is a growing segment of the population that wishes to remain in their homes as long as possible. To do so however, assistance is needed from medical professionals and home health aides.

Continuing care retirement communities

Continuing Care Retirement Communities, also known as CCRCs, are well known to retirees. The premise is that residents live on a campus-like setting in facilities that change as their care needs increase. For example, a CCRC resident may begin at independent living facility, shift to assisted living, and enter a memory-care unit or nursing home. Where a resident starts depends on their overall health, mental faculties, and mobility level.

A recent story out of Virginia recently received a great deal of national attention. An 83-year-old grandmother of five and great grandmother of five received a “Notice of Lease Violation” from the management office of her assisted living facility.  

What was the infraction?

It appears that Ms. Elsie Cruey had taken too many cookies from a community event. Ms. Cruery had previously run afoul of the community house rules when she took a partial gallon of milk after breakfast. She had hoped to combine the milk with the cookies she took as a late night snack.

Hospitals across the country are suing patients for unpaid bills. Insured patients are the primary target for these lawsuits. Hospitals are making bold assumptions about their patient’s ability to pay. They are of the belief that if the patient has insurance, then they are able to pay the outstanding balance. The patient’s perspective is quite different. They do have insurance but cannot pay their deductible or copayment. High costs and low wages are the main reasons why patients cannot pay their medical bills on time.

Deductibles Have Tripped in the Last Decade

According to the Kaiser Family Foundation, today 82% of employer health plans have a deductible. In 2006, only half of employer health plans had a deductible. That is up 32% since 2006. The average deductible has also increased from $584 in 2006 to $1,655 today.

Social Security Income (SSI) is a needs-based program administered by the Social Security Administration (SSA) to help people with disabilities pay for goods and services. In 2018, SSA made major changes to how Special Needs Trusts (SNT) are set-up and administered. What follows is a brief explanation of the program and the changes implemented beginning in April 2018.

Who is affected?

Approximately 7 million people receive SSI, a needs-based cash benefit to help pay for food and shelter. In 2019 the cash benefit amount for a single person was $771 per month; for couples the monthly cash benefit was $1,157. The cash benefit amount will increase in 2020, with couples scheduled to receive $1,175 per month and individuals $783 per month. For a couple to receive SSI their must be an eligible individual plus an eligible spouse.

Is an advance directive enough to ensure that your wishes are followed when you cannot express them because of disease or illness that affects your ability to make decisions for yourself? Physician Orders for Life-Sustaining Treatment (POLST Orders) for short, are often confused with advance directives. These medical care planning tools are very different from each other.

What is an advance directive?

An advance directive consists of a living will and a health care power of attorney. Every adult, regardless of age, should have one and update them from time to time, especially following a diagnosis of a serious medical condition.

The Social Security Administration just announced the Cost-of-Living (COLA) adjustment for 2020. Recipients of Social Security and Supplemental Security Income (SSI) benefits  will receive an increase of 1.6 percent in their benefit amount for 2020. Below is a list of the top highlights of the automatic COLA increase and information about when you can anticipate the benefit increase to start.


  • Social Security beneficiaries will begin seeing their increase beginning in January 2020.
  • Social Security Income (SSI) beneficiaries will begin seeing the increase on December 31, 2019.

Earlier this month the Center for Medicare Advocacy and the Long Term Care Community Coalition made a joint announcement regarding changes to the Nursing Home Compare website. Nursing Home Compare is a service provided by to help prospective nursing home residents or nursing home residents and their families obtain information about every Medicare and Medicaid certified nursing home in the country.

A nursing home is a place for people who can’t be cared for at home and need 24-hour nursing care. Over 15,000 nursing home facilities around the country will be affected by this change. Nursing home residents and their families will be able to easily identify if the nursing home they are considering has a history of resident abuse, neglect, and exploitation of its residents.

What’s happening?

Many of you may recall when President John F. Kennedy founded the Peace Corps in 1961 and may have even signed up as a volunteer to help provide social and economic development assistance abroad. Borrowing on this model, an initiative is underway to establish an internal national volunteer care corps to help older adults age in place by relying on the assistance of volunteers to help people manage their day-to-day living needs.

Introducing the National Volunteer Care Corps

The National Volunteer Care Corps is a government initiative run by the Administration for Community Living, a division of the U.S. Department of Health and Human Services. The National Volunteer Care Corps seeks to build an army of domestic volunteers to help older people live better and longer in their homes, especially if they can still take care of their primary needs. From teens, to college students, or civic minded adults, volunteers would perform the following tasks:

A common question asked of us is what happens when a will’s language is inconsistent with the titling of an account held with survivorship benefits? The immediate answer to the question is that the titling of an account will control over a will’s language. The practical effect on the survivor or beneficiary of the account, if there is a discrepancy with the name or a name has been changed, is to challenge the titling of the account in probate proceedings.

When an account is held with survivorship benefits to another account holder, how that account is titled may mean one of two things. Ideally, the named beneficiary, by operation of law, should automatically receive the contents of the account. If the titling is wrong or incorrect, legal intervention will be necessary to correct the account titling. In almost all cases, the account title will supersede any instructions to the contrary in the deceased person’s or maker’s will.

Why do people set up accounts with survivorship rights?

More seniors than ever are carrying high debt into retirement. Managing high debt simultaneously with managing the cost of daily living and medical care on a fixed income is a recurring problem in many households. The amount of debt burden has skyrocketed over the past decade.  

The National Council on Aging commissioned the Survey of Consumer Finances to study debt and how it impacts seniors economic security. The key findings are listed below:

  • Percentage of households headed by an adult 65 or older with any debt increased from 41.5% in 1992 to 51.9% in 2010 and then to 60% in 2016.
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