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Planning for Long-Term Nursing Home Care


As people age, many face the realization that a time may come when they will no longer be able to care for themselves due to physical or cognitive issues. A skilled nursing home, whether for a few months or indefinitely, may be necessary if daily medical care is required. This realization can be difficult to accept, and it would be easy to avoid the decision until the situation is critical. However, by being proactive and planning for this issue before placement is necessary, an individual retains control over the facility in which he/she is placed, and allows for proper financial and legal planning so the family is not left scrambling to figure how to deal with the expenses. With advance planning, it is often possible to minimize the personal cost of care, and secure many assets and/or income for the needs of the at-home spouse or even for other family members.  Without proper advance planning everything a person has worked for and saved may be consumed rapidly, leaving nothing for the family. While not easy to contemplate, advance planning and formulating a strategy for potential nursing home care is important. This approach allows an individual to put the correct financial plan in place, and to prepare and sign appropriate advance decision-making directives so that the best arrangements can be implemented if/when this time comes. A discussion of the financial and healthcare issues related to the long-term care of anyone over the age of 65, follows below.

Financial Planning

Few people have the financial resources to pay the annual expense of nursing home care, which, on average, can reach almost $88,000 for a semi-private room. Ordinary health insurance policies don’t typically cover any nursing home stays, and traditional Medicare only covers individuals for needed skilled nursing care, at 100%, for a maximum of twenty (20) days following discharge from a 3-day hospital stay.  If a longer stay is necessary, or if the care is deemed to be “custodial,” most individuals will have to use personal funds to pay the nursing home bill.  It is often possible to obtain assistance from the Medicaid Institutional Care Program (ICP). However, Medicaid has complex federal and state income-qualifying restrictions and asset limits that must be met in order to be eligible.  Not all assets are countable, such as a person’s home, but even after excluding the assets that are not countable, there may still be amounts that exceed the program limits and prevent eligibility.  A qualified elder law attorney can often help to formulate and implement a plan to preserve assets and still enable the individual to qualify for the Medicaid program and receive financial assistance.  This typically requires the preparation of various legal documents, such as Deeds, Contracts and Powers of Attorney, and these must be carefully prepared to explicitly allow the designated agent to engage in those actions that may be required to achieve Medicaid eligibility.  Proper advice from an elder law attorney can also help to avoid costly mistakes that may substantially delay eligibility.

Planning Your Medical Treatment

In addition to financial planning, it is equally important to leave comprehensive advance directives on who will have the authority to make healthcare decisions, and the type and extent of medical intervention that should occur, especially for end-of-life issues. These matters are principally addressed in Health Care Directives, Organ Donor Agreements and Living Wills.  These documents help immensely to provide legal access to medical records and to enable communication with medical professionals.  And, of course, these legal documents help to eliminate confusion, misunderstandings and possible disagreements among family members. Advance medical directives provide reassurance to your family members that your medical decisions are being implemented as you have chosen.

Consult a Florida Elder Law Attorney

The value of giving loved ones the peace of mind that their long-term care is covered cannot be overstated. These issues are complex, and family discussions may be difficult.  Nevertheless, they are essential.   An elder law attorney can provide can greatly assist by answering your questions, providing invaluable advice, eliminating uncertainty, and preparing important legal documents.  Elder law attorney William Rambaum understands how overwhelming these issues are, and is available to support and guide you on planning as you age. We serve clients in the Clearwater and Oldsmar area; contact the office today to schedule an appointment.



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