<p>If you try speaking with the discharge social worker at the hospital near where your folks live, they may have suggestions as well.</p>
<p>Dharma,
I’d also think that this great eldercare attorney of your mom’s is getting older as well and may not be the best attorney to be advising you. I definitely think she should have mentioned the 1/1/15 changes in the law. Actually overtime and related issues are NOT NEW and have been around since at least 2007, when I started my nonprofit and had to be careful about how many hours I had employees work. Having workers available to help during the evening/overnight has always been something they are SUPPOSED to be compensated for as well, whether or not folks are actually doing so, as it IS expensive.</p>
<p>I’m really not sure what this attorney is doing or supposed to be doing for you and your mom but if it involves transferring assets and expecting you or sis to be paying bills, I think I’d definitely opt for a 2nd opinion. It may cost a few more dollars but can save you A LOT of heartache. Sis hasn’t shown any interest in helping and I’d be sure NOT to give her any assets or control over any, as she has shown no interest in helping make sure your mom gets care. Moving assets and qualifying for Medicaid is very tricky and changes so it’s worth it to be sure you understand what is going on and don’t have a nasty surprise that will cost you a LOT.</p>
<p>Thanks for all the suggestions!</p>
<p>I read this thread every day but never post because luckily I’m not at a critical point with my 91 year old dad. But the collective wisdom here is amazing and I’ve learned so much about dealing with elder parents. So thank you all for sharing your hard earned experience!</p>
<p>But a question concerning a woman I work with. Elderly parents, trying to protect their assets and being advised by an attorney in CA to transfer the $100k in assets to the adult children through daily gifts of $7k. They want the parent to be able to qualify for medi-cal. I have explained that to my knowledge there is a 5 year look back period in CA but their attorney is advising them they can get around it!! What the heck? Talk about fraud! What do you guys think will happen?</p>
<p>HI mom, thanks for your input, bit I feel secure. I just reread and studied the lawyers web page and the range of services she offers is dense and complex, and her curriculum vitae is very long and full of leadership positions in a myriad of fields she helps clients with. Most importantly, she worked magic with my mother which was a miracle to see. </p>
<p>More later…</p>
<p>Sammy- When I had to qualify my mother for Medicaid, I had to show her bank records for the previous 5 years, including cancelled checks. I don’t see how your co-worker’s parent could get around that and not get caught writing $7K checks on a daily basis to empty the account.</p>
<p>Sammy - Maybe the lawyer is competent and has a legal work-around, Or maybe your colleague’s family will find that the gifts lead to a penalty period, and Medi-Cal will refuse to pay their parents’ bills. It’s hard to know without details that you probably won’t get.</p>
<p>Oh well, I tried. Social worker met with MIL/FIL yesterday, and they are considering their options regarding hiring in-home help, but not ready to make a decision. You can lead a horse to water, and all that. Back to watching the train wreck.</p>
<p>MomofJandL, I found that approaching my dad when he was exhausted with the burdens of taking care of my stepmother was the best time to approach him about getting help. Also, we got the help through an agency and I made it clear that we needed someone good so they would be a steady customer. Started with 1 shift, 3 days a week, then 4 days a week, then 7, then live-in.</p>
<p>Sammy, I think your coworker should get a second opinion. If it were that easy, everyone would do it.</p>
<p>Dharma,
Am glad that the attorney was good with your mom. Would really hesitate and get a 2nd opinion before transferring mom’s assets to you or sis without a 2nd opinion, no matter how credentialed she is. That is asking for trouble. She may be sharp, but you don’t want to be stuck with mom’s bills because she has done something that backfires.</p>
<p>Also, I am concerned that she didn’t take this tack with your mom previously and tell her she needed to go to AL before, causing you so much stress and making you twist yourself into a pretzel trying to make things work, without adequate info about how to pay for staffing. </p>
<p>Good luck moving forward and please be VERY cautious about what happens to your mom’s assets.</p>
<p>Sammy, I agree with the others. Your friend who was told about giving daily gifts of $7K should consult with another attorney, specializing in elderlaw. What the current attorney says makes NO sense and would NOT be in the elder’s best interests. In any case if you gift more than $14K to one person in one year, you have to file gift tax return (even tho nothing is due). There is a lookback period for qualifying for low income benefits–most say that period is 5 years, so that would affect any gifts and expenditures for 5 years prior to the person trying to get benefits for low income.</p>
<p>Also, the person who has the $100K in assets has more options and can get better care than someone who has NO assets and has to get whatever he or she is able to. Many places will accept a paying client and allow them to stay on once their assets are depleted as a low income client but would not accept them initially as a low income client.</p>
<p>In any case, don’t assume. Don’t risk a bigger can of worms down the road. At least do all the online research you can, to understand. Look for info on the details of what works for what and the magnifying glass you will be subject to. The first principle in crisis management is crisis prevention. Just saying.</p>
<p>From HI mom
I’m really not sure what this attorney is doing or supposed to be doing for you and your mom but if it involves transferring assets and expecting you or sis to be paying bills, I think I’d definitely opt for a 2nd opinion. It may cost a few more dollars but can save you A LOT of heartache. Sis hasn’t shown any interest in helping and I’d be sure NOT to give her any assets or control over any, as she has shown no interest in helping make sure your mom gets care. Moving assets and qualifying for Medicaid is very tricky and changes so it’s worth it to be sure you understand what is going on and don’t have a nasty surprise that will cost you a LOT.</p>
<hr>
<p>HI mom, I thought about your post all the way to and from driving DD2 to her volunteer hospital job. Part of the problem with the first visit may be my fault because I was frenetic and may not have given the lawyer the best opportunity to offer me counsel. But nonetheless, she did see my figure for salary and could/should have questioned it. But, to reemphasize, she is a prominent elder-care lawyer in a wealthy suburb of NYC and is President, Chair, Director, and so forth of a whole lot of councils, chapters, and Boards.</p>
<p>As for what the attorney is doing for my mother, I will tell you. The soon-to-be looming cost of in-home care makes it out of the picture for my mother by four months, certainly. The lawyer will help my mother get into AL and advise her on selling her house. Nothing about transferring assets, and certainly nothing about my sister or I paying bills. She has shown an interest in helping my mother, which I will detail below. </p>
<p>Aside from those few and simple things, she wants to help us secure a Promissory Note. Now, this is where I have questions. In both interviews she told me that after the sale of the house, my mother can put half of the money from the sale into a promissory note; the other half would pay for AL, until it runs out and my mother then goes to the NH on Medicaid. I had never heard of a promissory note and last night and this morning read several internet articles about it. It is a strange thing. It appears to be some kind of legal, binding, loan. From what I read, I don’t see how it fits into our picture at all. My only quess is that the design is that my mother “loans” the money to me (and my sister) and then, when my mother dies, the loan doesn’t have to be paid back.</p>
<p>My BIL is a retired lawyer with extra degrees heaped on top of the JD. I am going to call him this afternoon and ask him all you have brought up and specifically about the promissory note; if he doesn’t have the answers he will know someone who does and I don’t think he’d mind calling a colleague for me…he’s a big extrovert .I’ll also ask him to look at the elder-care lawyer’s website with me l If I’m still not satisfied I will make a short appt. with my own attorney and pay for it. But curiously, two weeks or so ago when I was researching something related to one or another taxes due to an employee, I called him on the phone about something that needed a simple yes or no answer. He didn’t know the answer, or, in fact, what was talking about–he said it sounded “new”–and that I knew more about it than he did. Frustrating. We have used him for Wills–our own and my mothers–my husband’s short-time freelancer legal needs, and to review a contract between an author and my husband as editor. This guy isn’t a powerhouse, but he should know what a Promissory Note is, its purposes, and how it works etc. </p>
<p>But to turn now to the interview between the lawyer and my mother. My mother sat down, and the lawyer recalled how my mother and late father consulted her ten years ago when the lawyer helped my mother get my father on Medicaid. They spoke warmly. The lawyer asked my mother, How are you? And to my astonishment, my mother–who has been holding together for weeks in a determined fashion–fell onto the table into a 90 lb heap of bones and flesh and said, I can’t go on. This morning I just wanted to die. I felt better in the nursing home. But since I came home from the nursing home, I have felt very unwell. The lawyer got my mother to sit up and spoke to her soothingly, using her hand to stroke my mother’s arm up and down. She said, Don’t talk like that! I will be your lawyer for ten years! She said, A, I don’ think you can live at home any more. I know a nice AL place in Carmel, near your daughter. You will be surrounded by other people, nurses, other guests, there are activities, good food and round-the-clock health care.My mother accepted this and agreed, but she questioned whether she should just go back to the NH; while she has some days left in her 100 pd Medicare days, the lawyer explained, the NH would cost $15,000 a month after she uses up the 100 days, and that my mother would do fine at AL. The lawyer continued to soothe my mother and explained–sort of–the promissory note. But for some reason she urged haste–haste to see AL and get in–haste to get the house ready and sell. </p>
<p>My mother quite pulled herself together and made us stop at Dunkin Donuts and go in, and to the A&P. She was quite cheerful in DD. It gave me heartache to witness, at the lawyers, how truly alone she is–despite my ever-seeming presence and johnny-on-the-spot helpfulness–which as I’ve described has a large element of “absence” to it–how old, how scared, how ill, how miserable.</p>
<p>So I’m waiting for a call from the AL place in Carmel. I drove over/walked in as its on the way to the volunteer job. It is simply “okay”, far from as nice as the majestic “Resort” where MIL lived (the one my mother hates for whatever are her complicated reasons). The next step is to get her to visit this new AL and have a tour and meal. I learned they do have apartments available. Hopefully tomorrow. I hope she likes it, there is a simple move, and a quick house sale and then i’ll have to figure out how to deal with a house packed with goods. I’m afraid my mother will say “absolutely not!” to this nearby AL, with the result of me taking her on tours of six or more in the vicinity.</p>
<p>Agree to get your mom moved and sell the house ASAP, as her living in the house will drain her assets and is NOT a good situation for her or you anyway. I’d urge caution about the promissory note. It doesn’t matter how many credentials this woman has, you and your sis should be cautious and understand what this promissory note is and what it does before you agree to it.</p>
<p>Folks can have gorgeous websites and may have helped many clients over the decades but may not necessarily be as up on current rules and regs as they once were. An eldercare specialty lawyer is one that will be most current on Medicaid regs rather than someone who does wills and practices law. One can mostly download forms to write wills and doesn’t have to keep up on finer points of elder law to write wills. In order to avoid penalties in Medicaid, one has to be VERY careful, as financial transactions are CAREFULLY watched. </p>
<p>I have already indicated I’d be VERY careful about giving ANY assets to your sis, as it’s doubtful any would be given back or available to your mom if this promissory note blows up and you and sis need to pay out of your own pockets, which will be a further drain on YOU and your immediate family. Any gaming of the system has been known to backfire in big ways, causing lots of heartache and costing lots of $$$$.</p>
<p>HI mom again, I posted but then read your 1 pm note. I went alone to the eldercare lawyer the first visit while my mother was in the NH. This was when I wrote out my two “cost comparisons” --caregiver vs AL-- and I told the lawyer how my mother would not look at the cost comparisons, and that I wanted her to take the less costly route of AL. That was the day the lawyer said it was “my mother’s choice” but of course my mother wasn’t in the room and the lawyer couldn’t “connect” with my mother, size her up, etc… Perhaps listening to me say that my mother was hell-bent on in-home care caused the lawyer not to look at what I had recorded as bi-monthly salary as obviously being too low (because this was before I had learned about hourly minimum wage requirements, overtime requirements, vacation, sick days, etc). If she had had a razor-sharp eye and noticed that the figure on my page looked wrong, it would have saved us a lot of time, trouble, and expense (for instance, paying $2,100 for the caregiver’s finder’s fee) and would have had us face the fact that AL (or NH) was the only solution, because in-house care was simply unaffordable. If I can find and learn enough about this Promissory Note to satisfy myself that it is a good and true thing–legal and in the toolbox of other eldercare lawyers–I have to view the mistake as just water under the bridge, because my mother likes/loves this lawyer. But if my BIL can’t give me or find me an assurance, or my own lawyer, then yes, I will consult another elder-care lawyer.</p>
<p>I am an attorney, as are many of my friends and relatives. I will say that Medicare and Medicaid law are specialities unto themselves and just having a law degree does NOT make one up on the finer nuances that can trip up the unwary. I’d be shocked if your BIL is up on the finer points of Medicare and Medicaid law if he doesn’t practice it as his speciality. These finer points change regularly and need to be closely followed. Having a loved one or relative who happens to have a law degree venture an opinion is a poor substitute for a 2nd opinion from a qualified expert in the field.</p>
<p>Case in point–one of my friends’ mom insisted on transferring title to two houses to her S. In exchange, he is supposed to give her $1000 a month allowance. H rarely sends her these checks, which is a huge hardship for her and her D (whom she lives with). He gets to live rent-free on one house and also gets rental income from the other but can’t even pay his mom! I can see this happening in other families as well, sadly including with your sis.</p>
<p>It’s like asking an internist which specific cancer treatment you should get and the pros and cons of each of the specific treatments that the oncologist is proposing to you. I’d get a 2nd opinion form an oncologist, NOT an internist–same here with the attorneys.</p>
<p>I am an attorney too and other than knowing vaguely about the 5 year look back I cannot and wouldn’t want anyone to rely on my advice in that very unique practice area. </p>
<p>HI mom, I realize in listening to you that it is pointless to ask BIL (or local lawyer) about anything related to Medicare/Medicaid. What I need to know about SPECIFICALLY is the legality of putting assets into a Promissory Note (thus making them unavailable to Medicaid). And I think the only lawyer who would know that would be an elder-care lawyer. It seems a shame to spend money we really don’t have, but I think I have to read up as much as I can on what is a Promissory Note and ask my husband if I can locate and schedule an appt with a 2nd opinion elder-care lawyer. Ideally, he would go with me.</p>
<p>Now see, this is just the kind of turn in the road where it would be great if my sister were helping me. One of her jobs in to work in a hospital’s radiology department, so she has all kinds of hospital connections and could easily locate an elder-care lawyer. I would imagine, too, that the cost would be lower in Reno, NV.</p>
<p><a href=“How Can Promissory Notes Be Used in Medicaid Planning?”>http://www.elderlawanswers.com/how-can-promissory-notes-be-used-in-medicaid-planning-12289</a></p>
<p>I googled Medicaid planning promissory note and a ton of stuff came up, this was the first. Will this reading and research ever end (and yes, I know a second opinion carries much more weight than a ton of reading…)?</p>
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<p>Yes, you really do need to get a second opinion on this. Either you’ll get confirmation that the Promissory Note route is safe, or you’ll be steered away from a big problem. That’s money well spent either way. </p>
<p>ETA – Why do you have to pay for the lawyer? Why wouldn’t your mom?</p>
<p>That’s a remarkable story about your mom at the lawyer. Wow.</p>