Pandemic Impacts Visiting Nursing Homes

In nursing homes where visits have resumed, they’re much changed from those before the pandemic. Nursing homes visits have been limited as long-term care facilities are taking steps to minimize any chances of transmission of COVID-19 to grandma and grandpa. To date, virus has been found in about 11,600 long-term care facilities, causing more than 56,000 deaths, according to data from the Kaiser Family Foundation.

AARP’s recent article entitled “When Can Visitors Return to Nursing Homes?” explains that the federal Centers for Medicare and Medicaid Services (CMS) has provided benchmarks for state and local officials to use, in deciding when nursing home visits can return and how to safeguard against new outbreaks of COVID-19 when they do. The CMS guidelines are broad and nonbinding, and there will be differences, from state to state and nursing home to nursing home, regarding when visits resume and how they are handled. Here are some details about the next steps toward reuniting with family members in long-term care.

When will visits resume? As of mid-July, 30 states permitted nursing homes to proceed with outdoor visits with strict rules for distancing, monitoring and hygiene. The CMS guidelines suggest that nursing homes continue prohibiting any visitation, until they have gone at least 28 days without a new COVID-19 case originating on-site (as opposed to a facility admitting a coronavirus patient from a hospital). CMS says that these facilities should also meet several additional benchmarks, which include:

  • a decline in cases in the surrounding community
  • the ability to provide all residents with a baseline COVID-19 test and weekly tests for staff
  • enough supplies of personal protective equipment (PPE) and cleaning and disinfecting products; and
  • no staff shortages.

Where visits are permitted, it should be only by appointment and in specified hours. In some states, only one or two people can visit a particular resident at a time. Even those states allowing indoor visits are suggesting that families meet loved ones outdoors. Research has shown that the virus spreads less in open air.

Health checks on visitors. The federal guidelines call for everyone entering a facility to undergo 100% screening. However, the CMS recommendations don’t address testing nursing home visitors for COVID-19.

Masks. The federal guidelines say nursing home visitors should be required to “wear a cloth face covering or face mask for the duration of their visit,” and states that allow visitation are doing so. The guidelines also ask nursing homes to make certain that visitors practice hand hygiene. However, it doesn’t say whether facilities should provide masks or sanitizer.

Social distancing. The CMS guidelines call on nursing homes that allow visitors to ensure social distancing, but they don’t provide details. States that have permitted visits, state that facilities enforce the 6-foot rule.

Virtual visits. Another option is to make some visits virtual. Videoconferencing and chat platforms have become lifelines for residents and families during the pandemic. Continued use after the lockdowns can minimize opportunities for illness to spread.

Here at the Law Office of Michael T. Huguelet, P.C., we understand that the COVID-19 pandemic has impacted your daily life. With visits limited, having a loved one living in a nursing home can take an emotional toll.

Reference: AARP (July 22, 2020) “When Can Visitors Return to Nursing Homes?”

Special Needs Planning for Parents
Individuals with special needs require special consideration in estate planning.

Special Needs Planning for Parents

Public benefits for individuals with special needs include health care, supplemental income, and resources, like day programs and other vital services. Some benefits are based on the individual’s disability status, but others are “needs tested,” where eligibility is determined based on financial resources, as explained in the article “Planning for loved ones with special needs” from NWTimes.com. This distinction is an important consideration in estate planning.

Needs testing” is something that parents must address as part of special needs planning, in concert with their own estate planning. This ensures that the individual’s government benefits will continue, while their family has the comfort of knowing that after the parents die, their child may have access to resources to cover additional costs and maintain a quality of life they may not otherwise have.

Families must be very careful to make informed planning decisions, otherwise their loved ones may lose the benefits they rely upon.

A variety of special planning tools may be used, and the importance of skilled help from an elder law estate planning attorney cannot be overstated.

One family received a “re-determination” letter from the Social Security Administration. This is the process whereby the SSA scrutinizes a person’s eligibility for benefits, based on their possible access to other non-governmental resources. Once the process begins, the potential exists for a disabled person to lose benefits or be required to pay back benefits if they were deemed to have wrongfully received them.

In this case, a woman who lived in California, engaged in a periodic phone call with California Medicaid. California is known for aggressively pursuing on-going benefits eligibility. The woman mentioned a trust that had been created as a result of estate planning done by her late father. The brief mention was enough to spark an in-depth review of planning. The SSA requested no less than 15 different items, including estate documents, account history and a review of all disbursements for the last two years.

The process has created a tremendous amount of stress for the woman and for her family. The re-determination will also create expenses, as the attorney who drafted the original trust in Indiana, where the father lived, will need to work with a special needs attorney in California, who is knowledgeable about the process in the state.

Similar to estate planning, the special needs process required by Medicaid and the SSA is a constantly evolving process, and not a “one-and-done” transaction. Special needs and estate planning documents created as recently as three or four years ago should be reviewed.

Our specialized team has the tools to tackle your estate planning needs, from Medicaid support to planning for people with special needs.

Reference: NWTimes.com (June 21, 2020) “Planning for loved ones with special needs”

When Planning for Retirement, Don’t Forget About Long Term Care Insurance

Roughly 60% of those turning 65 can anticipate using some form of long-term care in their lives, according to the U.S. Health and Human Services Department. Those individuals may be faced with a nursing home, assisted living, or in-home care.  The costs associated with these types of care make elder law planning extremely important.  This is one reason individuals should consider the possibility of long-term care insurance.

CNBC’s recent article, “Not having long-term care insurance can be ‘the single biggest devastator’ of your financial plan,” reports that over 8 million Americans have long-term care insurance. However, the cost of that insurance is rising. The increase is due to several factors, including the fact that companies under priced their policies for years and misjudged how many would drop coverage.  Because of those rising premiums, some individuals may choose self-insurance.  That means saving a pool of money to earmark for long-term care. Coverage is also available through Medicaid, which has eligibility requirements.  Despite these increases, when planning, one should consider purchasing  some form of coverage. This is because not being insured can be the biggest devastator of a financial plan.

The rule of thumb has been to buy LTC coverage at age 55. However, it really depends on your situation. The big unknown is health, and the odds of being able to qualify for coverage at age 60, compared to age 30 or 40, is vastly different.

A traditional LTC policy will cover the costs of care for a certain period of time, generally up to six years. The amount of coverage is based on the average cost of care for your location. Most insurers offer it in the form of a monthly benefit, and possibly with some inflation protection.  There’s also a hybrid policy that covers long-term care costs, but becomes life insurance paid to heirs, if it’s not used. Of the 350,000 Americans who purchased long-term care protection in 2018, 85% chose the hybrid coverage. It’s also called combo or linked-benefit. The big difference between a traditional LTC policy and the hybrid policy is you’ll pay more for the hybrid policy.

The attorneys at Michael T. Huguelet, P.C. would be happy to discuss your options for long term care planning and the benefits of long term care insurance so you have piece of mind that your assets are preserved and left to those who mean the most to you.  If you are looking for long-term care planning in Orland Park, Illinois or the surrounding suburbs of Chicago, please give us a call.

Reference: CNBC (October 14, 2019) “Not having long-term care insurance can be ‘the single biggest devastator’ of your financial plan”

 

Long-Term Care Planning is Important

The expense of long-term care is often astronomical. Many people who end up requiring long-term care initially pay for it out of their own their own assets.  Medicaid is the federal program that assists with healthcare benefits for those who qualify and cannot afford them.  Many people end up accessing Medicaid benefits, after their own assets have been depleted.  The Medicaid program can help with paying for home care, assisted living, and nursing home care, explains Insurance News Net’s recent article, “Medicaid planning.”

Speaking with an elder law or Medicaid planning attorney is a great idea to make sure people can qualify for Medicaid before they completely exhaust their resources.  These practitioners specialize in helping people qualify for Medicaid benefits far in advance of their assets becoming depleted.

For those who are thinking of transferring all of their assets to their children to qualify for Medicaid, the government has already thought of that. If you gift any assets to your children, you may be subject to a penalty before becoming Medicaid eligible. However, there are perfectly legal strategies that a senior can use to become eligible for Medicaid, while still keeping considerable assets.  Assets may be freely transferred between spouses to help gain eligibility for a spouse that needs care.  There are also many assets that are exempt for purposes of gaining eligibility.

With the guidance and planning from qualified legal counsel, seniors who require long-term care can get assistance with their healthcare from the government, while preserving assets for their loved ones.

The attorneys at Michael T. Huguelet, P.C. would be happy to sit down with you and assist with long term care planning so you have piece of mind that your assets are preserved and left to those who mean the most to you.  If you are looking for long term care planning in Orland Park, Illinois or the surrounding suburbs of Chicago, please give us a call.

Reference: Insurance News Net (September 29, 2019) “Medicaid planning”