The questioner was 67 years old and in fairly good health. For instance, if you purchase an annuity that doesn’t pay out for a number of years, and one spouse goes into a nursing home before the payout begins – that’s a problem. Once the institutionalized spouse is eligible for Medicaid, the resources and income of the community spouse will not be considered for continuing eligibility of the institutionalized spouse. The tough analysis associated with these transfers include whether someone has the legal authority to transfer assets to the community spouse (via a power of attorney or conservatorship that expressly permits such gifts) and what tax implications, if any, would result in such a transfer. Some factors that can increase difficult feelings after nursing home placement might include the disappointment of not being able to care for a spouse at home as originally planned, the perception (accurate or not) that others expect you to have been able to care for the person at home, and the acknowledgment that the person's disease is advancing. The focus of this article is how to get a loved one into a nursing home that accepts Medicaid payments. The countable assets of the couple above the community spouse resource allowance must then be “spent down.” A spend down, to an elder law attorney, merely means the conversion of a countable resource to either a non-countable resource or a new income stream, and does not necessarily mean that money needs to be spent. Protecting Assets When A Spouse Enters A Nursing Home As an Elder Law attorney, I often see the devastating toll the cost of nursing care can have on a married couple’s assets. Yes, many couples in this situation panic once they hear that Medicare stops paying. (Remember, these are all approximate numbers.) In addition, Hook Law Center can assist with Veterans disability pensions, Supplemental Needs Trusts, and provide planning and care management, including bill paying, account management and reporting services. They’ve seen friends or family spend nearly all of their retirement savings on nursing home care, leaving the surviving spouse impoverished for the rest of his or her life. In the case of a single individual, usually around half of his or her savings can be preserved while qualifying for Medicaid. You are allowed to own a home, a vehicle, have a retirement account, a burial plan and/or burial account (up to $10,000) and $2,000 in a bank account and still qualify for Nursing Home Medicaid. The engineering students at ECPI’s Richmond campus needed a project for their senior capstone class. Probably not. It’s the last day of the month immediately prior to either spouse’s first “period of institutionalization” lasting 30 days or more. If my spouse is going into a nursing home, can he or she transfer all of his or her assets to me and qualify for Medicaid? But, if one spouse is in an institution such as a nursing home and the other spouse is still living on the community, different rules apply. That’s because the healthy spouse can “convert” countable assets to a “stream of income” that would allow Mary to keep all of her income, and nearly all of the assets. Currently, the community spouse resource allowance is 50% of the total countable resources of the couple up to $120,900, with a floor set at $24,180. The spouse in the nursing home is required to contribute all his income except for $50 to the home, with several wrinkles. 1Rarefind- Medicaid law states that the community spouse can keep all of their own individual assets and 1/2 of the jointly held assets up to about 119,000$. Here are tips you need to know to protect yourself, your spouse and your assets. Even better, with the right guidance Mary can keep much more than CSRA. He’s had quite a lucky life in some respects, and unlucky in others. Spousal impoverishment protection affects legally married couples when one spouse is in a nursing home or taking part in a community waiver program and the other spouse is not residing in a nursing home or other medical institution for 30 days or more. The primary home and one car are also exempt. The students had to be quite creative, because the leg had to be made of certain materials which Ray Ray would not destroy by chewing. If Your Loved One is in Care On Lock Down due to Covid-19, North Carolina Elder Law Attorney: Medicaid Planning with Annuities, North Carolina Trust and Estates Lawyer: 5 Tips to Get Your Affairs in Order. This myth, I believe, arises from the fact that if a single individual does not reside in real property for 6 months then the home must be listed for sale, and that Medicaid may put a lien against the home upon the death of a Medicaid recipient. (336) 378-1122. It’s the amount of money that a healthy spouse can keep and still qualify the ill spouse for Medicaid in the nursing home. Myth – I can’t gift money to my spouse because of the 5-year look-back period. If they have $250,000, the healthy spouse only can keep the $119,220. 3). As we mentioned in the section on assets the asset limit in most states is about $2,000 for an individual, and $3,000 for a couple when both spouses are living together. Then came his second piece of good luck. Caregivers should not feel as though a nursing home is a failure on their part but instead as a logical next step for those needing 24 hour professional supervision and assistance. Their Florida home was worth $500,000, with approximately $200,000 owed on the mortgage. Website Hosting & Development by Get YOU Found. Given the average cost of nursing home care is over $225 per day, very few families can afford to pay out-of-pocket. For example, some assets, such as the primary residence of the community spouse, is a non-countable resource for Medicaid eligibility. A key component to proper planning is setting up a trust; in the case of nursing home costs, you want to set up a living trust. Set up a trust. Hire An Attorney To Draft A “Life Estate” For Your Real Estate. Naturally it’s best to plan ahead. If one spouse goes into a nursing care, for the purposes of Medicaid, the individual going into care can only have $2000 in non-exempt assets and the spouse remaining at home can keep half of the overall assets. Resources held by either the institutionalized (the spouse that needs care) or community (the spouse that does not need care) spouse shall be considered available to the institutionalized spousal however, certain exclusions apply to various assets. Thirdly, Income Only Trusts go a long way to help avoid probate. The CSRA amount, which the healthy spouse can keep by law, is one-half of the countable assets up to a maximum number set each year. It is normal to have a mix of emotions when caregivers determine a nursing home is the next step for their loved one. The right annuity can preserve funds for the well spouse, while allowing the other spouse to be eligible for Medicaid Long-Term Care benefits without spending down those excess assets. The plan should be custom tailored to each couple, and what works for one, may not work for another. Need to get started today? If your own income exceeds the allowance set by Medicaid you do not need to pay the difference to the nursing home; you can keep all of your income no matter how high. But when a nursing home crisis hits your family, getting the right guidance from a local, North Carolina firm you can trust is like having a “Late Pass” for protecting you and your family. Hardly enough when the average cost of nursing homes is over $6,000 per month, depending on where you live. This is called a Personal Needs Allowance (PNA). He loved his new home, and the other two dogs who already lived with the Glassners. So thanks to ECPI students, who used their ingenuity and technical smarts, Ray Ray is enjoying life once more as a four-legged canine! Susan had a friend who worked at ECPI’s Virginia Beach campus, Nadine Newhart, who contacted the Richmond campus for her. With the right help, you can make sure your spouse gets needed nursing home care, without going broke. Even it's another 10 years until your spouse goes into a nursing home, Medicaid will still need to establish the assets owned as of the time 10 years earlier when the CPI was first established. This holds true regardless of the equity value in your home. The balance of $349 ($1,800 - $1,451) will have to be paid to the nursing home. Clearly, take action or it can become TOO LATE! We are a member of the Special Needs Alliance (SNA), a by invitation only national network of attorneys serving disabled persons and their families. Local Elder Law Attorneys in … Additionally, the MCCA sets forth an exemption amount, known as the community spouse resource allowance, to ensure there is a small safety net for the community spouse. The institutionalized spouse can also deem money over to the community spouse up to around $2800 a month. I immediately broke into tears and ... know is against the wishes of your loved one. The key is to use a Federal and State rule in a way that we’ve helped clients for years. Most people know that in order to qualify for Medicaid coverage of a long-term stay in a nursing home, the nursing home resident cannot own more than $2,000 in cash or other "countable" assets. When assessing a loved one’s need for a nursing home, consider the amount of autonomy your loved one is able to perform. Instead, the Medicaid considers the primary residence of a community a non-countable, or exempt, resource when determining eligibility. The most upsetting cases involve healthy spouses that have essentially been impoverished as a result of the unhealthy spouse’s need for care. The POA can be written to go into effect only if the patient enters a … When your spouse is in the nursing home, you feel your world crashing down. It was an incredible feat of timing! Myth – Medicaid is going to take my house. This will probably require selling your home, and your spouse or partner will most likely have to move. For couples with one spouse in a nursing home, your family’s future depends on these 4 letters: “CSRA.” That stands for the Community Spouse Resource Allowance. Even if you wouldn't normally fall into the low-income category, there are ways to shelter your assets and increase your chances of eligibility for nursing home care coverage. The new leg is supported by a harness and wheel combination that allows Ray Ray to make turns. Once in a nursing home… The Hook Law Center (formerly Oast & Hook) offices are located in Virginia Beach, and Suffolk, convenient to the Peninsula, and Southside including the cities of Chesapeake, the Eastern Shore, Franklin, Hampton, Isle of Wight, Newport News, Norfolk, Poquoson, Portsmouth, Richmond, Smithfield, Suffolk, Virginia Beach, Williamsburg, Yorktown and Zuni. If you are interested in a free subscription to the Hook Law Center News, then please telephone us at 757-399-7506, e-mail us at mail@hooklawcenter.com or fax us at 757-397-1267. Married and one spouse moving to a nursing home When your spouse moves into a Medicaid funded nursing home, you are considered the community spouse, and as the community spouse, you are entitled to keep your home. In addition, one may serve as an advocate for an individual in a nursing home. The unlucky part is that a couple of years ago he was in an accident, and had to have his back right foot amputated. While protecting one’s assets from nursing home costs, an Income Only Trust is still able – as the name suggests – to provide income to the individual establishing the trust. Go Verified by ... could best be addressed by transferring her to a nursing home. I'll start by mentioning that this is likely the number one concern of all people who consult with me about an elder law or Medicaid planning issue. In fact, you can do this long before you think your loved one might ever end up in a nursing home. It’s one of the hardest decisions to make about a loved one’s care, and it can be emotionally difficult for everyone involved. In this case, if your income allowance is $2,500 a month, you will be able to keep $1,451 ($2,500 - $1,049) of your husband’s income each month. The CSRA amount, which the healthy spouse can keep by law, is one-half of the countable assets up … His first bit of luck was to be adopted by Susan and Phil Glassner of Norfolk. The most upsetting cases involve healthy spouses that have essentially been impoverished as a result of the unhealthy spouse’s need for care. © 2020 Greensboro Estate Planning and Elder Law Center. A four-year-old beagle named Ray Ray lives in Norfolk. For more on Medicaid's income protections for the healthy spouse, click here. Typically, clients, facing the situation of a spouse being admitted to a nursing home with assets greatly in excess of the CSRA, may consider a divorce in order to protect his/her assets. For example, if the couple has $150,000, the healthy spouse can keep $75,000. Another option is “Spousal Refusal,” which allows the Community Spouse to retain all of the assets without filing for divorce. A nursing home reviews all of an elderly person’s assets – and if married, the spouse’s assets – to determine what to use to pay for Long-Term Care before it applies for Medicaid. The basic fact is that such impoverishment can be completely avoided with proper guidance as a result of the Medicare Catastrophic Coverage Act of 1988 (“MCCA”), which essentially provides a framework to prevent spousal impoverishment under the Medicaid rules. Myth – We have too much money for Medicaid. Sign Up To Receive The Elderlaw Firm Newsletter, The Elderlaw Firm for North Carolina Elder Law Estate Planning 403 W. Fisher Ave, Greensboro North Carolina 27401. As an Elder Law attorney, I often see the devastating toll the cost of nursing care can have on a married couple’s assets. But there may come a time when the scales tip and a nursing home is the best choice. Content by elder law attorney, Andrew Hook and the Hook Law Center staff. Now comes the lucky part. 2. The fact remains, that while the house may need to be sold or when the house sells, Medicaid may be entitled to some of the proceeds, Medicaid does not actually take the home. Anything over half the assets plus $2000 must … So, can the nursing home or Government/Medicaid take your home. We are primarily meeting virtually with clients and in-person only when necessary.  We are taking serious precautions to protect our employees and clients during this time of heightened security measures. All Rights Reserved. Since the majority of persons in nursing homes for long term care utilize Medicaid to pay the bill, this article is relevant to most families. Hook Law Center encourages you to share this newsletter with anyone who is interested in issues pertaining to the elderly, the disabled and their advocates. When Your Spouse is In the Nursing Home, Get Better Results with the Right Actions and Advice  When your spouse is in the nursing home in Greensboro, NC or the surrounding areas, don’t expect the Medicaid Office to tell you how to protect yourself. and apply again later after you’ve spent much of your hard-earned retirement assets. For Mary in our example, that’s the difference between protecting nearly all of her and Bob’s retirement savings, or being broke the rest of her life. To do so, Ray Ray had to move from North Carolina where he had been taken in by a rescue group. Ouch! Naming you as the life tenant and … And if one spouse requires care in a nursing home facility, and the other remains home, it's certain the benefit will not cover living expenses for both. Our business is deemed an Essential Business and as such will remain open to service clients in this critical time. Don’t let that happen to you! As members of the alliance, Hook Law Center works with personal injury lawyers to resolve cases, enhancing judgments and awards for disabled clients while maintaining eligibility for Supplemental Security Income, Medicaid and Medicare benefits. This permits spouses to transfer assets between another without risk of a penalty period for the transfers. However, dealing with a missing foot was causing stress on his hips and spine. As a result, you should consult an experienced elder law attorney to develop a plan that will work for you. That led to other problems like gait and stress issues on his remaining legs. But don’t expect to hear about it from the Medicaid Office. Their CSRA will be based on the assets Bob and Mary owned as of May 31, not when Bob applies later for Medicaid. If one spouse is in the facility while the other remains in the home, the spouse in the nursing home may transfer a substantial amount of money and assets to the spouse who is still living in the community, and generally there are ways to protect the home as well. Medicaid does not take anyone’s home, let alone the primary residence of a community spouse. The balance of his income, less a small personal needs allowance, must be paid to the facility. And if you go to the Medicaid Office for help, you’ll likely hear that you need to spend half of your money (or more!) Both are short of the cost of assisted living. A married couple can have $126,420 thanks to the community spouse resource allowance. When calculating CSRA you must know the “snapshot date,” which is the date that CSRA is calculated. If you purchase an annuity and payments go to the spouse who then needs to go into the nursing home – that’s a problem. Hook Law Center:  Kit Kat, what can you tell us about ECPI helping a 3-legged dog walk again? The students got to work on it, and within no time they created a prosthetic leg for Ray Ray. So, if Mary’s husband, Bob, goes into the hospital on June 15, and then goes to a nursing home for a combined stay of at least 30 days, their snapshot date is May 31. Don’t “spend down” like the Medicaid Office tells you to do. The information in this newsletter may be copied and distributed, without charge and without permission, but with appropriate citation to Hook Law Center, P.C. Are you too late to protect your loved one, your family and your life savings? It’s the amount of money that a healthy spouse can keep and still qualify the ill spouse for Medicaid in the nursing home. Many caregivers and families make a huge effort to keep their loved one at home for as long as possible. North Carolina Will and Estate Attorney Says, “When It Comes to Cryptocurrency, Estate Planning Is a Must!”, ← Review Your Insurance Needs When You Retire, Protect Yourself and Your Family through Smart Estate Planning →. For couples with one spouse in a nursing home, your family’s future depends on these 4 letters: “CSRA.” That stands for the Community Spouse Resource Allowance. (Robyn Sidersky, “ECPI students accomplish a real feat, and an amputee dogs gets a prosthetic limb,” The Virginian-Pilot, November 3, 2017, pg. Learn more about life care agreements . Kit Kat:  Well, this is a wonderful story. These rules are commonly known as the spousal impoverishment rules. It’s a difficult time. North Carolina Elder Law Attorney: What are the Warning Signs of Dementia? Unfortunately, just like the single individual, the Nursing Home Spouse’s Retirement Accounts are not exempt and are an available asset and are … When your spouse enters a nursing home that is paid for by Medicaid, he or she is only able to keep a small part of their monthly income. Medicaid applicants with too much money or assets are denied coverage for long-term care and have to pay their own nursing home bills. It also allows that same individual to qualify for Medical Assistance or Medicaid. Myth – They only look at one spouse’s assets when determining eligibility. If your spouse or partner is not your co-borrower and you move someplace else for a majority of the year, or to a nursing home or assisted living for more than 12 consecutive months, the reverse mortgage loan will need to be paid back. When one spouse has to go into a nursing home, couples can save assets from Medicaid by purchasing an immediate annuity. While it would be nearly impossible to debunk all the myths pertaining to Medicaid we address, there are a few common ones that we at the Hook Law Center see most often. The short answer is yes, they will lose most of their income. In fact, I’ve even written you an excused “Late Pass” so you won’t feel tardy! With proper planning, most couples can protect their assets and qualify as an institutionalized spouse for Medicaid. There is hope…and it’s not too late if you get the right advice. In 2015, it is about $119,000. More often, seniors contemplate moving into a nursing home when the ability to independently perform daily activities of living becomes difficult. We’ve published other relevant articles that readers may want to review prior to this one, specifically on Medicaid eligibility for nursing home care and how much … subject to a minimum and maximum that is set by each state Medicaid agency The Virginia Medicaid manual has a blanket exemption for transfers between spouses. His mother, Susan, happened to see on Facebook a post about some students at ECPI’s Richmond campus who had made a prosthetic arm for a child. This can be a key tool for evaluation. For married couples, when only one spouse requires nursing home care, the couple can typically save most if not all of their life savings while still qualifying the resident for Medicaid. The planning, as previously mentioned, requires the conversion of countable resources to non-countable resources or a new income stream and does not require the impoverishment of the community spouse. Create a Funeral Trust – Certain irrevocable funeral trusts created for the Medicaid candidate and / or their spouse can enable a couple to reduce their countable assets by up to $30,000 (depending on their state of residence). Gets needed nursing home time they created a prosthetic leg for Ray Ray short of the community spouse resource.... 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