How to Manage Someone Else’s Social Security or Veteran’s Benefits

January 2, 2023Filed Under: Elder Law

In order to help Roberto manage his Social Security benefits, you have been assigned to assist him. In the Social Security system, you’ll be called Roberto’s “representative payee.”

The situation is similar if you’re appointed to help your elderly father, who has dementia, manage his Veteran’s benefit checks. In the Veterans Administration system, you’ll be called a “VA fiduciary.”

The word “fiduciary” applies in both cases. The law requires you to act to a high standard of good faith and honesty. This means that you must keep careful records, you must not mix the recipient’s money with yours, and you must spend the money for the recipient’s benefit, only.

There are other specific rules you must follow for these kinds of benefits. To assist you, the Consumer Financial Protection Board (CFPB) has issued a guide: “Managing Someone Else’s Money: Help For Representative Payees and VA Fiduciaries.” Download your free guide.

The guide reminds you that the benefits you’ll manage are intended to meet the recipient’s day-to-day needs for food, clothing, and shelter. So you must spend the money on those needs first. Only after those needs are satisfied may you spend the money on medical and dental expenses, or on what may be thought of as “extras” – home improvement, entertainment, or car payments.

If there is anything left over, you must bank it in an interest-bearing account. The CFPB leaflet provides guidance on how to title the bank account, which you must follow to protect the money from creditors. In all cases, the recipient’s bank account must be separate from yours.

The leaflet further emphasizes the need to document everything you do, as you will be responsible to report annually to the agency in question. The leaflet lists your duties, provides contact information for helpful agencies, and includes advice about what to do if you fear Roberto or your father is being exploited.

The guide is also useful for recipients of other benefits, such as from the Railroad Retirement Administration or other state agencies.

You’re guided in following the applicable rules, and you will be doing the person who receives benefits a great service. If you have questions or need additional help, please contact our Cincinnati office by calling us at 513-771-2444 to schedule a consultation.

Choosing the Right Care For Your Aging Loved Ones

December 26, 2022Filed Under: Elder Law, Long Term Care

According to sources, long-term care facilities are underfunded by government agencies. They lack the resources to do proper inspections of residential health facilities.

You may have seen the rating system provided by the Centers For Medicare and Medicaid Services (CMS). CMS awards stars to healthcare facilities on “Care Compare.”

The stars are there to help you make informed decisions. The more stars, the better the facility is supposed to be. However, the website also advises that in addition “to reviewing the information here, you should talk to your doctor, social worker, or other health care providers when choosing a provider.”

The good news is that the government is aware that residential care and government oversight must improve. There are efforts underway to better protect our nation’s elderly population. In the meantime, it is important to look beyond government ratings when investigating a facility for yourself or a loved one.

What to Look for in a Facility

Part of your research should include visiting the facility. Look for these qualities during your visit:

Well-groomed, engaged residents
Accessibility for residents with disabilities, such as elevators that can accommodate wheelchairs.
Decent food
Attentive staff
Nice rooms and furniture
Adequate health precautions

In addition to visiting, you will want to talk with current and former residents or their families. Their experiences will help you decide if any facility is a good fit for your loved one’s needs.

You will also want to evaluate practical issues such as affordability and location. Even the best facility in the world is not a good fit if no one will be able to visit the resident regularly.

In-Home Care

Of course, many older adults would rather receive in-home care instead of living in a residential facility. That option comes with challenges too. Government money available for in-home care is stretched thin, leaving many people on waiting lists to receive funds. Care workers are often not paid enough, affecting the availability and standard of care.

If you choose in-home care, consider having a family member regularly check in on the person receiving care. During these visits, look for evidence of safety, hygiene, and emotional well-being.

The research and visits will take time. However, the reward of knowing that your loved ones are as healthy and happy as possible is worth the effort.

We hope you found this article helpful. If you have questions or would like to discuss your personal situation, please don’t hesitate to contact us at 513-771-2444.

Residents of Nursing Homes Are Protected by the Policies of the Centers for Medicare and Medicaid Services

December 12, 2022Filed Under: Elder Law, Long Term Care

Nursing homes face a variety of public health challenges from infectious diseases like the flu and COVID-19. The Center for Medicare and Medicaid Services, CMS, outlines specific policies and protocols for residential health facilities. These measures outline policies related to visitations, nursing aid certification, and more. Nursing homes must comply with these policies to qualify for Medicare or Medicaid funds. The CMS goal is to ensure a minimum level of care for residents nationwide.

Nursing home residents are especially vulnerable to public health problems, such as infectious diseases. Their vulnerability comes from the inherent risks of congregate living and residents’ often fragile health, making strong public health policies especially important.

The Pandemic Health Emergency (PHE) from COVID-19 revealed a host of underlying problems in nursing homes across the United States. CMS guidelines changed to respond to the PHE and evolved again to reflect lessons learned from the PHE. While CMS regulates a minimal quality of care federally, states often supplement those policies.

State Legislation Goes Beyond Nursing Home Guidelines

A review of state legislatures finds twenty-three politically and geographically diverse states passed more than seventy new provisions affecting the operations of nursing homes. The laws cover a wide range of issues to benefit nursing home residents.

Connecticut law now permits its nursing home residents to designate an “essential support person” who can care for a loved one even during a public health emergency. In March 2021, the Alabama legislature enacted the “No Patient Left Alone Act.” Like Connecticut’s law, it ensures that residents have an advocate by their side, not merely a visitor stopping in for a quick hello.

Other states are ramping up efforts to provide tablets and other devices through lending libraries. Residents can borrow devices to communicate with their families and loved ones. Digital contact becomes necessary for some nursing home residents with families spread across the country and unable to visit frequently. These digital communications also help loved ones make appropriate care decisions and advocate for the resident’s needs.

Illinois reduced the cost of providing this equipment through grants via state funds received when health and safety violations of nursing homes reach a financial settlement.

Staffing levels are another issue the states are tackling. Addressing staffing shortages is a long-time response to a 1987 federal law requiring CMS facilities to maintain nursing staff sufficient to “attain or maintain the highest practicable well-being of each resident.” The vagueness of this law led several states to add more specific staffing requirements.

The office of the Attorney General of New York State in the Nursing Home Response to COVID-19 Pandemic report findings show lower COVID-related death rates in nursing homes with higher staffing levels. Arkansas Advocates for Nursing Home Residents Martha Deaver concurs that the standard of care decreases with less staff.

States are also ensuring facilities are not receiving excessive profits from government payouts to care for residents. New Jersey requires nursing homes to spend ninety percent of their revenues on direct care. New York deems the number to be seventy percent, including 40 percent to pay direct-care workers. Massachusetts regulations mandate nursing homes devote seventy-five percent to direct-care staffing costs and have no more than two people living in one room.

These states’ patchwork protections for nursing home residents are part of the nation’s nursing home care regulatory system. CMS sets the minimum requirements providers must meet in their facilities to participate in the Medicare/Medicaid programs at the federal level. It is permissible for states to implement specific additional requirements as long as they do not conflict with existing federal requirements.

Inequalities Among States for Residential Facilities

Because each state can implement additional nursing home regulatory improvements, there are uneven nursing home care provisions throughout the country. These differences may exacerbate healthcare disparities of financial status, race, or gender. Richard Mollot, executive director for the Long Term Care Community Coalition advocacy group, finds this hodgepodge approach “a poor substitute for comprehensive federal rules if they were rigorously enforced.” If you or a loved one is a nursing home resident, you should know the additional measures your state provides. Depending on how your state supplements the CMS minimum standards of care, you may need to do research that your chosen facility goes above and beyond the minimum requirements.

We hope you found this article helpful. If you’d like to discuss your particular situation, please don’t hesitate to reach out. Please contact our Cincinnati office by calling us at 513-771-2444 and schedule a consultation.

Plan Medicaid and Inheritances Carefully

October 17, 2022Filed Under: Elder Law, Medicaid Planning

It is possible to make mistakes when it comes to inheritances and Medicaid. It can be very costly to make those mistakes. When a person is drawing Medicaid benefits and inherits money or property, that inheritance jeopardizes the benefits. The inheritance must be handled carefully to minimize expensive penalties. What “careful” means, though, can be misunderstood without the necessary expertise.

The Right Steps for Handling Inheritance

The first and best idea is to call experienced elder law attorneys like us. (An even better idea is to call us well before any inheritance becomes a “problem.” The sooner you call us, the more money we can likely protect for you.)

An Ohio attorney was recently suspended partly because he mishandled this Medicaid-inheritance issue. The mistaken advice was that to protect the benefits, the person who stood to inherit should “disclaim” or “renounce” the inheritance – in other words, give it away to someone else.

Medicaid Rules and Inheritance Context

That advice would have been OK in the tax context. It was not OK in the Medicaid context. The Medicaid rules count inheritances regardless of whether the recipient keeps them or passes them on to someone else. The bad result, in such cases, is that the person receiving Medicaid would be charged just as if he or she had taken the money, even if he or she gave it away, and the person’s benefits would be docked accordingly. This can be a very expensive misstep.

The better result would be to consult us immediately. We can advise you on the necessary techniques to split the inheritance between the recipient and somebody else, like a child. If the right strategies are used, Medicaid would count the inheritance to an extent, but not as much as it would have if the recipient had simply given away the whole sum.

An even better result would be if the person leaving the inheritance had consulted us first. We know how to structure that person’s financial arrangements, to protect the people to whom the person wants to leave his or her legacy.

Elder law is a law unto itself. We know that complicated area of the law well and we have helped many people successfully meet the challenges it poses. If you have questions or would like to discuss your personal situation, please don’t hesitate to contact us at 513-771-2444.

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