NYC elder law

Assisted Living Facilities in Many States Have Little Federal Oversight Despite CMS Funding

Published on: April 1, 2018 | by Ettinger Law Firm

The dream of Americans is to age with dignity and independence while enjoying their golden years with family and friends and avoiding the need for any type of long term institutionalized care. However, trends in aging show that more and more Americans these days are relying on some type of intermediate institutionalized care before eventually moving into a nursing home to receive the attentive services they need.

However, despite receiving an estimated $10 billion in federal funding from the Centers for Medicare and Medicaid Studies (CMS), states encounter little oversight from regulators over the quality of care residents receive. Furthermore, over half the states do not report “critical incidents” to the federal government that include unexplained deaths, abuse, neglect or financial exploitation. All of that is according to a recent report from the Government Accountability Office (GAO).

Advocacy group Justice for Aging issued its own response to the GAO report to highlight the lack of accountability from many states and facilities receiving CMS funding. The directing attorney for Justice in Aging went as far as to point out that even among the 22 states that do provide the federal government with data on critical incidents the information is hard for the public to obtain and may not even illuminating enough.

Department of Justice Announces Charges in $500 Million Elder Fraud Schemes

Published on: March 27, 2018 | by Ettinger Law Firm

The U.S. Department of Justice recently announced hundreds of indictments against individuals engaged in often elaborate schemes to defraud hundreds of thousands of elders across the country. The Justice Department said in a statement that it levied charges against over 250 defendants for their roles that contributed to an estimated $500 million in total financial damages against victims.

“Today’s actions send a clear message: We will hold perpetrators of elder fraud schemes accountable wherever they are,” Attorney General Jeff Sessions said in announcing the charges at a press conference. The Department of Justice coordinated with dozens of federal and local agencies to make the arrests, including working with Federal Bureau of Investigations, the Federal Trade Commission and state attorneys generals.

The perpetrators of the scheme allegedly used everything from mass mailing system and telemarketing schemes to identity theft to commit financial crimes against some of the most vulnerable portions of the population. In the past several years, the Senate Aging Committee received thousands of calls from individuals complaining they were either victims or an attempted target of some type of elder fraud.

Adding a “Life Estate” to Your Estate Plan

Published on: October 3, 2017 | by Ettinger Law Firm

When planning for our later years, forward thinking individuals often wonder what is the best way to spend down their assets to qualify for Medicaid but still live a comfortable and dignified life until services like nursing care are absolutely needed. With the value of real estate skyrocketing over recent decades, homes that were just a few thousands dollars may put homeowners in a financially difficult spot now that the property is worth many times the initial investment.

Under federal Medicaid laws, individuals may only have a net worth below a certain level, including things like homes and automobiles in some cases. Often times, seniors need to “spend down” their assets to qualify for the invaluable services Medicaid provides and many individuals may attempt to give away homes or spend down savings accounts to qualify. However, Medicaid has a “look back” period that can last a few months, meaning seniors may be penalized for recently giving away assets or spending bank accounts before applying for coverage.

One solution which may be effective for some is to create a “life estate” with their home. By doing so, seniors can own, live in, and exercise full control over their home and simply pass it on to a beneficiary like a child once they pass. With the help of an estate planning attorney, individuals can create the life estate with the deed to their property and create a “remainder interest” for the person who will receive the property, known as the remainderman, upon the deceased’s passing.

Creating Savings Accounts for Disabled Family Members

Published on: September 26, 2017 | by Ettinger Law Firm

Individuals with disabled family members understand the many obstacles life can put in front of them and their family, especially when it comes to finances. For many, having a permanent disability can mean being unable to provide for oneself and that can mean relying on benefits from social welfare programs to get by. However, many of these programs have strict income thresholds that can exclude potential beneficiaries if they earn too much money or have too much capital.

Fortunately, New York is one of several states that allow disabled persons and their families to create special savings accounts to help maintain the person’s health, independence, and quality of life. The New York Achieving a Better Life Experience (NY ABLE) helps supplement but not supplant benefits provided through Medicaid, SSI, SSDI, private insurance and other sources and is exempt from om tax on its earnings and distributions, provided the funds are used to pay for qualified disability expenses.

The laws creating the ABLE statute was signed into law by Gov. Andrew Cuomo in December 2015 and is federally authorized by the federal Stephen Beck, Jr. Achieving a Better Life Experience (ABLE) Act enacted on December 19, 2014, as Section 529A of the Internal Revenue Code. The NY ABLE program is administered by Office of the State Comptroller in consultation with specific State agencies and individuals appointed by legislative leaders, as specified in the NY ABLE statute.

New York’s Medical Orders for Life-Sustaining Treatment (MOLST) Form

Published on: September 22, 2017 | by Ettinger Law Firm

In New York, patients have the right to make many decisions about their end of life care and even appoint a representative to do so in their interests if circumstances leave them unable to make such decisions for themselves. Using what is known as a Medical Orders for Life-Sustaining Treatment (MOLST) form, patients can create a doctor’s order that informs physicians and emergency care givers whether to administer treatment like CPR or place the individual on ventilator or other life-saving equipments.

MOLST forms can be used in combination with a do not resuscitate (DNR) order to help give patients the most control over how their health care is delivered in an emergency situation or at the end of life where tough decisions must be made. In order for the MOLST form to be valid, the document must be signed by your physician and yourself, otherwise doctors may continue to deliver treatment during and emergency. The form will become a part of your medical file and will transfer over to whatever facility you may be treated at.

The main difference between a MOLST and DNR order is the former covers a broader range of care doctors may deliver, including intubation, administering antibiotics, and interesting feeding tubes, with DNR orders only cover administering CPR. Often times, patients using a MOLST face a life-threatening medical condition or lives in a long term care facility like a nursing home or hospice.

What are Advance Directives for Healthcare?

Published on: September 16, 2017 | by Ettinger Law Firm

Advance directives for health care are legal documents that ensure an individual’s wishes are carried out if he or she cannot make decision. New York State recognizes three types of advance directives including a health care proxy, living wills, and do not resuscitate orders (DNR). Even younger and more healthy individuals should consider putting these types of directives into place in case of a serious accident or medical event.

Health Care Proxy in New York

A health care proxy allows individuals to name a health care agent who will make decisions if that person cannot make those decisions for himself or herself. Under state law, these types of decisions can take effect after two doctors examine the individual and determine that person cannot make decisions for his or her health. New York state offers standard forms for a health care proxy.

How Much Does an Estate to Go Through Probate?

Published on: September 12, 2017 | by Ettinger Law Firm

Planning your estate and having a last will and testament is important to ensuring your final wishes are carried out and your heirs receive everything you intend to pass on to them. Whether you are the testator or executor, there are many duties you will need to perform to make sure an estate passes as quickly as possible through probate court, including calculating the costs associated.

First and foremost, New York probate courts handling estates have a variable schedule of filing fees which depend on the size of the estate. Section 2402(7) of New York’s Surrogate’s Courts Procedure Act (SCPA) are as follows:

Value of Estate or Subject Matter Fee	Fee Rate
Less than $ 10,000	$45.00
$10,000 but under $20,000	$75.00
$20,000 but under $50,000	$215.00
$50,000 but under $100,000	$280.00
$100,000 but under $250,000	$420.00
$250,000 but under $500,000	$625.00
$500,000 and over	$1,250.00

Section 2402(8)(a) of the SCPA also proscribes a fixed fee for filing a petition to commence certain proceedings. These types of fees can range anywhere from $10 to $75, depending on the type of motion filed. Such petitions can include common probate proceedings such as filing wills and suspending a fiduciary.

What are the fees for executors in New York?

Under section 2307 of the SCPA, executor fees are based on the value of the estate. These fees can be between 2 and 5% of the total amount of estate money the executor receives and pays out. Executor’s fees in New York are as follows:

All sums of money not exceeding $100,000 at the rate of 5 percent
Any additional sums not exceeding $200,000 at the rate of 4 percent
Any additional sums not exceeding $700,000 at the rate of 3 percent
Any additional sums not exceeding $4,000,000 at the rate of 2.5 percent

All sums above $5,000,000 at the rate of 2 percent

These amounts come out of the value of the estate and in cases where multiple executors handle an estate, the split is commiserate on the amount of work performed by each individual.

Attorney costs for probate of a will

When going through probate, it is strongly suggested the executor seek help from an experienced and dedicated New York probate and estate lawyer. The fees associated with a probate attorney depend on size of the estate, work put in by the executor, and the complexity of the case.

What is a Qualified Personal Residence Trust?

Published on: September 9, 2017 | by Ettinger Law Firm

When planning their estate, many individuals consider setting up some form of trust to avoid family squabbles over assets, particularly the home. To achieve the goal of a smooth transition of assets and maintaining family harmony, most folks choose to set up some form of trust to avoid probate and reduce the amount of time and money executors need to spend in court.

Although many may not realize the significant wealth they have accumulated over the course of their life, the reality can quickly set it when it comes time to pay estate or gift taxes when passing on a home to heirs. After decades of skyrocketing real estate prices, home that were once purchased for several thousand dollars may now be worth millions, depending on the condition of the home and location.

One way for highly wealthy people to pass on their home with as little tax liability to heirs as possible is the creation of a qualified personal residence trust. Just like any type of estate plan, there are benefits and drawbacks to consider and it is strongly advised individuals consult with an experienced estate planning attorney to draw up trusts and wills.

Using Portability to Get the Most Out of your Estate Tax Exemptions

Published on: September 5, 2017 | by Ettinger Law Firm

One of the most common estate planning goals for high net worth married couples is to reduce their estate’s tax liability by taking full advantage of state and federal estate tax exemptions. The 2012 Tax Relief, Unemployment Reauthorization, and Job Creation Act (TRA) gave couples much more leeway to plan for their state through the portability of a deceased spouse’s unused estate tax exemption.

In 2017, the estate and gift tax exemption will be $5.49 million dollars for an individual, and just under $11 million for married couples, thanks to the 2012 Act. While there are a number of ways to properly implement the portability of estate and gift tax exemptions, one of the more common ways is to create a family trust where the assets of the first spouse to pass away will be placed in under the individual’s own gift and estate exemptions.

Without portability, couples can end up leaving millions of dollars in assets subject to taxation because of improper planning. Two of the most common reasons couples fail to properly use take advantage of gift and estate tax exemptions are unbalanced asset ownership or an inefficient estate plan.

Know the Law: What is a Durable Power of Attorney?

Published on: September 2, 2017 | by Ettinger Law Firm

An important consideration in anyone’s estate plan is to consider appointing a trusted individual to make important health and financial decisions in any case where the testator may be incapacitated and unable to act in their best interest. One way to do this is to create a durable power of attorney in a living will which names another person as an agent or an “attorney in fact” to decide whether or not to continue with life support treatment and other important medical decisions.

In New York, Pub. Health Law §2980, et seq. Health Care Agent and Proxies details the powers of the attorney in fact, the legal requirements to create such an arrangement, when the agreement may be revoked, and the state to state applicability of the durable power of attorney. Specifically, the law allows the attorney in fact to make “Any decision to consent or refuse consent of any treatment, service, or procedure to diagnose or treat an individual’s physical or mental condition.”

Health Law §2980 requires individuals to fill out Standard Form §2981 and name a competent adult to the position. Additionally, the form must be signed in front of two witnesses and indicate the principal wishes his or her agent be able to make healthcare decisions and that this authority begin when an attending physician decides to a medical degree of certainty the principle cannot act on behalf of himself or herself.