1. Long-Term Care Planning Seminar
Jurist Law Group, PLLC

2. “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

4. What documents are available?

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

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

7. 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

8. 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

9. How many powers of attorney are there?

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

11. 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)

12. 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

13. 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”

14. Physician Ordered Life Sustaining Treatment
“POLST”

15. 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

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

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

20. 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)

21. 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

22. 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

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

24. 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

25. 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”

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

27. 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!

28. Preserving Assets Through Gifting

29. 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.

31. Jurist Law Group, PLLC Plaza West Office Building
415 N. McKinley, Suite 1090
Little Rock, AR
(501) (office)
(501) (fax)