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Healthcare

The Health Care Industry’s Push Into Your Privacy

There is a battle for the healthcare market in the US between Amazon, Apple, and Google, and to a lesser extent, Microsoft and Facebook, which are all stepping up their efforts. Some of the businesses are underway, like storing medical records in the cloud for a fee or using patient forms that have been “anonymized” to create new tools. Some products already cater directly to patients, such as wearable medical devices with monitoring capabilities through the internet of things. Lobbying efforts by Silicon Valley “encouraged” the Department of Health and Human Services (HHS) as they defined the rule, known as the Cures Act, improving patient access to all of their electronic health information (EHI) and standardizing their formatting for ease of interoperability. While there is a need to continue the modernization of the health care system, the complexity of the undertaking (legacy computer systems and data), entrenched financial interests, and privacy fears have made a tough go of it.

ONC’s Cures Act Final Rule

From a technology perspective, health care and its associated patient records are no different from data mining other personal information in the age of surveillance capitalism. There is money to be made, vast sums of money based on your health records. Why else would these very cash-rich tech companies wade into such a risky field? Estimates are the healthcare industry will reach 11.9 trillion dollars by 2022, and electronic health care records (EHRs) represent a growing sector of the business. The digital side of healthcare continues to expand as new federal regulations mandate hospitals make changes, and because spiraling health care costs make the sector ripe for disruption. Tech expertise in digital data management, storage, and analysis in other markets translates well into solutions for the behemoth that is health care record keeping. The big tech companies that deliver the best solutions will dominate that market and become an even more intractable part of our lives.

Is your privacy protected? The government outlines eight exceptions to the definition of information blocking when it comes to the Cures Act. The final rule allows for eight categories of reasonable and necessary activities. These activities do not constitute information blocking as long as certain conditions are met, referred to as “exceptions.”

ONC’s Cures Act Final Rule

Google has already garnered bad publicity regarding patient privacy through its subsidiary Google Health in an enterprise-focused known as Project Nightingale. The problems arose when Google got access to some non-anonymized patient data without the patients’ knowledge while creating tools that manage and analyze medical records for doctors and hospitals.

Meanwhile, Amazon Web Services (AWS) enjoys a dominant position in the service-based cloud storage of health records, offering downloadable medical information databases for clients. To side-step privacy responsibilities, an AWS spokesperson said the obligation to comply with patient privacy regulations and policy was the responsibility of customers that sell the medical datasets through AWS. More recently, the joint health care venture Haven (Amazon, Berkshire Hathaway, and JPMorgan) seeking to target innovations in primary care, insurance coverage, and prescription drug costs has shuttered its operations after three years into their business partnership. The business sector is so complex that, most recently, entrenched health care companies are beginning to shake off these tech disrupters and are making deals more traditionally. Tech companies are countering with more joint ventures with established health insurers like Cigna and others.

The continuation of personal, wearable medical devices also sparks many privacy concerns. Like the latest Apple Watch, these devices can take ECGs, detect falls, and phone 911, for example, but the data set created, and communication systems for transferring this data make it hard to protect privacy. Yet you may find in the future that your medical doctor prescribes an Apple Watch, and your insurance will pay for it. Azure, Microsoft’s cloud division, is in direct competition with Google and AWS in the cloud storage business for medical records but declines comment on how patient data is used in its business plan or how it would protect patient privacy. Finally, Facebook already has a health care tool, Facebook Preventive Health, and if you select opt-in, Facebook will use your basic demographic information and recommend medical tests and treatments. The company says the tool does not use your health information or whether you use the tool in advertising. Have you heard this before?

The old hassle of getting paper medical records to prove you have been vaccinated as a child, transferring documents to a new doctor’s office, or even filling out the same medical history information repeatedly may give way to a new set of frustrations. Change is upon US health care and medical record-keeping systems; let’s hope the digitization of and ease in accessing health care records comes with modernized privacy laws that prioritize and protect patients. 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 our Reno office by calling us at (775) 853-5700.

Estate Planning, Uncategorized

Living Trusts Have Many Benefits for Seniors

It’s an unfortunate fact that seniors are prime targets for financial abuse and scams. Sadly, the elderly are often taken advantage of by strangers — and sometimes even their own family members. That’s why it’s important that planning is in place to help seniors protect themselves and their assets.

As we age, it can become increasingly difficult to manage our assets. Most of us will, at some point, need assistance with these details to help ensure that our financial and other assets aren’t depleted. If you or an aging loved one are looking for ways to safeguard assets, a Living Trust is often the best way to do so. Living Trusts allow seniors to rest assured that their finances and assets are managed by a trusted person.

What is a Living Trust?

Living Trusts help protect and manage the assets of those who cannot do so themselves due to age, illness, or disability. Many seniors assume that a will is the only protection they need. However, trusts are designed to safeguard the assets of the living, while wills only outline what happens to a person’s assets when the pass away. Furthermore, wills must go before a probate court and taxes must be paid on inheritances, while Living Trusts allow beneficiaries to avoid probate after their loved one’s passing.

To establish a Living Trust the owner, or grantor, places assets within the trust. The grantor then appoints a trustee to manage it and names beneficiaries to receive the assets of the trust when the time comes.

There are different types of Living Trusts. Let’s take a look at each and the ways these trusts can benefit seniors.

Testamentary Trust

A Testamentary Trust protects an elderly person’s assets when a spouse dies. Assets of the deceased are transferred into a trust — enabling the appointed trustee to make all financial decisions regarding those assets. This helps a surviving spouse by protecting him or her from fraud or mismanagement of assets. Trustees can help the surviving senior generate income from remaining assets via sales or investments and take advantage of tax benefits.

Revocable Living Trusts

A Revocable Living Trust safeguards seniors by making it more difficult for non-trustee family members to mismanage money or assets. The grantor (senior) can amend or revoke the trust at his or her own discretion without the consent of the beneficiary. This type of trust allows the grantor to stay in control of assets by either serving as a trustee or appointing one. In this case, the grantor, serving as trustee and beneficiary of the trust, appoints a successor in the event he or she becomes incapacitated or dies. This appointed person is then responsible for the disposal of the trust’s assets.

Irrevocable Living Trusts

An Irrevocable Living Trust is one that cannot be changed or revoked by the trustmaker. This means that the grantor/trustmaker gives up his or her rights to the assets once they are transferred. Seniors over 65 who are eligible for Medicaid often choose to transfer assets into an Irrevocable Living Trust to avoid having to dispose of assets in order to remain eligible for Medicaid coverage or long-term care benefits.  Once assets are in an irrevocable trust, they cannot be counted for Medicaid eligibility purposes, but there could be a penalty for transferring assets to an irrevocable trust.

An elder law attorney can assist in determining the best way to set up this type of trust and how to best transfer assets based on Medicaid stipulations. An Irrevocable Living Trust can provide income for seniors and their spouses. It also protects their property and other assets from being seized to pay for medical costs, without impacting Medicaid eligibility. This type of trust can also remain in place for a surviving spouse after the grantor’s death.

The sooner assets are placed in an Irrevocable Living Trust the better, as a penalty will be assessed by Medicaid during the first 5 years the trust is in existence (if Medicaid is required during that time).

Ultimately, Living Trusts give seniors more control over their assets than a will, allowing them to set parameters and stipulations and appoint a trusted advisor to help them make decisions. If you or your loved one would like more information about setting up a Living Trust, we can help. 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 our Reno office by calling us at (775) 853-5700.

Elder Law, Healthcare

Caregiving From Afar

A long-distance caregiver is someone who provides care to someone who lives at least an hour away. This type of caregiving takes many forms – from arranging for in-home care, money management, bill paying, and information coordinator. You may also provide respite care for a primary caregiver, conduct safety reviews, create emergency plans, or any combination of these tasks. Legal publisher Nolo cites more than seven million adults in the US acting as long-distance caregivers for elderly parents or relatives.

The greatest success in long-distance caregiving happens when there is a foundation of planning and preparation. If there is a primary caregiver for your parent, ask how you can be most useful. Also, talk to friends who provide care to see if they have helpful suggestions. You will need to identify local resources that can help provide care for your parent. Local providers can include Meals-on-Wheels, senior centers, elder transportation, and more. The National Institute on Aging offers several good websites to use as a starting point. It is best to visit your parent before planning to assess their current living situation, identify their health issues, and gather important information.

Things to consider as you go through each room of the home, the garage, and the yard include

  • Safety – Is there anything that poses a safety problem in the location? Poor lighting, area rugs, clutter, or whatever else might stop your senior from moving safely around the space should be removed or improved.
  • Accessibility – Are things accessible to the senior? Are they within easy reach? Are switches, doors, plugs, and cabinets readily at hand to perform the room’s desired or necessary tasks?
  • Adaptability – Are there ways to adapt things in the room to provide greater accessibility, safety, or ease of use? Will brighter lights or additional railings, grab bars, and even a stairlift help your parent?

Check to see if your loved one is taking proper care of themselves including

  • Home care – Is their living space clean? Is food properly stored and the kitchen clean? Is there any clutter posing a safety hazard?
  • Food – Can your parent prepare themselves a nutritious meal? Are the pantry and refrigerator stocked with good food that is not out of date? Are they drinking enough water? If they have a pet, do they properly provide them with water, food, and outdoor activity?
  • Medical care – Is your loved one taking all of their medications in the right dosages and at the right time? Can they fill their prescriptions at the drug store? Are they able to transport themselves to doctor appointments and labs for blood workups? Do they calendar, remember, and go to their doctor appointments? If they have a pet, do they take them to see a veterinarian for routine examination?
  • Finances – Are there stacks of unopened mail around the house? Are bills left lying around? These warning signs are a good time to take over their bill payment or set them up on auto payments through their bank.
  • Driving ability – If your parent is still operating a car, truck, or even a golf cart, are they doing so safely? If you find increasing numbers of traffic tickets or warning violations, they frequently become lost or experience fender benders while parking, or easily become nervous, angry, or frustrated while driving; it may be time for your parent to hang up the keys.
  • Lifestyle – Does your parent drink alcohol to excess? Do they smoke? Do they participate in medical or recreational marijuana? These activities can cause negative interactions with medications, create mental confusion, and increase the risk of falling.

Gather contact information for neighbors, friends, clergy, or anyone your parent is in contact with regularly. While these relationships are informal, these are people you can rely on to help out in an emergency. Review medical care records, remembering to get doctors’ names, emails, and phone numbers. Include medical insurance information, medications, and other important data on a comprehensive list. Update the list quarterly or anytime you know there is a change. Does your parent live in a “smart home?” Learn the passwords and interact with the audio-video and health monitoring functions to watch for potential problems and communicate with them.

At a bare minimum, know where your parents store their financial information. If it is online, request the passwords. Suppose you need to manage their money remotely. In that case, you will need details about income sources, checking and savings accounts, monthly bills and expenses, social security benefits and other government assistance programs, and investment accounts. Contact information should include accountants, tax preparers, or other people who know about your loved one’s finances.

Get copies of relevant legal documents and know where your parent keeps the originals, including wills, house deeds, and advance health care directives. If your parent has an attorney, get their contact information and introduce yourself to them. If your parent needs an attorney we would be happy to set up a meeting.

Once you conclude your initial assessment, regularly speak with your parents and visit as much as you are able. Build your network of local contacts and coordinate with them to assess changes. Know that your plan is going to change often. Even if your parents can remain in their home, they will require more services and care as they age, and you will need to be responsive to these changes. There is no one solution for every living situation. Begin with a solid assessment of your parent’s current needs and prepare and plan with that information as your starting point.

We help seniors plan for the possibility of needing long-term care, and we ensure the proper legal documents are in place so that their wishes regarding their finances and their care will be carried out.  If you or your parents would like to discuss the possibility of long-term care and how to access financial resources to pay for that care, we would be happy to speak with you. 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 our Reno office by calling us at (775) 853-5700.

Estate Planning, Healthcare

Inoculated Against COVID-19 Successfully? What’s Next?

COVID-19 is being administered to a growing number of people either through the program or becoming eligible for it. According to the medical community, vaccinated individuals are significantly less likely to contract COVID-19; however, they may pose a health risk to others. What then is appropriate behavior for vaccinated Americans when considering the health of others? For the moment, not much has changed.

First of all, experts have told us that the COVID-19 vaccines take at least two weeks from receiving the second dose (or the single dose of Johnson and Johnson) to build up your immune response. The Pfizer vaccine offers 95 percent efficacy, while the Moderna vaccine provides 94 percent efficacy, so you are highly resistant to COVID-19 but not completely immune. According to MarketWatch, Dr. Gregory Poland, infectious disease expert and director of the Mayo Clinic’s Vaccine Research Group in Rochester, Minnesota, the .9 percent difference in efficacy rates is “meaningless.” However, according to preliminary data, those who are vaccinated may still contract coronavirus though, they are more likely to be asymptomatic. In the same MarketWatch post, Dr. Thomas Russo, chief of infectious disease, University at Buffalo in New York, says, “… it’s not clear whether those vaccinated people would be able to pass it to others.” We are still in a time of great uncertainty regarding this pandemic.

There is a low risk of infection when socializing with other fully vaccinated individuals; however, most experts believe it will take months to achieve herd immunity as a nation. Herd immunity occurs when a large enough percentage of the population develops long-lasting immunity through naturally occurring infection resistance or vaccinations to a particular virus or disease.

Should you visit your local grandparent or other older relative now that you have the vaccine? Dr. Russo told MarketWatch if both you and your loved one are fully vaccinated, “the benefits of the visit will outweigh these small risks that they could have of developing a severe case of coronavirus.” The unprecedented rates of social isolation of the American elderly have taken a huge toll on their physical, mental, and emotional well-being. If you and your loved one have been fully vaccinated, make arrangements to meet safely.

The medical community speculates that a vaccination rate of 70 to 80 percent can bring about herd immunity in the US, but we are just beginning the nation’s vaccination journey. The advent of open borders and easing air travel restrictions from other countries continues to provide challenges. In the future, you might need to present a negative COVID-19 test to cross international borders. Currently, those Americans returning from Mexico must now meet this requirement before entering the US. The “slow the spread” protocols remain in place even though you are fully vaccinated.

Once you are fully vaccinated your way of life may not change for a while. It is still important to reach out to friends and loved ones who may still be suffering from feelings of isolation and/or depression. You may be able to visit a loved one in a care facility once you are fully vaccinated. And if you haven’t already, now is a great time to think about your future health, and to make sure you have the correct legal documents in place in case you are unable to make decisions due to illness or incapacity in the future. We would be happy to speak to you about what documents you should be thinking about, including a health care directive, living will, or other documents specific to your wishes and desires. If the past year has taught us anything, it is to expect the unexpected and plan accordingly. We can help! If you have questions or would like to discuss your personal situation, please don’t hesitate to contact us. Please contact our Reno office by calling us at (775) 853-5700.

Elder Law, Estate Planning

A Power of Attorney Allows Another Person to Act On Your Behalf

While he awaited the closing on his Texas house, Michael was enjoying his time in Florida. Unfortunately, he took a bad fall and ended up in a Florida hospital. He had his Texas powers of attorney, but the problem was that they were “springing” powers. They were only effective if Michael lost capacity. Michael’s capacity was fine, it’s just that he wasn’t in Texas when an offer on the house came through.

A power of attorney is a legal document that allows someone else to stand in your shoes, to speak, and act on your behalf. A document that is effective immediately – even if you’re perfectly capable of managing your own affairs at the time – is the better choice. Michael should have designated a Texas agent with immediate powers, in a document that was comprehensive enough to authorize the agent to conduct real-estate transactions on Michael’s behalf.

A document like Michael’s, however, that “springs” into life only on incapacity, would not serve him as he needed. And even if Michael had lost capacity, a doctor would still have to certify that he could no longer make his own decisions. This would cause delay and uncertainty when swift action was required instead.

Many are concerned that if they have a power of attorney that is immediately effective, their agent will abuse privileges that aren’t even needed at the time. This is a sign, however, that they don’t trust that person. And after all, it’s better to be alert and aware if such a thing should happen, instead of discovering the problem only when you’ve lost capacity and it’s too late.

An experienced attorney can help you find your way through many such pitfalls. If you have questions or would like to discuss your personal situation, please don’t hesitate to contact us. Please contact our Reno office by calling us at (775) 853-5700.

Elder Law, Estate Planning

A Comparison of Irrevocable Versus Revocable Trusts

For estate planning, a wide variety of trust types are available; the most common are revocable and irrevocable trusts. While there is some similarity, these two major categories of trusts have different purposes in your estate plan. Both can substitute for a last will and testament as an alternative way to distribute property, though a trust and a will often exist concurrently. Whether a revocable or irrevocable trust works better for your estate plan depends on what you need the trust to do for you.

The most striking difference between the trust types is as defined in the names. A revocable trust permits changes, amendments, and revocations at any time while you are alive and mentally capable of doing so. In contrast, an irrevocable trust does not permit amendments or revocations of any type while you are alive. The only changes to the terms of the trust are as the trust agreement itself defines and allows.

Both trusts, when properly implemented, permit the bypass of the probate process. A revocable and irrevocable trust will survive your death, and your named successor trustee will be able to distribute trust property free from court interference after you die. The trustee may only distribute assets that the trust owns in title to avoid probate.

Why seek to avoid probate? The process is slow and time-consuming, taking anywhere from six months but in most instances one to three years to complete. Although it varies by state, probate can be costly as the court takes a portion of the gross estate in probate fees even before the deceased’s debts are paid. The fee can be as substantial as ten percent. Finally, probate is a public process, and all documents and information will become part of the public record. Estate debts and assets become public records, as are the distributions of assets. Anyone who cares to look up this public record can know which beneficiary received what and often make targets of inheritors for scams or burglaries.

Both trust types help you control property after you die with conditions you outline as to how to use trust assets once you pass away. Conditions are usually age restrictions, punishments for bad behavior, and incentives to promote good behavior. These conditions must not violate public policy. Revocable and irrevocable trusts can set up conditions regarding distribution while you are alive. However, in a revocable trust, if you create the trust, control the trust as trustee, and are the trust beneficiary, you will NOT receive protection from creditors or others who may have a claim against you. This lack of credit protection in a revocable trust is significantly different from an irrevocable trust.

An irrevocable trust can prevent the distribution of assets to certain entities or people, like a long-term care facility or a creditor. The irrevocable trust must be in place and active before protection from the debt accrued to be effective or be within certain time limits to qualify for government programs such as Medicaid. The irrevocable trust creates a legal wall separating you and your assets permitting the shielding from creditors or long-term medical care costs. Asset protection is one of the most useful aspects of an irrevocable trust.

An irrevocable trust is also a vehicle to shield your multi-million dollar wealth from excessive federal estate taxes to preserve generational wealth. 2022 tax exemptions include:

  • $12,060,000 federal estate tax exemption with a 40 percent top federal estate tax rate
  • $12,060,000 Generation-Skipping Transfer (GST) tax exemption and a 40 percent top federal GST tax rate
  • Lifetime gift tax exemption is $12,060,000 and a 40 percent top federal gift tax rate
  • An annual gift tax exclusion amount increase to $16,000

In summary, both trust types can provide estate planning benefits depending on your needs.

Revocable Trust

  • Permits control of your assets, their distribution, and how they are spent after you pass
  • Permits bypassing the probate process
  • Limits probate if you have properties in multiple states and want to avoid probate in each state
  • You desire to simplify the distribution of your property to your heirs and children when you pass away.

Irrevocable Trust

  • Permits control of your assets, their distribution, and how they are spent after you pass
  • Permits bypassing the probate process
  • You have concerns about future long term medical costs
  • You have implicit trust in your children or other family members to take care of your property
  • You want to preserve generational wealth by protecting your assets from creditors or long-term care facilities
  • You want to protect your assets from potential future lawsuits
  • You want to limit federal estate taxes on your estate

Trust types in estate plans are as varied as those individuals seeking to enact them. To best protect your interests and those of your beneficiaries, meet with a qualified estate planning attorney who can explain the type of trust that best suits your needs. 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. Please contact our Reno office by calling us at (775) 853-5700.

Estate Planning

The Procedure for Settling an Estate Without a Will

Caring.com reports, despite the COVID-19 pandemic, the percentages of older Americans without a will have remained the same. Remarkably, younger adults with a will show an increase of sixty-three percent compared to pre-pandemic times. This 18 – 34 year old demographic is now sixteen percent more likely to have a will than those 35 – 54 years old. These younger adults typically cite COVID-19 as the impetus to start taking estate planning seriously.

caring.com

Dying without a will (dying intestate) or dying with an invalid will cause logistic problems, becoming financially and emotionally draining on the loved ones you have left behind. In the absence of a will to name an executor, the state will provide a list of people eligible to fill the role. Should probate court be necessary, the court will make a selection based on this list.

Who Will Settle My Estate without a Will?

Typically, states make a surviving spouse or registered domestic partner their first choice. If there is no spouse or partner, then adult children usually follow next on that priority list, then parents or other closest family members related by blood. Further next of kin includes grandparents, grandchildren, aunts and uncles, nieces, and nephews.

There are rare instances where the state can find no next of kin. In this instance, your assets will wind up in the state’s coffers. Suppose your heirs are more distant next of kin. In that case, they may require an affidavit notarizing them to be heirs to the estate property and further documentation requirements to transfer ownership of assets. State intestacy laws encourage reasonable efforts by probate authorities to identify heirs in the absence of a valid will or no will at all.

In all cases, without a will, there must be a petition to the court to appoint a personal representative to settle your debts, final taxes, minor guardianship of children, and distribution of your personal property. In the absence of any legal heirs, the law permits the court to appoint any legally competent person.

What Relationships Are Acceptable for Representation without a Will?

Each state has relationship qualification requirements of intestate succession that may not be as obvious as you think. For instance:

  • Surviving Spouse – must have been legally married to the decedent at the time of death.
  • Legal separation or pending divorce – a judge will determine whether or not the surviving member of the couple is a surviving spouse.
  • Common-law marriage – Very few states recognize common-law marriages, and each state has its own sets of circumstances for approval.
  • Same-sex couples – Same-sex marriage is now legal in all 50 states and has the same rights and responsibilities as all legally married couples. Same-sex registered domestic partners or civil union partners recognition is state law dependent.
  • Adopted children – in all states, legally adopted children inherit from their adoptive parents in the same manner as biological children.
  • Stepchildren – Most states will not include stepchildren who were never legally adopted.
  • Foster children – These children will not usually inherit as foster parenting is not adoption.
  • Children adopted by an unrelated family or adult – Most states recognize that placing a child up for adoption severs the legal tie between them and their birth parents. Under intestate succession laws, neither the child can inherit from the parents nor the parents from the child.
  • Children adopted by a stepparent – Depending on state law, a child adopted by a stepparent may still inherit from their biological parents.
  • Children born after the parent’s death – Any child conceived before a parent’s death but born after (posthumous child) inherits just as children born during the parent’s life.
  • Children born out of wedlock – These children always inherit from their birth mother unless an unrelated family adopts them. To inherit from the father, the child usually must show some paternal proof.

Inheriting under intestate succession laws may require an heir to live a certain amount of time longer than the decedent. Depending on the state, this can be 120 hours, five days, or merely having outlived the decedent for any period of time qualifies them as an heir. If an heir dies, close relatives such as the deceased person’s child may inherit all or some for what their parent would have received. Known as the “right of representation,” these children or grandchildren may be eligible as heirs though it can be complicated to establish depending on state law.

What Could Happen to My Minor Children Without a Will?

If you have minor children having a valid will allow you to name a personal guardian(s). In the absence of a will, a judge will have to appoint an interim guardian until enough information about the situation is gathered to determine the best decision for the welfare of the children.

Depending on your circumstances, a will can be a straightforward document that removes the onus on your surviving loved ones to handle your responsibilities. If you have minor children or substantial assets, your will may be part of a larger estate plan.

Don’t let the state decide who inherits your money and your property. We would be happy to help you figure out a plan that works for you. Please contact our Reno office by calling us at (775) 853-5700.

Elder Law, Elder Living

Before Moving Your Parents to an Assisted Living Facility, Follow These Six Steps

For aging parents, assisted living communities provide essential care and a sense of calm and peace of mind. Identifying the suitable facility “fit” for your loved one is a journey requiring matching your parents’ needs, budget, and lifestyle with desirable locations. Research and preparation yield the best results when all parties participate by asking questions and engaging in open and honest conversations about expectations.

When your elderly parents need more help than an in-home caregiver can provide, A Place for Mom recommends taking these six steps to learn about assisted living before committing to relocating your parents. If you are unsure if your parents need help, check for any of these eighteen signs that indicate it is time to intervene for their benefit and safety.  

1.    Have a conversation with your family.

Where applicable, include all siblings in the first discussion no matter how far away they may live. If you are the driving force behind calling the meeting, be clear about your capacity to participate and provide care.

If you are already your parent’s caregiver, be honest about how challenging the job is and remind them you cannot perform the duties indefinitely without support. Work at the outset to settle any disagreements. Securing family members’ support is key to providing a smooth transition and reducing your workload. Your siblings may surprise you with input or solutions you may not have imagined.

If your parents are unwilling to listen to your proposed shift in their care, find a quiet moment when you can relay your feelings, observations, and concerns. Though your parents may be in denial, you must listen to them and document their apprehensions as well as their preferences. If they remain unmoved, perhaps employ the services of a professional mediator who can provide all involved a voice in a safe and constructive environment.

2. Understand what assisted living can do to help.

Big life changes can bring about significant stress, particularly with the elderly, who tend to be resistant to change. You can evaluate your parents’ needs with an assessment of their activities of daily living (ADLs). Recognize that assisted living encompasses far more than many people realize, although it is not as involved as memory care or nursing homes. Please do some research to understand what assisted living offers and match it to your parents’ requirements. And while healthy skepticism is reasonable, don’t forget to consider the potential benefits assisted living offers. Finally, speak to a local senior living advisor who has expertise in senior care. A Place for Mom offers free advisor services providing personalized advice and recommendations.

3.     Make a plan to cover costs for your parents’ care.

Cost may be the most significant determining factor when looking for senior living options. Assess what your family can afford monthly and seek out assisted living communities that match your budget. If you are fortunate, your parents may have savings or long-term care insurance that will help defray the costs. Many families must explore other avenues.

Speak candidly to your parents about their finances. The most successful transition plans are born from open, honest dialogue about the critical factors in their move. Assisted senior living can be costly, so bring everything into the open to reduce stress and avoid surprises. Help your parents to understand the prices and costs of assisted living communities. Understand options for care payment, whether private funding or health care insurance, Medicare, or VA benefits.

4.     Virtual tour or pay a visit to a senior living community.

Nothing can replace a trip through an assisted living community. It is better than brochures, photos, reviews, and floor plans. Tour a minimum of three communities that make your short-list. Try to schedule time for your parents to tour as well. Mealtimes can be an excellent time to tour as you can gauge residents’ satisfaction and interaction and the onsite staff. Print out this Community Touring Notes checklist for easy comparison.

5.     Consult several varied sources to determine the best assisted living community.

Talk to as many people as you know to learn from their experiences. Relying on a narrow range of information can lead to bad outcomes. Read senior living community reviews. Learn about your parents’ state regulatory environment, background check requirements, and appropriate agency licensing. Please take advantage of federal programs and speak to the long-term care ombudsman. Their job is to resolve issues related to safety, health, and residents’ rights in senior living communities. Setting up a meeting with an elder law attorney as new resident contracts in assisted living communities can be confusing. Understanding the scope of an assisted living community contract is crucial to identifying what is provided and avoiding unforeseen or hidden costs. An elder law attorney is best for this contract review as they will typically aspire to higher levels of professional conduct as they serve a vulnerable population.

6.     Prepare your parents for the transition to senior living.

Once discussions with your parents are underway, do not delay the move. The more time your parents have to mull things over, the more uneasy they can become about the unknown. Become action-oriented and help them to downsize by consolidating their possessions. Plan and coordinate the move carefully to minimize stress levels for all involved. Senior move managers know what to expect and can help your move run smoothly. Be sure to gather and manage your parents’ legal, medical, financial, and other essential documents to ensure they are not misplaced or lost during the move.

Being compassionate to your parents is vital during this life transition. Involving all family members in a constructive dialogue to create a positive approach to the move is critical. Some parents may make a move with relative ease, while other parents may present more challenges. For the best possible experience, follow these six steps to help your parents move to an assisted living community.

If you or your parents would like to discuss options for paying for long-term care, we would be happy to help. We help families plan for the possibility of high long-term care costs and to understand payment options available, like Medicaid or programs offered by the Veterans Administration. It’s important to understand these options to avoid running out of money while paying for long-term care.  We can also help by reviewing facility contracts when admitting a loved one to assisted living or a nursing home. If you have questions or would like to discuss your personal situation, please don’t hesitate to contact us. Please contact our Reno office by calling us at (775) 853-5700.

Our Blog

VA and USPS Collaborate to Protect Veterans Against Fraud and Scams

Through an agreement, the United States Postal Inspection Service (USPIS) and Veterans Administration Privacy Service (Office of Privacy and Records Management, OPRM) continue to provide information to veterans and their dependents about avoiding scams and protecting personal information. Operation Protect Veterans is a national anti-fraud campaign that alerts veterans and their families who have a long history of being targeted for financial abuses, often leveraging a veteran’s sense of duty and loyalty to fall prey to scams. The USPS also supports the VA’s More Than a Number campaign, which seeks to educate veterans and their beneficiaries on protecting themselves from identity theft.

Scams that target veterans run the gamut from subtle to outright audacious. Some of the better know scams may include:

  • VA phishing scams: Fraudsters, posing as VA employees in electronic communication, contact veterans via “phishing,” including email spoofing, text messaging, and instant messaging. The goal is to obtain important information like Social Security numbers and personal financial information. The data is then used to access bank accounts or open fake credit card accounts.
  • Benefits buyout offers: This setup involves a scammer taking advantage of a veteran’s immediate financial needs by offering a quick, upfront purchase of future disability or pension payments at a fraction of its true value.
  • Fraudulent records promotions: Scammers will charge fees to veterans’ access to government forms or military records. This information is available for free through the VA for forms and the National Archives for military records.
  • Bogus employment offers: Veterans often fall prey to fake job descriptions posted online. Applying for these fake jobs, veterans provide personal information on applications, and scammers will usually also charge an employment “fee.”
  • Fake charitable request: Scammers, in this instance, will often use plausible branding techniques, making fraudulent claims about charitable donation collection that will not benefit wounded service members or veterans.

The most basic advice to all veterans is, do not provide information to unknown entities. Research and verify all offers and claims from outside sources. If you do not understand an offer, ask a trusted loved one for help. If the scammer persists or makes financial threats remember the surest tactic is to hang up the phone, press delete, or don’t open a link you were not soliciting, or that is unknown to you. The links provided can be of great assistance to connect veterans and their loved ones to programs and educational videos to help them identify a scam before personal loss ensues. If you have a loved one that is not web-savvy, help them to understand what to look for to prevent mail fraud, bank fraud, or some other type of scheme.

The VA Privacy Service and USPIS, with their continued partnership, share a common goal: to educate veterans and their families about known scams and provide simple precautions they can take to protect their identity and money. Both the US Postal Inspection Service and the VA want to help veterans and their dependents avoid becoming victims.

If you have questions or would like a private meeting to discuss your planning needs, please don’t hesitate to contact us. Please contact our Reno office by calling us at (775) 853-5700.

Elder Law

When Should Medicaid Crisis Planning Be Considered?

Individuals who meet certain asset requirements are eligible for Medicaid, a federal and state program that helps them pay for long-term care costs. Long-term care often creates devastating financial impacts on Americans, particularly the elderly, and for those family members who lose hours of income (and more) while providing care for their loved ones. The Medicaid system is still one of the best options to afford long-term care. Medicaid crisis planning is a strategy that can help you qualify for Medicaid without experiencing financial ruin.

As a joint federal and state, social safety net Medicaid differs by eligibility rules and regulations in every state, and even by name. Unfortunately, people often wait until a catastrophic event brings about sudden illness, disability, or other medical crises before planning long-term care. Under duress, a family system will listen and take advice from misinformed individuals, such as non-attorneys or attorneys who do not practice elder law. Perhaps unwittingly, these people tend to give the worst advice: spend everything you have until you qualify under the Medicaid eligibility rules. Though this approach can work, there are far better strategies that can be employed.

With the help of an elder law attorney, Medicaid crisis planning allows you to qualify for Medicaid nursing home/LTC without spending down all of your life’s assets. Working with an elder law attorney to devise a personal Medicaid crisis plan is a logical and financially prudent approach to long-term care and allows you or a loved one to use legally approved strategies to qualify for Medicaid before spending everything you own on the high cost of nursing home care.

If you have a loved one who is either in a nursing home or about to enter a nursing home, that is the time to speak to an elder law attorney. There are legal strategies that allow a person who needs long-term care to divest themselves of some of their assets and use the rest to pay for their care until Medicaid eligibility is met.  The sooner an elder law attorney is employed, the quicker Medicaid eligibility can be met.  However, it’s never too late, even if you or a loved one are already in a nursing home. 

The level of complexity involved in Medicaid crisis planning deems it necessary to retain an elder law attorney, preferably one specializing in Medicaid planning. Eligibility requirements vary, calculations are complex, timing is crucial, forms are ever-changing, and laws are amended. An elder law attorney can tailor your financial situation to the best Medicaid crisis planning solution and protect your financial future. If you have questions or would like to discuss your personal situation, please don’t hesitate to contact us. Please contact our Reno office by calling us at (775) 853-5700.