Hurley Elder Care Law Newsletter - September 2018

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September 2018  

Is Medicaid Becoming the Long-Term 
Care Insurance for the Middle Class?

In our September 12th blog, we explored Mr. and Mrs. Smith’s situation:
Mr. and Mrs. Smith have been married for 50 years.  About six years ago, Mrs. Smith began showing signs of dementia. At first, Mr. Smith refused to acknowledge that there was any problem, but their children and church family finally convinced him to take her to a neurologist. Mrs. Smith was diagnosed with dementia, and she was able to live at home with her husband as a primary caregiver for the next 4 ½ years.  Six years after her first symptoms, Mrs. Smith is no longer able to walk, dress herself, feed herself or use a toilet. She requires total assistance, and Mr. Smith is no longer able to care for her on his own.  She spends most of the day in her bed, and her children want their dad to get more help.
After reviewing all of their options, it seems as if a nursing home is their only viable option. Assisted living communities and personal care homes cannot offer her an apartment because she can no longer walk or transport herself (a requirement set by the state for all new admissions into personal care homes and assisted living communities). At $20/hour, private duty home care is too expensive for the amount of hours Mr. and Mrs. Smith need help. Spending that money on her care would quickly deplete all of their assets, and Mrs. Smith could live another 3-5 years. This leaves nursing home care.  Sure, nursing homes cost $8,000/month, but Mr. Smith has been told that his wife can get on Medicaid and that Medicaid can help pay for her nursing home care.
Mr. Smith was shocked when he was told that his wife could be eligible for Medicaid. Although they have never been wealthy, Mr. and Mrs. Smith always worked decent paying jobs and saved for retirement in their IRAs.  They have one car and home that they own outright that is worth about $200,000.  Their savings total about $120,000, and their IRAs combined total over $80,000.  With their IRA distributions, pensions and Social Security checks, they have about $4,400/month in income ($3,000 for him, and $1,400 for her). Mr. Smith never even considered Medicaid for them—he thought Medicaid was only for extremely poor people.
Let’s analyze the requirements for nursing home Medicaid in Georgia and the Smiths’ financial situation.
To get Medicaid:
-The resident going into the nursing home must have less than $2,250/month of income; Mrs. Smith only makes $1,400.
-A married couple must have less than $125,600; Mr. and Mrs. Smith have a $200,000 house, $120,000 in the bank, $80,000 in IRA, and a car—this puts them with assets over $400,000.  Fortunately, the house, car, and IRAs are exempt for Medicaid eligibility. This means they have $120,000 in assets and are eligible for Medicaid.
For the Smiths, not only are they eligible for Medicaid, but Mr. Smith will also be able to keep a portion of Mrs. Smith’s income every month. Medicaid allows the spouse still living at home to have up to $3,090 in income.  Since Mr. Smith’s income is $3,000, he can keep $90/month of Mrs. Smith’s income (and then the rest of her income will go to the nursing home).
The Smiths were in a very difficult situation, but their story is not uncommon.  Many working class and middle class families that never used public benefits in the past have to rely on these safety net programs in order to pay for their long-term care needs. With costs easily exceeding $70,000, it is no wonder that so many families are looking for help anywhere they can. In many ways, Medicaid has become the long-term care insurance policy for the working and middle class. We as a country have not fully addressed the issue of how we should be paying for the long-term care needs of our disabled and frail citizens.  And our legislators have condoned this approach by giving us rules to protect well spouses and to help individuals qualify for benefits after spending or  transferring some of their assets.
Hurley Elder Care Law has been serving families for many years that are navigating the options for paying for long-term care costs.  Our initial phone consultation is always complimentary, so please contact our office at (404) 843-0121 or through our website. 

Given that Medicaid is the long-term care insurance for the working and middle class, maybe you should start the process of planning for it today!

Family Business
We would like to introduce you to the newest Hurley member! Jennifer Ghorley is an attorney originally from Canton, GA. She received her undergraduate degree from the University of Alabama in Tuscaloosa and attended Faulkner University’s Thomas Goode Jones School of Law where she received her JD, as well as an LL.M. in Alternative Dispute Resolution (which is a Master of Laws). Jennifer practiced law at a small firm before joining Hurley. Jennifer was recently married and now lives in Canton with her husband, Graham, and their dogs. The couple enjoys traveling, cooking and entertaining family and friends. 

Upcoming Speaking Events and CEs
Continuing Education (CE)
*All CE topics are certified for case managers, nurses and social workers

The decision to transfer a family member to a nursing home can be a difficult one. It is the family’s responsibility to explore facilities and to make decisions about which facilities can best meet the patient’s financial, physical, and 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. *This CE is currently full but please feel free to join the waitlist.
5:00 PM- 7:00 PM, The Fountainview Center, 2631 North Druid Hills Road, Atlanta, GA 30329, RSVP:
Healthcare professionals are being challenged with meeting the needs of an older population that is living longer with more complex issues and fewer family supports than ever before. Do you ever feel overwhelmed/lost when dealing with this population? This seminar will offer guidance for professionals dealing with the new aging family. We will explore elder orphans, elderly immigrants, and blended families.
5:30 PM- 7:00 PM, Pebblebrook at Park Springs, 5610 New Bermuda Road, Stone Mountain, GA 30087, RSVP:
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 professionals questioning the best course of action. Please join Danielle 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.
5:30 PM- 7:00 PM, Morningside of Alpharetta, 253 N. Main Street, Alpharetta, GA 30020, RSVP: 

What healthcare documents does everyone really need and how do they work? What are the repercussions of needing care and having no documents in place?  What options do healthcare providers have when families need to take action? We will review the essential documents every adult needs including the General Durable Power of Attorney, The Georgia Advance Directive for Healthcare and various other documents that may be recommended.
4:00 PM- 6:30 PM, Emory Johns Creek Hospital, Classrooms A and B, Main Conference Room, 6325 Hospital Parkway, Johns Creek, GA 30097, RSVP:

Every 67 seconds someone in the U.S. develops Alzheimer’s, and one in three seniors will die with Alzheimer’s or another dementia.  The purpose of this activity is to review the basics of Alzheimer’s disease and then analyze the financial impact of the disease to families and employers as well as those affected by it.  Knowing the options available and planning for the unexpected loss in functional and cognitive capacity is the best way for healthcare professionals to advise their patients and families. 
11:30 AM- 1:00 PM, Sunrise of Huntcliff Summit 1, Essex Ballroom on the 6th floor, 8592 Roswell Road, Sandy Springs, GA 30350, RSVP:

Georgia’s aging population is facing a crisis in long-term care. Costs are skyrocketing and most families can’t afford to spend over $100,000 a year for care. Healthcare professionals are on the front lines providing information and tools to help navigate this difficult time. This seminar offers practical information to healthcare providers detailing Georgia’s long-term care options. This seminar will outline strategies for accessing public benefits to pay for care including Georgia Nursing Home Medicaid and VA Aid and Attendance. 
5:30 PM- 7:00 PM, Delmar Gardens of Smyrna, 404 King Springs Parkway, Smyrna, GA, 30082, RSVP:

For more details and a complete list of upcoming events, please visit Hurley Elder Care Law Community Education.
Recent Blogs
Home to a Nursing Home- Explore these expert tips on nursing home placement without hospitalization.

Is This Legal- Read about the legal and ethical implications of Medicaid planning.
Proactive Planning- Can you just put Moms assets in a trust and apply for Medicaid?

Elder Care Resources
GA Nursing Home Medicaid Update- As of July 1, 2018, the personal needs allowance has increased to $65/month.

Will They Take My House?- Read about three ways to protect your house from Medicaid Estate Recovery.

Helping Our Own Families- When elder care professionals face aging issues within their own families.

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 eleven 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       
6340 Sugarloaf Pkwy. Suite 200, Duluth, GA 30097

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