Ralph Robbins
Certified Financial Planner
Ralph S. Robbins, CFP©, is a licensed Certified Financial Planning Practitioner and an Accredited VA Claims Agent specializing in Eldercare Financial Planning. He works everyday helping families in crisis find creative ways to fund long-term care expenses and deal with family financial issues.
Show:
Articles Question
Question
Question
How do I get legal gaurdianship over my maternal grandmother?
Petition the family court in your county. Some have pro se divisions and they will help you file and appoint an attorney pro bono for you.
Question
Can you set up a living trust for a parent without an attorney?
Any attorney advertising for such services will be able to complete a simple will. If it is indeed simple, there is no reason not to shop... Any attorney advertising for such services will be able to complete a simple will. If it is indeed simple, there is no reason not to shop by price as long as counsel appears competent. see more
Question
Will Medicare pay for a bed bound patient?
Medicare provides limited benefits for long-term care. If your patient is "bed bound" they may qualify for Medicaid and/or a... Medicare provides limited benefits for long-term care. If your patient is "bed bound" they may qualify for Medicaid and/or a veteran's non-service connected pension to assist with the cost of care. see more
Question
What is a "hardship case" in nursing home?
This is very easy to fix. Federal law permits your mother to create an "Irreovocable Qualified Income Trust" to divert the... This is very easy to fix. Federal law permits your mother to create an "Irreovocable Qualified Income Trust" to divert the excess income and allow her to qualify for Medicaid immediately. Some states post this trust document on their Medicaid website (e.g. Texas) but other states don't. You do not need a lawyer to do this but you may have to seek one if you can't find another alternative. What state are you in? see more
Question
I would like to file a colmplaint against a financial advisor in Florida. How do handle this and what forms d...
What "type" of advisor and what "type" of investments are you speaking of? "Financial Advisors" are licensed... What "type" of advisor and what "type" of investments are you speaking of? "Financial Advisors" are licensed by one or more entities as insurance agents and/or securities representatives (brokers). Let me know what the problem is and I will help guide you. see more
Question
My mother has Alzheimer's and is having a terrible time with her money. How can I become power of attorney to...
Too late. A power of attorney can only be granted while the principal is competent. If you have no such document in place your only... Too late. A power of attorney can only be granted while the principal is competent. If you have no such document in place your only option will be petitioning for guardianship. You might as well start researching this now because it is going to take months to get done. Sorry, but perhaps your mother's mistake will provoke others to action before they get stuck as you are. see more
Question
How do I claim expenses for taking care of my uncle who has dementia, like travel expense, gas, preparing meal...
If you are providing more than 50% of your uncle's financial support you may take him as a dependent and may be able to deduct the... If you are providing more than 50% of your uncle's financial support you may take him as a dependent and may be able to deduct the expenses you outlined as such.
Alternatively, you may wish to enter into a Personal Caregiver Agreement with him whereby he compensates you for your time and/or expenses. see more
Alternatively, you may wish to enter into a Personal Caregiver Agreement with him whereby he compensates you for your time and/or expenses. see more
Question
my parents have no money and their gas just got turned off. I don't have funds to support them. What can I do?
Is that the only issue? Bills can be paid automatically; or they can be sent to you to pay. Or a person can be hired locally to do it... Is that the only issue? Bills can be paid automatically; or they can be sent to you to pay. Or a person can be hired locally to do it (their is a professional organization of professionla bill payers...believe it or not).
It sounds to me, though, that your parents are at risk and you must take action now. If you are unable to deal with the situation you have two choices:
1. Hire a geriartric care manager local to them. An initial assessment will run about $250 and ongoing service about $100 per hour.
2. There are many "Just Checking" programs that will keep tabs on them (contact your local Area Agency on Aging).
2. If all else fails, and if you really can't help them due to time, money, and distance, call the equivalent of Adult Protective Services in the county where they live. They will take over the situation and make sure they are safe. Be aware, however, that if you take this route the state may begin guardianship proceedings and I can assure you it will not be you that will be selected as guardian. see more
It sounds to me, though, that your parents are at risk and you must take action now. If you are unable to deal with the situation you have two choices:
1. Hire a geriartric care manager local to them. An initial assessment will run about $250 and ongoing service about $100 per hour.
2. There are many "Just Checking" programs that will keep tabs on them (contact your local Area Agency on Aging).
2. If all else fails, and if you really can't help them due to time, money, and distance, call the equivalent of Adult Protective Services in the county where they live. They will take over the situation and make sure they are safe. Be aware, however, that if you take this route the state may begin guardianship proceedings and I can assure you it will not be you that will be selected as guardian. see more
Question
My dad has cancer, mom has dementia. Where can we find a skilled nursing facility where they can have a room t...
It may not be possible for them to share a room together as their needs will be very different. Facilities have very strict requirements... It may not be possible for them to share a room together as their needs will be very different. Facilities have very strict requirements as to who they will admit and under what circumstances.
Dad will need medically related long-term care whereas mom will require a secure dementia unit. If you find a facility that can satisfy both needs, terrific, but the best that will occur will probably be that they will be able to visit and perhaps dine together. see more
Dad will need medically related long-term care whereas mom will require a secure dementia unit. If you find a facility that can satisfy both needs, terrific, but the best that will occur will probably be that they will be able to visit and perhaps dine together. see more
Question
How can I get paid or get financial help to keep our home and keep caring for my dad?
Honestly, you are asking the wrong question. It is impossible for you to care for all three of you on just your father's Social... Honestly, you are asking the wrong question. It is impossible for you to care for all three of you on just your father's Social Security. You and your wife need to make money and take care of yourselves. Period. Whatever you have to do, you do.
Your dad's funds should be used for his care - not yours!
That being said, your father may qualify for Medicaid and if he is an eligible veteran he may be able to receive a non-service connected pension of up to $1,650 per month.
Contact your county Agency on Aging and the local Veteran Service Office. see more
Your dad's funds should be used for his care - not yours!
That being said, your father may qualify for Medicaid and if he is an eligible veteran he may be able to receive a non-service connected pension of up to $1,650 per month.
Contact your county Agency on Aging and the local Veteran Service Office. see more
Question
Does Social Security fund elderly transportation?
No. Social Security does not provide such service. Transportation services are provided by municipalities and counties with Federal... No. Social Security does not provide such service. Transportation services are provided by municipalities and counties with Federal support through the Older Americans Act.
To find service contact your local Area Agency on Aging or Aging and Disability Resource Center. see more
To find service contact your local Area Agency on Aging or Aging and Disability Resource Center. see more
Question
My Uncle lives in a nursing home. How much of his own money, in his bank accounts, can he keep? He has Medica...
If you uncle is on Medicaid and is applying for nursing home benefits he will not be permitted to have more than $2,000 in cash assets in... If you uncle is on Medicaid and is applying for nursing home benefits he will not be permitted to have more than $2,000 in cash assets in 2010. This includes all bank accounts, stocks, bonds, life insurance, annuities, etc.
He cannot have income of over $2,022 per month in 2010. see more
He cannot have income of over $2,022 per month in 2010. see more
Question
Can you set up a living trust for a parent without an attorney?
Yes you can. However your parents will still have to be competent to do so. If they are, then you can use one of the legal form websites... Yes you can. However your parents will still have to be competent to do so. If they are, then you can use one of the legal form websites such as LegalZoom.
Be aware that information on these sites may not be as complete as you would like. I had a client who had prepared a Power of Attorney on LegalZoom and the document was pretty much ok but they did not tell him that the document had to be notarized. This obviously caused him some problems.
Your parents really should have all of the following documents if they are establishing a living trust:
1. The living trust document
2. Pour over will
3. Springing or Durable Powers of Attorney
4. Health Care Surrogate (aka Medical Power of Attorney)
5. Living Will
Here in Florida we can easily find attorneys who will prepare all of the above for about $600 for a couple. At that price it makes no sense to it one's self. Perhaps the situation is similar where you live... see more
Be aware that information on these sites may not be as complete as you would like. I had a client who had prepared a Power of Attorney on LegalZoom and the document was pretty much ok but they did not tell him that the document had to be notarized. This obviously caused him some problems.
Your parents really should have all of the following documents if they are establishing a living trust:
1. The living trust document
2. Pour over will
3. Springing or Durable Powers of Attorney
4. Health Care Surrogate (aka Medical Power of Attorney)
5. Living Will
Here in Florida we can easily find attorneys who will prepare all of the above for about $600 for a couple. At that price it makes no sense to it one's self. Perhaps the situation is similar where you live... see more
Question
What can I do when my mom is in denial about her health, driving, and self-care and when confronted she places...
When dealing with these types of issues I have found that four things are important: 1. Always be on the side of the elder. Be their... When dealing with these types of issues I have found that four things are important:
1. Always be on the side of the elder. Be their champion for their independence and freedom.
2. Determine what the real issue is. Usually the presenting problem or objection is not the "real" issue.
4. Be creative. Find mulitple solutions and options to problems or concerns (e.g., a friend takes her to church, she goes on a shopping trip with a women's club, the doctor's office picks her up for her appointment, you hire a town car for her "spa day" to take her to get her hair done, etc.).
3. Negotiate. If you do this, then I'll do that...or if I do this, will you do that? Offer positive alternatives that the elder may find attractive. see more
1. Always be on the side of the elder. Be their champion for their independence and freedom.
2. Determine what the real issue is. Usually the presenting problem or objection is not the "real" issue.
4. Be creative. Find mulitple solutions and options to problems or concerns (e.g., a friend takes her to church, she goes on a shopping trip with a women's club, the doctor's office picks her up for her appointment, you hire a town car for her "spa day" to take her to get her hair done, etc.).
3. Negotiate. If you do this, then I'll do that...or if I do this, will you do that? Offer positive alternatives that the elder may find attractive. see more
Question
What is the difference between an Assisted Living Facility and a Nursing Home?
The primary differences are licensing, level of care, and cost. Assisted living facilities (AL) offer primarily non-medical assistance... The primary differences are licensing, level of care, and cost.
Assisted living facilities (AL) offer primarily non-medical assistance with activities of daily living and offer a generally supportive environment for those who are able to manage some aspect of their own care. Many AL's have expanded services to include more intense and secure care for residents with memory disorders. Each assisted living facility has its own admissions criteria with some requiring higher degress of functioning than others.
Here in Florida, some AL's have an "upgraded" license which permits them to provide more medically oriented services.
Nursing homes (NH) provide skilled nursing services and custodial care typically for those who meet at least an "intermediate" level of care requirement. Definitially, this means that the recipent requires some care ordered by, but not necessarily delivered by, a skilled professional (MD, RN, RPT, OT, PT, etc.).
Of course one of the crucial differences is cost. NH is about twice the cost of AL. However in most states Medicaid will only provide benefits for NH care. Check with your state's Department of Elder Affairs or equivalent to find if Medicaid benefits are available for assisted living. Also keep in mind that Veteran Pension benefits can be obtained for AL and NH care. see more
Assisted living facilities (AL) offer primarily non-medical assistance with activities of daily living and offer a generally supportive environment for those who are able to manage some aspect of their own care. Many AL's have expanded services to include more intense and secure care for residents with memory disorders. Each assisted living facility has its own admissions criteria with some requiring higher degress of functioning than others.
Here in Florida, some AL's have an "upgraded" license which permits them to provide more medically oriented services.
Nursing homes (NH) provide skilled nursing services and custodial care typically for those who meet at least an "intermediate" level of care requirement. Definitially, this means that the recipent requires some care ordered by, but not necessarily delivered by, a skilled professional (MD, RN, RPT, OT, PT, etc.).
Of course one of the crucial differences is cost. NH is about twice the cost of AL. However in most states Medicaid will only provide benefits for NH care. Check with your state's Department of Elder Affairs or equivalent to find if Medicaid benefits are available for assisted living. Also keep in mind that Veteran Pension benefits can be obtained for AL and NH care. see more
Question
My mom is currently in a rehab facility but will be going into a nursing home soon. What will happen with her...
I'm sorry to hear of your mother's situation. The first question is: Does this appear to be a permanent situation? If mom will... I'm sorry to hear of your mother's situation. The first question is: Does this appear to be a permanent situation? If mom will be moving from her home and her confinement will be long-term there are many financial issues to deal with and I would encourage you to explore long-term care financing issues and public benefit planning as soon as possible.
With respect to your immediate question I will assume you are speaking of property taxes. If mom will continue to own the home then of course property taxes will continue to be payable. The only question may be whether or not she will be able to maintain her "homestead exemption" if she currently receives one. I would call the property appraisers office or the tax collectors office in your county.
If she will be applying for Medicaid benefits there will be much to consider regarding the residential property as well as other assets. see more
With respect to your immediate question I will assume you are speaking of property taxes. If mom will continue to own the home then of course property taxes will continue to be payable. The only question may be whether or not she will be able to maintain her "homestead exemption" if she currently receives one. I would call the property appraisers office or the tax collectors office in your county.
If she will be applying for Medicaid benefits there will be much to consider regarding the residential property as well as other assets. see more
Question
I take care of both of my parents and have Power of Attorney for my dad. The lawyer said I didn't need POA for...
Get a new lawyer. I cannot think of any instance where one should not have a either a springing (comes into effect at an event such as... Get a new lawyer. I cannot think of any instance where one should not have a either a springing (comes into effect at an event such as incapacity of the principal) or durable (in effect at signing) power of attorney in place.
As suggested above, having a Medical Durable Power of Attorney in place is crucial to making health care decisions for a loved one when they are unable to do. This may also be called a "Health Care Surrogate" or "Health Care Proxy" in some jurisdications. Sometimes you will find the Health Care Powers contained in the Durable power.
Whether contained in the general powers document or not, a separate power of attorney, is required for financial and contractual matters. So essentially, your loved one should have both a Durable Power of Attorney AND a Health Care Surrogate "Power of Attorney". see more
As suggested above, having a Medical Durable Power of Attorney in place is crucial to making health care decisions for a loved one when they are unable to do. This may also be called a "Health Care Surrogate" or "Health Care Proxy" in some jurisdications. Sometimes you will find the Health Care Powers contained in the Durable power.
Whether contained in the general powers document or not, a separate power of attorney, is required for financial and contractual matters. So essentially, your loved one should have both a Durable Power of Attorney AND a Health Care Surrogate "Power of Attorney". see more
Question
My mom is really comfortable in her nursing home right now. What will we do when all her money is gone?
Luvmom... I hope you did not pay the attorney you consulted a large fee because you did not, in my opinion, receive good advice. Planning... Luvmom...
I hope you did not pay the attorney you consulted a large fee because you did not, in my opinion, receive good advice. Planning for long-term care financing, particularly the notion of combing personal resources with public benefits, is legitimate, codified in law, and beneficial to the care recipient. Planning is not about "hiding money".
Yes, it is true that it is not permitted to "gift" to entities in contemplation of applying for Medicaid. Any such gifting, with few exceptions, is subject to to the famed "five year look back". However there are several strategies that will provide additional funds to a Medicaid recipient while allowing them to qualify for and maintain benefits. Among them are:
1. The Personal Services Contract (aka "Personal Care Contract")
2. The Supplemental Needs Trust
3. A proprerly structured immediate annuity.
With respect to the house, again you recieved inaccurate information. In most states the primary residence is consider an exempt asset for Mediciad qualification purposes. This is based on the notion of "intent to return" which is assumed in most states. Medicaid does not "attach a lein" to home when one qualifies for Mediciad. The only time the home may be "attached" is at the recipient's demise under a process known as "estate recovery".
In most states estate recovery is only applicable to probate assets. If the title of the home is properly worded (search for "enhanced life estate deed" or "lady bird deed") the home will by-pass probate and therefore, (in most states) not be subject to Medicaid estate recovery.
Here in the state of Florida the home can also remain an exempt asset if it is rented and the NET proceeds from the rental are used for the Medicaid recipient's cost of care. And again, if the home is properly titled, it will be exempt from recovery.
From a moral or ethical point of view let me also mention that from my perspective after having worked with hundreds of families over the past ten years that purpose of Medicaid planning for the overwhleming majority is not to benefit heirs or circumvent public policy but, rather, to accomplish the goal you stated... to provide good care.
For instance, funds transfered to the supplemental needs trust mentioned above allows the applicant to qualify immediately for benefits but for the monies transferred to it to be used for the health, maintenance, and welfare of the recipient. The money can be used to buy up to a private or "nicer" room for the Medicaid recipient, to purchase clothing and entertainment, to supplement medical and personal needs, etc. Any funds remaining in the trust upon the demise of the recipient must go back to the state for Medicaid reimbursement for cost of care before heirs recieve any residual from the trust (same holds true for the immediate annuity also mentioned above).
The problem with not planning ahead, not using all of the tools at your disposal, and spending all of your parent's money first is that you then may NOT be in a position to provide for what you stated your goal was "...to provide the best care possible".
Proper planning before or in crisis is best for the care recipient and is supported by sound public policy. see more
I hope you did not pay the attorney you consulted a large fee because you did not, in my opinion, receive good advice. Planning for long-term care financing, particularly the notion of combing personal resources with public benefits, is legitimate, codified in law, and beneficial to the care recipient. Planning is not about "hiding money".
Yes, it is true that it is not permitted to "gift" to entities in contemplation of applying for Medicaid. Any such gifting, with few exceptions, is subject to to the famed "five year look back". However there are several strategies that will provide additional funds to a Medicaid recipient while allowing them to qualify for and maintain benefits. Among them are:
1. The Personal Services Contract (aka "Personal Care Contract")
2. The Supplemental Needs Trust
3. A proprerly structured immediate annuity.
With respect to the house, again you recieved inaccurate information. In most states the primary residence is consider an exempt asset for Mediciad qualification purposes. This is based on the notion of "intent to return" which is assumed in most states. Medicaid does not "attach a lein" to home when one qualifies for Mediciad. The only time the home may be "attached" is at the recipient's demise under a process known as "estate recovery".
In most states estate recovery is only applicable to probate assets. If the title of the home is properly worded (search for "enhanced life estate deed" or "lady bird deed") the home will by-pass probate and therefore, (in most states) not be subject to Medicaid estate recovery.
Here in the state of Florida the home can also remain an exempt asset if it is rented and the NET proceeds from the rental are used for the Medicaid recipient's cost of care. And again, if the home is properly titled, it will be exempt from recovery.
From a moral or ethical point of view let me also mention that from my perspective after having worked with hundreds of families over the past ten years that purpose of Medicaid planning for the overwhleming majority is not to benefit heirs or circumvent public policy but, rather, to accomplish the goal you stated... to provide good care.
For instance, funds transfered to the supplemental needs trust mentioned above allows the applicant to qualify immediately for benefits but for the monies transferred to it to be used for the health, maintenance, and welfare of the recipient. The money can be used to buy up to a private or "nicer" room for the Medicaid recipient, to purchase clothing and entertainment, to supplement medical and personal needs, etc. Any funds remaining in the trust upon the demise of the recipient must go back to the state for Medicaid reimbursement for cost of care before heirs recieve any residual from the trust (same holds true for the immediate annuity also mentioned above).
The problem with not planning ahead, not using all of the tools at your disposal, and spending all of your parent's money first is that you then may NOT be in a position to provide for what you stated your goal was "...to provide the best care possible".
Proper planning before or in crisis is best for the care recipient and is supported by sound public policy. see more
I have a joint checking account with Mom. Are they entitled to all the money in this account?
Even though the account is joint, Medicaid will consider all the funds contained therein your mother's unless you can prove that contributed half the value of the account.
Understand that all of mother's income (save $35 per month in most states) must go her cost of care, i.e., the nursing home. She is permitted to retain $2,000 assets.
Austin's reply above really doesn't apply to your circumstances as her husband was not on Medicaid at the time. Moreover, the rules are different for spouse transfers than for those between a parent and sibling. see more