Power of Attorney Concept - paperwork representing a Power of Attorney, with a magnifying glass over, highlighting Power of Attorney.

What Your Family Needs to Know About Powers of Attorney

by Elder LawEstate Planning
Powers of Attorney Concept - paperwork representing a Power of Attorney, with a magnifying glass over, highlighting Power of Attorney.

In this series, I will get right to the point about what I think your family needs to know about important topics in elder law, estate planning, and estate administration. My goal is to provide information so that you can make more informed decisions and clarify your estate planning goals. In this article, the topic of discussion is Powers of Attorney. 

What is a Power of Attorney?

A Power of Attorney is an agreement that someone called a “principal” signs to allow another person or entity, called an “agent,” to make certain decisions for them.

There are Different Types of Powers of Attorney

There are different types of Powers of Attorney. In Pennsylvania, different sections of our law cover types of Powers of Attorney. Chapter 54 of the Decedents, Estates and Fiduciaries Code covers Health Care Powers of Attorney while Chapter 56 covers Financial Powers of Attorney. 

In my office, I prepare separate documents for these. In the past it was common to see these powers combined and I still review a fair amount of documents that were drafted that way. 

I like these to be separate because you may wish to choose a different people to manage your health care decisions and financial decisions, and, as stated above, the standards for both documents are governed by different sections of law. 

Powers of Attorney are Essential for All Adults

I cannot overstate the importance of having Powers of Attorney. Every time I review a client’s estate plan, I review these documents to make sure they are in order. 

Married couples are often surprised when I tell them that they need Powers of Attorney and that they may not be able to make important financial decisions for each other without them. Here’s a simple test – ask yourself, do you have a retirement account (an IRA or 401k for example)? If you answer yes, you need a Power of Attorney so that your spouse can make important decisions involving that account in the event you become unable to do so yourself. 

Young adults are also surprised to learn that it is wise for them to have Powers of Attorney as well. Even if young adults do not have an accumulation of financial assets to plan for, it is important for them to name the people they trust the most to make medical decisions for them in case they become incapacitated in the future.

You Do Not Lose Power to Manage Your Affairs

When you sign a Power of Attorney, you allow someone else to make decisions for you. You do not give up the power to make these decisions for yourself while you can. You are simply allowing someone else to step in and help you. It is important to understand that in this case, you are not limiting your own power by giving someone else power. 

Some Documents are Better Than Others

As I have alluded to earlier in this post, not all Powers of Attorney are written the same way. They are not all of equal quality. I have to draft new Powers of Attorney for clients because their current documents do not grant their agent enough power to protect their assets in the event of a nursing home crisis. 

Pennsylvania law has specific criteria that must be met in the document in order for the agent to be able to gift, or transfer assets out of the principal’s name. Most documents that I review allow the agent to make what we call limited gifts but in order to execute most plans to protect assets, we need the document to allow the agent to make unlimited gifts.

I have found trying to save a few dollars by purchasing do-it-yourself documents online or through big box office supply stores to be a particularly bad idea. These documents tend to lag behind important changes in the law because they aren’t updated frequently or quickly enough. The end result is that the client has to pay twice for an appropriate document and therefore has spent more than they needed to by trying to save money.

Trusting Your Agent is Key

The most important factor in choosing an agent for your Power of Attorney is trust. You need to have unwavering trust that the person you are choosing will make decisions that are in your best interest.

The law provides some safeguards regarding the behavior of agents by imposing certain duties on them when they act for you, however, this is no substitute for making sure that you choose someone you trust to fill this role. 

Banks May Not Accept Old Powers of Attorney

From a practical perspective, the ultimate goal of having a Power of Attorney is that it will work when your agent has to use it. In other words, you expect that when your agent provides your Financial Power of Attorney to the bank, the bank will put it on file and allow the agent to write checks for you and take care of other important banking activities. 

Banks and other financial institutions tend to be suspicious and require more intense scrutiny of documents that were not prepared recently. Powers of Attorney that are 5 years old, for example, may garner heightened scrutiny, and Powers of Attorney that are 10+ years old may be considered “stale.” Sometimes, after review by their legal department, banks choose not to accept these older documents. 

The best way to ensure that your Power of Attorney will be accepted is to have it reviewed every 5 or so years and to keep it updated when the law changes. This will ensure that when it is presented to the bank, the most current form is being used. 

Although age of the document should not matter because a Power of Attorney should be acceptable as long as it was executed according to the law at that time, it’s best to err on the side of caution here. Instead, focus on what’s important – getting the result that you want, which is making sure your document will be accepted when your agent needs to use it.

Portrait of a family with two young children posing together outside

New Blog Series: What Your Family Needs to Know About Estate Planning, Elder Law, and Estate Administration

by Elder LawEstate Planning

As an attorney, I often walk a fine line between listening to my clients describe what they want and on the other hand, explaining to them what they need. It can be difficult sometimes to give meaningful advice and yet not steer the client to the decision I think they should make. 

In many cases I find that clients can initially be uncertain about what it is that they want. I attribute this to families not having access to information to help them understand key issues for their planning even before our first meeting. 

As I continue to grow in practice I also continue to further my commitment toward providing truly client-centered service. To me, client-centered service begins with clients sharing their planning goals with me so that I can show them the legal tools we can use to achieve them. My experience has revealed that education is the most effective tool to assist in bridging the gap between goals and reality, creating a plan with the client that accomplishes their goals and also meets their needs. 

It is because of my commitment to education that I decided to create this new blog series – What Your Family Needs to Know. 

In this series, I will get right to the point about what I think your family needs to know about important topics in elder law, estate planning, and estate administration. My goal is to provide information so that you can make more informed decisions and clarify your estate planning goals.

It is important to note that the contents of these articles are not to be taken as legal advice but rather to serve as a starting point in becoming educated. You should consult an attorney if you need advice on your specific matter. If you are located in northeastern or central Pennsylvania and would like to speak with Cardinal Estate Planning about your case, we would be happy to setup a free consultation.  

Senior Man In Dressing Gown Using Walking Frame Being Helped By Female Nurse With Digital Tablet

How to Choose a Professional Home Care Provider, Continued

by Elder Law
Senior Man In Dressing Gown Using Walking Frame Being Helped By Female Nurse With Digital Tablet

When choosing a home care provider, it’s important to ask for references. Suitable references include doctors, discharge planners and other patients or their family members. Be sure to contact the references and ask questions such as:

  • Do you refer clients to this provider often?
  • Do you and the provider have a contractual relationship? If so, do you require that the provider meets special standards for quality care?
  • What feedback have you received from patients under the care of this provider?
  • Do you know if this provider has cared for people with conditions similar to those of my loved one? If so, can you provide me with contact information for these individuals?

To learn more about finding and choosing the right professional home care provider, visit the National Association for Home Care & Hospice website.

The cost of care.

Of course, one of the factors you must consider in obtaining professional care for your loved one is the cost. Here is a link to the Genworth Cost of Care Survey, which provides median costs for home care, assisted living care and nursing home care across the country.

Contact an Experienced Pennsylvania Elder Law Attorney

If you have additional questions or concerns regarding finding the right home care provider, contact the experienced Pennsylvania Elder Law attorney at Cardinal Estate Planning by calling 570-252-9043 to schedule an appointment.

Smiling senior patient sitting on wheelchair with home care nurse supporting her.

How to Choose a Professional Home Care Provider

by Elder Law
Smiling senior patient sitting on wheelchair with home care nurse supporting her.

Perhaps you have realized that you simply can’t continue to provide adequate care to your loved one. Or maybe your loved one lives far away and your responsibilities at home won’t allow you to serve as caregiver. In either case, you may need to turn to a professional home care provider. The question is, how do you choose the right person for this important task?

How Do I Select the Right Home Care Provider?

The National Association for Home Care & Hospice (NAHC) has created a valuable checklist with questions you should ask providers and others who may be familiar with the provider’s history. Here are some of the questions NAHC recommends.

  • How long has the provider served the community?
  • Does the provider have literature explaining its services, eligibility requirements, fees, and funding sources? Does the provider have what is known as a “Patient Bill of Rights” outlining the responsibilities and rights of the provider, caregiver and patient?
  • How does the provider choose and train its caregivers?
  • Are therapists or nurses used to evaluate the patient’s needs? If so, do they consult with the patient’s family members and physicians?
  • Does the provider include the patient and members of his or her family in developing a care plan? If changes to the level of care are needed over time, are patients and family members involved in making these decisions?
  • Is the patient’s course of treatment documented? Does the patient receive a copy of this documentation, and do the caregivers update it as changes occur? Does the provider take the time necessary to educate family members on the care being provided to the patient?
  • Does the provider assign supervisors to oversee the quality of care patients receive in their homes? If so, how often do these supervisors make visits? Who can the patient and his or her family members contact with questions or complaints? How does the provider follow up on and resolve any problems that might arise?
  • What are the provider’s billing procedures? Does it furnish written statements explaining all of the charges? Are payment plans available?
  • What procedures does the provider follow in case of an emergency? Are the provider’s caregivers available 24 hours a day, seven days a week?
  • How does the provider ensure patient confidentiality?

Next time we’ll discuss the importance of asking providers for references, and what to ask them.

Contact an Experienced Pennsylvania Elder Law Attorney

If you have additional questions or concerns regarding finding the right home care provider, contact the experienced Pennsylvania Elder Law attorney at Cardinal Estate Planning by calling 570-252-9043 to schedule an appointment.

Side view of a happy senior woman smiling while drawing as a recreational activity or therapy outdoors together with the group of retired women.

Finding the Right Nursing Home: Don’t Rely Entirely on the Five-Star Quality Rating System

by Elder Law
Side view of a happy senior woman smiling while drawing as a recreational activity or therapy outdoors together with the group of retired women.

The Five-Star Quality Rating System was created in 2008 by the Centers for Medicare and Medicaid Services (CMS). It has become a popular tool for families to find a quick summary of a given nursing home’s overall level of quality. CMS posts its ratings on the medicare.gov website.

Unfortunately, the accuracy of this rating system is open to question. An investigation by the New York Times, in particular, reveals a number of shortcomings. Let’s begin by looking at how the system operates.

Ratings are based on a combination of self-reported data from 15,000-plus nursing homes, as well as on-site examinations conducted by state health inspectors. A nursing home’s overall score, its star rating, depends on the results of the inspection, the amount of time nurses devote to residents, and the quality of care received by residents.

To evaluate the rating system’s reliability, the New York Times created a database with millions of payroll records to analyze the amount of hands-on care residents actually received in nursing homes. The Times also examined 373,000 reports by state inspectors, and the financial statements 10,000-plus nursing homes submitted to the government. Additionally, The Times was able to access data that is not readily available to the public.

This investigation revealed that nursing homes had submitted inaccurate information, thereby making themselves look safer and cleaner than they actually were. Other erroneous information included exaggerated levels of staffing, underreporting the use of potentially hazardous antipsychotic drugs, and minimizing the number of health problems and accidents among residents. Worse, when even highly rated nursing homes were inspected by CMS investigators in person, they were just as likely to fail the inspection as pass it; information submitted by nursing home operators and owners was rarely audited; nursing homes may have been tipped off before unscheduled, impromptu inspections; and inspectors frequently minimized violations they discovered at highly rated nursing homes, which allowed these facilities to maintain their stars.

All of this is troubling, to say the least. It suggests that a nursing home’s five-star rating should be taken with a grain of salt, or perhaps even a shakerful. It also reminds us of the importance of closely scrutinizing every aspect of a given nursing home oneself. AARP provides a detailed checklist to help you evaluate a nursing home on a wide range of crucial criteria.

Contact an Experienced Pennsylvania Elder Law Attorney

If you have additional questions or concerns regarding finding the right nursing home, contact the experienced Pennsylvania Elder Law attorney at Cardinal Estate Planning by calling 570-252-9043 to schedule an appointment.

Senior couple meeting with elder law attorney

The Difference Between a Living Will and a Health Care Power of Attorney

by Elder Law
Senior couple meeting with Estate Planning attorney

Many people are confused about the difference between a living will and a healthcare power of attorney. A living will specifies life prolonging treatments you do or do not want in the event you either suffer from a terminal illness or are in a permanent vegetative state. It does not become effective unless you are incapacitated and, generally, requires certification by your doctor, and another doctor, that you are either suffering from a terminal illness or have been rendered permanently unconscious. So if you suffer a heart attack, for instance, but do not have a terminal illness or are not in a permanent state of unconsciousness, a living will does not have any effect. You would still be resuscitated, even if you had a living will indicating that you don’t want life prolonging procedures. A living will is only used when your ultimate recovery is hopeless.

For situations where you are incapacitated and unable to speak for yourself, but your condition is not dire enough to make your living will effective, you should have a health care power of attorney or health care proxy. A health care power of attorney is a legal document that gives someone else the authority to make health care decisions for you in the event you are incapacitated. The person you designate to make these decisions on your behalf will do so based upon what you would want, so of course you must be sure to talk with them in great detail about your wishes. 

Another way to think about a living will.

We sometimes refer to a living will as a Love Letter. What do we mean by that? By making your health care wishes known and clearly describing them to your family, you not only ensure your desires will be carried out, you also spare your loved ones the trauma of having to make a critical medical decision on their own. Even though your ultimate recovery may be hopeless, making critical medical decisions can lead to infighting and permanently damage relationships between family members; stressful battles between hospital staff and family; and haunt your loved ones with guilt for years to come. 

In effect, a living will is a final, thoughtful expression of love for your family and your hopes for their emotional well-being in the future. Of course, a living will can’t do any good unless your physician and loved ones know about it. This may be a very difficult conversation to have, especially with your family, but letting them know what you want, and why, truly lessens their burden and helps them come to terms with your desires in advance and with minimal stress. We have the experience and understanding to counsel you on the best ways to begin such a conversation, and then, design an effective living will capable of ensuring your wishes are carried out and protecting your family emotionally.

Contact Us

If you have additional questions or concerns regarding living wills and health care power of attorneys, contact the experienced Pennsylvania Elder Law attorney at Cardinal Estate Planning by calling 570-252-9043 to schedule an appointment.

Stressed Asian Senior Couple using calculator and facing a medicaid crisis

Managing a Medicaid Crisis

by Elder Law
Stressed Asian Senior Couple using calculator and facing a medicaid crisis

In the United States, the median monthly cost of a semi-private room in a nursing home is currently more than $7,500. The cost of a private room exceeds $8,500 per month. Depending on where you live, costs can be considerably higher. In addition, costs rise according to the level of care needed and they are expected to increase dramatically in the future.  (See the current costs for home care, adult day care, assisted living, and nursing home care in your area.) To make matters worse, nearly 70 percent of us over the age of 65 will require long-term care at some point in our lives and 20 percent of us will need long-term care for five years or more. 

All of this helps explain why so many families exhaust their life savings within a few years of a family member entering a nursing home. And why more than half of all nursing home stays are now funded by Medicaid. 

A Medicaid Crisis is a situation where a person has already moved to a nursing home, or must enter one in the very near future, and has been informed that he or she owns too many assets to qualify for assistance from Medicaid to pay for it. Given the high cost of nursing home care, this situation is indeed a financial crisis for all but the wealthiest families. 

If you or a loved one is facing a Medicaid Crisis, try to remain calm. Much of the information we hear about Medicaid from friends, relatives, nursing home staff, caregivers, and many others is outdated or incorrect. A qualified elder law attorney can help you obtain assistance from Medicaid if you must enter a nursing home next month, next week, or tomorrow. In fact, it is possible to get Medicaid assistance even if you are already in a nursing home. And if you have applied for Medicaid assistance in the past but you have been rejected, it is entirely possible that a qualified elder law attorney can still obtain the financial assistance you need.

You’ve worked too hard to lose your life savings to the nursing home. Don’t let misinformation or unexpected life changes prevent you from getting the financial assistance you need and deserve.

Contact Us

If you have additional questions or concerns regarding a Medicaid Crisis, contact the experienced Pennsylvania Elder Law and Estate Planning attorney at Cardinal Estate Planning by calling 570-252-9043 to schedule an appointment.

GettyImages-1196485602

Quickly Determine What Services are Covered by Medicare by Downloading this Free App

by Elder Law
Portrait of a cheerful senior businesswoman using Medicare app on smart phone

Does Medicare cover a test or procedure recommended by your doctor? You’ll know at a glance if you use Medicare’s new “What’s Covered” app. 

This free app lets you search for specific services or browse a list of alphabetized services to determine what is covered by Medicare Parts A and B. You can also access basic information about costs.

While the app provides an extensive list of the services, tests, and procedures covered (or not covered) by Medicare, it does not take into account a user’s specific co-insurance, supplemental insurance, or deductibles. 

The What’s Covered app is part of an initiative by the Centers for Medicare and Medicaid Services (CMS) to modernize Medicare and empower beneficiaries. Other CMS initiatives include price transparency tools, improved online support, and a webchat option on the Medicare Plan Finder. 

You can get the What’s Covered app from the App Store or Google Play.

Contact Us

If you have additional questions or concerns regarding Medicare, contact the experienced Pennsylvania Elder Law and Estate Planning attorney at Cardinal Estate Planning by calling 570-252-9043 to schedule an appointment.

Senior woman sitting on sofa thinking about social security

What Women Need to Know about Social Security

by Elder Law
Senior woman sitting on sofa thinking about social security

While Social Security is a crucial component of many Americans’ retirement income, it is particularly important to women. According to the National Committee to Preserve Social Security and Medicare, 48 percent of elderly unmarried women relied on Social Security for 90 percent or more of their total income in 2017.

The Social Security Administration (SSA) has written a booklet detailing what women should know about Social Security. Here are the highlights:

Nothing keeps women from getting their own Social Security benefits.

  • If you’ve worked and paid taxes into the Social Security system for at least 10 years, and have earned a minimum of 40 work credits, you can collect your own benefits as early as age 62
  • Social Security benefits are based on your lifetime earnings. SSA adjusts (or “indexes”) your actual earnings to account for changes in average wages since the year the earnings were received. Then, SSA calculates your average indexed monthly earnings during the 35 years in which you earned the most. SSA applies a formula to these earnings and arrives at your basic benefit, which is called your “primary insurance amount”
  • If you become disabled before your full retirement age, you might qualify for Social Security disability benefits if you’ve worked and paid Social Security taxes in five of the last ten years
  • If you receive a pension from a job where you didn’t pay Social Security taxes, such as a civil service or teacher’s pension, your Social Security benefit might be reduced

There is no “marriage penalty.”

  • If you are married and both you and your spouse have worked and earned enough credits individually, you can each receive your own Social Security benefit. For example, if you are due a Social Security benefit of $1,200 per month and your spouse is due a Social Security benefit of $1,400 per month, you can receive $2,600 per month in retirement benefits

If you’re due two benefits, you generally receive the higher rate, not both

  • As a spouse, if you are eligible for benefits based on both your own work record and that of your spouse, you may be required to file for both benefits. If so, you generally receive the higher benefit amount
  • A wife with no work record or a low benefit entitlement on her own work record is eligible for between one-third and one-half of her spouse’s Social Security benefit
  • Most working women who reach retirement age receive their own Social Security benefit because it’s more than one-third to one-half of the husband’s rate
  • If your spouse dies before you do, you can apply for the higher widow’s rate. (You’ll find more information about that below)

If you are divorced but were married for at least 10 years, you may be eligible for some of your ex’s Social Security

  • Divorced women who were married for at least 10 years may be eligible for Social Security based on their ex-spouse’s record. This applies only if you are unmarried and not entitled to a higher benefit on your own record when you become eligible for Social Security
  • Some women sign divorce decrees relinquishing their rights to Social Security on their ex-spouse’s record. However, clauses like these in divorce decrees are rarely enforced
  • Benefits paid to a divorced spouse DO NOT reduce payments made to the ex or any payments due the ex’s current spouse
  • Generally, the payment rules that apply to divorced wives and widows are the same as the rules that apply to current wives and widows. This means most divorced women collect their own Social Security while the ex is alive, but they can then apply for higher widow’s rates when the ex dies

When your ex dies, you may be due a widow’s benefit

  • Widows are eligible for between 71 percent (at age 60) and 100 percent (at full retirement age) of what their spouse was getting before the spouse passed away
  • SSA must pay your own retirement benefit first, then supplement it with whatever extra benefits you are due as a widow to take your Social Security benefit up to the widow’s rate
  • SSA also can pay you a $255 one-time death benefit if you were living with your spouse when your spouse died
  • If you made more money than your spouse (or ex-spouse), then your spouse might be due a survivor’s benefit if you die before your spouse does

You can learn more by reading the SSA publication What Every Woman Should Know, which is available for free.

Contact Us

If you have additional questions or concerns regarding social security, contact the experienced Pennsylvania Elder Law and Estate Planning attorney at Cardinal Estate Planning by calling 570-252-9043 to schedule an appointment.

Young carer helping senior relocate to nursing home

Moving on—Help for Seniors Relocating to Nursing Homes or Assisted Living Facilities

by Elder Law
Young carer walking with the elderly woman in the park

Moving to a new home is stressful in and of itself. When the move involves a senior relocating to a nursing home or assisted living facility, the situation is considerably more complicated, both emotionally and physically.

Fortunately, a number of companies now specialize in helping seniors and their loved ones move to long-term care facilities, or even relocate to smaller, senior-friendly private homes. Together, these companies are known as Senior Move Managers. The National Organization of Senior Move Managers (NASMM) was formed in 2002. NASMM now comprises Senior Move Management companies across the United States, Canada, and overseas.

According to the NASMM website, Senior Move Managers typically provide all or some of the following services, depending on the particular company and the senior’s specific needs:

  • Creation of an overall move or “age in place” plan
  • Organizing the move, sorting belongings, and downsizing
  • Customized floor plans
  • Arranging for the profitable disposal of items that are no longer wanted through auction, estate sale, consignment, buy-out, donation, or a combination of these methods
  • Interviewing, scheduling and overseeing movers
  • Arrangement of shipments and storage
  • Supervision and oversight of professional packing
  • Unpacking and setting up the new home
  • Related services, which can include cleaning, waste removal, shopping, senior escort, assistance with the selection of a realtor, helping to prepare a home for sale, and more

Learn more about the National Organization of Senior Move Managers.

Moving to a Nursing Home or Assisted Living Facility in Pennsylvania

If you have additional questions or concerns regarding relocating to nursing homes or assisted living facilities, contact the experienced Pennsylvania Elder Law attorney at Cardinal Estate Planning by calling 570-252-9043 to schedule an appointment.