December 2023




From The Certified Elder Law Attorney's Desk:




Transfer on Death and Beneficiary Designations: Death on an Estate Plan








William W. "Bill" Erhart












Blog Spotlight:





How Medicaid Penalizes Gifts: The Rules





By: Catherine Read










December 5th, 2023














Article of Interest:




How to support older family members during the holidays




Help make the holidays magical — not miserable — for older loved ones with this expert-backed list of dos and don'ts.






By Latasha Doyle







November 22, 2023







Calendar of Events










Inspirational Quote







Our Team


From The Certified Elder Law

Attorney's Desk:


William W. “Bill” Erhart








Transfer on Death and Beneficiary Designations: Death of an Estate Plan

Transfer on death or TOD accounts, sometimes known as Payable on Death or POD are form beneficiary designations. Beneficiary designations are most commonly known to us in life insurance. Every life insurance policy has a beneficiary. We are all familiar with  beneficiary designations for our 401K or IRA. It is rare that we do not designate a beneficiary for an IRA. And if married, by law, the beneficiary of a 401K is the spouse.


When you set up your estate plan, you think carefully about who is going to inherit  or take your property when you die. Whether you use a will or a trust, our definition of estate planning is: 


You want to control your property while you are alive,


Take care of yourself and loved ones, if you become disabled,

And give what you have to whom you want, 

The way you want and 


When you want. 


And save every last tax dollar, administrative fee and legal cost

possible.


TOD accounts disrupt and thwart these goals.


If you did your estate planning with us, you considered who your executor, agent or trustee will be, who will make health care decisions for you, who will assist you with financial and health decisions if you have diminished capacity, what property will avoid probate, what proportion of your estate an individual will receive, whether to inherit outright or in trust, what type of trust and how to allocate certain assets, how to include  IRAs and 401Ks and the special tax rules all these follow. All this can be undone with thoughtless TOD  designations.


Recently we assisted a family with an infirm parent. The parent had a detailed revocable trust plan prepared by another law firm which specialized in estate planning. The attorney is highly regarded. The trust detailed how expenses will be paid upon death, what percentages each child shall receive, the timing of the final distribution, the professional trustee in charge of the post-mortem administration, tax considerations, personal property distribution and whether in trust or outright. At least two children have mental impairments. They should not be given significant assets.


Hence the professional trustee designated in the revocable  trust to manage the assets.


The vast majority of the plan was disrupted by a financial advisor who suggested to the parent, at the time over the age of 90, to change the entire scheme by designating a large investment account as TOD. 


When the adult child who was incapacity trustee asked the financial  advisor how debts and taxes due be paid, the financial advisor said that it was up to the other children as to whether any of the debts would be paid from their share. There was no plan.


Actually, the IRS cares little about TOD and will aggressively pursue the TOD beneficiaries for taxes owed by the parent or the parent’s estate from whatever the child receives. Unfortunately, the IRS does not care about collecting pro-rata from each beneficiary, but will collect from whichever beneficiary is most available. This leaves that unfortunate individual with the task of seeking reimbursement from the other beneficiaries. 


When you set up a TOD account, the assets go directly to beneficiaries upon the owner's death. While these accounts avoid probate, this must be carefully coordinated with the overall estate plan, especially for larger accounts and estates.


While simply titling an account "Transfer on Death" and adding a beneficiary or two may be quick and easy, it is not simple. 


For one, there is no asset protection. The asset goes to the individual outright.


Second, your TOD accounts need to be coordinated with your overall estate plan. The importance of this grows with the size of your net worth. Failing to keep beneficiaries' updated as your family changes can work inequities. Some children become successful while others suffer disabilities or other misfortunes. 


Third, be careful when naming a minor as beneficiary on your

Transfer on Death account. Investment firms will not release the assets of an account to a minor.  This can require a limited court guardianship. A TOD does not give instructions on how to manage and use the money. When the minor reaches the age of majority, it must be given to the child.


Fourth, in addition to protecting the young from mismanagement, a trust can protect your beneficiaries from creditors at any age. With a TOD account, the only condition necessary for your beneficiary to have a right to the asset is your death. 


If a child has a judgment against them, the creditor could potentially seize the asset intended to benefit the family. If there is a divorce after receiving the asset it can be a consideration in a property, support or alimony dispute.


If creditor protection is a concern, placing an asset in a beneficiary controlled trust can keep it safe for the benefit of your children and out of reach of their creditors.


Finally, with a TOD account, who is responsible for paying your final expenses? How do you ensure that a TOD beneficiary reimburses the one who pays for your funeral and final bills? With a TOD account, you cannot.


With a trust, your debts can be paid out of trust assets, and the remainder, once your debts are settled, distributed equally to your intended beneficiaries. The same can occur by using a will as the probate estate pays the expenses.


Trusts do involve more expense and effort at the outset than transfer on death accounts. But that expense should be viewed in the light of an investment in protecting yourself, your family, and the assets you want to leave for them.


How Medicaid Penalizes Gifts: The Rules



Tuesday, December 5th, 2023

By Catherine Read



Prior gifts harm Medicaid applicants by delaying when Medicaid starts. The delay is directly linked to the total gift value over a five-year period. This delay significantly harms persons needing care now. We see this time and again. Below we explain the basic rules on how Medicaid penalizes gifts.


How Do Gifts Arise?


A parent gives money to her child. The gift might be large or small, one time or repeated. Medicaid counts even gifts of a few hundred dollars.


A parent might have thought Medicaid permitted a gift because the gift had tax benefits. Not so. Tax planning is different than Medicaid planning. A gift for less than the annual gift tax exclusion (in 2023, $17,000) does not require a gift tax return and does not count against a person’s lifetime gift and estate tax exemption (in 2023, $12.92 million). But this is still a gift for Medicaid purposes.


Gifting is The Foundation of the Medicaid Rules


Asset transfer rules are the foundation of the Medicaid rules. The three key concepts are: gift/transfer, lookback period, penalty. Each is interrelated: a gift that occurs during the lookback period is penalized. When a client in need of long-term care Medicaid has transferred assets, our task is to analyze the transfer for these elements. If we can demonstrate to Medicaid that an asset transfer is not within these elements, penalty might be avoided. But the elements are unbending. Below are the main elements.


First, a gift, also called an uncompensated transfer. A gift is a transfer of assets for less than fair market value. It is the first line of attack to have a transfer not be considered a gift. Full fair market value must be given in exchange for the transfer. 


Second, a gift is penalizable if it occurs during the lookback period. The lookback period is the 60 months (5 years) before one applies for Medicaid.


Third, how is a gift during the lookback period bad? The penalty. The penalty is the number of months the Medicaid applicant is ineligible for Medicaid because of the total gifts made during the lookback period.


How does Medicaid calculate the penalty period? Medicaid takes the total of the gifts made during the lookback period and divides it by the penalty period divisor as determined annually by the State. In 2023 the penalty period divisor in the State of Delaware is $10,953.


Here is an example of how to calculate the penalty period using easy numbers: Father gifts $50,000 to his son. 2 years later the father enters a nursing home and applies for Medicaid. Medicaid looks back 5 years and sees the gift made 2 years prior. At the time of application the penalty period divisor is $10,000. $50,000 divided by $10,000 is 5 months.


When does the penalty period start? When the applicant is determined “otherwise eligible” for Medicaid but for the penalty period. This means:


Financially eligible: the applicant’s assets are below the permitted resource amount, as determined by Medicaid. In 2023, 1) the resource limit for a single individual is $2,000; 2) for a married couple, the maximum resource limit for the spouse residing in the community is $148,620 (called the Community Spouse Resource Allowance) and the institutionalized spouse’s resource limit is $2,000.


AND


Medically eligible: This means being determined to require an institutional level of care. The individual need not reside in a nursing home: it could mean nursing home services, services equivalent to nursing home but in another setting, or home and community based services under a waiver program. Nursing facility care, assisted living, and in-home care are covered.


If there is going to be a penalty, it is important to get the penalty period started as soon as possible. How? File the application once below the resource limits and get the penalty assessed. An applicant may have to file a second application once the penalty period has expired.


The Deficit Reduction Act of 2005


The Deficit Reduction Act of 2005 (the “DRA”) became effective February 8, 2006. It is still key legislation.


The DRA greatly changed Medicaid in at least two ways:


First, it changed the lookback period to 60 months (5 years). For gifts made prior to the effective date of the DRA, the lookback period was 36 months.


Second, under the DRA the penalty period starts NOT at the date of the transfer of the assets, but the date the Medicaid Applicant is otherwise eligible.



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How to support older family members during the holidays


Help make the holidays magical — not miserable — for older loved ones with this expert-backed list of dos and don'ts.

By Latasha Doyle

November 22, 2023

Due to a variety of reasons, a quarter of adults 65 and over are considered socially isolated, and a “significant portion” of older adults in the U.S. report feeling lonely, according to the National Academies of Sciences, Engineering, and Medicine. And the American Psychological Association notes that during the holidays, those numbers may be amplified, thanks to the “holiday blues,” which can cause irritability, fatigue and sadness. Knowing how to care for and support your older loved ones in small ways can help reduce some of that loneliness and help you connect with them on a deeper level.

Navigating this time of year with your older loved one can be emotional and stressful for family caregivers. Here are a few tips from professionals that will help you support older adults — without overextending yourself. 


What to do during the holidays

Here, a list of “dos” when it comes to caring for and connecting with older loved ones this holiday season.


DO: Include your family member in event and/or meal planning

The holidays are chock-full of celebrations and family meals. Include your older loved one in the planning, from choosing the courses to picking out linens, or ask them to help you cook if they are able. According to Misty Taylor, a registered nurse and senior vice president of Clinical Operations and Quality at BrightStar Care, this makes older adults feel needed and gets them excited about the upcoming event or meal with family. 


DO: Make some of their favorite meals or treats

Maybe your loved one grew up eating rhubarb pie on Christmas Eve or they have a go-to family latke recipe. Whatever it is, make sure to include their favorite food or dessert in any meals or holiday celebrations. This makes them feel special and shows you care. 



“Making their favorite foods or treats can also be really powerful if a senior has memory challenges,” says Alicia Allen, a registered nurse in Broomfield, Colorado. “It brings them back to something they likely remember and love.”


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