Ohio Legacy Asset Protection Trusts

There are certain types of trusts that a person can create to protect their estate from lawsuits, bankruptcy, divorce settlements, government expropriation and other creditor claims against their property. Many persons have what is commonly referred to as a revocable living trust. These are usually set up in order to avoid probate. However, this type of trust offers no creditor protection. Traditionally, a person could not set up their own trust for their benefit and at the same time protect their estate from creditors. Trust law prohibited this type of trust. However, this has changed in many states.

Ohio is one of those states that has a special statute permitting a person to create this type of trust. The Ohio Legacy Trust Act was passed effective March 27, 2013 adding new provisions for the creation of an asset protection trust. The Ohio version of a domestic asset protection trust is known as an “Ohio Legacy Trust.” It is one of the best statutes in the country of this type. There are many other details that I can’t cover in this short biog. One important detail to be aware of is that you must plan ahead and create this trust prior to any actual creditor claims or other legal actions against you. The law prohibits any type of transfer of property to this trust if you have a pending creditor claim. As with all other estate planning, it is important to plan ahead.

Can You Visit Nursing Home Residents After They are Vaccinated?

COVID vaccines are starting to roll out to nursing homes across the country, signaling the beginning of the end of the pandemic. Once your loved one has had both doses of the vaccine, you may be able to visit, but precautions are still necessary.

The federal government entered into a partnership with CVS and Walgreens to deliver the vaccines to nursing home residents, who have high priority for being vaccinated, according to the Centers for Disease Control and Prevention (CDC) guidelines. The pharmacy companies began administering vaccines in 12 states in mid-December and will expand to 36 states before year’s end. Both the Pfizer the Moderna vaccines require two shots three or four weeks apart.

Restrictions on nursing home visitors vary from state to state, with some states limiting them and others allowing more visitation. Currently, the CDC recommends that nursing homes allow indoor visitors if the facility has had no COVID cases for 14 days. Once vaccines have been distributed, restrictions may ease further.

According to the New York Times, experts recommend that to be safe, you should wait until two weeks after your loved one gets the second dose of the vaccine before visiting. The safest time to visit would be after all the residents and staff have been vaccinated and you receive the vaccine as well. Even if you and your loved one are vaccinated, you should still wear a mask when visiting. As long as COVID is spreading in the community, mask wearing is still recommended.

Noting that the vast majority of older adults with chronic conditions live at home, long-term care consultant Howard Gleckman asserts that these vulnerable adults along with their caregivers should also be vaccinated as soon as possible. As states ration their limited initial supplies of the vaccines, Gleckman says, “they should remember the millions of people who are at high risk of severe illness or death from the virus, but who are living at home.”

For more information about the vaccine rollout to nursing homes, click here and here.

Thanksgiving during COVID

This is a difficult time for us to continue to balance COVID-19 safety protocols & government restrictions with spending time with our families and loved ones. The CDC has issued some guidelines for celebrating Thanksgiving :
https://m.emailupdates.cdc.gov/rest/head/mirrorPage/@lIie1UBTdMtWe9u7NFnRaoqgvmZv-N5jV6fmPS2nYOQXVIPyuiVz9uULj_TGPOZSg-G–UIZHBdxY-xmVVBRTO7q0jrfS1VkJRnfxjMYMBm5F1d5.html

The National Consumer Voice for Quality Care is an organization that is an advocate for nursing home residents and their families. They have also issued some specific guidance related to nursing home residents:

https://act.theconsumervoice.org/site/MessageViewer?dlv_id=6827&em_id=3465.0

Have a safe and happy Thanksgiving holiday.

 

Asset Protection with Trusts

Clients often ask me about protecting their estate. Sometimes they are not specific and I have to ask them: Who or what do you want to protect your estate from? Often the reply is something vague about the government or taxes. After some discussion, we usually narrow this down to the following risks:

1. Protecting your estate from the cost of nursing home care.
2. Avoiding probate.
3. Protecting against lawsuits.
4. Protecting against possible civil unrest or major changes to our political, tax or legal system.

All of these financial risks are valid concerns but require a client discussion of the potential risk and the client’s risk tolerance. There are many persons who have lost their hard earned life savings or their business because they did not plan for one of these events.

There are certain types of trusts and other legal arrangements that can accomplish protection against all these threats to preservation of your estate. However, especially with respect to items 3 & 4 above, you must do this planning prior to any actual lawsuit or government action. There are laws that will prevent you from successfully implementing this type of planning if the government or a creditor has already taken action against you. Legal planning in advance is essential for a successful estate plan to protect your estate.

MEDICAID ELIGIBILITY FOR NURSING HOME RESIDENTS

Thursday, November 18, 2020 @ 8:45 AM – 12:00 PM
and Wednesday December 9 2020 @ 8:45 AM – 12:00 PM
via ZOOM online of course

This seminar has been approved for 3 CEU’s for Licensed Social Workers & Counselors. This is not a consumer oriented seminar. The intended audience is nursing home and other personnel who work with residents applying for Medicaid eligibility. This seminar will focus on Medicaid eligibility from the point of view of the nursing facility. It will not focus on planning techniques to preserve assets and achieve Medicaid eligibility. The objective is to provide information, tips and relate the experience of Michael J. Millonig to assist nursing homes in avoiding problems with Medicaid applications.

TUITION: Tuition is $40 for persons requiring credit if pre-registered and paid two business days prior to the day of the seminar. Registration on the day before or the day of the seminar is $60.00. COVID-19 special: If you do not need Licensed Social Workers & Counselors CEU credit, there is no charge. However, you must register. Please send a check for $40.00 via U S Mail to Michael Millonig LLC, Attn: Medicaid CE Seminars, 7929 Washington Woods Drive, Dayton, Ohio 45459-4026.

November 18 Zoom registration link:

https://zoom.us/webinar/register/8516040660756/WN_jORW2WfUQ3CrEXgaXsLoRA

December 9 zoom registration link:

https://zoom.us/webinar/register/8316040662131/WN_nB6W7TKOTqaPm1DHhvCXBA

Medicare Open Enrollment Starts October 15: Is It Time to Change Plans?

Medicare’s Open Enrollment Period, during which you can freely enroll in or switch plans, runs from October 15 to December 7. Now is the time to start shopping around to see whether your current choices are still the best ones for you.

During this period you may enroll in a Medicare Part D (prescription drug) plan or, if you currently have a plan, you may change plans. In addition, during the seven-week period you can return to traditional Medicare (Parts A and B) from a Medicare Advantage (Part C, managed care) plan, enroll in a Medicare Advantage plan, or change Advantage plans.

Beneficiaries can go to www.medicare.gov or call 1-800-MEDICARE (1-800-633-4227) to make changes in their Medicare prescription drug and health plan coverage.

According to the New York Times, few Medicare beneficiaries take advantage of Open Enrollment, but of those who do, nearly half cut their premiums by at least 5 percent. Even beneficiaries who have been satisfied with their plans in 2020 should review their choices for 2021, as both premiums and plan coverage can fluctuate from year to year. Are the doctors you use still part of your Medicare Advantage plan’s provider network? Have any of the prescriptions you take been dropped from your prescription plan’s list of covered drugs (the “formulary”)? Could you save money with the same coverage by switching to a different plan?

For answers to questions like these, carefully look over the plan’s “Annual Notice of Change” letter to you. Prescription drug plans can change their premiums, deductibles, the list of drugs they cover, and their plan rules for covered drugs, exceptions, and appeals. Medicare Advantage plans can change their benefit packages, as well as their provider networks.

Remember that fraud perpetrators will inevitably use the Open Enrollment Period to try to gain access to individuals’ personal financial information. Medicare beneficiaries should never give their personal information out to anyone making unsolicited phone calls selling Medicare-related products or services or showing up on their doorstep uninvited. If you think you’ve been a victim of fraud or identity theft, contact Medicare.

Here are more resources for navigating the Open Enrollment Period:

Medicare Plan Finder, which helps you find a plan to match your needs: www.medicare.gov/find-a-plan
Medicare coverage options: https://www.medicare.gov/medicarecoverageoptions/
The 2020 Medicare & You handbook, which all Medicare beneficiaries should have received. The handbook can also be downloaded online at: medicare.gov/forms-help-resources/medicare-you-handbook/download-medicare-you-in-different-formats
The Medicare Rights Center: www.medicareinteractive.org
Your State Health Insurance Assistance Program, which offers independent counseling: https://www.shiptacenter.org

Medicare May Not Cover the Coronavirus Vaccine After All

While Medicare would cover a coronavirus vaccine approved through normal channels, if the Food and Drug Administration approves the vaccine through an emergency use authorization (EUA), Medicare will not cover it unless the government acts.

As we previously reported, the CARES Act provides that if a COVID-19 vaccine becomes available, Medicare is required to cover this vaccine under Part B with no cost sharing. Medicare Advantage plans are required to include the basic coverage offered by Medicare Parts A and B, so this coverage also applies to beneficiaries in Medicare Advantage plans.

However, it is possible that the federal government will authorize the use of the vaccine through an EUA, which is a faster method of approving drugs needed in a crisis situation, like the coronavirus pandemic. Medicare does not cover costs of vaccines approved under EUAs.

In order to ensure that the vaccine is free, the government will need to act. One option is that Congress could change the language in the CARES Act to ensure coverage. In addition, doses purchased by the federal government will be free of charge.

Michael Millonig selected for Best Lawyers in America- Elder Law

Michael J. Millonig has been selected for inclusion in the 27th Edition of The Best Lawyers in America in the practice area of Elder Law. Inclusion in Best Lawyers is based on a rigorous peer-review survey comprising a total of more than 9.4 million confidential evaluations by top attorneys across the nation. This rankling is reserved for the top 5% of private practice attorneys nationwide. For more information see  https://www.bestlawyers.com/ Michael has also been Certified as an Elder Law Attorney by the National Elder Law Foundation since 1998, is an OSBA Board Certified Estate Planning, Trust and Probate Specialist and a member of the National Academy of Elder Law Attorneys since 1991. The practice of elder law includes preparation of wills, trusts, powers of attorney, living wills, probate, guardianships, planning for special needs children, asset protection planning from lawsuits and protecting estates from nursing home costs.

Which Nursing Home Rating System Should You Trust?

Choosing a nursing home for a loved one is a difficult decision and it can only be made more confusing by the various rating systems. A recent study found that using both Medicare’s Nursing Home Compare site and user reviews can help with the decision making.

The official Medicare website includes a nursing home rating system. Nursing Home Compare offers up to five-star ratings of nursing homes based on health inspections, staffing, and quality measures. See https://www.medicare.gov/nursinghomecompare/search.html However, Medicare’s rating system is far from perfect. The staff level and quality statistics ratings are based largely on self-reported data that the government does not verify. The ratings also do not take into account state fines and enforcement data or consumer complaints to state agencies. Nursing homes have learned how to game the system to improve their ratings.

While Nursing Home Compare doesn’t include consumer feedback, Yelp and other online platforms like Facebook, Google, and Caring.com allow users to review individual nursing homes. These user reviews are highly subjective, and it can be difficult to judge their legitimacy. These reviews are not usually taken seriously–for example, consumer guides to finding a nursing home do not usually suggest that consumers consult online reviews. (It should be noted, however, that Caring.com goes to great lengths to ensure the integrity of its reviews, including having senior care experts read every submission before publication.) See https://www.caring.com/about/review_guidelines/

In order to better understand what consumers were saying about nursing homes online, researchers at the University of Southern California evaluated 264 Yelp reviews and grouped them into categories. The researchers found that consumers rate different aspects of nursing home care than does the official rating system. User reviews were more emotional and more likely to focus on staff attitudes and responsiveness rather than on the quality of health care. See https://academic.oup.com/gerontologist/article/58/4/e273/4980329

The researchers concluded that user reviews can be used in conjunction with the Nursing Home Compare site to paint a fuller picture of life at the nursing home because they present complementary information. According to the study, online reviews shouldn’t be dismissed because they “directly capture the voices of residents and family members, precisely the kind of information nursing homes and their consumers need to hear and may want to act on, if resident-directed care is to be achieved.”

Yelp has gone a step further than other consumer review sites and has teamed up with the investigative news organization, ProPublica, to provide users with additional information. ProPublica’s Nursing Home Inspect site, allows users to compare nursing homes based on federal data. Yelp users viewing a nursing home review page see a ProPublica box that provides information on the nursing home’s deficiencies and fines.

To read an article about the study, See
https://www.nytimes.com/2018/05/11/health/nursing-home-ratings-yelp.html

Profile of Older Americans

A report tiled the 2019 Report on Older Americans was just released by the Administration on Aging (AoA), part of the Administration for Community Living, an operating division of the U.S. Department of Health and Human Services. Some of the many interesting facts revealed are:

1. Over the past 10 years, the population age 65 and older increased from 38.8 million in 2008 to 52.4 million in 2018 (a 35% increase) and is projected to reach 94.7 million in 2060.

2. In 2018, older women outnumber older men at 29.1 million older women to 23.3
million older men.

3. A larger percentage of older men (69%) were married as compared to older women (47%). In 2019, 31% of older women were widows.

4. The need for caregiving increases with age. In 2018, the percentage of older adults age 85 and older who needed help with personal care (21%) was more than twice the percentage for adults ages 75–84 (8%) and five times the percentage for adults ages 65–74 (4%).

5. The 85 and older population is projected to more than double from 6.5 million in 2018 to 14.4 million in 2040 (a 123% increase).

6. There were 93,927 persons age 100 and older in 2018 – almost triple the 1980 figure of 32,194.

7. The older population is expected to continue to grow significantly in the future. Growth slowed somewhat during the 1990’s because of the relatively small number of babies born during the Great Depression of the 1930’s. But the older population is beginning to burgeon again as more than one-third (36%) of the “baby boom” generation is now age 65 and older.

8. The population age 65 and older increased from 38.8 million in 2008 to 52.4 million in 2018 (a 35% increase) and is projected to reach 94.7 million in 2060. By 2040, there will be about 80.8 million older persons, more than twice as many as in 2000.

The full report is available at
https://acl.gov/aging-and-disability-in-america/data-and-research/profile-older-americans