Boston Estate Planning and Probate Lawyer & Attorney : Gosselin & Associates Law Firm : Serving Boston, Winchester, Hingham, Wellesley, Manchester

I admire Roto Rooter. Few other businesses are so financially successful using a single tool - such as the spiraling drain cleaning tool. As an elder law and Medicaid attorney in Massachusetts I am starting to feel like Roto Rooter. New Medicaid regulations and qualifications have made it nearly impossible at the time of nursing home admission to protect an elder's assets. Despite the strict guidelines and pre-planning requirements of the Deficit Reduction Act and interim state and federal regulation, we are still winning the battle of family asset protection.

 Of course, our one tool in Massachusetts is the Medicaid Qualifying Immediate Annuity, also called Single Premium Immediate Annuity (or SPIA). These annuities are quite simple, the Medicaid applicant or their community spouse contributes a lump of funds to an annuity account with an insurance company and the insurance company returns the money to the annuitant over a fixed period of time consistent with their life expectancy under the HCFA life expectancy tables. When the annuitant dies then either the family or the Commonwealth of Massachusetts Division of Medical Assistance gets the remaining funds depending on very specific rules.

 But there are several other options for elders and their families facing long term care financing and Medicaid qualification. There is an exception for the principal residence where the nursing home resident's spouse is still living in the home. This exception also applies to siblings, minor, blind or disabled children. The other major exception is for children who are caregivers for their parents (the "caregiver exemption") in the two years prior to the elder's nursing home admission.

 From an estate planning perspective and for non-real estate assets, our choices are more limited. Besides the Medicaid Annuity, Special Needs Trusts can also be used without disqualification for anyone in the Medicaid applicant's family. Disqualification for Medicaid is the term used by the Massachusetts Division of Medical Assistance (MassHealth) to describe the time period for which a Medicaid applicant or nursing home patient is ineligible for Medicaid benefits.

 Of course, advance estate planning can solve a lot of these Medicaid qualification issues. Generally, if an elder client is in good health,  under 80 years of age and has the wherewithal to pay annual premiums, then Long Term Care Insurance is a great option. Premiums can be costly on a cash basis, but I have never had an elder law client who had has a claim with her Long Term Care Insurance company complain about the benefits. The benefits are generally cash payments for home care and nursing home care. Many people call Long Term Care Insurance "nursing home insurance," but it is really much more than that as it also includes a home- care benefit.

 With the same foresight as an insurance applicant, elder law clients at Gosselin Law are often advised when they are healthy (or as I like to say "when you are still buying green bananas") to set up irrevocable trusts that preserve the step-up in tax basis and remove the elder law client's assets from inclusion in their resource calculation by MassHealth. The "trick" is that after setting up and funding these types of Medicaid trusts, the elder is not elegible for Medicaid for five years. At one time the waiting period was much shorter on transfers and trusts, but now, it is a uniform five years before the trust's Medicaid "protections" kick in.

That's about it for asset protection and Medicaid qualification. Whatever you do, do not apply for Medicaid without speaking with an elder law attorney, no matter how much the nursing home pushes you to sign papers or an application company, such as Medi-Services encourages you to 'just get it done' - keep your pen in your pocket until you speak with an elder law attorney. If you are facing the spectre of paying the outrageous costs of a Massachusetts nursing home from your own funds, please call Gosselin Law for a free telephone consultation to review your Medicaid asset protection options. Our phone number is (toll free) 877-325-6746 or 781-729-0313. We have offices throughout Massachusetts (Boston, Hingham, Wellesley, Winchester and serve Amherst, New Bedford, Barnstable and Pittsfield through satellite and in-home appointments.

 

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I admire Roto Rooter. Few other businesses are so financially successful using a single tool - such as the spiraling drain cleaning tool. As an elder law and Medicaid attorney in Massachusetts I am starting to feel like Roto Rooter. New Medicaid regulations and qualifications have made it nearly impossible at the time of nursing home admission to protect an elder's assets. Despite the strict guidelines and pre-planning requirements of the Deficit Reduction Act and interim state and federal regulation, we are still winning the battle of family asset protection. If you are facing the spectre of paying the outrageous costs of a Massachusetts nursing home from your own funds please call Law for Life for a free telephone consultation to review your Medicaid asset protection options. Our phone number is (toll free) 877-325-6746 or 781-782-6000. We have offices throughout Massachusetts (Boston, Hingham, Wellesley, Winchester and serve the Worcester, Springfield, New Bedford/Fall River, Barnstable and Pittsfield areas through satellite and in-home appointments.

Often our only tool in Massachusetts is the Medicaid Qualifying Immediate Annuity, also called Single Premium Immediate Annuity (or SPIA). Although pooled income trusts have their place, we are not convinced that they will be available much longer as an emergency planning tool. These annuities are quite simple, the Medicaid applicant or their community spouse contributes a lump of funds to an annuity account with an insurance company and the insurance company returns the money to the annuitant over a fixed period of time consistent with their life expectancy under the HCFA life expectancy tables. When the annuitant dies then either the family or the Commonwealth of Massachusetts Division of Medical Assistance gets the funds depending very specific rules.

But there are several other options for elders and their families facing long term care financing and Medicaid qualification. There are exception for the principal residence where the nursing home resident's spouse is still living in the home. Same with siblings, minor, blind or disabled children. The other major exception is for children who are caregivers for their parents (the "caregiver exemption") in the two years prior to the elder's nursing home admission.

From an estate planning perspective and for non-real estate assets, our choices are more limited. There is the Medicaid Annuity (for which Law for Life is recognized as a Massachusetts source for the design and implementation of annuity based plans), but also the use of Special Needs Trusts that can be establish without disqualification for anyone in the Medicaid applicant's family. Disqualification for Medicaid is the term used by the Massachusetts Division of Medical Assistance (MassHealth) to describe the time period for which a Medicaid applicant or nursing home patient is ineligible for Medicaid benefits.

Of course, advance estate planning can solve a lot of these Medicaid qualification issues. If an elder client has good health, is generally under 80 years of age and has the wherewithal to pay annual premiums then Long Term Care Insurance is a great option. Premiums can be costly on a cash basis, but I have never had an elder law client that went on claim with Long Term Care Insurance complain about the benefits. The benefits are generally cash payments for home care and nursing home care. Many people call Long Term Care Insurance "nursing home insurance", but it is really much more than that as it includes a home care benefit that can be even more important to elders in need of services.

With the same foresight as an insurance applicant, elder law clients at Law for Life are often advised when they are healthy (I like to say "when you are still buying green bananas") to set up irrevocable trusts that preserve the step-up in tax basis and remove the elder law client's assets from inclusion in their resource calculation by MassHealth. The "trick" is that after setting up and funding these types of Medicaid trusts, the elder cannot qualify (or apply) for Medicaid for five years. At one time the waiting period was much shorter on transfers and trusts, but now it is a uniform five years before the trust's Medicaid protections kick in.

That's about it for asset protection and Medicaid qualification. It is imperative to speak with a competent elder law attorney such as us experts at Law for Life (our phone number is 781-782-6000 or toll free at 877-325-6746) regarding your personal situation as the regulations are very complex and change often during the year. Whatever you do, do not apply for Medicaid without speaking with an elder law attorney, no matter how much the nursing home pushes you to sign papers or an application company, such as Medi-Services encourages you to 'just get it done' - keep your pen in your pocket until you speak with an elder law attorney.

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The call came like all the others, a middle aged woman looking for help in navigating the maze of rules and regulations between bringing her father from his home of many years to what he always called "the waiting room", waiting to die of course.

She explained that she and dad had been together for 43 years since her mother died in a car accident when she was just 8. Dad's spirit was so crushed that his only daughter could not consider another choice - she needed to dedicate her life to caring for her depressed father. He did work, had saved some money, paid for the house, but not much was left after paying for nurse's aides, hospital beds and special medications. The only real monetary value was in the house which had a reverse mortgage put on years ago that has eaten away the home's equity along with a rapidly declining market. The house was ordinary with yellowed walls from the years of dad's smoking two packs of cigarettes a day.

In virtually all cases we are able to establish a Medicaid asset protection plan to conserve assets for the family - and not the nursing home. But here it was quite different. You see, the daughter was terminally ill with lung cancer and COPD, despite never putting a cigarette to her lips, but her devotion to her heavy smoking father came not only with the obvious prices of missed career, romance and a family of her own, but her very health. Dad was still in reasonably good health, driving to his Knights of Colombus meetings, taking in a Red Sox game at Fenway with a close friend from time to time, even driving to Mohegan Sun and Foxwoods from time to time to let it ride.

Since the daughter can no longer care for her father's daily needs (and he has been so conditioned to be waited on hand and foot so as to be completely incapable of doing household tasks for himself), she asked me to place him in a nursing home for the rest of his life since she herself needed nursing and hospice care. As I explained on the telephone that while nursing homes can accept anyone for residency and that MassHeath (the Massachusetts Medicaid service) can provide a myriad of taxpayer paid services, her father would not be eligible because he was not sick or even incapable of caring for himself, that unless they were to private pay, there would no way for him to be admitted to a nursing home.

The quietest moment of my legal career ensued.

The point here is that Medicaid qualification requires both financial qualification, which we hear about all the time, but also medical qualification. The state has in recent months not approved long term medical qualifications, but rather limited 90 day approvals are showing up more and more often. The consequence is ongoing reviews of patients who are clearly qualified for long term care - a true waste of already limited resources. The moral of this story and similar situations is to review potential calamity before things become a crisis. The crisis in this client's situation will result in the use of all the home equity to provide in-home services and a diligent search by A Place for Mom to find an appropriate PACE Assisted Living Placement with and Aid and Attendance Veteran's benefit. Law for Life is singularly focused on the needs of elders and their families in identifying and obtaining the most cost effective and financially conservative course of action possible.

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(From The Boston Globe) The cost of nursing-home care has risen 17 percent across the country over the past five years, a new survey shows. While the rate of increase was slightly lower in Massachusetts at 16 percent and even lower in Boston at 10 percent, the cost of care in Massachusetts was still well above the national average. One year in a nursing home private room costs $109,396 in Boston and $106,321 in other parts of Massachusetts. That compares to the national average of $76,460, according to the Cost of Care Survey conducted by Genworth Financial, a company based in Richmond, Va., that sells long-term care insurance. Alaska has the most expensive care, at $187,902, followed by New York City at $145,392. Connecticut is also more expensive than Massachusetts, at $119,678. The annual survey of long-term care also looked at the cost of assisted living, hourly home care, and adult day health care. In Boston a one-bedroom unit in an assisted-living facility cost $54,052 per year, in the rest of the state it cost $46,440, and an average of $36,090 in the rest of the country. Alaska again topped the list, at $54,809. The hourly rate for a home health aide was $23.40 in Boston, $22.41 outside Boston, and averaged $19.18 across the country. Adult day health care is a spot of moderation in Massachusetts. Five days a week cost $15,337 a year in Boston, $14,009 in the rest of Massachusetts, and an average of $15,236 nationally.

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Whenever I meet with a new estate planning client I like to take the time to know what brought them to finally sit down and plan the disposition of their assets at death (what many people call 'getting my affairs in order' or 'getting my will done'). Some decide to get their will done because of some event in their lives, a new baby, a new marriage, a new divorce, a recent death, an inheritance; while others have much more unexpected reasons for finally getting it all in writing.

For example, I met a client once who had an overwhelming fear that her grandmother's china collection would be separated at her death that she made elaborate provisions for it in a trust (I don't think she ever actually ate on it!). Another client came to me because they intentionally wanted to make the probate process miserable for their heirs, looking to me to make the most complex and inefficient plan possible so her estranged family would have great difficulty in getting at her property through the Probate Court (needless to say we sent her elsewhere for her tormenting plan). Yet other clients are motivated, even upon their deaths, by nothing more than saving money on taxes - what I call making Uncle Sam a lesser heir to your estate. I guess it is good to do what's legal to reduce your estate taxes, but some folks are more worried about the savings in tax than protecting spendthrift kids from them summarily blowing their increased inheritances. We are seeing more and more people getting their estate planning done, not to avoid probate or reduce estate taxes, but to protect their pets. I guess pets are people, too.

Whatever the reason to getting an estate plan done, it's truly the action of taking the steps necessary to complete a plan that matter, as without proper planning,  incapacity or death can have many unintended consequences. GosselinLaw.com >

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One of the most misunderstood words in the legal profession is trust. I am talking about a trust, the legal document. Many people can describe to me what a trust does ("it avoids taxes", "it keeps things secret", "it allows me to tell my son what to do with my money", "it manages my money", etc.) Few people actually see the essence of what a trust is, and what it is not.

Black's Law Dictionary defines a trust as "a right of property, real or personal, held by one party for the benefit of another." Or, "an obligation arising out of a confidence reposed in the trustee or representative, who has the legal title to property conveyed to him, that he will faithfully apply the property according to the confidence reposed, or, in other words, according to the wishes of the grantor of the trust." Well, that's a lot of help. I like to think of trusts as nothing more than "instructions". The person making the trust instructs the trustee to do something for the benefit of another person (the beneficiary). Try the exercise of replacing the word 'trust' with the word 'instructions' and I think you'll see how simple it can translate legal jargon. Trusts are really the modern equivalent of wills a generation ago. They are affordable, flexible, can avoid probate, reduce will contests and protect your family from a myriad of legal problems. Some types of trusts can even help you qualify for Medicaid as part of a comprehensive Massachusetts elder law plan.

Although trusts come in many different flavors and styles, the core element is protection of assets and ease of management. Some countries, most notably France, have no legal identity for trusts. Even the term 'trust' can't be easily translated into French, because there is no legal equivalent. As a result it can be very difficult for trusts to acquire property in France or otherwise conduct business as they are not recognized as separate legal entities. Although the concept of a trust may exist in other countries as a practical matter trusts are only used by the super rich and powerful. During the middle of the 20th century, as U.S. banks and trust companies became more competitive to offer services to a burgeoning (upper) middle class that came about after World War II, trusts became more available. In sum, a good written set of instructions left in the hands of a good person is your best defense against an unwanted outcome upon your incapacity or death. Trusts fit the bill. Let one of Law for Life's experienced trust and estate planning attorneys help you with your personal trust planning. Call them at Gosselin Law at 781-729-0313.

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The death of emergency Medicaid planning is official. Let us mourn the techniques of the estate planning and elder law bar that allowed elders to qualify for Medicaid benefits despite having significant assets. Due to the Deficit Reduction Act of 2005 (passed in 2006) most planning opportunities now involve five year plans and more complex trust instruments. While we are still working on these more complex trusts, including irrevocable trusts, intentionally defective grantor trusts and the like; the demand for our services at the time of Medicaid application has diminished markedly. Despite the law change in Massachusetts (and Federal law), there are still steps we can take for asset protection for elders at the time of application including promissory notes, certain annuities and special needs trusts for certain family members - Medicaid planning is not entirely hopeless, but the best opportunities for elder law attorneys have been signed away by the governments lawyers and Congress. So, what is a lawyer to do?

We are not the type to passively sit by as other lawyers eat our lunch. We have been working diligently for the past several months re-tooling the asset protection aspects of our law firm to be more directly focused on the asset protection needs of high and ultra high net worth individuals who are concerned with protecting assets from all types of judgment creditors. This planning involves the use of trusts, corporate entities and legal jurisdictions where the laws favor the protection of assets (in exchange for bringing new cash to places perhaps not normally thought of as centers of the legal or financial world - like Nevada and Alaska).

In the coming weeks I will be participating in significant training and axe sharpening programs to help make sure that our law firm is on the cutting edge of asset protection, not only in the US but also in cooperation with certain off-shore legal jurisdictions where certain planning can be beneficial for particular clients. I leave shortly for a conference in Las Vegas where the Nevada trust industry will woo my estate planning asset protection attention. In a nutshell, asset protection involves transferring legal ownership of assets to another person, in most cases this person is a trustee and under the various state laws (such as Nevada asset protection law) at least of these trustees must be a Nevada trust company. By so transferring the legal ownership, as well as structuring the language and documentation of the trust so that it conforms with state law, you can achieve protection from certain types of creditors over time (in Nevada you can protect assets in as little as two years), including judgment creditors and even spouses in a divorce.

Our law firm works cooperatively with Nevada legal counsel to make sure that all asset protection documents conform to Nevada legal requirements as these are not Massachusetts documents. We will be revisiting this topic in much greater detail in the coming months as our law firm will be working diligently to bring our clients up to speed on this exciting estate planning opportunity. The main advantage of Nevada asset protection and other state and countries is the use of charging orders (how creditors are paid in the event of a claim) and certain tax benefits. Not only is this legal, but it is a prudent use of client's resources as it is one of the few ways that we can preserve estate tax planning opportunities while locking in the protection of assets.

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There's been a lot of buzz lately about the estate tax limits being raised by this Congress to lofty new levels. Once they raise estate tax exemption limits (estate taxes are taxes paid as part of the probate and non-probate administration processes to both Federal and Massachusetts tax authorities, currently estate taxes kick in at $2,000,000 for Federal purposes, Massachusetts law lowers this limit to collect Massachusetts a few more dollars), estate planning will become less of an exercise in tax avoidance and more targeted to special needs planning, trusts for various special purposes (like dynasty trusts, spendthrift trusts, asset protection, elder law and Medicaid planning, charitable trusts, really whatever estate planning lawyers can think up), and just simple will planning.

So what's going to be fun about that? Our legal clients will no longer be the near affluent seeking to minimize their estate taxes, but either we will have more of the super rich seeking lawyers who can minimize their estate taxes and help them avoid probate or we will have families with unique estate planning opportunities. An article that caught my eye talks about a unique way to dispose of your corpse by helping your alma mater raise a few new dollars. Colleges are now pushing for niches for cremains or full blown cemeteries on their properties. I wonder if the school's cheer leading squad, marching band and mascot can be hired to come to your funeral? Is your final resting place determined by your grade point average? If so, some students may find themselves near the campus laundry instead of on a nice bluff overlooking the quad.

Note to Middlebury College (my alma mater): you are already included in my estate planning; I send you a check or two every year and I volunteer a 100 or so hours a year interviewing new prospects between trying to be a lawyer in Massachusetts - so, you can't have my body too. Once my probate administration is over down at the Middlesex Probate Court, I want my family to rest comfortably knowing that all my debts have been paid and they can file my final probate account in peace. Thanks, but no thanks, I'm not paying any more tuition bills. **************LOS ANGELES -- The rooms in this college dorm have no electricity, no running water, and ceilings that are just 11 inches high. But the residents don't mind. They're dead. Draped in sky-blue marble, the honeycombed structure -- which is tucked behind a set of spooky glowing stones at Chapman University in Orange, Calif. -- is designed to house the cremated ashes of alumni, faculty, and pets.

The mini-cemetery is part of a small but growing trend on college campuses. This summer, Notre Dame will unveil a pair of limestone and brick mausoleums laced with full-body crypts selling for as much as $11,000. And the Citadel military college in South Carolina is adding 400 urn niches to a carillon tower that holds one of the Western Hemisphere's biggest collections of Dutch bells. The University of Southern California is also studying the idea of campus tombs for a proposed multifaith chapel.

Think of it as continuing ed for the dead -- or the ultimate college reunion. In today's mobile society, some people feel more connected to their alma mater than to their hometown, said cemetery consultant Mel Malkoff, who oversees Chapman's columbarium and is working on similar projects with other schools. "People look back on their college years and say, `Those were the best days of my life,' " Malkoff said. "Why not spend eternity there?" Hoping to cash in on such sentiments, some universities don't stop with enrollment space. They also offer custom urns -- or coffins blessed by monks. As odd as such practices might sound, they're rooted in the past. College graveyards were once fairly common, said historian David Sloane of USC, author of "The Last Great Necessity: Cemeteries in American History." In the early 1800s, before embalming became widespread, it was often impractical to ship home the body of a deceased student or professor. Iowa State University's 131-year-old dead zone holds about 800 corpses, mostly faculty but also two students, a night watchman, and his dog. Notre Dame's sprawling burial ground debuted in 1843, one year after the school was founded, along with a mortuary that helped subsidize tuition costs.

By the late 20th century, many longtime college cemeteries were languishing. The University of Virginia's 1828 graveyard ran out of room in the early 1960s, said Dr. Dearing Johns, a cardiology professor who heads the school's cemetery committee. School officials decided against expanding it -- until an alum who wanted to be buried on campus suggested a columbarium wall and paid for the construction with three friends. It's a great way to generate money," said columbarium chief Andrea Patenaude of the University of Richmond, which recently transformed a sliver of campus into a million-dollar serpentine wall carved with 2,900 niches priced at $3,000 each. A spider logo, depicting the school's mascot, climbs the bamboo gate leading to the wall. Duke University is charging $25,000 a pop to bury ashes in its new 2-acre memorial garden. Part of the motivation for Duke's program was that people had begun scattering ashes there on the sly. The profits will help finance the school's vast public gardens.

Chapman's dorm for the dead, with prices ranging from $2,500 to $5,000 per two-urn chamber, was built to help fund the school's new chapel. A meditative garden leads to the memorial, which sits behind a wall of white onyx that is illuminated from within to symbolize "the elusive separation between the living and the dead, a separation of a single breath," according to designer Susan Narduli. Colleges aren't the only institutions offering alternative burial space. A German soccer team recently announced plans to open a public cemetery next to its stadium, according to news reports. A similar idea was floated in San Diego a decade ago, when a businessman urged the Padres baseball team to install 70,000 cremation niches in the outfield wall of its new park. Despite a potential windfall of $175 million, Padres management balked at the proposal.**************** If Red Sox nation could put little cremains niches in the Green Monster with glass walls so you have an unobstructed view of Manny Ramirez running down fly balls... I might want to get half a dozen of those now just to stretch out and watch the game without getting beer spilled on me.

Since this is supposed to be a legal blog, there are a few things that you should know about the disposition of a corpse in Massachusetts. Under Massachusetts law your corpse is not the property of your executor or your probate estate. Your corpse belongs to your next of kin. Effectively there is an order of degrees or relations that Massachusetts law requires you to follow. Your spouse has first claim to your corpse (even that 24 hour romance in Vegas counts). We have had many a case of the new spouse (often known as the StepMonster, not to be confused with the Green Monster) burying or cremating their spouse completely contrary to the wishes of the family (and even the deceased spouse). After the spouse, the children have collective priority, an issue when they do not agree as to the disposition of the corpse. The most famous case happened in Red Sox Nation, when Ted Williams' family needed to go to probate court to decide whether the splendid splinter would be frozen or cremated. My advice as a lawyer is to pre-pay for your funeral. I have only had a couple of cases where the family would rather pay from their inheritance to arrange burial instead of taking the freebie.

NOTE - The response to the blog has been overwhelming, from best we can tell there are hundreds of regular readers already. I apologize again for using some words a little too much (you know the words: probate; Massachusetts law; Boston lawyer; real estate; estate planning; elder law; Medicaid), we expect that this will no longer be so necessary as the blog is added to its own server and web site soon. I also promise to bring you entries that relate to your interests and concerns. To do this, I need your input and ideas. Feel free to email me at Gosselin@GosselinLaw.com or add comments.

PS - The new building is near getting its permits, we expect the construction trailer to be on site next week and the fun to get started. To those that do not know, Gosselin & Associates, P.C. (from now forward to be known publicly as "Gosselin Law") is creating the largest and most modern law office ever in Winchester, Massachusetts (hey, can't fault me for bragging a little!). Seriously, we will have about 8,000sf of space, a conference facility seating about 60, several conference rooms, a full service kitchen, a gym with a personal trainer on staff, a children's room, all on site storage and a great parking lot - even a dog yard for my Australian Shepherd. My big headache at the moment is trying to figure out the difference between "Whisper Sage" and "Dusty Hemlock", those who know what this means, know what I mean. More construction updates as I get them. We hope to move in October or November.

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