Older woman sitting with estate planning attorney

Determining The Medicaid and Medi-Cal Snapshot Date — How Does Medicaid Do It?

The Medicaid “snapshot” date applies to married couples when only one spouse applies for Medicaid assistance with the cost of long-term care. Medicaid (also known as “Medi-Cal” in the State of California) calculates the assets of the married couple as of the snapshot date to determine eligibility for Medicaid benefits. 

This article explores the concept of determining the Medicaid snapshot date – how does Medicaid do it? 

A California estate planning attorney can explain how you might be able to qualify for Medicaid help with long-term care expenses.

An Overview of the Medicaid Snapshot Date

The spouse seeking long-term care Medicaid could be needing in-home, community-based, or nursing home care. The snapshot date can predate when the person gets admitted to the nursing home. In other words, the snapshot date has already passed before most people realize they will need help with the cost of long-term care. 

For example, if an individual applies for Medicaid benefits and services they will receive in their home or in the community, the snapshot date is usually the date of the Medicaid application. Sometimes, however, Medicaid will use the date on which the person had a functional needs assessment to find out if the individual meets the functional requirements for eligibility.

When a person applies for Medicaid benefits to help with the cost of nursing home services, the snapshot date could be on one of several dates. The individual had to have been an inpatient at a hospital or nursing home for at least 30 days without going home before they may be eligible for Medicaid long-term care. If a patient is directly admitted from a hospital to a nursing home, Medicaid will add the days of the hospital stay to the days at the nursing home.

How the Snapshot Works

The applicant for Medicaid long-term care will have to fill out an asset declaration form and financial documentation. The forms must provide sufficient details about the value of all assets owned by the applicant spouse and non-applicant spouse as of the snapshot date.

Medicaid will then add up the total countable assets of the couple. Not all assets count for purposes of Medicaid eligibility. When one spouse continues living in the community, that “community spouse” gets credited with having more than half of the assets of the couple, making it easier for the long-term care spouse to qualify for Medicaid.

The government agency will calculate the Community Spouse Resource Allowance (CSRA) so that the community spouse does not have to become destitute to pay for the other spouse’s long-term care. In California, the asset limits are $2,000 for the long-term care applicant and $137,400 for the non-applicant spouse if the applicant will receive Medicaid benefits and services in an institutional or nursing home setting.  

Remember, not all assets count toward total assets for Medicaid eligibility. In California, the asset limits are the same for Medicaid waivers to receive in-home or community-based long-term care services. We understand that these Medicaid and Medi-Cal rules and calculations are confusing. You do not have to learn all the details and loopholes for yourself. A California estate planning attorney can help you navigate Medicaid and Medi-Cal long-term care issues. Get in touch with our office today for legal help, we offer a free consultation.

woman with parkinson's disease holding hands with nurse

Why an Estate Plan Is Essential If You Have Parkinson’s Disease

After a devastating diagnosis like Parkinson’s disease, you will likely spend some time thinking about your future and how the progressive nervous disorder will impact your life. Although there is no cure yet for Parkinson’s, you might want to manage the things that are within your control. For example, some medications can slow the progress of Parkinson’s disease. 

Talking with a California estate planning attorney can help you exercise some control over your future financial situation and medical decisions. Having a voice on those issues is why an estate plan is essential if you have Parkinson’s disease.

Legal Documents That Can Benefit People Living with Parkinson’s Disease

Many people think of estate planning merely as writing a will or living trust that states how you want your assets distributed after your death. In reality, an estate plan can protect you during your lifetime as well. Here are some documents that can be valuable for people with Parkinson’s disease:

  • Durable Power of Attorney for Financial Management. If you become incapacitated from an illness or injury, signing a durable power of attorney ahead of time can give someone the legal authority to handle your bill-paying, bank accounts, investments, and other property for you.
  • Advance Health Care Directive. This document lets you decide who will make your medical decisions if you cannot perform that function or communicate your wishes.
  • Medical Records Authorization. The person who makes your medical decisions needs to have access to your medical records to make informed decisions about your healthcare.

In some situations, it might be appropriate to create additional legal documents to protect you and your loved ones.

How Parkinson’s Disease Can Affect Your Legal Capacity

As the disease worsens, you might develop difficulty expressing your wishes by speaking or writing. Also, you might experience cognitive challenges. The Mayo Clinic says that Parkinson’s can cause slurred speech or other difficulties producing speech that others can understand. 

The illness can also make it hard for you to communicate your wishes in written form due to tremors and other nerve and muscle impairments. In the later stages of Parkinson’s, a person can develop dementia and other cognitive losses.

Depending on the severity of the disease, a judge might decide that the person with Parkinson’s no longer has the legal capacity to act on his own behalf. If that happens, it is too late for you to sign legal documents, like a power of attorney, living trust, or other papers. 

The court may need to appoint someone to serve as your conservator or guardian and make decisions about where you live, what medical care you receive, and day-to-day personal choices. Also, the judge would have to appoint someone to manage your money for you. Although the individuals the court selects might look fine on paper, the appointees might be the last people you would want to make your decisions for you. 

A California estate planning attorney can help you create an estate plan that will let you choose who will take care of you and your assets if you become vulnerable because of Parkinson’s disease or some other illness or injury. An estate plan can also let you decide who will inherit from you one day. Contact us today.

elder woman with alzheimer's talking to caregiver

Helping Loved Ones With Alzheimer’s Preserve Their Memories

If your loved one has Alzheimer’s disease or another form of dementia, you might want to try to capture and safeguard their memories before those moments are lost forever. There are also things you can do to help trigger happy memories for your relative.

A California estate planning attorney can advise you on how to protect the estate and legal rights of your loved one. Here are a few suggestions of techniques you can use when helping loved ones with Alzheimer’s preserve their memories:

Record Your Relative Talking About the Past

Generations to come will treasure hearing stories told in your loved one’s own voice. You might ask him or her to let you record them talking about events from the past. Oral histories can provide a wealth of information that someone else telling the story cannot provide. You might consider making a video recording as well as audio to preserve your relative’s image and well as voice.

Although you might feel a sense of urgency to capture as much information as possible while your relative can still participate in the process, pushing your loved one too hard could backfire. Set a timer to limit the length of the recording sessions. Take frequent breaks. Stop the session if your relative appears to be tired or gets irritable before the timer rings. Patience is the key to successfully recording an oral history.

Collect Treasured Items for a Memory Box

Souvenirs, trinkets and other objects with sentimental significance can help a person with dementia grasp memories from events. Gather items from many different events from multiple eras of the person’s life. Heirlooms can also help the individual remember the person who originally owned the object. Place the items in the loved one’s hands so that the tactile sensation can magnify the impact of the objects. Talk about the items and the events associated with them.

After you make the memory box, do not merely place it on a shelf. The Mayo Clinic suggests that you pull out the memory box frequently and talk with your loved one about the moments from the past. Doing so helps with memory and reminds the person of the many things he has accomplished in his lifetime.

Convert Family Photos and Videos

Old photos and videos can fade and deteriorate. If possible, you might want to have them copied and converted to a current format that your relative will find more accessible. Make it easy for your loved one to enjoy the photos and videos. For example, uploading many digital photos into a frame that will scroll through them with the tap on the frame can make it easy for him to view pictures without having to fumble through photo albums.

Play Music That is Meaningful to Your Loved One

Make a list of your loved one’s favorites songs or genres of music, then create a mix of those tunes. Music is a powerful tool to reach deep into the brain and activate memories. Whether sacred music, show tunes, Frank Sinatra, or something else, you can bring great joy to your loved one with carefully curated music.

Use Aromas and Textures to Trigger Memories

Sensory stimulation can reach a person with Alzheimer’s or another form of dementia and help them remember things from the recent or distant past. Scents like a favorite perfume or aftershave can trigger memories. Holding a cherished item can reduce the person’s anxiety or depression. Using their hands to make simple projects can provide tactile stimulation to the brain. A California estate planning attorney can help you create an estate plan that will let you choose who will take care of you and your assets if you become vulnerable because of Alzheimer’s or some other illness or injury. An estate plan can also let you decide who will inherit from you one day. Contact us today.

power of attorney

Can I Draft a Power of Attorney for My Parents?

As long as your parents are still legally competent, they  can execute a power of attorney. However, if you want to avoid a claim that you, as their child, have improperly procured the document for your own benefit, you should have your parents contact a California estate planning attorney directly to assist them.

A California estate planning attorney can answer your parents’ questions, guide them through the process, and draft the documents for their signatures. 

Undue Influence and Powers of Attorney

Other relatives are likely to object to a power of attorney that they feel unfairly enriches the person who wrote or obtained the document. Let’s say that you take care of your elderly father, who lives in your home. He becomes frail and essentially housebound. You have him sign a financial power of attorney so that you can take care of his banking, manage his income and investments, and pay his bills. 

If you receive any financial benefit from using the power of attorney, and sometimes even if you don’t receive a benefit, your siblings or other relatives might accuse you of unduly influencing your father to sign the document. Undue influence can be grounds to challenge and invalidate the document.  Your relatives may also accuse you of financial elder abuse, and demand that you prepare an accounting and return any funds that they allege were wrongfully taken or used by you.  They may make these demands, or file a lawsuit against you, even if all of the funds are used for your parents’ care.

The best way to avoid problems like these is for your parents to work closely with a California estate planning attorney who can draft an enforceable power of attorney and protect your parents’ legal rights – while protecting you from a claim that you improperly procured the document. A lawyer can also advise you on the law that governs the proper ways to use these documents. Contact our office today.

elderly couple estate planning

Signs of Undue Influence in Elderly Estate Planning

It sounds like the plot of a movie – someone tricks, pressures, or forces an older adult to change their will or trust, cutting out everyone else from the inheritance and leaving all or most of the assets to the person who exerted undue influence. California law is intended to protect people from this financial abuse, but it still happens frequently. 

Our state statutes cannot always prevent undue influence from happening, but the law gives people damaged by the improper conduct a potential remedy to pursue. A California elder law attorney can help you evaluate the facts of your situation and advise you as to whether you might have grounds to contest a trust or will for undue influence.

Signs of Undue Influence in Elderly Estate Planning

Sometimes, your instincts tell you that something is wrong, but it can be challenging to put into words why you feel that way. Here are four factors you might want to think about if you are considering talking to a lawyer:

  1. Whether the ultimate outcome was unfair. Let’s say that your brother was estranged from your father decades ago. He came back into your father’s life during your dad’s final illness. They resolved their differences, and your dad changed his will to leave everything to you and your brother equally. Because the outcome looks equitable, the court would be less likely to declare the new will invalid. If the new will cuts you out and leaves everything to your brother, however, the court may be much more inclined to find undue influence.
  2. Whether the victim was vulnerable. Advanced age, loneliness, dependence, illness, disability, and other issues can make a person vulnerable. If your dad moved in with your brother before he changed his will and your brother provided needed financial help and other care to your dad, your dad’s illness and dependence could be indications of vulnerability.
  3. Whether the influencer acted in bad faith to control the older person. If your brother limited your dad’s social contacts, used emotional blackmail, or delayed providing your dad with his medications or other medical attention until he signed a new will or trust, those tactics would be signs of undue influence.
  4. Whether the influencer had some apparent authority that the victim relied on or trusted. For example, some people will give more weight to what a doctor, clergy member, or male relative tells them than what other people say. If someone with apparent authority over your elderly relative tries to “cash in” on that relationship, to the detriment of the older person’s other natural heirs, that fact could indicate undue influence. 

In a nutshell, undue influence is unethical behavior that takes away the victim’s free will and achieves an unfair result. When this happens, a court can take action to void the will, codicil, or trust agreement. 

People with the most contact with the victim, like caregivers, relatives, and friends, are most often accused of undue influence. Sometimes the claims are true, but not always. Instead, sometimes a close relative who ignored and neglected an older adult demands to get an equal share with those who provided years of hands-on care for the individual. Inheritance shares do not have to be equal to be fair.  They just have to faithfully reflect the elder’s wishes.

Contact our office today. Our California elder law attorney can provide guidance, whether you think someone unduly influenced your loved one or someone accuses you of perpetrating undue influence. 

Elderly patient in nursing home.

Identifying Elder Abuse in Nursing Homes

Attending to the needs of an aging loved one at home isn’t always easy or possible. Assisted living facilities and nursing homes can offer welcome relief and reassurance that your elderly loved one will receive the care and attention they deserve. 

However, while many senior care homes provide a loving and supportive environment for their residents, elder abuse in long-term care facilities is a growing cause for worry.  This holds particularly true in California, where nearly 13% of all nursing home complaints involve abuse, neglect, and exploitation of the elderly.  

California elder abuse attorneys caution that identifying elder abuse in nursing homes can be challenging. Many signs of elder abuse are dismissed as symptoms of underlying medical conditions or failing mental capacity. 

Understanding types of elder abuse and identifying factors is vital to ensuring your loved one’s safety in a nursing home.  

Four Common Types of Elder Abuse

Elder abuse takes many forms. It often presents as emotional or physical harm perpetrated against older adults.  It also includes neglect and financial exploitation. 

Physical Assault

The intentional use of force or unwanted sexual contact against an older person that results in physical harm or injury is considered physical elder abuse. 

  • Hitting
  • Spanking
  • Spitting
  • Bruising
  • Unwanted touching
  • Sexual assault
  • Unnecessary restraint
  • Overmedicating
  • Withholding medical treatment

Emotional Abuse: 

Any form of mistreatment that causes psychological harm or distress to an older person is a form of emotional abuse. 

  • Isolation
  • Intimidation
  • Humiliation
  • Indifference

Neglect:  

Any failure to provide for the routine care or specialized needs of an older person is considered elder neglect. 

Elder neglect comprises more than 50% of elder abuse cases. 

Nursing homes are obligated to monitor and care for elderly residents and provide for their complete care.  Whether intentional or unintentional, a failure to provide the appropriate standard of care required by a resident for their health and safety is neglect. 

Financial Exploitation:

The unauthorized use of an older person’s identity, property, or finances is financial abuse.

  • Stolen money
  • Undue influence or fraud to obtain lifetime gifts, pay-on-death transfers, or an inheritance
  • Property theft
  • Embezzlement
  • Blackmail
  • Investment fraud
  • Healthcare fraud
  • Identity theft

What are the Warning Signs of Nursing Home Elder Abuse?

Identifying elder abuse is difficult because the warning signs mimic other physical ailments and mental decline common in older adults. An initial indicator that something is wrong with the care of your loved one might be friction between the elderly person and their caregiver, but not always.  Additional warning signs of maltreatment include:

Physical warning signs:

  • Unexplained or frequent bruises, welts, or broken bones
  • Broken hearing aids or eyeglasses
  • Consistent bed sores
  • Drug overdoses 
  • Unexplained changes in medication 
  • Signs of restraint
  • Regular or prolonged periods of isolation

Emotional warning signs:

  • Sudden onset of mumbling, rocking, thumb-sucking
  • Controlling caregiver behavior

Neglect warning signs:

  • Bed Sores
  • Soiled clothes
  • Bug bites
  • Weight loss and malnutrition
  • Poor Hygiene 
  • Poor facility maintenance

Financial exploitation warning signs:

  • Missing items or cash
  • Changes to wills, trusts, and powers of attorney
  • Added signatories or beneficiaries on accounts
  • Unnecessary purchases
  • Unusual purchases
  • Duplicate healthcare billings
  • Unpaid bills

California Elder Abuse Attorneys, Protecting Our Elderly

California elder abuse attorneys understand the trauma experienced by victims of nursing home abuse and the corresponding pain caused to family members.

If you are a victim of nursing home elder abuse, or if you suspect a loved one of being abused, it is essential you contact an elder abuse attorney for legal advice and support.

Contact us today for a consultation today to learn more about protecting your elderly loved ones during their golden years.

Woman at a nursing home being taken care of by nurse during

Nursing Homes & The Coronavirus Outbreak

Nursing homes have struggled with the coronavirus outbreak. Residents in long-term care facilities and nursing homes are at high risk for COVID-19. Reasons for the high risk given by the Centers for Disease Control include the fact that many nursing home patients are elderly adults with underlying health conditions. Also, the nature of nursing homes, gathering many elders into a relatively enclosed space, makes it easier for the virus to spread.

According to an article in The New York Times, one third of the coronavirus fatalities in the United States are either nursing home residents or staff members of long-term care facilities. As of this writing, more than 153,000 nursing home residents and staff have been infected by COVID-19. Thousands of nursing home patients and staff members have died since the outbreak. Family members are alleging that negligence is a factor in many of those deaths. Our California elder law attorneys weigh in.

Nursing Homes Seek Immunity from COVID-19 Liability

The nursing home industry is aware of the liability that facilities may face because of the coronavirus pandemic. For that reason, the nursing home industry is pushing for immunity from lawsuits for employees and owners of long-term care facilities. Some states have granted nursing homes explicit immunity for nursing homes for coronavirus lawsuits. Other states have granted some level of immunity for nursing homes against COVID-19 lawsuits.

It is important to fight blanket immunity for nursing homes during the COVID-19 outbreak. Long-term care facilities that fail to take reasonable steps to protect and care for residents should be held liable for their negligence and recklessness. Immunity allows nursing homes that intentionally or carelessly breach their duty of care to their patients to go unpunished for their wrongdoing. Immunity prevents patients and families from seeking the justice they deserve. Even during a pandemic, long-term care facilities must be accountable to their patients and the patients’ families. 

Concerned Californians can contact Governor Gavin Newsom to express their opposition to blanket immunity for nursing homes. You can contact Governor Newsom’s office online or by calling (916) 445-2841. 

Nursing Homes and Infection Control Requirements 

Nursing homes have a duty to provide adequate care for their patients, which includes infection prevention and infection control. Some nursing homes have a history of failing to follow required infection-control measures. As COVID-19 continues to spread throughout the state, nursing homes in California should implement measures to control infection throughout their facilities.

Sadly, some facilities have failed to address the pandemic. Facilities failed to follow the state’s guidelines for nursing homes during the COVID-19 outbreak. They failed to limit access to the facility and ensure that staff members experiencing symptoms remained at home. Some facilities failed to provide the required PPE for staff members to prevent the spread of the virus. 

Nursing homes that failed to take reasonable steps to protect their patients from COVID-19 could be liable for damages in a wrongful death lawsuit or personal injury lawsuit. 

Contact a California Elder Law Attorney for More Information 

Families who fear for their loved one’s health and wellbeing can contact a California elder law attorney for help. Nursing homes can be held liable for negligence and incompetence. It may be crucial to pursue a claim now instead of waiting.