Hurley Elder Care Law Newsletter - June 2017
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June 2017   

Nursing Home Medicaid for Married Couples —

Learning from Others 

The stress of caring for a spouse with a disability or serious illness can be crippling. Many of our spousal caregivers come to our office after months or years of caring for their loved one at home for as long as they can and face the decision of moving their spouse into a nursing home after running out of any other options. It’s a difficult decision, and many of our families are terrified of the financial strain of paying for nursing home care and also of dealing with Medicaid (or with DFCS). There are so many questions, so many fears and so much misinformation. Here is the story of a family we have helped--maybe you will find something helpful from reading about their situation:

The Shipps

Mr. Shipp and his daughter, Anna, visited our office because Mrs. Shipp’s recent short-term rehab stay in a nursing home is ending, and Mr. Shipp does not think he can care for her at home again. They are considering long-term care in the nursing home for Mrs. Shipp, but Mr. Shipp is unsure if they can afford it. Neither spouse has a high income: Mr. Shipp receives around $1,700 per month between his Social Security check and a small pension, and Mrs. Shipp receives around $1,200 per month from Social Security. The couple’s home is worth about $110,000, and their other assets equal about $150,000. The nursing home that Mrs. Shipp is at costs $7,800/month. Although their combined incomes would barely cover half of that cost, Mr. Shipp was told that their assets were way too high to qualify for Medicaid. Mr. Shipp was very frugal, but he figured he needed at least $2,300 per month to pay his basic expenses. He had no idea how he was going to afford his day-to-day needs, keep up the mortgage payment, and pay Mrs. Shipp’s nursing home bill each month without help. If his wife ever qualified for Medicaid assistance, he had heard horror stories about people losing their homes to the state. Mr. Shipp had no idea what he was going to do.

Hurley Elder Care Law’s Plan

Fortunately, Mr. Shipp was referred to Hurley Elder Care Law by the nursing home’s social worker--perhaps there was a way that Medicaid could help this family. When a single individual applies for Medicaid, he or she can have no more than $2,000 in countable assets, but the rules are a bit different for married couples. In this case, the couple’s home would not count against them for Medicaid. Of the $150,000 in financial accounts they held, most of those would be protected as well under the Medicaid rules for well spouses. As a first step in our planning, we suggested taking Mrs. Shipp’s name off of the home and putting it in Mr. Shipp’s name alone. Spouses are allowed to make such transfers of assets without worrying about the 5-year lookback period. With regard to the financial accounts, although most of their money was protected, (Georgia allows the well spouse to have $120,900 and the nursing home resident to have $2,000), we wanted to protect the remaining $27,100. The Shipps could spend that amount on the nursing home bill; but those funds can also be spent on other things as long as it is spent on something beneficial to the couple. In some cases, we recommend spending funds on home repairs, new furniture or appliances, or an upgraded vehicle. But Mr. Shipp’s circumstances presented a much more practical solution. They had no pre-paid burial accounts.  Medicaid allows the nursing home resident and spouses to set aside up to $10,000 each for funeral arrangements. So, after paying one month of nursing home fees and setting up two burial accounts, we quickly attained Medicaid eligibility for Mrs. Shipp.

We were also able to help Mr. Shipp with his monthly income.  Medicaid requires that each nursing home resident pay a patient liability (which is usually the majority of his or her income) to the facility before Medicaid pays anything. In this case, that would mean Mrs. Shipp would owe the nursing home around $1,200 each month, and Mr. Shipp would be expected to live on his $1,700 monthly income. However, when the income of the spouse staying at home does not equal $3,022.50 per month, he or she is allowed to keep some of the nursing home spouse’s income to bring his/her income up to this Maximum Monthly Maintenance Needs Allowance (or the total of the couple’s combined income, whichever is less). This spousal diversion is made before the patient liability is paid to the nursing home. This means Mr. Shipp is allowed to keep all of Mrs. Shipp’s income and pay none of her income to the facility each month.

Mr. Shipp thought he was at risk of losing his house and his entire life savings because his wife needed nursing home care. We were able to alleviate those fears, make sure that Mrs. Shipp received the appropriate level of care, and ensure that funds were left for Mr. Shipp’s future. Medicaid rules can be overwhelming, and there is no shortage of misinformation about this vital program. If you or someone you know has questions about how Medicaid could work for them, please call our office for a complimentary consultation at (404) 843-0121.

Family Business Our attorney, Danielle Humphrey, is going to be an empty nester very soon. Her youngest son Ross graduated from Pace Academy a few weeks ago and he will start classes at Georgia Tech this fall. Kim and her husband Mark just returned from a trip to Italy where they spent 10 glorious days under the Tuscan sun. Everyone else from Hurley has been enjoying fun weekends by the pool to start the summer off right!
Upcoming Speaking Events & CEUs
Thursday, June 15- Join Danielle Humphrey, JD, CELA, for a Complimentary Lunch CEU on "Ethical Dilemmas in Geriatric Care: A Case Study Approach” at Parc At Duluth

Unique challenges exist at the intersection of ethical decision-making and geriatric care. Even though we have clear ethical principles, the messy realities of patients and families often leave helping professionals questioning the best course of action. Are there times when you should advocate for the family caregiver instead of the patient? Is it sometimes okay to disclose confidential information? Does your patient have the right to make her own decisions? Please join Hurley Elder Care Law in a discussion of unique ethical dilemmas in geriatric care. With the use of case studies, we will explore issues related to client identification, capacity, confidentiality, undue influence, conflicts of interest, and informed consent. Each case is unique, and we look forward to your input. CEUs available:  1 core or ethic hour for social workers (GA NASW); 1 contact hour for case managers (CCMC) and 1 contact hour for RN's (TNA).

11:00 AM Optional Tour of the Community, 11:30 AM -12:00 PM: Registration and Lunch, 12:00 PM-1:00 PM  CEU Education, Parc at Duluth, 3315 Peachtree Industrial Blvd, Duluth, GA  30096,  RSVP:

Thursday, June 22 -Join Michelle Allen, LCSW, for a Complimentary CEU on "Successful Nursing Home Placements" at Hurley Elder Care Law

The decision to transfer a family member to a nursing home can be a difficult one. The many emotions arising from such a decision may be impacted further by a complex placement process. It is the family’s responsibility to explore facilities and to make decisions about which facilities can best meet the patient’s financial, physical, social needs, but health care providers also play a crucial role. Case managers and social workers must understand how to complete the DMA-6 and Level 1, how to navigate the options, and how to advise families on paying for nursing home care. Please join us to learn what you need to accomplish Successful Nursing Home Placements. CEUs available:  1 core hour for social; 1 contact hour for case managers.

4:00 PM-4:30 PM Registration & Snacks, 4:30 PM-5:30 PM  CEU Education, Hurley Elder Care Law,  100 Galleria Parkway, Suite 650, Atlanta, GA 30339, RSVP:

*** This “Successful Nursing Home Placements” CEU is at full capacity.  Please add your name to the Eventbrite waitlist for a cancellation opening. *** 

Tuesday, June 27- Join Danielle Humphrey, JD, CELA, for a Complimentary Dinner CEU on "Capacity, Competency, and Ethical Interventions: A Legal Discussion for Healthcare Providers” at Elmcroft at Mt. Zion

Conflicts of interest and determining decision-making capacity often create complex ethical dilemmas for case managers, social workers, and other practitioners working with older adults. Competing interests of the older adults’ family can also make helping individuals make difficult decisions even more challenging. This presentation will provide guidance and tools for assessing areas of concerns when clinicians are confronted with ethical dilemmas. The presenter will explain the difference between capacity and competency and provide guidelines for evaluation. Our speaker will also will review an ethical decision-making model for practitioners to use when confronted with such dilemmas in clinical practice. CEUs available:  1 ethic or core hour for social workers (GA NASW); 1 contact hour for case managers (CCMC); 1 contact hour for RNs (TNA).

5:00 PM-5:30 PM Registration & Dinner, 5:30 PM-6:30 PM CEU Education, Elmcroft of Mt. Zion, Jonesboro, GA 30236, RSVP:

Wednesday, July 12 - Join Danielle Humphrey, JD, CELA, for a Panel Discussion on “The Next Stage”—Senior Living and Planning, at Forsyth County Senior Services

Learn more about the importance of legal documents such as Wills, Trusts, Georgia Healthcare Advance Directives and Financial Powers of Attorney and the implications of not having them. Other panel members include representatives from Avita Community Partners-Behavioral Health, Georgia Division of Aging Services, APS and Transitional Care Physicians of Atlanta.

2:00 PM-3:00 PM, Forsyth County Senior Services, 595 Dahlonega Street, Cumming, GA 30040, RSVP: Dan Hill,, 770-781-2178, Ext. 5039


For more details and a complete list of upcoming events, please visit Hurley Elder Care Law Community Education.
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Traveling with the Elderly- Read nine great tips before this summer!

Elder Care Resources
The PSA Test for Prostate Cancer- Learn if this test is still recommended.

Alzheimers Research Focus- Prevention is a more likely outcome than finding a cure.

NH Medicaid for Couples- Protect the house from Medicaid Recovery.

Miles P. Hurley, JD, CELA  Miles P. Hurley founded Hurley Elder Care Law in 2006 to provide legal assistance to the elderly population on issues relating to aging including retaining independence, quality of life and financial security. Mr. Hurley is one of ten attorneys in the state of Georgia to receive the Elder Law Attorney Certification, and one of approximately 400 nationwide. 
Hurley Elder Care Law is dedicated to the process of long-term care and estate planning. 
Call us today for a free phone consultation with a client coordinator at (404) 843-0121.

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Hurley Elder Care Law
100 Galleria Pkwy, Suite 650
Atlanta, GA 30339

Satellite Offices
2011 Commerce Dr. Suite 100, Peachtree City, GA 30269   
225 Creekstone Ridge, Woodstock, GA 30188       
2180 Satellite Blvd, Suite 400, Duluth, GA 30097

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