Q. Our mother just moved into a nursing home for care and has qualified for a Medi-Cal subsidy to help with the cost. However, Medi-Cal wants all of mom’s income to go to the nursing home as her “co-pay”. That leaves nothing to cover her home expenses, including her mortgage, property taxes, insurance and upkeep. We want to keep her home in the family, but we do not have the funds to make these payments. Is there anything we can do?

A. Good news: Yes, there is !   But first a bit of background: Medi-Cal assumes that all of mom’s care needs will be met in the nursing home, and that there is therefore no need to permit an income set-aside to pay to pay for home expenses while she is not actually living there.

Indeed, with the exception of a very modest income set-aside, consisting of a $35 Personal Needs Allowance and enough to pay her medical insurance premiums, all of mom’s income must go toward her nursing home bill as her “Share of Cost” (“SOC”), before Medi-Cal will pay the balance.   This leaves nothing to pay for her house expenses.

Further, the option of selling the home would usually not be wise, as this would convert an exempt asset into a large amount of cash which would then likely terminate her Medi-Cal eligibility.

Still further, most Medi-Cal applicants prefer to keep their home, whether in the hope that they may one day be able to return home, or so that they can pass it on to their children as an inheritance.

But there are two solutions to the problem of finding monies to pay these expenses:

(1) Physician’s Certification:  The first is where her doctor certifies in writing that it is likely that she will be able to return home within 6 months of entry into the nursing home. If the doctor so certifies, then a portion of mom’s income may be set aside to pay house expenses but only for that 6 month period. While this option is theoretically available, as a practical matter it is rare that a physician is able to so certify, as most residents are chronically ill and not likely to return home. Further, even with this certification, the home upkeep allowance would be limited to only $209 per month, a number that hasn’t been changed in decades and is wholly inadequate to preserve one’s home in today’s economy. Note: There is an Assembly Bill now pending which — if passed and signed by the Governor– would increase this deduction. See below.

(2) Rent Out the Home:  The second circumstance is much more “doable”.  If, instead of keeping the home vacant, you rent out her home, then the rental income may first be used to pay home-related expenses, and only the excess after payment of these expenses (i.e., the net rental income) would go to the nursing home as mom’s SOC.

Note: If there is a mortgage, Medi-Cal only permits the use of mom’s gross rental income to pay the interest portion of the monthly mortgage, but not the principal portion.  Fortunately, however, the interest portion is usually the lion’s share of most mortgage obligations, and in these situations, the family is usually able to muster the modest additional funds necessary to cover the smaller principal portion. It may also be prudent to rent out the home to reduce the risk of vandalism (vacant homes are at greater risk), and to eliminate the risk that mother’s homeowner’s insurance may lapse (which may well occur were the home left vacant).

And even though the net rental income, after payment of these expenses,  will increase mom’s SOC, this increase does not impose any real financial hardship upon mom, as it is essentially funded by the renter.

Where your goal is to preserve mom’s home, this rental option is likely  the most practical method of preserving your mother’s home, honoring her wishes, and avoiding a forced sale.

_______________

References:  22 CCR §50605 [“Maintenance Need–Persons in Long Term Care“. and §(b)(3) “verified medical determination”]; 22 CCR §50508 [“Net Income From Property“.  Calculation of “net income” from property].

Note:  the Medi-Cal Home Upkeep Allowance limited to only $209 per month even with physician certification; Medi-Cal Eligibility Division Information Letter No.: I 09-01 (April 16, 2009). Note, an Assembly Bill has been introduced into the California Legislature that would, if passed, increase this home upkeep allowance: AB 1042 (Wood); Text of AB 1042

Q. I am setting up a “Living Trust” and considering name all three of my children, together, as successor co-trustees. Do you have any thoughts as to whether that makes sense?

A.  Yes, I do. Your desire to treat all of your children equally, or at least not to appear to favor one over the others, is understandable. However, naming all to serve together is not generally a good idea, and here’s why:

Need for Unanimity in Every Trust Decision: Unless your trust provides otherwise, California law requires that – where there are multiple trustees – all decisions by the trustees must be unanimous. What if one of your children does not agree with a decision suggested by the others? You may then have a “stalemate”. This would be of special concern if your children do not always agree with one another. Indeed, sometimes sibling rivalries — which were never fully resolved during childhood– might manifest in your children as adults, impairing the smooth administration of your trust.

Majority Rule? Providing that any decision must be made by a majority of the co-trustees might be a solution, providing that there are always at least three co-trustees. But, if for any reason one of your children were unable or unwilling to serve, reducing the co-trustees to only two, California law would generally then require unanimity between the remaining two.

Disagreements Could Present Problems: If one of your trustees felt that the others were acting inappropriately and, perhaps, in breach of their fiduciary duty, the non-consenting trustee(s) might then have a duty to petition the court to resolve the issue and/or to seek the removal of the offending trustee(s). Not only would this court proceeding potentially exacerbate the relationship between your children, but it would likely involve a significant expense to the trust, something that you would presumably prefer to avoid.

Authorize Actions by Any Trustee, Alone?: If you are determined to name all three of your children as co-trustees, you might consider a special provision in your trust to authorize trust action upon the signature of one (1) trustee, alone, albeit providing that he or she must first confer with the others. Again, however, if your co-trustees do not get along, empowering any trustee to have this unilateral power could again create problems:  if the other two co-trustees disagree with the proposed action, and yet the initiating trustee nevertheless goes forward with it, his/her doing so will undoubtedly create further rift in your children’s relationship.

For all of the above reasons, I was always recommend that parents choose only one child at a time to be trustee, and designate the others to be the successor trustee, to assume that role only if the prior nominee is unable or unwilling to serve. To avoid hurt feelings, parents might explain their decision to their children in ways that minimize resentment, such as the following:  choosing their individual trustees in birth order, or in geographic proximity to the parents, or based upon each child’s familiarity with financial matters, or based upon the time that each child would have to devote to the parents’ trust. Remember, being selected as a trustee is not only an honor, but can also be a burden in terms of the commitment of time and financial responsibility.

Alternatively, if there is much rivalry between the children, parents might select a professional trustee, such as the trust department of the parents’ favorite bank. But parents should first check with their bank, as some have requirements in terms of the size and composition of the trust estate that the bank will accept.

Q. If I seek entry into a nursing home for my mother, will it be tougher to find a bed if she goes in as a Medi-Cal beneficiary?

A.  Unfortunately, that is a distinct possibility. See the following article published by California Advocates for Nursing Home Reform (“CANHR”), and re-printed here with permission:

“Over the past 5 years, one of the most disturbing violations of state and federal laws has been the increase in discrimination against Medi-Cal beneficiaries who need nursing home care.

Call a nursing home and tell them that your mother, a Medi-Cal beneficiary, has dementia along with other medical issues and that her doctor has recommended a nursing home– good luck in finding a placement within 200 miles – or at all!  Tell them that your mother is in the hospital on Medicare, and your chance of finding a nursing home placement increases 100%.  Because Medicare reimbursements are higher than the Medi-Cal daily rates, discrimination against accepting Medi-Cal eligible residents has become the preferred way for nursing homes to increase their profits.

Illegal?  Yes, such discrimination is illegal under both state and federal laws.  In fact, certification for Medi-Cal is totally voluntary and nursing homes who wish to participate in the Medi-Cal program must sign a provider agreement certifying under penalty of perjury that they will adhere to all state and federal laws, which include a prohibition against Medi-Cal (Medicaid) discrimination. Despite these laws, nursing homes have found numerous ways of discriminating to reduce their Medi-Cal population and free beds up for private pay or Medicare residents.

If a resident does happen to find placement as a Medicare patient, when Medicare days are terminated, the facility will often tell the resident or the resident’s family that the resident must leave; that they only retain “short-term” residents; that they don’t have any Medi-Cal beds; or that the resident – despite all evidence to the contrary –  no longer needs the nursing home level of care. These are falsehoods, of course, aimed at scaring residents out of the facility.  The truth is that, in California, if a nursing home is certified for Medi-Cal – all the beds are Medi-Cal certified.  There is no such animal as a “short-term” nursing home.  If they have a bed at all, it’s a Medi-Cal bed.

Because Medi-Cal does not pay for a private room, a common practice is to transfer the resident to the Medi-Cal “ghetto”, i.e., a section of the facility with 2-3 bed rooms all on Medi-Cal with limited staffing and no rehab services or  to transfer the resident to the acute care hospital and refuse to readmit them, regardless of their right to a bed hold, the right to return to the facility and their right, even if the bed hold time has passed, to the first available bed

Nursing home discrimination against Medi-Cal beneficiaries and residents has become epidemic in California, and the state regulatory agencies do nothing to contain it.”

For more information about discrimination and resident discharges, contact the CANHR office in San Francisco at 1-800-474-1116.

Attorney’s Note:  Often, the key is to enter a nursing home directly following a hospital stay of at least three nights’ duration. This will trigger the preferred MediCARE coverage for a limited period, usually between 20 and 100 days. Thereafter, the patient will need to pay privately or qualify for a Medi-Cal subsidy. But once in the nursing home, the patient may legally stay if he/she continues to need nursing home care, although some advocacy may be needed to resist some of the above tactics. If the patient feels that he or she is not ready to leave the nursing home, or that more planning is needed to ensure patient safety, the patient can appeal a discharge with the State by calling the Office of Hearings and Appeals at 916-445-9775.

If you need legal advice or advocacy, you may wish to contact our firm for assistance.

References:  See the following fact sheets on the CANHR website:  Transfer and Discharge Rights; Legal Authorities, as well as the following more abbreviated summary, entitled “Nursing Home Discharge Rights…What To Know Before You Go”.

Q. I am thinking about giving my home to my son now, so that probate can be avoided and my
affairs simplified when my time comes. Any comment as to whether this plan makes sense?

A. Caution: Transferring your home to your son by gift during your lifetime can have adverse
tax consequences. Example: assume that you purchased your home many years ago for
$100,000, and suppose it is worth $,650,000 today. If you give it your son during your lifetime,
he “steps into your shoes” and the IRS will treat the home as if your son had acquired it for
$100,000. This is called “carry over basis”. If he then sells the home for $650,000, he will be
obliged to recognize the $550,000 difference ($650K – $100K) as capital gain and pay tax
accordingly. This could result in a whopping tax bill for him and actually lessen the net value of
your gift.

True, there would be some relief from this tax situation if your son moved into the home and
lived in it for at least 2 years before sale. In that event, he would be entitled to exclude a part of
the capital gain, i.e. $250,000 if he is single and up to $500,000 if he is married. However, this 2
year residential requirement is often impractical if your son already owns a home, or plans to sell
it sooner than 2 years, or prefers to treat it as a rental.

By comparison, if you hold the home until your death and pass it to your son as an inheritance,
this tax problem can be avoided. The IRS will then treat the home is if your son had acquired it
at its date of death value. In tax parlance, the home’s tax basis would be “stepped up” to its
market value at the date of your death. Example: if it is worth $650,000 at your death and your
child then sells it for $650,000, his capital gain would then be “0” and no tax would be due.
Quite a difference!

In your situation, you may wish to consider a Living Trust, which would accomplish your
objective of avoiding probate while simultaneously obtaining the favored tax treatment which
accompanies transfers upon death. This arrangement would also allow you to retain home
ownership in case you later need to obtain a reverse mortgage to help with your future long-term
care expenses.

Sometimes parents who have received long term care benefits from the Medi-Cal program,
consider a gift of their home in order to avoid a Medi-Cal recovery claim after their death.
However, if that is the motivation, there are ways to both avoid a Medi-Cal recovery claim while
still preserving favored tax treatment. If this is a concern, professional guidance from an
attorney knowledgeable in Medi-Cal planning is extremely important.

Q. My wife and I hold title to her home as joint tenants, and most of our cash assets are in the
form of two large IRA accounts and one big annuity. We have basic wills which leave everything
to the other and then on to our children. Our son suggested that our wills may not control what
happens to our assets when one of us dies. Should we be concerned?

A. Perhaps, in the sense that your wills will not control what happens to your assets when one of
you dies. Rather, the form of title will control as to your home, and the beneficiary designations
on your IRA’s and annuity will control what happens to those assets. Here is the way it works:

Your Home: Since you and your wife hold title to your home in joint tenancy, when one of you
dies the other will automatically become the owner by right of survivorship. The right of
survivorship is the primary feature of joint tenancy. In essence, the form of title overrides your
wills. It is only when the survivor later dies that his or her will may control who ultimately gets
the home. While many couples in California do hold their home in joint tenancy, it is often not
the best form of co-ownership. One principal reason: it does not optimize the tax benefits that go
along with holding title as ”community property” if the home has appreciated significantly in
value since the time of purchase.

Your IRA Accounts: Each of your IRA accounts will, upon the death of the IRA owner, go to
the primary beneficiary named in the account agreement signed when you created your IRAs.
Presumably, the primary beneficiary for each of you is the other spouse and, if deceased, your
children. However, the pattern of distribution very much depends upon who you designated as
primary and contingent beneficiaries when you created your accounts. It is always wise to review
these designations and retain in your permanent file a copy of the documentation you signed
when you created your accounts. As a lawyer, I have been involved in at least one case where the
IRA custodian lost the paperwork on a very large IRA account, almost costing the designated
beneficiary a six-figure tax bill because of the resulting delay in distribution. The IRS has strict
rules about handling inherited IRA accounts, and these must be observed on a timely basis to
avoid unnecessary tax.

Your Annuity: the person or persons to receive your annuity would, just like the IRA, depend
upon who was named as the beneficiaries on the annuity contract, itself. The same would be true
if you owned any other insurance products or policies. Where you have designated named
individuals to be primary or contingent beneficiaries, the contract or policy controls and not your
will.

In view of the above, whenever clients come in to see us for estate planning, we always urge a
review of all beneficiary designations associated with IRA and other retirement accounts, as well
as annuities and other insurance products. Where appropriate, the beneficiary designations can
then be modified, so that the plan design accomplishes the clients’ goals and everything works
together. In many cases, the clients choose to name their Living Trust as the contingent
beneficiary of these contracts and policies, so that the plan of distribution integrates with the plan created in their trust.

Q. My 86-year-old mother is in a nursing home and receives a Medi-Cal subsidy. We just learned that her brother died and left her $200,000 in his trust. Will the receipt of this inheritance bounce mom off of Medi-Cal? Is there anything we can do?
A. The answer to your first question is easy: yes, the receipt of that inheritance will put her over the resource ceiling and result in the termination of her Medi-Cal nursing home subsidy. If she is unmarried, that resource ceiling is a very modest $2,000.
As your second question, there may be things you can do. Here are some options:
1) Purchase A Prepaid Funeral Plan. If she has not already made her final arrangements, she can purchase a prepaid funeral contract or fund an irrevocable burial trust for herself and other members of her immediate family. Most mortuaries have forms available. Those funds will then be considered exempt and will not count toward her resource ceiling.2) Pay Debts and Expenses: If Mom has any outstanding debts or expenses, she can pay them. Be sure to pay by check and retain full documentation.
3) Reform Brother’s Trust? In some cases, it may be possible to reform her brother’s trust by court order during trust administration, so that the bequest would bypass your mother and, instead, go into a Special Needs Trust (“SNT”) for her benefit. The SNT would then be managed by a trustee, which could be a family member or a professional trustee appointed by the court. If properly set up and administered, the funds distributed to the SNT would then not count against her $2,000 Medi-Cal resource ceiling. Instead, they could be used to pay for things that Medi-Cal does not cover, such as a companion to spend time with her or even to supplement healthcare expenses not paid by Medi-Cal.
In some cases reformation might even be possible without court involvement under a new out-of-court procedure called “Decanting”.
4) Join Pooled SNT: If it is not possible to reform her brother’s trust, consider joining a pooled SNT. These are SNT’s set up and managed by nonprofit organizations, whereby all of the funds are invested and professionally managed as a group, but separate accounts are maintained for each individual beneficiary. Distributions from the pooled SNT could likewise be used to pay for things that Medi-Cal does not cover. The drawback is that funds remaining in the pooled account after Mom’s death must first be used to reimburse the state to the extent of Medi-Cal benefits paid out for her, and the excess, if any, may remain in the fund for its ongoing nonprofit purposes.
5) Gifts? If mom has full capacity to consent to gifts, or if she has in place a Durable Power Of Attorney which has adequate gifting powers (most do not), consideration might be given to a very carefully designed plan of divestment in favor of children or other family members. CAUTION: gifts are frowned upon by Medi-Cal, and any gifting plan should be designed and supervised by an Elder Law attorney with special expertise in this area. If gifts are not handled properly, they may result in the termination of Mom’s Medi-Cal benefits.
As to all of the options, timing is very important, and it is usually necessary to design the plan before the inheritance is actually received so that it can be fully implemented in the month of receipt. To avoid running afoul of the Medi-Cal rules, obtaining expert advice is essential.

Q. I hear that Medicare has developed an “App” to help beneficiaries determine what benefits may be covered. Do you have any information on this?

A. Yes. Recently, as part of its initiative focused on modernizing Medicare and empowering beneficiaries, the Center for Medicare and Medicaid Services (“CMS”) has developed and launched a new “App” (short for “Application”).  The App is free and can be easily downloaded onto your smart phone or computer from the Medicare.gov website, or from the Apple App Store or Google Play.

On the App, you can search for what’s covered and what’s not covered under Medicare Parts “A” and “B”, how and when to get covered benefits, and obtain basic cost information and other eligibility details.  It can be especially helpful when, say, you are at the doctor’s office and need to determine whether a recommended procedure is covered. Just take out your smart phone and use the App. The information is right in your pocket!

However, the App does not give results for extra benefits that Medicare Advantage plans may cover but that Original Medicare does not. Also, it does not ask details about your specific insurance, so the App does not take into account the user’s supplemental insurance, co-insurance and deductibles.  Essentially, it provides a way that you can carry in your pocket the same information otherwise available online and in the Medicare Handbook available at Medicare.gov.

Examples of the types of questions the App can answer include:

  • When are mammograms covered?
  • Is home health care covered?
  • Will Medicare pay for diabetes supplies?
  • Can I get a regular cervical cancer screening?
  • Will my Medicare benefits cover a service to help me stop smoking?

To get the new “What’s Covered” app, go to www.Medicare.gov and click on the link on the home page which says “Learn About our new App”.

The App is part of an initiative by CMS focused on modernizing Medicare and empowering beneficiaries. Other initiatives include:

  • Enhanced interactive online decision supportto help beneficiaries better understand and evaluate the coverage options and costs of original Medicare compared to Medicare Advantage plans.
  • New price transparency tools that let consumers compare the national average costs of certain procedures between settings, so people can see what they will pay for procedures done in a hospital outpatient department versus an ambulatory surgical center.
  • A new webchat option in the Medicare Plan Finder.
  • New easy-to-use surveys across Medicare.gov so consumers can tell CMS what they want.

Have fun next time you’re at your doctor’s office and help spread the word to your doctor’s staff and other patients.

Q. As a part of our “bucket list”, my wife and I have decided to purchase cemetery plots for each of us in advance of need. But in doing our inquiries to cemeteries, we were quite surprised by the prices of these plots. We heard that that there may be a way to purchase plots in the cemetery of our choice at a “wholesale” price. Do you know anything about that?

A. Yes. I believe you refer to purchasing cemetery plots in the secondary market, such as through independent “cemetery brokers”. These folks are independent dealers who assist individuals to re-sell their previously purchased cemetery plots when they no longer intend to use them, whether because of relocations, divorces, or changed burial preferences.

These independent brokers are licensed by the State of California as Cemetery Brokers, under the Department of Consumer Affairs, Cemetery & Funeral Bureau. They are not employees of the cemeteries, but work closely with them to assist individuals re-sell their unwanted plots. They fill a very important need as the cemeteries, themselves, often will not re-purchase previously sold plots.

These brokers typically have an existing inventory of plots available for resale in most of the existing cemeteries, and you are likely to find they have just what you are looking for, often at prices 40% to 60% less than the prices for which similar plots would sell if sold directly by the cemetery. The brokers’ inventories usually also include other burial options, such as crypts and niches.

By the same token, for those who wish to sell their unwanted plots, contacting an  independent cemetery broker may also be a wise move. However, before listing  plots for sale, sellers should check with the cemetery to make sure they have the legal right to sell their plot and to ask about the fees the cemetery will charge to transfer the burial rights to a new buyer. Also, if the original plots were purchased together with other family members, sellers will need the consent of their co-purchasers before listing the plots for sale.

For more information, try a Google internet search using words such as “Cemetery Plot Brokers”. One example of an independent cemetery broker listing plots in the Bay Area is:  www.LowCostGraves.com. Another, with a national inventory is www.FinalArrangementsNetwork.com.  Consider, also, the offers of sale on sites such as ebay and Craigslist.

For more information, visit the following State of California website maintained by the Department of Consumer Affairs, Cemetery and Funeral Bureau: www.dca.ca.gov.  For any questions, you might call the Bureau directly  at 1-800-574-7870, or email it at: emailcfb@dca.ca.gov.

Q. My husband suffers from dementia and we have significant expenses for care in the home. In order to help with these expenses, I have been thinking about selling our vacation property which we no longer use or cashing in one of his annuities. I would also like to set up a Living Trust and make Wills. The problem is that my husband cannot sign the necessary legal documents.  Unfortunately, he does not have a Durable Power of Attorney which would allow me to sign for him.  Is there some way to overcome this problem?

A. Yes. There is a legal procedure whereby you can petition the superior court to make an order that takes the place of your husband’s signature. It is called a Substituted Judgment and  involves petitioning the court for an order that, in essence, asks the court to substitute its own judgment for your husband’s. The resulting court order would then usually be accepted in lieu of your husband’s signature by title companies, banks, insurers and others.  It could also authorize the creation of estate planning documents for both of you.  This could be a perfect solution to your problem.  For a married person, a formal conservatorship is not required to invoke this procedure.

Upon your petition, the court will assess your husband’s situation to determine whether the proposed order seems reasonable under the circumstances and whether, if granted, your husband’s interests will be protected and his needs for ongoing support and care met.  If the court is satisfied, an order will then usually be made in accordance with the petition.  Often, the court’s decision is based upon your written petition and the written report of the court-appointed Guardian, and is frequently made without a formal hearing.  Once granted, you would then be free to engage in the  transactions that you propose.

This procedure is designed to provide the necessary consent for a particular transaction or series of transactions which involve, primarily, community property, but may also include your husband’s separate property if the court finds “good cause”.   However, the procedure has even broader application and can also be used to help you handle other legal matters for him, such as the following: creating, modifying or revoking a “Living Trust”, making a will, making gifts, selling real property, arranging a loan, exercising options under life insurance, annuity policies or retirement plans, and for other purposes.  In our practice, we have used the Substituted Judgment procedure very effectively to assist with asset preservation strategies and Medi-Cal planning for long-term care.

By the way, the Substituted Judgment procedure is also available to unmarried individuals, albeit in the context of a full-blown conservatorship, which typically requires ongoing court management and associated legal proceedings for the remainder of the incapacitated person’s lifetime.  By contrast, for a married couple, the procedure is much more streamlined and the court’s powers are invoked by a petition which usually is resolved in one court hearing.

As you imply, had your husband previously signed a Durable Power of Attorney (“DPOA”) with adequate powers when he had full mental capacity to do so, his DPOA might then have been used to achieve many of your goals (except that a DPOA cannot be used to make a Will).  However, in situations such as yours, the Substituted Judgment procedure can be a very powerful tool to overcome legal impediments associated with incapacity.

Q.  Do you mind if I ask how you got started working with seniors and doing the kind of long-term care estate planning that you do?

A.  Not at all. In a word, I owe it all to my grandmother.

After my grandfather died in the 1960s, my grandmother, Lena Ponsky, became the head of our family in spiritual and religious matters, and I suppose we always thought that she would assume that role forever.

Just to provide a bit of background: my grandmother had always been a very strong and independent woman, always undertaking leadership positions in her volunteer organizations and charitable work.  Although she did not drive, she would walk or take the bus all over the East Bay to run errands and go to meetings, and I recall her doing so well into her 80’s. How independent was she? Well, on one occasion she needed to have a number of teeth extracted. Rather than calling any of her adult children or grandchildren for help going to and from the dentist, she said nothing to anyone and took herself back and forth to the dentist’s office by bus, holding a cold compress to her jaw all the way back home. In fact, we only learned of her visit to the dentist later that evening when she telephoned to chat about the events of the day.

However, as she approached 90 years of age, we noticed signs that she needed assistance. It appeared that she was not getting adequate nutrition, was not leaving her apartment very often, and it seemed that her eyesight was failing. To address these concerns, we ultimately found other living arrangements for her, including assisted living and later skilled nursing care. As we began to deal with her care, we found that we had many questions, not just about providing for her needs, but also about how to deal with her finances, pay for the cost of care, protect her estate and many others. However, we found the answers very difficult to come by, as very few people had the information that we needed. Indeed, we had to search far and wide for limited information.

Suddenly, a kind of light bulb flashed in my mind! And here’s what it was:

Until then, I – along with my attorney colleagues – had practiced traditional estate planning, centered on what I call “death planning.”, i.e. planning designed to pass on one’s assets to heirs and beneficiaries at death.  However, I had long felt that there was something missing from this approach, but in my early years as an attorney I could not quite put my finger on it.

Suddenly, while working to help my Grandmother, I realized what was missing. My grandmother’s circumstances essentially showed me a different way of thinking about seniors and elders in declining health. The question for them was not “What happens when I die?” but rather “What happens if I don’t die, but live on and need long-term care?”

And, right then and there, my current focus in Elder Law was born. As a result of that flash of insight inspired by my Grandmother, I have been serving the planning needs of seniors and those who love them by focusing on the legal and financial challenges of longevity, including the ever-present question of how to pay for the cost of long-term care.

And now you know the “back story”.

About Gene Osofsky