How will President-Elect Biden Help Seniors with COVID-19?

Before you object, take note. This is not a political “post”.  Whenever there’s a change of Administration, it makes sense to look to the winning candidate’s platform and policy aspirations to predict how new leadership may impact things we care about. And I care about care for seniors. Home Healthcare News’s recent article entitled “‘Our Work Begins with Getting COVID Under Control’: What a Biden Administration Means for Home-Based Care” says that long-term care and protecting America’s senior population will need to be at the very center of President-Elect Biden’s response.

“Our work begins with getting COVID under control,” Biden said during his victory speech. “We cannot repair the economy, restore our vitality or relish life’s most precious moments — hugging a grandchild, birthdays, weddings, graduations, all the moments that matter most to us — until we get this virus under control.”

As the U.S. nears the mark of 18 million total coronavirus cases, the Biden administration’s response to the ongoing pandemic will need to be wide-ranging and thorough, impacting everything from vaccine development and distribution, to additional rounds of relief for health care providers.

“I will spare no effort — or commitment — to turn this pandemic around,” Biden continued.

The 78-year-old Biden has commented that he has a deep appreciation of home-based care. In July, he outlined a $775 billion plan to overhaul the nation’s caregiving infrastructure, which primarily consists of women and people of color. Biden said he wants to create upwards of three million new caregiving and education jobs over the 10 years and provide pathways for former caregivers to re-enter the workforce. That plan also called for a $450 million increase in funding for senior care. Some of those funds would be earmarked to improve wages and labor conditions for in-home care workers.

“Home health workers do God’s work, but aren’t paid much,” the then presidential candidate said on social media. “They have few benefits, and 40% are still on SNAP or Medicaid. It’s unacceptable. I’ll give caregivers and early childhood educators a much-needed raise.”

Biden has repeatedly brought attention to very specific, innovative programs that typically only industry insiders know about. This includes making specific references to CAPABLE, the program from the Johns Hopkins School of Nursing aimed at supporting aging in place, by coordinating nursing, therapy and handyman services in the home.

Biden and his Administration will likely try to get more resources for home-based care providers and other long-term care operators. In its official policy plan for nursing home regulations, for instance, the Biden team stated it would invoke the Defense Production Act to increase the overall supply of PPE. Right now, “protecting older Americans” is one of the main priorities featured on the Biden-Harris Transition website, which hasn’t been overlooked by those in aging services.

“Dealing with the coronavirus pandemic is one of the most important battles our administration will face, and I will be informed by science and by experts,” President-Elect Biden said recently.

Regardless of how you voted, I hope you’ll join me in wishing the new team success in that fight.

Reference: Home Healthcare News (Nov. 9, 2020) “‘Our Work Begins with Getting COVID Under Control’: What a Biden Administration Means for Home-Based Care”

Estate hassles start here

Is Probate Required If There Is a Surviving Spouse?

There is a common misconception is that you do not have to probate a Will when your spouse dies. As the old song said, “It ain’t necessarily so”. Probate, also called “estate administration,” is the management and final settlement of a deceased person’s estate. It is conducted by an executor, also known as a personal representative, who is nominated in the will and approved by the court. Estate administration needs to be done when there are assets subject to probate, regardless of whether there is a will, says the article “Probating your spouse’s will” from a colleague in The Huntsville Item.

Probate is the formal process of administering a person’s estate. In the absence of a will, probate also establishes heirship. In some regions, this is a quick and easy process, while in others it is a lengthy, complex and expensive process. The complexity depends upon the size and value of the estate, whether a proper estate plan was prepared by the decedent prior to death and if there are family members or others who might contest the will.

Family dynamics can cause a tremendous amount of complications and delays, especially if the family has blended children from prior marriages or if a child has predeceased their parents.

There are some exceptions, when the estate is extremely small and when probate is not required. However, in most cases, it is required.

A recent Court case affirmed the rule that a will not admitted to probate is not effective for proving title and thereby ownership, to real estate. A title company was sued for defamation after the title company issued a title report that included the statement that the decedent had died intestate, that is, without a will.

The decedent’s son, who was her executor, sued the title company because his mother did indeed have a will and the title report was defamatory. The court rejected this theory, and the case was brought to the Appellate Court to seek relief for the family. The Appellate Court ruled that until a will has been admitted to probate, it is not effective for the purpose of proving title to real property.

If a person owns real estate, they must have an estate plan to ensure that their property can be successfully transferred to heirs. When there is no estate plan, heirs find out how big a problem this can be when someone decides they want to sell the property or divide it up among family members.

Problems also arise when the family finds that they must pay taxes on the property or that there are expenses that must be paid to maintain the property. Without a will, the disposition of the property is determined by the state’s estate law. Things can become complicated quickly, when there is no will.

If the deceased spouse has children from outside the most recent marriage, those children may have rights to the property and end up owning a portion of the property along with the surviving spouse. However, neither the children nor the surviving spouse can sell the property without each other’s approval. This is a common occurrence.

There are also limitations as to how probate can be used to distribute and manage an estate. In some states, the time limit is four years from the date of death.

An estate planning attorney can help the family move through the probate process more efficiently when there is no will. A better situation would be for the family to speak with their parents about having a will and estate plan created before it’s too late.

Reference: The Huntsville Item (Nov. 22, 2020) “Probating your spouse’s will”

 

man thinks about what went wrong

What Happens If You Fail to Submit a Change of Beneficiary Form?

This is a story about robbing Peter to pay Paul’s heirs. Wealth Advisor’s recent article entitled “I’m being denied an inheritance. Can they do that?” explains the situation where an individual, Peter, was given a CD/IRA by a friend named Paul. If you fail to submit a beneficiary designation form your lifetime, your estate planning may have unexpected results. It is one of the key estate planning mistakes.

Paul told Peter that he wanted him to have it, in case anything happened to him. Paul was married and didn’t tell his wife about this. Paul’s wife was the beneficiary of several other accounts.

A beneficiary form document was signed before Paul died, and they got it notarized.

Paul died somewhat unexpectedly, and Peter took the signed and notarized beneficiary designation form to the bank to see about collecting the money.

However, the bank told Peter that there was no beneficiary designation given to them prior to Pauls’ death.

Is there anything that Peter can do?

The article explains that it’s a matter of timing, and it’s probably too late. That’s because it looks like Paul failed to submit a written beneficiary change form to the financial institution prior to his death. (The bank or brokerage firm may have its own rules about when you must support a change.)

As a result, the financial institution must distribute the CD to the person or entities that otherwise would be entitled to receive it, which varies from state to state.

In most states, you can choose any IRA beneficiary you want. However, in nine community property states, you are required to name your spouse as your heir. If you want to name anyone else, your spouse must give written permission. The same laws apply, if you want to change your beneficiary designation.

The nine community property states are Arizona, California, Idaho, Louisiana, Nevada, New Mexico, Texas, Washington and Wisconsin. In Virginia, you can name anyone you like, except with work-related plans like 401k’s. On those, you’ll need your spouse’s permission to name anyone else (like kids or a trust).

The only way for Peter to see the money, is if he can show that Paul intended for him to receive the asset. That bank doesn’t want to be sued by another person, who claims they’re entitled to the CD. And litigation to straighten it out can be lengthy and expensive.

This is a complex issue. In a situation like this, it’s best to speak with an experienced estate planning attorney who can examine the specifics of this type of issue.

Reference: Wealth Advisor (Nov. 24, 2020) “I’m being denied an inheritance. Can they do that?”

 

Who makes medical decisions?

What are Young People Doing to Help Seniors in Isolation?

With the pandemic continuing to be a part of our world, family caregivers are increasingly concerned about loved ones’ isolation at home or in facilities. What can others do to help?

Many older adults and their family caregivers have little human interaction in “normal” times, and the pandemic makes it even worse.

Research shows that isolation and loneliness are as detrimental to health as smoking 15 cigarettes a day, says AARP’s recent article entitled “Teens Reach Out to Isolated Older Americans Through Online Programs.”

However, some new programs and approaches that have come about in the coronavirus quarantine can have a positive impact far beyond the pandemic. Let’s look at three virtual intergenerational programs that bring hope for the future.

Music and Games to Brighten Spirits. Fifteen-year-old Maya Joshi and her twin sister, Riya, started daily video calls with their grandparents when the pandemic took hold. Seeing how much their grandparents enjoyed it, Maya decided to do something to help other isolated older adults. She launched Lifting Hearts with the Arts in April. The intergenerational program involves teen volunteers connecting online with residents in 17 Illinois nursing homes and assisted living facilities. They present musical performances, games and 1:1 video chats.

These virtual activities are making a significant impact and are improving the residents’ moods, said the director of programming at a nursing home in Springfield, Illinois. After one resident grew more comfortable with the technology, she began initiating video calls with her friends and family. These seniors now have something to look forward to and they like seeing young smiles on the screen.

Meals and conversation To Eliminate Loneliness. The Los Angeles-based Youth Movement Against Alzheimer’s (YMAA) YouthCare program, in partnership with the University of Southern California, has been training students to provide in-home nonmedical respite and cognitively stimulating activities for people living with dementia.

The program was suspended when the COVID-19 lockdown began. As a rapid response to the pandemic, YMAA reached out to their chapters in high schools and college campuses across the country to create Meals Together. It’s a program where students have virtual visits during mealtime with those in early stages of dementia and their caregivers.

In only three months, 39 YMAA chapters are participating in the expanding program. They now serve 175 users. They partner with nonprofits, like Meals on Wheels and assisted living facilities, to identify older participants. Seniors can also sign up on their own.

Natashia Townsend, YMAA’s director of caregiving programs, says they describe the program to participants in early stages of dementia as a way to help the students as they prepare for their careers. “It makes them feel empowered to help someone else,” Townsend explains. The youth volunteers also find it rewarding. “It’s just a great way to connect, and a lot of our seniors are feeling lonely at this time; they just want to feel like they have a friend,” she says.

Reference: AARP (July 27, 2020) “Teens Reach Out to Isolated Older Americans Through Online Programs”

 

Getty Heir Dies at 52

Wealth or notoriety doesn’t exempt a family from tragedy or loss. John Gilbert Getty died recently in San Antonio, Texas. According to law enforcement sources, the wealthy oil heir and rock musician was found unresponsive in a city hotel room. Foul play is not suspected.

“With a heavy heart, Gordon Getty announces the death of his son, John Gilbert Getty,” a family spokesperson confirmed in a statement. “John was a talented musician who loved rock and roll. He will be deeply missed.”

Syracuse.com’s recent article entitled “John Gilbert Getty, heir to J. Paul Getty oil fortune, found dead at 52” explains that John Gilbert Getty was the grandson of famed industrialist J. Paul Getty.

The patriarch of the family founded the Getty Oil Co. and was once named the richest living American. He had five sons and died in 1976 at age 82.

Obviously and sadly, the family’s wealth or notoriety doesn’t exempt it from tragedy or loss. Another grandson, J. Paul Getty III, made headlines when he was kidnapped and lost an ear as a teenager in Rome. J. Paul Getty delayed paying a ransom, which is portrayed in the 2017 film, “All the Money in the World” and the 2018 TV series “Trust.”

According to the Los Angeles Times, John Gilbert Getty was wealthy himself. He was the owner of several homes in L.A. including a $3.9 million Hollywood Hills West property that he bought in 2018. At the time, the family fortune was estimated to be $5 billion.

John Gilbert Getty’s father, Gordon Getty, is a multi-billionaire and one of the richest people in the United States.

“My father was awesome- coolest man to ever land on this planet and I will forever be the proudest daughter,” Ivy Getty wrote on Instagram. “Love you so much Dad….life is cruel sometimes…. I have not one, but two guardian angels watching over me now.”

John Gilbert’s survivors include his father, Gordon; his daughter, Ivy; and two brothers, Peter and Billy. One of his brothers was found dead at his Los Angeles home in 2015. The Los Angeles County coroner’s office found that Andrew died from intestinal bleeding and had methamphetamine in his system.

Their mother Ann Getty died from a heart attack at her San Francisco home in September.

Reference: Syracuse.com (Nov. 24, 2020) “John Gilbert Getty, heir to J. Paul Getty oil fortune, found dead at 52”

 

Medical Advice by Teleconference

How Did Country Star Hal Ketchum Die?

Country music star Hal Ketchum, who found fame in the ’1990s with the critically acclaimed album “Past The Point of Rescue,” passed away at home, according to a report in The New York Post entitled “Country singer Hal Ketchum dead at 67 after battle with dementia.”  His death was hard enough on his family. The high medical bills and expenses associated with his dementia are still with them.

Ketchum’s wife Andrea shared the news on his Facebook page, writing: “With great sadness and grief, we announce that Hal passed away peacefully last night at home due to complications of dementia. “May his music live on forever in your hearts and bring you peace. Andrea.”

Ketchum was diagnosed with acute transverse myelitis, an ailment of the spinal column, which forced him to relearn basic tasks, such as how to walk and play the guitar.

However, he continued to record and would often hit the Billboard Hot Country Songs charts. Ketchum sold more than five million records in his career. His two most famous songs were “Small Town Saturday Night” and “Hearts Are Gonna Roll.”

He has had his songs recorded by many artists, including Trisha Yearwood and Neal Diamond. Ketchum earned five million-air awards from BMI, acknowledging those songs that have been broadcast over one million times.

In 2019 his wife announced he was suffering from early on-set senile dementia and would no longer be touring.

“Dementia is an exhausting and confusing illness and now it’s time for Hal to stay home with loved ones,” she shared, saying that he was glad to be at home with friends and family.

Dementia is more frequently found in people over the age of 65. However, it can also affect younger people. Early onset of the disease can start when people are in their 30s, 40s, or 50s. Treatment and early diagnosis can slow the progression of the disease and maintain mental function.

Ketchum’s family organized a benefit concert in January 2020 to help with medical bills and raised over $20,000.

“Hal has sung his last tune for us on this earthly plane of existence,” read the description of the concert, according to The Sun.

“He can no longer tour or make records to support his family. Now it’s time for us to step up and help with the almost insurmountable medical bills and living expenses that are piling up.”

Ketchum became an addict at 15 after losing his mom to MS. He started with alcohol and moved on to drugs, including cocaine. However, he became sober in 1997, after spending a month at the Betty Ford Clinic. He married his wife Andrea in 2014.

Reference: New York Post (Nov. 24, 2020) “Country singer Hal Ketchum dead at 67 after battle with dementia”

 

Choosing your advisors

Is a Tax Change a Good Time to Check My Will?

A last will and testament or a living trust can make certain that your goals for legacy and asset disposition are satisfied and carried out. However, what most people fail to grasp is that a will or trust needs regular review—especially if the document was written or involved the creation of a trust prior to passage of tax reform, the Tax Cuts and Jobs Act (TCJA), in 2017, says Financial Advisor’s recent article entitled “Tax Changes Make This A Good Time To Revise A Will.”

Wills can pass on assets, but taxes have come to greatly impact how much money is passed on. People usually understand the primary components, including the tax implications, of their wills.

These include:

  • The unlimited marital deduction
  • Applying current rules to make non-taxable gifts of up to $15,000 per person
  • The current estate tax exemption of $11.58 million
  • Health care directives
  • Naming trustees and executors; and
  • Creating long-term trusts with non-taxable asset transfers.

Wills and trusts were created prior to the passage of the TCJA may not consider that tax reform changed the amount which can be exempted from estate taxes.

The law more than doubled the amount that can be exempted from estate taxes. The potential tax changes could cause many more Americans to have a taxable estate, and it’s important to have a full understanding of your assets and carefully decide who you want to receive them. You must also decide if you want them passed outright or through a trust.

Privacy is a good reason why some people often prefer living trusts. They also like the quick processing and avoiding probate.

Estate plans should be reviewed every few years, and wills should be reviewed more frequently because life changes are the biggest reason for trouble in revising wills.

Divorce, separation or marriage; the birth or adoption of children, as well as a child reaching adulthood; and changes to finances, location and health all can play important roles.

Reference: Financial Advisor (Nov. 9, 2020) “Tax Changes Make This A Good Time To Revise A Will”

 

Homeownership and Medicaid Can Be Problem

The challenges begin when homeowners don’t do any Medicaid planning and decide the best answer is simply to gift their home to their children. It doesn’t always work out well for the homeowners or their children, warns the article “Owning real estate without jeopardizing Medicaid paying for nursing home” from a midwestern website, limaohio.com.

A key tax avoidance opportunity is usually missed, when real property is gifted outright (among other problems). The IRS says that if someone owns real estate, when that person passes, the heirs may eliminate a large portion of the taxable gains, if the real estate ends up being sold by an heir for more than the original owner paid for the property.

Let’s walk through an example of how this works. Let’s say Verner buys a farm for $1,000. The cost to buy the farm is referred to as her “tax basis.”

If the family is planning for the possibility of nursing home costs, Verner might want to give that farm away to her children Page and Charlie. She needs to do it at least five years before she thinks she’ll need Medicaid to pay for long-term nursing care, because of a five-year lookback. (Long term care insurance might protect Verner during the 5-year lookback.)

When Verner gifts the farm to Page and Charlie, the two children acquire Verner’s tax basis of $100,000. Page gets $50,000 of the tax basic credit, and so does Charlie.

The years go by and Page wants to buy out Charlie’s half of the farm. The farm is now worth $500,000. So, Page pays Charlie $250,000 for Charlie’s half of the farm. Charlie now has a tax basis of $50,000 which is not subject to tax. And Page receives $200,000 more than her $50,000 tax basis, and Page will need to pay capital gains on that $200,000 gain.

It could be handled smarter from a tax perspective. If Verner owns the farm when she dies, then Page and Charlie get the farm through her will, trust or whatever estate planning method is used. If the farm is worth $300,000 when Verner dies, then Page and Charlie will get a higher tax basis: $300,000 in total, or $150,000 each. By owning the farm when Verner dies, she gives them the opportunity to have their tax basis (and amount that won’t be taxed if they sell to each other or to anyone else) adjusted to the value of the property when Verner dies. In most cases, the value of real estate property is higher at the time of death than when it was purchased initially.

There’s another way to transfer ownership of the farm that works even better for everyone concerned. In this method, Verner continues to own the farm, helping Charlie and Page both avoid taxes, and keeps the property out of her countable assets for Medicaid. The solution is for Verner to keep a specific type of life estate in the farm. This needs to be prepared by an experienced estate planning attorney, so that Verner won’t have to sell the farm if she eventually needs to apply for Medicaid for long term care.

Your estate planning attorney will be able to help you and your family navigate protecting your home and other assets, while benefiting from smart tax strategies

 

Reference: limaohio.com (Nov. 7, 2020) “Owning real estate without jeopardizing Medicaid paying for nursing home”

 

estate planning delay

No Time Like the Present Pandemic to Get the Estate Plan Going

The pandemic has made many people focus on depressing things, like death. Many of us are worth more dead than alive.

Federal News Network’s recent article entitled “It’s your estate, but who gets it?” says that lack of control is one of the frustrating things about this already terrifying pandemic. We can wear masks, keep our distance and avoid crowds, but then what?

There are some very important and valuable things that are still under your control. One of these is estate planning.

Any number of things could have occurred in 2020 that are off your radar because you’re still adjusting to the many changes the pandemic has brought to our everyday lives.

Many people see their estate plan as one of life’s necessary chores. Once it’s signed, they simply file it away and forget about it. However, an estate plan should be reviewed regularly to be certain that it continues to meet your needs. Here are just a few of the life events that make it essential for you to review and possibly revise your estate plan with an experienced estate planning attorney:

  • The birth or adoption of a child
  • You are contemplating divorce
  • You have recently divorced
  • Your child gets married
  • Your child develops substance abuse problems or has issues with managing finances
  • Those you’ve named as executor, trustee, or agents under a power of attorney have died, moved away, or are no longer able to fulfil these obligations
  • Your child faces financial challenges
  • Your minor children reach the age of majority
  • There has been a change in the law that impacts your estate plan
  • You get a sizeable inheritance or other windfall.
  • You have an estate plan but can’t locate it
  • You acquire property; or
  • You move to another state.

If any of these events occur, talk to your estate planning attorney to see if it is necessary to revise your estate plan to address these issues.

Reference: Federal News Network (Nov. 4, 2020) “It’s your estate, but who gets it?”

 

generations

What’s the Difference Between Nursing Homes and Assisted Living?

My parents had the best experience in the dozen or so years at the end of their lives, at a continuing care community in the Richmond area. But there are many choices for senior living.  US News & World Report’s recent article entitled “Nursing Homes vs. Assisted Living” explains that a big question is determining what type of facility is the best fit, a nursing home, assisted living or another senior community. According to the National Institute on Aging (NIA), long-term care residences include:

  • Assisted Living Facilities
  • Nursing Homes
  • Board and Care Homes; and
  • Continuing Care Retirement Communities.

We will look at the major differences among these options.

Assisted Living. Assisted living and nursing home facilities are different in many ways. One big difference is in how to pay for them. Some assisted living facilities do not accept Medicaid and are private pay only. Medicaid does cover nursing home care because states must do so under federal law. That’s the only way some can cover the cost in many instances.

Otherwise, the primary difference is in the level of care each can provide. Assisted living is for those who need some help with daily care, but not as much as what a nursing home has to offer. These facilities are for those who can still take care of themselves, but could use a bit of help with daily activities such as:

  • Housecleaning and laundry
  • Household chores and cooking
  • Bathing
  • Medication management; and/or
  • Transportation to medical appointments or stores.

The residents use any or all of the services offered and pay for the level of care they are receive. However, the more care, the higher the cost. Assisted living residents typically have their own private apartments and share common areas, like the dining room and community rooms. Most offer three meals a day for those who don’t want to cook, 24-hour supervision and security and socializing and recreational events with other residents. Many assisted living communities even permit pets.

Nursing Homes. Nursing homes are also called “skilled nursing facilities” and provide a higher level of daily care—especially medical care that assisted living facilities aren’t equipped to handle. Along with the same help for daily living that assisted living communities provide, a nursing home can offer:

  • Nursing care
  • Rehabilitation services, such as physical, occupational and speech therapy
  • Help getting dressed or in and out of bed
  • Frequent or daily medical management for chronic conditions; and
  • Some facilities specialize in memory care for patients suffering from Alzheimer’s disease or other forms of dementia.

Board and Care Homes. Also called “residential care facilities” or “group homes,” these are small homes of 20 or fewer residents living in private or shared rooms. Similar to assisted living facilities, these places can provide personal care and meals but no nursing or medical care.

Continuing Care Retirement Communities. Also called “life care communities,” they offer different levels of service in one location, like independent housing, assisted living, and a skilled nursing facility all in one place. Residents can begin at one level of care and transition into higher care, as needed.

How to pay for care is another common misunderstanding, because unless you have long-term care insurance, assisted living is paid out of pocket. For a skilled nursing facility, if you are hospitalized and discharged to a care facility, Medicare will pay a set amount for a certain time. The responsibility for payment then goes back to the resident.

Only when a senior is legally destitute, can you use Medicaid. Talk to an elder law attorney about the details.

Reference: US News & World Report (November 52, 2020) “Nursing Homes vs. Assisted Living”

 

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