Long-Term Care Planning Seminar Jurist Law Group, PLLC

“It’s not enough for a great nation to have added new years to life “It’s not enough for a great nation to have added new years to life. Our objective must be to add new life to years.” John F. Kennedy

What documents are available?

Last Will & Testament Trusts (Revocable vs Irrevocable) Powers of Attorney Living Wills DNR Orders POLST HIPPA Release

Why is a power of attorney the most important estate planning document?

It enables a person (the “principal”) to appoint another person (the “agent”) to handle a wide variety of powers and duties should the principal become incapacitated

John Kenneth Galbraith If wrinkles must be written upon our brows, let them not be written upon the heart. The spirit should never grow old. John Kenneth Galbraith

How many powers of attorney are there?

Several different types of Powers of Attorney General Springing Durable Financial Health care Limited (Specific Purpose)

Durable Power of Attorney Effective for life Unless revoked by the principal All are presumed durable unless specifically stated otherwise Automatically revoked at death incapacity (unless durable) at divorce (when spouse named)

Durable Power of Attorney Drawbacks No guarantee a third party will honor it i.e. Banks or brokers Social Security Doesn’t Accept VA Doesn’t Accept

Springing Power of Attorney Effective only upon the principal’s incapacity Incapacity must be conclusively established Should contain a clear definition of the term “incapacity”

Physician Ordered Life Sustaining Treatment “POLST”

POLST More specific orders from the physician For inpatients Copies and faxes can be used Original encouraged HIPAA permits disclosure of POLST to other health care professionals as necessary

POLST Covers CPR Medical interventions Antibiotics Artificially administered nutrition Summary of medical conditions Signature of physician

How does all of this tie in with long-term care planning?

What is Long-Term Care Planning? The process of planning for your future should you require long-term care It’s about getting the best care in the least restrictive environment while protecting (not “hiding”) your assets for your spouse and future generations (not hiding)

How your power of attorney is prepared has an effect on what your agent can do to protect your assets should you ever need long-term care

Arkansas Average Nursing Home cost is $67,000 a year Arkansas Average Nursing Home cost is $67,000 a year! How do you pay for long-term care? Out of pocket Long-term care insurance and other private medical insurance Medicare Medicaid Veteran’s Benefits

VA Aid & Attendance Married Veteran $26,028 Single Veteran $21,960 Married w/Sick Spouse $17,232 Surviving Spouse $14,112

Income and asset limitations Exempt vs. Non-exempt Nursing Home Medicaid (AR Choices for in-home care or Assisted Living where accepted) Income and asset limitations Exempt vs. Non-exempt Transfer of Assets Rules 5 year “look-back” period Ineligibility period of 1 month for every $5,493 transferred ARChoices: absolute bar for any gift made in last 5 years

Married Couples Gather countable assets for both Then divide in half Community spouse gets to keep half Maximum $123,600 Minimum $24,720 Other half may be “spent down”

Is a married couple required to spend down one half of their assets before they qualify for Medicaid? Simple Answer is YES

Will I lose my home? Home is an exempt asset until you pass away Medicaid estate recovery will file a claim in probate against you home!

Preserving Assets Through Gifting

Can I still give assets away to protect them from long-term care even if I’m already in a nursing home? Yes… But remember, there is a one month ineligibility or waiting period for Medicaid of about one month for every $5,493 gifted.

Jurist Law Group, PLLC Plaza West Office Building 415 N. McKinley, Suite 1090 Little Rock, AR 72205 (501) 400-8250 (office) (501) 400-8190 (fax) info@juristlawgroup.com www.juristlawgroup.com