The Part Where I Realized I Was My Clients’ Families

Back in my grandparents’ house, we decided to get the house ready for when grandma came home, because she was definitely coming home (We are Italian, after all!). We all chipped in, pulled up all the carpeting, threw out all the throw rugs, tossed some clutter, and hired Back Home Safely to install a new railing and to ensure the house was safe and functional.

Back at the rehab grandma was making progress. She was getting PT 2x/day, her vitals were regulated and after almost three months of me annoying her to push herself she was walking with a walker on her own and would even walk on her own holding my arm.  Yet again, my grandmother showed her strength, defying all the doctor’s predictions that she would never walk or even stand again. The good thing….

SHE MADE IT TO MY WEDDING!

Eric then started drafting estate planning documents since my grandparents, both age 82, did not know they needed them. He also went over all their financials (which took all of about 10 minutes since they had nothing) and advised us to apply for Medicaid to pay for grandma’s care at home.

Grandma was about to come home in need of care and they were in no position to pay for it nor accept it mentally. We had spoken to the rehab about requesting the PAS so that she would be covered for her stay in the rehab as well as the soon-to-be care at home. The PAS is an extremely important request often overlooked due to the overwhelming care responsibilities families have getting their loved one back into “good health”.

I started the Medicaid application, collecting all the documents and financials the County requested. As I stated in an earlier post, it should have been a simple Medicaid application since they had nothing left. Well…. SURPRISE, SURPRISE. We knew that my aunt was on all the bank accounts since she lived with my grandparents and helped them with the bills but didn’t know it would possibly cause a penalty. My aunt also deposited some of her money into these accounts to help contribute to the house that was titled in her name. My grandparents contributed to the mortgage and property taxes on a home they didn’t own and there was no rental agreement. My grandmother was also the sole beneficiary on my grandfather’s life insurance policy. As you can see, even seniors with no money have complicated lives. The trail is too intertwined and confusing for a lay person to navigate without the help of a trained professional.

I cleared up the confusion in this Medicaid story for the County caseworker and made my appointment to submit the application. I appeared on May 5, 2013 (Cinco de Mayo) and waited over an hour, aggravated after the case manager informed me that his staff was out celebrating the holiday. My caseworker finally returned from lunch, drunk, yes DRUNK. Thankfully, Eric was with me and handled the matter in an unemotional professional state and answered all the questions I had worked so hard to make clear for this individual.

I am Clelia Pergola, and even though I helped start Goldberg Law Group I realized that my most important lesson was happening in real time – a role reversal – I was just like my clients’ families.

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Rehab is a Term for the Entire Family

Back in my everyday life, I was working at an another eldercare law firm, where I was getting into work before anyone got in to ensure the work was being done, I was weeks away from my bridal shower and I had just, within that week of grandma going into ICU, moved out of my grandparents’ house living on my own for the first time ever. I NEVER missed a day of work yet NEVER missing a day with my grandmother. I would run to the hospital and sit by her bed side from 5:30 to 10:30 sometimes even later, because if I didn’t see her she would pass away (Italian Guilt). Weekends I would be there all day long, holding her hand and talking to her.

We were all so relieved to know Nonna could breathe on her own once again. Then she spoke, a bit raspy but nonetheless was communicating. But what did that communication entail but hallucinations and paranoia. Grandma called a family meeting, so I waited for the family to be there and facetimed my mom. Then she told us, the nurses and doctors were trying to kill her and stealing all her important documents that were hidden behind the bed. Although any other person outside the situation would see this as a red flag we as a loving devoted family said this must be just because she has just gone through so much and moved onto the kidneys failing as our next plan of attack.

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To further complicate matters, I began building Goldberg Law Group with Eric Goldberg. Although it was the most stressful time of my life, I recognized the good fortune that I had found a career that paralleled my life experiences and I sought to make a difference in the elder care world. Little did I know during that turbulent stage of my life, with my grandmother’s health hanging in the balance, that Eric and I had started building what many consider to be the most compassionate and process-driven eldercare law firm in the region.

Back at the hospital, grandma’s organs were all functioning but with a lot of assistance from all the medications she was now being given. The doctors were advising us to speak to the discharge planners to have her transferred to a sub-acute facility by the end of the week. They also informed us that she would never walk again or even stand up on her own. My family and I were devastated but we remained optimistic.

We looked into various options and decided on a 5 Star Medicare Rated facility. WELL… within less than one week she was already having medical complications because the facility was not following the treatment plan established in the hospital. So, back to the hospital she went. I then reached out to my contacts in the industry to guide me going forward. A week later, she was discharged once again to another sub-acute facility and this time we made sure we communicated with each department to ensure they were following the new orders. I visited her twice daily to help and encourage her to do her exercises.

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My bridal shower was that weekend and as expected she was unable to stand on her own. I dressed in my outfit and drove to the facility so she could see me, her only grandchild (and for all intents and purposes, her fourth child) and off to the “celebration” I went. The next morning, it was back to reality. My goal was to get her standing and walking in preparation for my wedding four short months away.

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My World Has Changed Forever

After six years of caring for my grandmother, and finally ready to tell my story, my Nonna has passed away. I started this blog to connect on a deeper level with those of you who are caregivers in the industry and also to share my experience with those who cannot imagine the challenges of caregiving. The struggles of a family caregiver are surreal in that the caregiver is both emotionally and physically involved with the loved one while attempting to stay afloat in the outside world.

Caregiving is not something one necessarily speaks about and sometimes one might not even admit that she has, in fact, become a caregiver. The unfortunate truth is that the people that once loved and cared for us will inevitably decline and need us to love and care for them. We need to make decisions, some of which are life altering or life threatening, on another life that we care so deeply about. Sounds simple, right? I mean we all know right from wrong. Wrong! When we are emotional, caught by surprise, multi-tasking, exhausted and then asked to make important decisions, we may choose the wrong path or simply be distracted from what needs to be done.

Over the last six years, Grandma went through so many ups and downs; from hospital visits, to rehabs, all types of therapy, dementia, to losing her best friend, her husband. We, as a family, stuck by her side always willing to do whatever it took to help but never realizing what she was going through since we couldn’t possibly experience her pain. To compound matters, after grandpa passed away, Grandma became mostly non-verbal so it was hard for her to communicate what she was feeling.

Six years ago Grandma was a hard working Italian woman; cooking, cleaning, and acting as an AMAZING caregiver to her kids (including myself). She never realized that she was the ultimate role model, teaching and touching so many people with her motherly ways.

Then, one morning while making the bed (because if the bed isn’t made then the room is a mess) BOOM!!! She fell. She was rushed to the emergency room with blood clots traveling to her lungs. Diagnosis: Pulmonary Embolism. The doctors did emergency surgery to save her life. She spent the next few months in a corner room in the ICU at St. Joseph’s Hospital in Paterson unresponsive and on a ventilator due to her collapsed lungs and kidney failure.

My family and I went every day to be by her side. We were convinced she was still thinking and hearing us as we noticed she would wiggle her toes in response to our questions. We all took various responsibilities whether it be to comfort her, tasks at home, doctors, finances and documenting each and every day and conversation. We focused on one organ at a time trying to juggle different parts of her body that were shutting down.

As she began to improve, the doctors told us that we needed to get her 100% off the vent so that they could pull it out and she could breathe on her own. So, we would “coach” and encourage her to breathe and breathe with her. But after two failed attempts the doctors began discussing a tracheotomy. We had no choice but to agree that if she failed one last time they would be forced to move forward with the procedure since they could not aggravate her esophagus any further. Grandma with a trach! Ughhhh. Well, they pulled out the tube one last time and miraculously she began to breathe. She had beat the odds, BUT at a grave expense. Grandma was changed forever.

I will continue the story in a few short weeks. While it is cathartic to me, I feel it is also important to tell the story, for if it helps one person to understand the challenges of caregiving or to recognize that it is truly a national epidemic it has been worth telling.

Thank you to all who have been following. I look forward to sharing.

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Clelia’s Caregiving Story Update

Last week, Clelia’s caregiver journey finally ended. Two weeks prior to her 87th birthday, Lidia Barone, “Ma,” took her last breath lying in bed surrounded by the people who loved her dearly. I watched as a family joined together in her last days waiting for the inevitable. The last two weeks were a gift to the Barone family. Due to her inability to swallow, Lidia stopped taking the medications prescribed to help ease her pain. As a result, she regained some of her clarity and began to enjoy her family again. The family cried and laughed together. They truly bonded over the undeniable loss of their matriarch. I listened as they told stories of the small Southern Italian town that is always at the center of their lives, Marano Principato.

Marano Principato, the town that draws them back to live, pushes them away, and then draws them back again time and time again. The residents of Marano Principato are both kind and untrustworthy. They are generous yet vicious. Fun yet cold. The town and its people have shaped the Barone family more than any typical place ever could.

As I looked at the dozens of photographs displayed around Lidia’s room it occurred to me that the woman lying in the nursing home bed had accomplished everything she set out to do. She married a fine man who needed to make a living. When there were no jobs in their small Italian town, they emigrated to France. From France, they moved to the United States. When they thought it best for their children, they moved back to that mystical town of Marano Principato. Then, once again it was time to leave and come back to the U.S., but only after their children reached adulthood and Olga had given birth to Clelia.

As I looked at a photo of a twenty-something Lidia Barone in France, I realized that her life must have felt like a fast train traveling through time – on board it feels like your destination is so far away, but the stops come faster and faster until the conductor cries, “Last stop. Everyone must disembark.”

Time moves swiftly. In our practice we see our clients’ wartime photos. Pictures of young men and women – strong and patriotic – not quite the confused elder needing our assistance to figure out how to pay for care. Those moments frozen in time must be cherished and not forgotten. For those are the people behind the mask of wrinkles and physical pain. Those are the people that once had hopes and dreams.

Every death is not only the end of a story, but the beginning of new chapters in a continuing saga. Where there was just Lidia and Domenico, now there are children, a grandchild, and great grandchildren. Lidia Barone may have had an interesting life filled with adventure and love, but in the end her family has only photos, memories, and lessons learned.

Did she live the American Dream or did she merely play her role in raising a good family, affecting some of the people she met along the way? We can only surmise her impact on the thousands of people that she touched, but her family is a testament to the power of one individual and what she can accomplish in 87 short years. Rest in peace, Ma.

-Eric R. Goldberg, Esq.

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Why You Need a Certified Elder Law Attorney

When you look for an attorney to help you with a special needs or elder law issue, you should look first at Certified Elder Law Attorneys near you. Why? Because they have demonstrated that they understand your legal problems, and they can help you.

The Certified Elder Law Attorney (CELA) certification has frequently been referred to as “the gold standard” for elder law and special needs practitioners. This reflects the hard work and proof required before an attorney can proudly proclaim that he or she holds the valued designation.

Preparation for a CELA designation includes several steps and several different types of qualification, all of which are designed to assure that clients receive good legal care. Before being certified, an applicant must:

Have practiced law for at least five years, and have focused at least half of their practice in the special needs/elder law field for at least the last three of those years.

Demonstrate “substantial involvement” in special needs and elder law practice, by demonstrating a minimum number of individual cases, spread across a number of different categories making up the “elder law” definition.

Study for, take and pass a rigorous, day-long written examination. Recent pass rates have been below 50% — and that is of applicants who have already met the experience requirements.

Undergo a review by peers and colleagues, focused on the applicant’s reputation for ethical and competent representation in elder law and special needs planning matters.

There are over 400 CELAs in the country, so not every community has even one person who has been certified. Your lawyer should be a CELA — it is your surest method of independently confirming that she (or he) is more than just qualified. After all, you deserve the best legal representation available.

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New Year & New Beginnings

The holidays and The New Year have come and gone and with them so many celebrations and emotions. This past weekend I celebrated my youngest son, Gino’s, 1st birthday. He was born Christmas Day and while it should have been such a happy event, it was ironically bittersweet. It was the first event that my Nonna would miss due from here on out.

I have hosted Christmas Day at my home since my eldest child, Dante, was born. Today is that day. My husband, Brandon, and I are shocked awake when Dante runs into my room, “Mommy, let’s go see if Santa ate the cookies and milk we left out for him.” We run into Gino’s room and pick him up on the way to the kitchen. The cookies and milk are gone, MAGIC! Then we run into the living room and witness Dante’s eyes light up in response to all the toys. He looks back at us in disbelief. Brandon and I smile. Dante opens all his presents and plays while I put the finishing touches on all the dishes I started two days prior, finish all the sides and appetizers, and swiftly clean the house in preparation for my family. My excitement builds.

Soon, the entire family arrives, including Nonna. Frankie and Marisa pick her up from the nursing home and bring her to the house. My dear Nonna comes in and we all say “Hi”, looking at her so very closely, almost like a mom looking at her child to detect the signs of an oncoming illness. We all hope this will be a good day with Nonna . . . but then it begins. My uncle informs us the nursing home didn’t have her ready. My aunt adds that the nursing home didn’t give her the correct medications. So now we have thoughts, concerns and actions that need to be taken care of. But we move on since it is Christmas. My impulse is always to act immediately. Today, I hope it can wait.

We sit down and eat. I had pureed food so Nonna can enjoy exactly what we are eating. She spits a lot now which I have learned is from her dementia. It’s tempting to correct her, to tell her to stop. I have learned that it doesn’t matter what I say anymore. The disease has taken over and it is slowly taking my Nonna away. We put Italian folk songs on and dance and sing in my grandfather’s memory as we do every time we get together. My mom and I run over to my grandmother grabbing her hands and waving them back and forth – a silly dance with her. She smiles and our hearts warm up. I begin to clean up. As it grows dark outside we prepare Nonna to leave. It strikes me that I may as well be dressing my toddler.

As my mother and I walk her to the front few steps I feel Nonna’s weight bearing down on my arm. I yell to Frankie to grab a chair, “She’s gonna fall!” Just in time we get her to sit on the chair half in and half out of the front doorway. I kneel down, look into my grandmother’s eyes and realize she’s getting that glazed look. I tell my family she’s losing her color. My mother cries. My grandmother begins convulsing. I sit there and hold her knowing that this will pass after she vomits. This time, she spares me this indignity. We get her inside and on the wheelchair and affix the ramp to the front stairway my mother had bought years ago thinking this time would never come. With effort, we help my Nonna into the car and Frankie drives her back to the nursing home. Once again, we now have a lot to do: We will call the nursing home so they can call a neurologist first thing tomorrow morning, question the nurses about the severity of her convulsions when we are not there, and call her other doctors to ask why this is happening. Does she have a UTI? Has something else changed? Is this an indication that her dementia is worsening?

In the meantime, we do our research as a family and find that with dementia sometimes too much activity and glimpses of memories can trigger episodes such as these. But, soon I will host the next family event, Gino’s 1st birthday. I so very much want my Nonna there to celebrate with us. We are devastated but agree as a family that we can no longer take her out of the nursing home to attend events just so we feel better about the situation. Family events have become torture for her. Now we realize that we have entered yet another chapter in this terrifying part of life.

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Congratulations to Eric R. Goldberg, CELA

With a New Year brings new beginnings.

Goldberg Law Group is proud to announce that our very own Eric Goldberg has become a Certified Elder Law Attorney (CELA). For those of you who are not familiar with this designation, it’s a big deal! To become a CELA one must:

1. Pass a rigorous full day exam comprised of 12 subjects, including: Health and personal care planning, pre-mortem legal planning, fiduciary representation, legal capacity counseling, public benefits advice, and special needs counseling.

2. Receive favorable recommendations from five other attorneys, some of which must be CELA’s.

3. Focus his or her practice on elder law, commit to continuing legal education and have substantial experience in most of the subject matters tested in the exam.

Historically, only a small percentage of applicants are accepted as CELAs. Many applicants take the exam three times before passing. Therefore, the CELA group is comprised of a tiny group of the finest and most experienced elder law attorneys in the country.

Eric and I sat down last year to discuss whether he wished to attempt this monumental and time-consuming task. He wanted to make certain that I would handle some of his duties while he studied 3-4 hours per day for months. Of course, I agreed! We decided to move forward with the application process.

In Eric’s words, “I wanted to be a CELA for two reasons: First, our practice is special. We use the most modern planning techniques combined with perhaps the most efficient and client-centric organizational structure in the elder law field. We truly want to help our clients. I wanted to add this prestigious designation to rubber stamp those attributes. Second, I wanted a reason to delve deeper into elder law – to expose myself to areas of this wonderful field that I don’t practice on a daily basis. It worked! I gained so much knowledge in the last few months that I feel it has propelled the practice further.”

Once again, we’re proud of Eric. At Goldberg Law Group we always look for ways to increase our knowledge and services to serve our seniors in the most intelligent, respectful and efficient manner possible.

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Clelia’s Caregiving Story

I will be writing periodically from my corner of the world to tell you a little about my life and the struggles I’ve seen as a caregiver. For those who don’t know, I’m a caregiver to my grandmother. My grandmother is so much like a mother to me that I call her “Ma”. She, in turn, calls me “daughter”. I’m also the lucky mother of two gorgeous little boys, Dante Domenico (three and a half) and Gino Angelo (eleven months old). I truly represent the sandwich generation!

I was born in Cosenza, Italy in 1984 in a beautiful villa, built by my family, in a small town called Marano Principato in Calabria. The view of the mountains is unparalleled. I am very lucky to have been born in this magical place and I am fortunate to call it my second home. Other than my immediate family, the rest of my family all still live there.

In the 1980’s a United States citizen was allowed to bring only one non-U.S. citizen family member to the United States at a time. My mother, who had U.S. citizenship, brought my father to establish our life here with my uncle, Zio Franco (my mom’s brother). I remained in Italy with my Nonna Lidia and Nonno Mimo (my grandparents) and Zia Marisa (my mom’s sister). I continued to attend school and chase the chickens around the property, crying and begging my grandmother not to kill them for dinner that week (haha). Zia Josephine in Paterson, New Jersey applied to be my sponsor so that I could receive my citizenship. I waited to be approved for close to one year. I then flew here with my grandparents and Aunt Marisa to live in West Paterson, New Jersey. Soon thereafter I moved to Totowa, New Jersey where I was raised and attended school.

I lived my entire life in the same house with my mom, grandma, grandpa, aunt and uncle. Even though I was an only child, my aunt and uncle were like older siblings to me, hence why I call them Marisa and Frankie. My parents separated when I was only 5 years old and my father moved back to Italy. My remaining immediate family rallied together and showered me love, affection and memories. In fact, one would say I was a bit spoiled because as the old saying goes, “If mom says no, ask grandma,” then grandpa, then Frankie, then Marisa . . . Someone was bound to say “yes”.

My mom was a single hard working mom, with no American college degree. She worked long hours while going back to school part-time to attain her bachelor’s degree. My grandparents would take me to school and pick me up; grandpa would discipline me; and grandma would spoil me rotten, cooking for me anything and everything under the sun whenever I wanted. Family members would take me back to Italy for many years to see my friends, family and continue my heritage, traditions and way of life. I even went for an entire summer with just my Nonna and Nonno and boy did I learn what it was like to be a young Americanized girl in Italy with two veryyyy strict Italian grandparents.

Needless to say, as all of you probably do, I have a ton of beautiful long lasting memories which have helped me through these last five and a half years of caregiving for my grandparents. I will share some more of these memories as you get to know me, my family and the joys/struggles of caregiving.

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What is the difference between owning a home as Tenants in Common and owning a home as Tenants by the Entirety?

Often during an estate planning process, it is often necessary to review the deeds to any real estate our client own in order to determine how assets will pass upon the client’s passing. At this time, clients often ask about the legal language used in the deed. But what do these terms mean? Although both terms sound similar, they both grant very different rights to the parties.

The terms tenants by the entirety is a form of real estate ownership that only a husband and wife can have. If the deed does not expressly use this term, then a deed that specifies the land is owned by spouses signifies the tenants by entirety relationship. This ownership grants survivorship and inseverability to the ownership. Survivorship means that upon the death of one of the spouses, the other spouse absorbs the other’s ownership interest by operation of law. Therefore, this real property will pass outside of the provisions of the spouses Will. Inseverability means that neither spouse has the authority to sever, alienate, or otherwise affect his/her share of the property without the consent of the other spouse. Additionally, since both owners are spouses, the transfer upon death to the surviving spouse is not a taxable event.

On the other hand, New Jersey Statutes dictate that unless the grantees are married, or the deed specifies a joint tenancy, a conveyance from a grantor to multiple grantees creates a tenancy in common. It is presumed that the home is owned equally with other co-owners however the deed can specify otherwise. Further, there is no survivorship feature. Therefore when one owner passes away, that owners share passes under their estate. Each owner also has the authority to sell his/her share without consent of the other owner. No single co-owner has the right to out the other co-owners from occupying the property.

Clearly, the language used in a deed is extremely important. I strongly advise an individual to consult with an attorney before transferring any real estate.

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New York Home Care Medicaid Planning

There are generally two types of Medicaid: Home care (or Community) Medicaid and nursing home (or Institutional) Medicaid. To qualify for either type of Medicaid, in New York (in 2016), an individual cannot have more than $14,850 in non-exempt assets. Exempt assets generally include, among other things, your home (provided that the equity in your home is less than $828,000) and your retirement accounts (provided that your retirement accounts are in “payout status”). Any asset that is not exempt is called an exposed asset or otherwise called a non-exempt asset or an available resource for Medicaid purposes.

Imagine the following scenario: Applicant owns a home worth about $700,000. He also has an IRA worth approximately $500,000. Applicant is currently withdrawing his Required Minimum Distributions (RMDs) from the IRA. Applicant also has a checking account with approximately $10,000 in it. Applicant’s monthly income includes his Social Security Retirement income of $1,260, pension income of $1,800, and a small other pension of $800.

Because the equity in the Applicant’s home is less than the $828,000 threshold, his home is not counted as an available resource for Medicaid purposes. Because the Applicant’s IRA is in payout status (i.e., he is withdrawing his RMDs), the IRA is not counted as an available resource for Medicaid purposes. And, finally, because the Applicant’s checking account is less $14,850, the checking account is not counted as an available resource for Medicaid purposes. This means that the Applicant is qualified for home care Medicaid.

Imagine the following modification to the above scenario: In addition to the above, the Applicant also has a $250,000 brokerage account. The home is still not counted as an available resource. Nor is the IRA or the checking account. But, the $250,000 account at UBS is not an exempt asset. In fact, it is an exposed asset and will be counted as an available resource for Medicaid purposes. What should the Applicant do if he wants to qualify for home care Medicaid?

In New York, there is no penalty period or look-back period for home care Medicaid. That’s not true for nursing home Medicaid, but that’s for a different discussion. One thing that the Applicant could do to qualify for home care Medicaid would be to create a Medicaid Irrevocable Income-Only Trust and transfer the $250,000 brokerage account into the Trust (or, some say re-title the $250,000 brokerage account into the name of the Trust).

The Applicant is the grantor (a/k/a creator) of the Medicaid Irrevocable Income-Only Trust and someone the Applicant appoints (e.g., child or children) is the Trustee (a/k/a manager). The Trust agreement provides that the Applicant gets all of the net income from the Trust, but he cannot get any of the principal from the Trust. By preventing the Applicant’s access to the principal of the Trust, we prevent Medicaid’s access to the principal of the Trust. And, since income does not disqualify anyone from Medicaid, it is safe to pay the income from the Trust to the Applicant.

And, what, you may be asking, is the income from the Trust? Income from the Trust depends on what the Trust assets are invested in. In this case, the Trust asset is a $250,000 brokerage account. In that account may be stocks, bonds, some cash, etc. So, income from the brokerage account would be dividends, interest on the bonds, interest on the cash account – in other words, whatever type of income one would normally earn on an investment account. All of that income would be paid from the Trust to the Applicant – monthly, quarterly, semi-annually, however often the Applicant wants it.

You may be also asking: what happens if the Applicant needs more than just the income from the Trust? What happens if the Applicant needs some of the principal from the Trust? Just because we said above that paying principal from the Trust to the Applicant makes that principal available to Medicaid (which it does), it is not impossible to get some portion of the principal back to the Applicant. This is where the Trustee(s) and Beneficiary(ies) come into play.

A Medicaid Irrevocable Income-Only Trust agreement generally provides that, although the Trustees cannot pay principal to the Applicant, the Trustees may pay principal to the Beneficiary(ies). Imagine the following further modification to the above scenario: In addition to the above, we know that the Trustees of the Trust are the Applicant’s two children. We likewise know that the Applicant’s two children are also the Beneficiaries of the Trust. In addition to paying the Applicant the net income from the Trust, the Trust agreement also allows the Trustees to pay to the Beneficiaries any portion they want of the principal of the Trust. This means that the Applicant’s children, as Trustees, can pay a portion (or all) of the Trust principal to themselves, as Beneficiaries, legitimately, pursuant to the terms of the Trust agreement. And, if the Beneficiaries, as the Applicant’s children, choose to give to their father, the Applicant, all or some portion of the principal they received from the Trust, then that’s their business and they do not need to explain anything to Medicaid.

So, with the Medicaid Irrevocable Income-Only Trust, the Applicant has protected the brokerage account, as follows: The Applicant transferred the brokerage account to the Trust; the Applicant will keep the same amount of income from the Trust as he had been receiving from the account before he transferred it to the Trust; none of the principal will be available to Medicaid; but, if the Applicant ever needs principal, then his children can decide at that time to give him some.

Here are a few points to consider when using a Medicaid Irrevocable Income-Only Trust:

  • A Medicaid Irrevocable Income-Only Trust-based plan should only be considered with the help of a qualified Elder Law attorney.
  • Penalty periods and look-back periods are real, but only in the world of nursing home Medicaid benefits.
  • A Medicaid Irrevocable Income-Only Trust based plan should be contemplated with great caution if there is a real risk of imminent nursing home care.

The Medicaid Irrevocable Income-Only Trust is only one tool in the Medicaid planning toolbox. If you would like to learn more about Medicaid Irrevocable Income-Only Trusts and other types of Medicaid planning, or have questions regarding the above, please contact us.

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