Category Archives: Elder Law

Medicaid & Mortgages

MEDICAID & MORTGAGES

How many times have you heard the advice, “Pay off your mortgage before retirement”? Many couples are very proud of the day they finally don’t have a mortgage hanging over their head. There is much to be admired about being debt free. However, debt is not always bad. Surprisingly, when facing long term care, sometimes having a mortgage can even help!

When one spouse becomes ill and must begin receiving long term care, the healthy spouse at home may wonder how they will afford to pay for their spouse’s nursing home without losing everything. The answer for most is Medicaid. Medicaid has complicated rules that must be satisfied in order to qualify, and sometimes navigating them can seem counter intuitive. Sometimes taking out an equity loan on the house can save you thousands of dollars.

This plan only works in a very specific, but not uncommon situation. This plan may most benefit a married couple, where one spouse is ill and needs long term care, but the other spouse is staying in the family home, and the bulk of that couples’ net worth is invested in the house.

SPOUSAL QUALIFYING ASSETS FOR MEDICAID

First a brief review on what happens when one spouse needs to qualify for Medicaid (see article Basics of Medicaid for more detail).

Medicaid is a means tested program, which means when determining eligibility it looks at an individual’s assets. There are two ways of classifying assets for Medicaid; exempt assets and countable assets. Exempt assets mean that Medicaid does not count them when determining eligibility. These assets are; the residential house, one car, all personal items, and prepaid funerals. All other assets are considered countable assets.

In order to see if the countable assets are low enough to qualify, Medicaid looks at the value of the assets on two different dates; the snapshot date, and the date Medicaid is applied for.

The snapshot date is the first day that the ill spouse is institutionalized for more than thirty consecutive days. If this date has not yet occurred, the snapshot date is the first date Medicaid was applied for. There is only one snapshot date. If a snapshot date has not already been established, applying for Medicaid while one is over assets, will immediately establish a snapshot date, even though the first application will get rejected. Once the snapshot date is established, then the couple can reapply in the future once assets have been spent down to a qualifying level.

On the snapshot date a “picture” is taken of the value of the countable assets. It does not matter whose name the assets are titled in. In most instances, the community spouse gets to keep half, and the rest must be spent down to $2,000 in order for the ill spouse to qualify for Medicaid. For example, if a couple has $100,000 on the snapshot date, the community spouse gets to keep $50,000 and the ill spouse must spend $48,000 to spend his side down to $2,000 to qualify for Medicaid.

There are minimum and maximum restrictions on this rule. In 2019, the community spouse is allowed to keep a minimum of $25,284 and a maximum of $126,420. This means, if the couple has only $30,000 in countable assets, the community spouse gets to keep $25,284 and the ill spouse must spend only $2,716 to get below the $2,000. However, if a couple has $300,000 in countable assets, the community spouse only gets to keep the maximum of $126,420 and the institutionalized spouse has to spend down  $171,580 to reach a qualifying level of $2,000 or less.

MORTGAGES, CREDIT AND DEBT

With a better idea of how Medicaid works for couples, we can now look at how debt comes into play. For the most part, Medicaid does not consider debt when looking at eligibility. Debts are not counted against you.

It does not matter if you have a $5,000 bank account and a $3,000 credit card bill, as far as Medicaid is concerned, you do not qualify because you have $5,000 in countable assets, which is too high. However, you are allowed to spend down your assets by paying your debts. So if you paid off your $3,000 credit card bill, leaving $2,000 in the bank, you would qualify for Medicaid. Obviously the nursing home would prefer the money be spent paying for care, which is an option, but an individual applying for Medicaid can pay off any debts he likes so long as they are his debts (cannot pay off student loans for a grandchild, for example).

This means that if a couple is looking to spend down money to qualify for Medicaid, a large loan like a mortgage can be a very quick way to spend down money to get a person qualified for Medicaid. If a person doesn’t have a mortgage, they may even want to take out an equity loan on the home to increase the amount of countable assets before the snapshot date, knowing that when the time comes to spend that money down, they will be able to repay it.

EXAMPLE

Let’s use an example to illustrate how a loan on the house can sometimes be an advantage. There are two couples that live next to each other, and have a similar financial picture.

Dwight and Angela have a house and a bank account with a net worth of $360,000. They have a house worth $300,000 and no mortgage, and have a bank account worth $60,000. Their neighbors Jim and Pam also have a house and a bank account with a net worth of $360,000. They have a house worth $300,000, but have taken out a loan with $150,000 of the equity which they did not spend, but instead added it to their $60,000 bank account. The bank account is now worth $210,000.

Both Dwight and Jim need to go into a nursing home. The wives go to apply for Medicaid for their spouses to help pay for their husbands’ care.

Dwight & Angela

The house is an exempt asset, but on the snapshot date Angela and Dwight had $60,000 in countable assets. Angela gets to keep $30,000 and they need to find a way to spend down $28,000 to get Dwight qualified for Medicaid (he gets to keep $2,000). She spends the money down on Dwight’s nursing home care for three months, and then he qualifies for Medicaid. At the end of the day, the couple has a net worth of $332,000 and Dwight is receiving Medicaid.

Jim & Pam

The house is an exempt asset, and on the snapshot date Jim and Pam had $210,000 in countable assets. Pam gets to keep $105,000 and they need to spend down $103,000 for Jim to be qualified for Medicaid (he gets to keep $2,000). They spend the whole $103,000 on repaying the equity loan they have on the house, bringing it down to just $45,000 owed on the house. Pam may also be able to apply to Medicaid to keep an extra part of Jim’s income to help with the mortgage payment.  The couple still has a net worth of $360,000 and Jim can begin receiving Medicaid immediately.

Obviously Jim & Pam are in a much better situation than Dwight & Angela at the end of the day.

WARNINGS & CAVEATS

This plan does not benefit single people.

This plan does not benefit married couples who already have over $250,000 in countable assets outside of the house.

This plan only works if the mortgage is taken out before the snapshot date. Once the snapshot date is established it cannot be changed. Ideally on the snapshot date, assets are as close to $253,000 as possible, though this is not always within the individual’s control.

Remember, this has to be an equity loan, not just a line of credit.

In order for the plan to work, it’s important to keep the money safe once the equity is pulled out of the house. This means, you should NOT:

  • Invest in high risk options, like the stock market. (choose something risk free)
  • Gift the money. (NEVER gift money when considering Medicaid without consulting an attorney)
  • Loan the money out.
  • Go on a spending spree. (Just because the money can be accessed does not mean it should.)
  • Tie the money up by purchasing an annuity, or a long term cd or something else you can’t access when you need it.

This is just one of many strategies that can help a couple facing long term care. Everyone’s situation is unique and therefore everyone’s estate plan is different. The laws change and are often nuanced. Consult with a specialist attorney who can help you find the right plan for you.

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The Four Biggest Trust Mistakes

The Four Biggest Trust Mistakes

Trusts can be wonderful estate planning tools used to address a myriad of issues. These four common mistakes, however, can cause a trust to create more problems than it solves.

Mistake #1: Choosing the Wrong Type of Trust

Trusts can be used for tax planning, Medicaid planning, estate planning, protecting vulnerable beneficiaries such as minor children, disabled individuals or even future unborn generations. No trust can do everything; however. It is important that your trust be carefully crafted to meet your particular goals and needs.

Mistake #2: Choosing the Wrong Trustee

The job of the trustee can be a difficult one. The trustee should manage the assets in accordance with the settlor’s wishes. He must invest prudently, keep orderly accounts, file taxes and treat beneficiaries fairly. Choosing an inept or worse, a dishonest, trustee can prove disastrous.

Mistake #3: Not Funding the Trust Properly

A trust is like a basket which holds assets. If property is not titled to the trust, you have an empty basket. Assets can be titled to the trust either during the settlor’s lifetime or at his death. Generally an attorney who draws a trust will also draw a will that “pours over” assets into the trust through the probate estate. This is somewhat inefficient. Assets titled jointly with survivorship to another person or name someone other than the trust as a designated beneficiary will not be governed by the trust provisions. Some assets should not be titled to the trust. Titling assets such as IRA’s, 401 K’s, 403 B’s and qualified annuities to the trust may cause major tax ramifications.

Mistake #4: Not Keeping Your Trust Up To Date

As your life circumstances change, your trust should evolve to meet your needs, just as your personal and financial situations change, so do the laws surrounding trusts. Plan to review your trust every 2 to 5 years or when you have a major, life changing event such as the birth of a child, death of a spouse, marriage or major change in fortune. Be sure to have all of your asset information as well as all prior trust amendments when you meet with your attorney.

Your trust is an important part of your estate plan. Avoid these costly mistakes by working with an experienced and knowledgeable attorney.

Medicaid for Your Spouse Issues and Traps

Medicaid for Your Spouse Issues and Traps

You pledged “for better or worse”, “for richer or poorer”, and “in sickness and in health”. What do you do now that things are worse, your spouse is so sick he needs round the clock care that you cannot provide at home and you are facing the prospect of becoming poorer and poorer?

As families seek Medicaid to help with the cost of long term care, they should be aware of some commonly overlooked obstacles.

Place your loved one in a facility that accepts Medicaid

Independent living and many assisted living facilities do not accept Medicaid especially in their “Memory Care” sections. Some facilities will accept Medicaid, but only after the patient has paid privately for some period of time.

It is especially important to know the facility accepts Medicaid in the case of married couples. The assets that the healthy spouse is able to keep are based on the total assets that the couple has on the date of institutionalization (the “Snapshot Date”). Paying for care in a non-qualified facility may reduce the amount of funds that the healthy spouse eventually gets to keep.

Title Assets Appropriately

To qualify for Medicaid, the ill spouse can have only $2,000 in countable assets. The healthy spouse (the spouse living at home) can keep much more. In addition to the “exempt” assets (the house, one car, household goods, funeral plots, and irrevocable funeral plans), the healthy spouse can keep half of the couple’s countable assets with a minimum of ($24,720 in 2018) and a maximum of ($123,600 in 2018). It is important to retitle assets properly to maintain Medicaid eligibility and to avoid Medicaid Recovery upon the death of the healthy spouse if possible.

Assume that the married couple has a home – owned jointly with right of survivorship, joint checking, savings and investment accounts as well as IRA’s and life insurance policies naming each other as beneficiaries. The healthy spouse, using a power of attorney or guardianship if necessary, should retitle the couples assets as follows:

  • Keep the joint checking account with no more than the ill spouse’s $2,000. Deposit the ill spouse’s Social Security and other income to that account.
  • Open a new account in the healthy spouse’s name alone “payable on death” to children. Have the healthy spouse’s income deposited into the new account. Transfer excess from the joint account to this new account each month to keep the joint account at $2,000 or below. Pay the household bills from the new account.
  • Title the savings account and investment accounts in the healthy spouse’s name alone “payable on death” to the children.
  • Name the children as beneficiaries on the healthy spouse’s IRA and life insurance policy.
  • Cash out or change ownership of the ill spouse’s life insurance.
  • Cash out or annuitize the ill spouse’s IRA.
  • Title any vehicles in the name of the healthy spouse alone “transfer on death” to another family member.
  • Title the house in the healthy spouse’s name alone.
  • The healthy spouse should change her will to name children as beneficiaries.

Set up a Qualifying Income Trust for High Income Individuals

Once on Medicaid, the ill spouse’s monthly income will be used for his personal spending ($50 per month), a monthly income allowance (MIA) for the spouse at home to help meet her needs and a patient liability payment to the facility. However, if the ill spouse’s gross income is above the Special Income Limit ($2,250 in 2018) he will not qualify for Medicaid regardless of his need.

High income individuals must establish a special “Qualified Income Trust” (QIT) to filter the excess income in order to qualify. This QIT must be established and funded in the month the Medicaid Application is made. If it is not, the application will be denied. This problem is compounded by the fact that a Medicaid application can take months to process. If the QIT is not in place during those months, Medicaid will not pay.

Seeking and paying for long term care for your spouse is complex and stressful. A qualified Elder Law Attorney can help you understand the process and make a plan to protect assets and secure the best care possible for your loved one.

Is Your Power of Attorney Right For You?

Is Your Power of Attorney Right For You?

In my opinion, a power of attorney (POA) is a more important document than a will. While a will may control what happens to my family and my possessions when I die; a POA controls what happens to ME while I’m still alive. Because the POA is needed most when I am incapacitated, it’s good to get things right.

Do I have the right POA?

Ohio has two types of POA. The healthcare POA directs who will make your medical decisions when you are unable. The financial POA gives your agent the authority to handle certain financial matters as described in the document. Both documents are important and one cannot substitute for the other.

Have I named the right agents?

The person you choose as your agent will be making important life decisions for you. Consider a person’s character and abilities to handle the duties assigned rather than their proximity to you or birth order. Remember, too, to name one or more backup agents in case your chosen agent is unable to help you when needed.

Did I give my agent the right amount of power?

Your agent can only do those acts specifically described in the document. Thus, if the POA does not say that your agent can open accounts in your name or establish a trust for you he cannot. Similarly, if the POA says that the agent can change the beneficiaries on your life insurance or transfer your house to himself he can.

Is the POA executed in the right way?

A healthcare POA requires a notary or two witnesses to observe and verify the signature. The witnesses cannot be the signer’s physician, medical caregiver or the named agent. Financial POA’s must be notarized if the agents are to be able to deal with real estate in Ohio.

Do the right people have the document?

A POA does no good unless it is used. Be sure that your agent and backup agents know they have been named and what is expected of them. Be sure that they have or know how to locate the document, itself. Although Ohio laws may recognize a photocopy, many financial institutions will demand to see an original before allowing the agent to act.

Powers of Attorney are important to your overall estate plan and should be carefully drafted to fully meet your needs and goals. Consult with your attorney to be sure that your legal documents are right for you!

Steps to Take In Fighting Financial Neglect & Exploitation

Steps to Take In Fighting Financial Neglect & Exploitation

Physical and cognitive impairments of aging can rob people of the ability to manage their finances. It can also make them more susceptible to being robbed by others. Many instances of financial neglect and exploitation go unreported because of shame, guilt, fear that the victim may lose independence or concern that the perpetrator (who may be a close friend or family member) will retaliate.

You may notice signs of financial neglect or exploitation such as confusion or fearfulness, unpaid bills, lack of medical care, unnecessary services, goods or subscriptions, missing items or cash, large or frequent withdrawals from bank accounts, or suspicious changes in property titles or legal documents. Stepping in to help can be problematic. Overstepping can cause resentment and distrust, but stepping back could mean financial ruin for the victim. So what steps should you take?

  1. Stepping Forward Without Stepping on Toes

Assuming that the victim recognizes that there is a problem, there are a number of ways you can help him to help himself.

  • Simplify – Reducing the number of transactions can make things much more manageable. Consolidate accounts, set up automatic payments of bills, limit purchases to one credit card.
  • Reduce – Get off of junk mail lists, sign up for the do not call registry, clear out and shred extraneous paperwork.
  • Organize – Sort and store important legal and financial papers and tax records, itemize and safeguard valuables and collectibles, set up a system to collect and review bills and monthly statements.
  • Monitor – Request and review credit reports annually, check references of caregivers and other service providers, work with an accountant, attorney and financial advisor, etc.
  1. Stepping It Up to Keep A Step Ahead

If your loved one’s impairments are too severe, you may need to step forward to handle things yourself. If you are named agent under a durable financial power of attorney, you are able to handle any matters listed in the document. With the “immediate” POA, either you or the principal can act. If yours is a “springing” POA, you cannot act until a certain event – usually that a doctor has certified that the principal is too ill to handle things himself.

You must present your POA to any bank or other financial institution that you deal with, have it registered or recorded and your signature accepted. Whenever you sign, be sure to write the principal’s name, sign your name and indicate that you are acting as agent under POA.

If property is in a trust, the trustee manages the assets rather than the agent under POA. Co-Trustees can both manage assets. A successor trustee can take over when the initial trustee resigns or becomes incapacitated.

  1. Stepping In

Since the POA is given by the principal, he can also take it away. And he can continue to handle his own finances as well. If your loved one’s judgement is severely impaired and he is at risk of self-neglect or exploitation, it may be necessary to bring a guardianship action through the Probate Court. This is an adversarial action in which you would need to prove to the court that the principal is incompetent and that you are an appropriate person to manage his affairs. You would need to post a bond insuring your good management and account to the court annually for your transactions. In bringing a guardianship action, you will want to have an attorney with you every step of the way.

To manage social security or VA income, you must apply directly to the agency to become a payee. Keep careful records as annual accounting’s will be required.

  1. Stepping Aside

If you find that your loved one is in severe danger or needs more help than you are able to give, you should report the neglect or exploitation to your county Adult Protective Services (APS). Anyone can make a confidential report and the APS will investigate and seek to help. Many professionals who work with seniors are “Mandatory Reporters”. Mandatory Reporters are required to report suspected abuse to the APS.

Mandatory Reporters Include:

Psychologists                                                                 Social Workers
Nurses                                                                            Counsellors
Peace Officers                                                               Clergymen
Coroners
Marriage & Family Therapists
Attorneys                                                                         Employees of:
Physicians                                                                         Ambulatory Health Facilities Osteopaths                                                                        Home Health Agencies
Podiatrists                                                                         Residential Facilities
Chiropractors                                                                   Nursing Homes
Dentists                                                                              Hospitals

As of September 29, 2018, more professionals will be added as mandatory reporters. These are marked with a star below:

Firefighters                                                                     Real Estate Brokers
Ambulance Drivers                                                            or Salesmen
Notary Public                                                                 Financial Planners
Paramedics                                                                     Investment Advisors
Pharmacists                                                                    CPA’s
Dialysis Technicians

Employees of:
Mental Health Agencies
Banks or Credit Unions

Any person who has reasonable cause to suspect elder abuse, financial or otherwise, may make a confidential report, if the report is made in good faith, the reporter will be immune from criminal or civil liability and protected from employment discrimination or retaliation.

TO REPORT ELDER ABUSE IN OHIO CONTACT YOUR COUNTY DEPARTMENT OF JOB AND FAMILY SERVICES

OR CALL 1-855-OHIO-APS (1-855-644-6277) TOLL-FREE 24/7

 

 

Many Ways to Transfer Property at Death

Many Ways to Transfer Property at Death

They say “Where there’s a will, there’s a way”, but there are a number of ways that property can be passed at death without a will. The probate court provides a process to pass on inheritance to the next of kin of the decedent when he dies “intestate” (without a will). Property can also be passed without probate court involvement if it is held “jointly with right of survivorship” (JWROS), with a designated beneficiary or in a trust.  Ohio law even provides that title to vehicles may pass directly to a surviving spouse without probate.

The first step in sorting out a decedent’s estate is to determine what assets he owned and how they are titled. Heirs or beneficiaries can then follow the procedures required to collect the assets.

Intestate Property

The probate court oversees the process of transferring property held in a decedent’s name alone. Without a will, anyone may apply to administer the estate. The closest relatives living in Ohio have first priority to be the administrator and must be notified or sign off for someone else to administer. The administrator is generally required to post a bond (an insurance policy that he will handle his duties properly) in order to protect all the heirs. Because there is no will to grant powers, the administrator will need to get probate court authority to sell or transfer assets. Once the bills have been paid, the administrator will distribute the remaining assets to the decedent’s next of kin in accordance with the Ohio Statute. The probate process can be complicated so it is best to have an attorney assist with the administration.

Joint with Right of Survivorship

Virtually any type of property can be held jointly with another person; real estate, a bank account, even a vehicle. Just because something is held jointly doesn’t mean the survivor gets to keep the asset when an owner dies, but this is often the case. Most times, a certified death certificate and an affidavit outlining the facts is all that is needed to collect survivorship property.

Designated Beneficiaries

A person can name beneficiaries who are to receive an insurance policy, IRA, annuity, bank account, stock account, house, car or other property when the title owner dies. The designation of a beneficiary is given directly to the insurance company, bank, brokerage, county recorder or whoever keeps the record of ownership. To claim the property, the beneficiary must contact that company or agency to make the claim. Claim forms and procedures vary greatly. Making a claim may be as simple as presenting a death certificate or may involve completing multiple page claim forms that require a medallion guarantee signature from a bank or brokerage. Each beneficiary may be required to make decisions about cashing or continuing the account and withholding for taxes.

In the case of an IRA, for example, a spouse may elect to roll the IRA into her own name, name her own beneficiaries, and wait until she needs to make required minimum distributions. If multiple children inherit an IRA, they can divide it into separate inherited IRA’s and each decide whether to cash out immediately or “stretch” it out for years taking only the required minimum distributions. Each holder of an inherited IRA or inherited Roth IRA must begin taking required minimum distributions immediately and should name beneficiaries for their own account.

Trust Assets

Assets titled to a trust are administered by the surviving or successor trustee as directed by the terms of the trust. If all of the creators of the trust have died and there is no one surviving who can revoke the trust, its’ terms become irrevocable and a federal tax identification number must be assigned to the assets. The Trustee must follow proper protocols for notifying beneficiaries, managing the assets and handling the taxes. A qualified attorney and accountant may be needed to advise the Trustee.

Vehicle Transfer to Spouse

Ohio law allows a surviving spouse to transfer an unlimited number of vehicles to herself so long as the total value is less than $65,000, and so long as there is no one else who owns the vehicle jointly with right of survivorship, is designated a TOD beneficiary or is named in the will to receive the vehicle. To transfer, the spouse must take her ID, the vehicle title or registration showing VIN number, and a certified copy of the death certificate to the county BMV title office, sign an affidavit and pay a small transfer fee.

Handling the transfer of a decedent’s property can be a complicated affair under the best of circumstances. The process can take weeks or even months. Dealing with the myriad of details while grieving the loss of a loved one can seem overwhelming. An experienced attorney can help to organize, understand and control the process.

Caretaker Child

Caretaker Child

For many seniors, owning a home is synonymous with the American Dream. The goal is to stay in the family home, and then pass it on to the next generation. The nightmare that plagues many older Americans is being forced to sell their homes to pay the expenses of long term care. For this reason, many seniors want to transfer their homes to their child or children especially if the child resides with them.

In most instances, transferring a home to a child or other family member may cause a penalty period in which Medicaid is not available to pay for care. In certain circumstances, the transfer can be considered exempt and the penalty can be avoided. One such exempt transfer is to a “Caretaker Child”.

The “Caretaker Child” is one who resides in the parent’s home providing care for at least two years prior to the parent moving into a long term care facility such as a nursing home or applying for assistance from a Home and Community Based Services (HCBS) waiver program, such as PASSPORT. Simply residing in the house is not enough. The Caretaker Child must provide needed care which otherwise would have required the parent to go to a nursing home or apply for a HCBS Medicaid program.

The Medicaid rules are quite specific as to what a Caretaker Child must do in order for the exemption to apply.

  • The Caretaker must be a natural or adopted child.
  • The child must actually reside in the parents’ home with them.
  • The parent must require help with activities of daily living or instrumental activities of daily living (See lists) to such an extent that he or she would require nursing home care if the child were not there to help
  • The child must continuously live in the home providing the care for at least two years immediately prior to the parent going into a nursing home or applying for HCBS Medicaid help.
  • The child must continue to live in the home until the transfer is made, even if the parent is placed in the nursing home or receiving HCBS Medicaid.

To prove herself, the Caretaker Child, must provide Medicaid with documentation that she meets the definition. For the transfer of the home to be exempt from penalty, Medicaid will require written proof from the parent’s doctor and the child providing care. Medicaid will scrutinize this documentation to determine if the exemption applies. It is the family’s responsibility to keep careful records as they go.

If you hope to protect the family home via a Caretaker Child exempt transfer, it is important to begin documenting your status as early as possible.

  • Be sure that you have a proper power of attorney in place in case you become too ill to sign the deed when the time comes
  • Talk to your doctor about the kind of care required and your child’s role in providing that care.
  • List the activities and actions that your child performs to keep you safe at home.
  • Your child should keep a journal or calendar of your activities, doctor’s visits, hospital stays and changes in your condition.
  • Keep a checklist of care and services provided on a regular basis.

Contemporaneous records can help you remember all your child has done and to assemble necessary proof when needed. That documentation must show the date that the child moved into the home, the parent’s condition that required the care to stay out of the nursing home, the extent and type of care that was provided, the amount of time the child devoted to the care, and other activities such as school and work, that the child was involved in during that period.

The Caretaker Child exclusion cannot be used for early planning. It is a crisis exemption as the status of Caretaker Child can only be determined at the time the parent enters the nursing home or applies for a HCBS Waiver Program. If the child moves out before the transfer is made, the exemption is lost.

There may be adverse consequences of transferring the home that should be considered.

  • The child may not qualify for certain real estate tax exemptions that the parent had
  • Transferring to the Caretaker Child may defeat the parent’s intention to divide his property equally among all of his children.
  • Transferring the house during the parent’s lifetime may create a capital gains tax problem when the child sells the house.
    • For example, if the parent purchased the house in 1950 for $30,000 and the house is now worth $230,000, the capital gain would be $200,000. A lifetime transfer gives the child the same basis ($30,000) as the parent. If the child received the house at the parents death, the child would get a “step up” in the basis to $230,000 and there would be no capital gains when the house is sold.

The laws surrounding Medicaid and the transfer of the house are complicated and constantly changing. Seek the help of a qualified elder law and estate planning attorney who can analyze your unique situation and create a plan most appropriate for you.

Activities of Daily Living (ADL)

            ADL’s are self-care activities that everyone must perform to lead a normal, independent life.

Eating: Do you have the physical ability to swallow or chew food? Do you have trouble moving food from the plate to the mouth?

Bathing & Hygiene: Can you bathe yourself and brush your own teeth?

Dressing: Are you physically able to dress yourself and make appropriate clothing decisions?

Grooming: Can you comb your hair and trim your toenails and fingernails? Can you properly apply makeup or shave yourself?

Mobility: Can you move around without the assistance of a walker, wheelchair, or cane? Can you successfully get out of bed, get onto and off of the toilet, go up and down the stairs and sit or rise from the couch or other furniture on your own?

Toileting & Continence: Are you able to use the restroom without any assistance or handle your own ostomy bag?

Instrumental Activities of Daily Living (IADL)

IADL’s are activities a person must perform in order to live independently in a community setting during the course of a normal day.

Some examples of IADL’s include:

  • Shopping
  • Cooking
  • Washing laundry
  • Housecleaning
  • Managing medications
  • Using a telephone
  • Managing money
  • Driving
  • Handling mail