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November 26, 2009
SENIORS FACING MORE CUTS
The next cut for seniors is aimed at the most vulnerable group of seniors, those in nursing homes. Regulations are now being written, and will be implemented in the near future, that will prohibit seniors facing nursing home care from placing any of their assets in a pooled trust. This has been confirmed by a letter I received from the Family Trust of Massachusetts, one of the five pooled trusts in Massachusetts.
What is a pooled trust? A pooled trust is an already established trust that pools together funds from eligible individuals, but with each individual having their own separate account. For Medicaid purposes, transferring your money into the pooled trust has been an allowable spend down item that would permit you to go on MassHealth, but with the understanding that the Commonwealth will have the right to place a lien upon your interest in the trust upon your death.
Why is this happening? This regulation change is the result of a directive issued by the Center for Medicare and Medicaid Services in May of 2008 that directed all states to impose a penalty for anyone who transfers assets to a pooled trust. I strongly oppose this cut because by putting your money into one of these trusts, you’re simply asking the state to allow you use a small portion of your money during your last days. Upon your death they will still get the money. You are not allowed to make gifts out of this money, it may only be used for your own personal care. After your death, the state comes in and takes back what they had paid for your care. Can’t they wait until you are dead?
Pooled trusts are the only way to allow someone to die with dignity. The pooled trust doesn’t permit someone to give away their money, it preserves it for their use during their lifetime. Governor Patrick has just cut the amount a nursing home resident may keep out of their monthly income to $60 per month. A friend whose wife is a nursing home resident says that this amount of money doesn’t even cover the cost of a hairdresser, his wife’s only luxury as a nursing home resident. Funds in your pooled trust may be used to pay for other necessities that you could not afford on your $60 per month allowance.
Funds in a pooled trust may be used to pay for telephone and cable. Holiday cards and gifts can be bought at the nursing home, and don’t forget to save some money for the occasional bingo game. When a nursing home resident needs hospitalization, MassHealth will pay the nursing home for up to 10 days to hold the bed while you are hospitalized. If your hospitalization last longer than 10 days, you either need to privately pay, or you lose your room. For many, using funds in their pooled trust is the only way that they could afford to pay for their bedhold and be allowed to keep their room while temporarily hospitalized.
Many nursing home residents have family that visits, and gives them additional money to pay for these necessities and bedholds. But what if there is no family around or the family is unable to afford to give the nursing home resident these additional funds? Apparently our Federal elected officials don’t really care.
This article gives general information and not specific advice on individual matters. Persons wanting individualized advice on matters discussed should contact an advisor experienced in those matters. To the extent this article provides information on legal matters, it is based on law in effect in Massachusetts on the date of posting (laws in effect in other states are often quite different).
Ronald H. Surabian is a CPA and attorney who works at the Elder Law Center in Saugus, Massachusetts. He also holds Masters in accounting and a Masters in tax law. He currently serves as the President of the Friends of the Saugus Senior Center and is an active member of the Massachusetts Chapter of the National Academy of Elder Law Attorneys. If you have any questions, please call me at the Elder Law Center, One Essex Street, Saugus, MA 01906 (781)233-4444. To view this or any prior article, please visit our web site at www.elderlawcenter.org