Walnut Creek Elder Law Blog

One of the most frequently asked questions I receive as an elder law attorney in Walnut Creek, CA is, “Can the State of California take my home if I die after having been on Medi-Cal?”

 The state will not actually take your home. But your home, if it is in your estate when you die, can be subject to a claim by the state after your death for the amounts the state has paid for your care. This claim will be paid when your property is sold from your estate. The state can only recover for the amounts they have actually paid for your care. Presently the amount they can recover is $7,092 per month, minus the share of cost that you have contributed to a nursing home. This amount of course would be less than what you would have paid as a private pay patient in a nursing home.

 In order to establish your home as an exempt asset when you apply for Medi-Cal, you must confirm your intent to return home if you have entered a nursing home. There is a question on the Medi-Cal application which allows you to establish this intent.

 The state will not pursue a claim for reimbursement against a surviving spouse of a Medi-Cal recipient as long as she is still living in the property. When she dies, the state will pursue the claim against any assets she received from her spouse, including the home, if he was a Medi-Cal recipient. In addition, the state cannot pursue a claim against the home if the Medi-Cal recipient is survived by a minor, blind or disabled child.

 There are techniques allowed by the state for protection of the home from a claim after death. For instance, we can “transmute” or transfer the ill spouse’s interest in the home to the well spouse during his life, and reserve a life estate to the well spouse. We can also transfer the home from a single Medi-Cal recipient to his children, for instance, and reserve a life estate to the Medi-Cal applicant. Transfers such as these must be done correctly and pursuant to the regulations in order to avoid a state claim, and in order to avoid capital gains issues. Please be aware that there is no protection for the home if it is in the revocable living trust of the Medi-Cal recipient when he passes away. Asset protection planning must be accomplished while the Medi-Cal recipient has good mental capacity. Otherwise, we may have to go to court to correct the problem. Do not rely on the idea that your financial durable power of attorney and revocable living trust will allow you to make these transfers during mental incapacity. The estate planning documents require specialized language in order to do this, and most plans do not have the requisite language.

 Keep in mind that the state cannot make a claim against assets that are not in your estate when you die. You will need the help of your elder law attorney aka your asset protection attorney in order create a long term care and asset protection plan for you. 

 Written Michael J. Young, elder law attorney, Medi-Cal attorney, senior law attorney and probate attorney in Walnut Creek, CA and former in-house counsel for title insurance companies. Mr. Young is a Medi-Cal attorney and is VA Certified. He is a member of NAELA www.WalnutCreekElderLaw.com LawYoung1@Gmail.com 1931 San Miguel Dr., Suite 220, Walnut Creek, CA 94596. 925-256-0298. Mr. Young serves Contra Costa and Alameda Counties, including the cities of Walnut Creek, Alamo, Danville, Concord, Brentwood, Pleasant Hill, Antioch, Clayton, etc. Mr. Young advises clients regarding Probates, Probates with Real Estate, Medi-Cal, nursing homes, asset protection, the VA Aid and attendance pension benefit, and long term care planning. Mr. Young is an Elder Law Attorney and Probate Attorney with offices in Walnut Creek, CA. Walnut Creek Elder Law Attorney, Walnut Creek Probate Attorney. Senior Law Attorney

You should get your ducks in a row long before a crisis occurs, especially where your health and finances are concerned. Many of our clients come to see us when a crisis is occurring. For instance, their spouse or loved one is in the hospital or has just entered a skilled nursing facility. At this stage the planning is usually more difficult, and we may be facing memory issues of the ill person. It may also be more difficult to preserve the home as a legacy for the clients’ beneficiaries. The home is many times our clients’ largest asset.

As part of long term care planning, we plan how various stages of care will be paid for and determine what assets and resources are available. We proceed to get our ducks in a row to protect assets. We also line our ducks up for obtaining Medi-Cal to pay for the skilled nursing facility and the VA Aid & Attendance Pension Benefit to pay for in home care or an assisted living facility. Gifting and spending issues for Medi-Cal and VA are considered. The longer we have to do long term care planning, the easier it is for all concerned. In addition, your peace of mind can be assured earlier on. 

FAMILY DYNAMICS: When we are able to do pre-planning for our clients, we can better take into account issues concerning family dynamics. We need to know which family members are helping the ill person, and who can be relied upon when help is needed. We can offer suggestions for the well spouse for her care for the ill spouse when he comes home. We will be better able to find out if there is serious infighting and resentments among family members. When a crisis occurs, these dynamics become intensified.

LEGAL DOCUMENTS: Are the legal documents up to date? If they are, you are in a tiny minority. If you have not gone to an elder law attorney in the last several years, your documents are probably not up to date. There is specialized language that can be utilized for asset protection and for government benefits planning in the various documents. For instance, if we want to preserve the home and protect it from a Medi-Cal lien, and the ill person has severe memory issues, we may not be able to proceed to transfer the home to the well spouse or a child without going to court. Most revocable living trusts and financial durable powers of attorney do not contain this specialized asset protection language.

Pre-planning will also allow us to discuss any changes that may be needed in the trust, will, financial durable power of attorney and other estate planning documents. Family dynamics are always changing with the occurrence of deaths, divorces, children who are themselves in need of care, second marriages, etc.

Written Michael J. Young, elder law attorney, Medi-Cal attorney, senior law attorney and probate attorney in Walnut Creek, CA and former in-house counsel for title insurance companies. Mr. Young is a Medi-Cal attorney and is VA Certified.  www.WalnutCreekElderLaw.com LawYoung1@Gmail.com 1931 San Miguel Dr., Suite 220, Walnut Creek, CA 94596. 925-256-0298. Mr. Young serves Contra Costa and Alameda Counties, including the cities of Walnut Creek, Alamo, Danville, Concord, Brentwood, Pleasant Hill, Antioch, Clayton, etc. Mr. Young advises clients regarding Probates, Probates with Real Estate, Medi-Cal, nursing homes, asset protection, the VA Aid and attendance pension benefit, and long term care planning. Mr. Young is an Elder Law Attorney and Probate Attorney with offices in Walnut Creek, CA. Walnut Creek Elder Law Attorney, Walnut Creek Probate Attorney. Senior Law Attorney

Most of our clients make it well known in their long term care plans, that if they become ill, they wish to be taken care of at home for as long as possible. My parents made a pact with each other that if either of them had to go to “rehab”  as my mother called it, which is a skilled nursing facility, that they wanted to return home and be taken care of at home. My mother died at home under hospice care. Your elder law attorney can make these desires known in your elder care estate planning documents. In fact, at the Law Offices of Michael J. Young in Walnut Creek CA, we have our clients sign a separate “Intent To Return Home Document,” which states that if they have to go to a nursing home, it is always their intent to return to their home.

Most of our clients also make it known in their long term care planning documents that if they have a terminal illness, and they would only survivie by being hooked up to machines, that they would rather instead, be allowed to die with dignity, and not be hooked up to machines.

Many people do not know that hospice care can take place at home, and that hospice care professionals can come to your home. Hospice is also often paid for by Medicare or private insurance. To qualify for hospice, a physician must confirm that in their opinion, their patient is likely to die within a six month period. This is generally all that is required. I remember how relieved my siblings and I were when my mother was on hospice at home, and various nurses, social workers, doctors, priests and other aides came into my parents home to attend to my mother. All of us benefitted from this process. 

The hospice process allowed my mother, my dad, myself and my siblings to  to appreciate our last days together with my mother, outside of the traditional, more hectic hospital atmosphere.  

For more information about hospice, long term care planning, asset protection, Medi-Cal qualification and the VA Aid & Attendance Pension Benefit, please feel free to contact Michael J. Young at The Law Offices of Michael J. Young in Walnut Creek, CA. www.youngelderlaw.com www.walnutcreekelderlaw.com

Written Michael J. Young, elder law attorney, Medi-Cal attorney, senior law attorney and probate attorney in Walnut Creek, CA and former in-house counsel for title insurance companies. Mr. Young is a Medi-Cal attorney and is VA Certified.  www.WalnutCreekElderLaw.com LawYoung1@Gmail.com 1931 San Miguel Dr., Suite 220, Walnut Creek, CA 94596. 925-256-0298. Mr. Young serves Contra Costa and Alameda Counties, including the cities of Walnut Creek, Alamo, Danville, Concord, Brentwood, Pleasant Hill, Antioch, Clayton, etc. Mr. Young advises clients regarding Probates, Probates with Real Estate, Medi-Cal, nursing homes, asset protection, the VA Aid and attendance pension benefit, and long term care planning. Mr. Young is an Elder Law Attorney and Probate Attorney with offices in Walnut Creek, CA. Walnut Creek Elder Law Attorney, Walnut Creek Probate Attorney. Senior Law Attorney

Medi-Cal can pay for your stay in a skilled nursing facility if you qualify. Under the state’s regulations, your home can be confirmed as an exempt asset in the Medi-Cal application. This means that you can keep your home, if you are otherwise qualified, and still receive Medi-Cal. This is true whether you are single or married. The concept is that you should not have to lose your home in order to receive this public benefit.

 The problem is that the state will want to recoup the payments it has made to the nursing home for your benefit, when you die. If your home is in your estate when you die, the state will put a lien on your home for the amount it has paid to the nursing home on your behalf. If the state has paid out $150,000 for you, they will put a lien on your home for that amount. When you die and your estate is settled, the state will be satisfied first for their lien of $150,000, and your beneficiaries will receive what is left. The state will not pursue a lien against a surviving spouse who still owns the home, but when she dies, the state’s lien will attach to the home and the state will recoup their payments at that time. 

There is a legal technique which is permitted under the regulations, which will allow you to protect your home against a Medi-Cal lien. It is called a “reserved life estate,” and your elder law attorney or senior law attorney can advise you in this regard. If the Medi-Cal applicant owns a home, we can transfer her interest in the home to her spouse, or to her children, for instance. A life estate in the home is reserved on the deed in favor of the Medi-Cal applicant. This means that the applicant owns the home for the rest of her life, and that her spouse or children own the remainder interest. The applicant is entitled to rents, issues and profits derived from the real estate. These interests are confirmed on the county record. When the Medi-Cal applicant dies, the home is not in her estate because her life interest disappears at the time of her death by operation of law, and her spouse or her children then receive the full interest in the property. Elder law planning and asset protection planning can be further pursued for the surviving spouse with your elder law attorney, to likewise protect her interest in the home.

Although under real estate law the home is not in the Medi-Cal applicant’s estate when she dies, so that a Medi-Cal lien cannot attach to the home, another benefit in using this technique is that under the IRS regulations, the reserved life estate interest should be recognized as keeping enough interest in her home in her estate, so that there should be a “step-up in basis” for capital gains purposes at the time of her death.  

If you have lost mental capacity at the time we would like to make a transfer of your interest in your home and reserve a life estate in your favor, we will need to look at the language and powers in your revocable living trust and financial durable power of attorney. If the powers are not there, and they usually are not, you may have to pursue a court petition through an elder law attorney who is familiar with this area of the law, in order to reform your documents to allow for this transfer. Most revocable living trusts and financial durable powers of attorney do not contain this favorable language. As a result people who are “baby boomer” age or older should consider getting their “Ducks In A Row” and have their elder law attorney or senior law attorney create an elder care plan for them, which will include estate planning documents with this favorable, asset protection language. An elder law attorney who is familiar with Medi-Cal qualification can certainly help you in this regard. Michael J. Young is an elder law attorney who practices in Walnut Creek, CA.

Written Michael J. Young, elder law attorney, Medi-Cal attorney, senior law attorney and probate attorney in Walnut Creek, CA and former in-house counsel for title insurance companies. He is Medi-Cal attorney and is VA Certified.  www.WalnutCreekElderLaw.com LawYoung1@Gmail.com 1931 San Miguel Dr., Suite 220, Walnut Creek, CA 94596. 925-256-0298. Mr. Young serves Contra Costa and Alameda Counties, including the cities of Walnut Creek, Alamo, Danville, Concord, Brentwood, Pleasant Hill, Antioch, Clayton, etc. Mr. Young advises clients regarding Probates, Probates with Real Estate, Medi-Cal, nursing homes, asset protection, the VA Aid and attendance pension benefit, and long term care planning. Mr. Young is an Elder Law Attorney and Probate Attorney with offices in Walnut Creek, CA. Walnut Creek Elder Law Attorney, Walnut Creek Probate Attorney. Senior Law Attorney

Many of our older clients are being taken care of by their spouse, or by one or more of their adult children or another family member. The older person of course appreciates the help, and the caregiver feels gratified in their role. The caregiver may also feel extremely guilty if they don not help. The care often takes place in the older person’s home or in the home of a child. Also, spouses and children will at times spend nights in their loved one’s care facility to help with the care.

But, being a caregiver for an older person can be a 24 hour a day, seven days a week job. And, the work can be exhausting. We receive calls all the time from family members or from spouses, who tell us that they can’t do it any more. I remember when my brother and I were trying to take care of our elderly father. My brother and I finally got to the point where we could barely pick our Dad up to help maneuver him to the bathroom. Toileting issues were difficult for everybody. Our Dad also would not cooperate with taking his medications, and there were other problems. My brother and I finally decided that we did not have the requisite skills to properly care for our Dad any longer, but we suffered with the guilt associated with making this decision. I do remember being amazed however, when we hired an experienced in-home care giver for our Dad, how the care giver, because of his training, could easily move our father around.

If you find yourself in the caregiver role, please keep in mind that your own health can suffer as the result of helping your loved one. How many times have we heard of the well spouse passing away from exhaustion caused by her helping her ill spouse? Please give yourself a break. Call other family members and friends to help you. You can utilize adult care services, where you take your loved one to spend several hours during the day. You can also hire a caregiver, and there are many fine agencies in the area who have qualified people who can help you.

Please feel free to contact us if you have questions along these lines, as we may have suggestions for help you can receive within the elder care community 

At the Law Offices of Michael J. Young in Walnut Creek, for many years now, we have helped clients and their families with questions such as these. We also continue to help seniors keep what they have earned. We do this through the preparation of asset protection plans, long term care plans, revocable living trusts, powers of attorney and wills, and assistance with applications for Medi-Cal and the VA Aid and attendance Pension Benefit.

Written Michael J. Young, elder law attorney, Medi-Cal attorney, senior law attorney and probate attorney in Walnut Creek, CA and former in-house counsel for title insurance companies. He is Medi-Cal attorney and is VA Certified.  www.WalnutCreekElderLaw.com LawYoung1@Gmail.com 1931 San Miguel Dr., Suite 220, Walnut Creek, CA 94596. 925-256-0298. Mr. Young serves Contra Costa and Alameda Counties, including the cities of Walnut Creek, Alamo, Danville, Concord, Brentwood, Pleasant Hill, Antioch, Clayton, etc. Mr. Young advises clients regarding Probates, Probates with Real Estate, Medi-Cal, nursing homes, asset protection, the VA Aid and attendance pension benefit, and long term care planning. Mr. Young is an Elder Law Attorney and Probate Attorney with offices in Walnut Creek, CA. Walnut Creek Elder Law Attorney, Walnut Creek Probate Attorney. Senior Law Attorney

PROBATE is a court proceeding that is used to distribute your assets to your beneficiaries at the time of your death. Probates are complex, and require that numerous forms and regulations be followed, before the court will sign an order distributing your assets to your beneficiaries or heirs. 

A probate with regard to your home and other real estate assets can usually be avoided with the use of revocable living trusts. To do this, title to your home would be transfered on the County Record from yourself, to yourself as trustee under your revocable living trust. For instance, the deed would be from John Doe to John Doe as Trustee of the John Doe Revocable Living Trust dated January 15, 2012. The terms of the trust will state who the home will be distributed to after you die, and this transfer can be completed on the County Record without a probate. 

However, not everybody passes away with their home in a revocable living trust. There are many occasions where individuals will pass away with their home in their name alone, and they may or may not have a will. A probate will probably be required whether they have a will or not. The terms of the will determine who the beneficiaries of the home will be. If there is no will, the home will be distributed to the “heirs at law” of the decedent.

With regard to real estate, a probate is required to clear the title so that the property can be distributed to the beneficiaries or heirs of the decedent, or so that the property can be sold and the proceeds of sale distributed to the beneficiaries or heirs. Clients will ask me why a probate would be required if the decedent has a will naming somebody as a beneficiary. To find the answer to this, we first need to first look at the County Record to see who the record owner is for the home. The last deed of record could be in the name of John Doe. John Doe is now deceased, so who can sign a deed from John Doe to his beneficiary? The answer is no one, which is why a court order would be required.

Written Michael J. Young, elder law attorney and probate attorney in Walnut Creek, CA and former in-house counsel for title insurance companies. www.WalnutCreekElderLaw.com LawYoung1@Gmail.com 1931 San Miguel Dr., Suite 220, Walnut Creek, CA 94596. 925-256-0298. Mr. Young serves Contra Costa and Alameda Counties, including the cities of Walnut Creek, Alamo, Danville, Concord, Brentwood, Pleasant Hill, Antioch, Clayton, etc. Mr. Young advises clients regarding Probates, Probates with Real Estate, Medi-Cal, nursing homes, asset protection, the VA Aid and attendance pension benefit, and long term care planning. Mr. Young is an Elder Law Attorney and Probate Attorney with offices in Walnut Creek, CA. Walnut Creek Elder Law Attorney, Walnut Creek Probate Attorney