Author: Jane Fearn-Zimmer, Esq.

Jane M. Fearn-Zimmer, Esquire is a partner at Archer Brogan, LLP. She dedicates her practice to serving clients in the areas of elder and disability law, special needs planning, asset protection, tax and estate planning and estate administration.
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Medicaid Redeterminations: Act Now!

The COVID-19 pandemic public health emergency is scheduled to expire as of May 11, 2023. https://www.cms.gov/About-CMS/Agency-Information/Emergency/EPRO/Current-Emergencies/Current-Emergencies-page. As a result, Medicaid recipients need to remain focused to protect their benefits from termination.

What are Medicaid Benefits?

Medicaid is a federally funded health care program which can pay for long-term care. https://www.medicaid.gov/medicaid/long-term-services-supports/index.html. The MLTSS Medicaid program in New Jersey provides benefits for long-term care in nursing homes and assisted living facilities, as well as in the home.

Participation in the Medicaid program is means-tested and strictly regulated. Only people with low assets and low income qualify for MLTSS Medicaid. https://www.nj.gov/humanservices/dmahs/clients/medicaid/#:~:text=To%20be%20eligible%20for%20New%20Jersey%20Medicaid%2C%20a,meet%20specific%20standards%20for%20financial%20income%20and%20resources.

In Burlington County, where my elder law office is located, and throughout New Jersey, a single individual cannot have more than $2,000 in countable assets and qualify for MLTSS Medicaid. Having even one dollar over the $2,000 countable asset limit on the first day of the month can disqualify an individual ineligibility for Medicaid for the entire month. Surprisingly, retirement account balances are included in the $2,000 countable resource limit.

Under federal law, New Jersey (and other states which have opted to receiving Medicaid funding) must follow certain requirements. One of those requirements is processing periodic Medicaid eligibility redeterminations.

What is a Medicaid Eligibility Redetermination?

A Medicaid redetermination is a review by the county Medicaid office of a Medicaid enrollee’s finances. The purpose of the redetermination is to re-confirm that despite the passage of time, the Medicaid enrollee’s resources are still below the $2,000 Medicaid eligibility threshold.

Fortunately, a Medicaid redetermination may involve only a review of one month of financial statements, unlike the Medicaid application, which takes into account sixty months of bank statements.

In a Medicaid redetermination, the Medicaid enrollee (or his or her authorized agent) completes the Medicaid eligibility redetermination form. They provide one month of bank statements for the enrollee. The agency scrutinizes the statements for changes like an inheritance, a death of a spouse, bank balances over $2,000 and large gifts during the period reviewed.

It’s a good idea to take care in completing a Medicaid redetermination, because an increase in the bank balance on the first day of the month can trigger a termination of the entire month of Medicaid eligibility. This can translate into liability for thousands of dollars of medical expenses for someone with very limited assets and income.

What Has Changed

During the public health emergency, the government recognized that there were significant disruptions in living situations, and employment. As a policy matter, health insurance coverage needed to be kept in place until the pandemic ended. New rules curtailed Medicaid terminations during the public health emergency. Now that the end of the public health emergency is drawing near, some of those protections are being lifted.

What You Need to Do

In Marlton, New Jersey and the surrounding counties where I practice elder and disability law, I have noticed that redetermination packets are being sent out to many Medicaid enrollees. https://fearnzimmerelderlaw.com/The redetermination forms must be completed and returned promptly. If you moved during the pandemic, this can be a problem, because you may not receive the forms if they are sent to an old address.

If you receive Medicaid and you have moved since January 2020, contact your county Medicaid office with your new address and email.

Check your mail for the Medicaid redetermination form. Be sure to complete and submit the form promptly, using a delivery method that allows you to confirm receipt by the county Medicaid office. It is a good idea to consult an attorney if you have questions about the Medicaid redetermination form or if you receive a termination notice.

Contact your attorney right away, in the event of a Medicaid termination notice. Medicaid terminations can jeapardize important benefits, leaving you or your spouse responsible for thousands of dollars in long term care and other medical bills, with limited funds to pay them.

On By Jane Fearn-Zimmer, Esq.In Medicaid, UncategorizedLeave a comment

Yes, Virginia, You DO need a Will!

On By Jane Fearn-Zimmer, Esq.In Estate Planning, UncategorizedLeave a comment
  • Many assume that if they pass away leaving family behind, their family will take care of their affairs and they don’t need a Last Will and Testament. Generally speaking, failing to plan means planning to fail. While every case is unique, most people DO need a will. Here are some important considerations.
  • A Will establishes who will be responsible for your affairs and/or your funeral. If you don’t have a Will, there may be confusion about who will do this and how your estate will be distributed. A Will can also you to prevent your personal representative from have to post a bond to probate your estate.
  • A parent with a minor child needs a Will to appoint a guardian for the child if the other parent is unavailable.  A Will enables the inheritance to be invested profitably. Without a Will, the funds will be deposited in the Surrogate’s Intermingled Trust Fund. The funds will be invested at bank rates until the child reaches majority, which could be years. During that period, the child’s parent or guardian cannot withdraw the funds without a court order.  
  • Business owners need a Will, to wind up the business and to protect their family.   

  • Your Will allows you to control what happens to your property after your lifetime. Unless you state otherwise through beneficiary designations and/or your trust or Will, the law of intestate succession will control who gets your estate.

Estate Planning for Gen Z’s and College Students

On By Jane Fearn-Zimmer, Esq.In Estate Planning, UncategorizedLeave a comment
Photo by RODNAE Productions on Pexels.com

Going away to school is exciting.

But before taking Junior to college or to his first apartment, don’t forget legal matters. There are key financial and legal documents you need in place. These documents are a general durable power of attorney, health care proxy and living will for Junior. Once Junior attains the age of majority, his doctor, nurse, academic registrar, landlord or bank needs these documents to speak with you.

Having the documents in place can bring peace of mind. Busy Gen Z’s need time to learn how to “adult.” They feel overwhelmed by the financial side of “living their best life.”

If you insist that Junior sign his legal documents before leaving home, you have done him a favor.

With these documents, you can lead Junior by example in dealing responsibly with adult challenges. These could be “surprise medical bills,” health insurance reimbursements, credit card billing, income tax issues. Once you shown him how to manage such challenges, he will thrive. And you can relax and just be the proud parent!

Since Gen Z’s are the digital generation, make sure you have a well-crafted durable power of attorney with digital asset powers. If the unthinkable happens, you will want to be able to access Junior’s Instagram or other social media accounts in an emergency.

If Junior doesn’t execute a health care proxy, you will wish he did when he is in an urgent care facility located ten hours away!

Junior should also share a list of credit card and financial accounts with the customer service number for each account. That way, if he misplaces his credit card, it is easy to report. Also note his digital accounts numbers, usernames and passwords (i.e., student identification username and password, and the health insurance username and password).

For more practice tips on estate planning for your family, contact Jane. 

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Helping Someone With Dementia Sell the Home

On By Jane Fearn-Zimmer, Esq.In Dementia, Elder Law, Estate Planning, Guardianship, Long-term care, MedicaidLeave a comment

Selling the home through guadrianship

Sometimes, a home must be sold, but the homeowner is no longer able to sign a listing or sale agreement due to cognitive impairment, confusion, advanced dementia or severe and persistent addiction issues (i.e., Wernicke-Korsakoff syndrome), or new onset dementia after recovering from COVID-19.  covid-19-pneumonia-increases-risk-of-dementia-study-says  Others may be temporarily incapacitated due to cardiac issues, surgery, or severe illness.  These conditions can prevent an adult from being temporarily or permanently able to make important financial, medical or legal decisions.  Adults who can no longer make decisions may be incapacitated.  And in real estate bubble with many residential properties reaching their peak value, it’s critical to act fast to accept the best home sale offer.

Unfortunately, incapacitated adults are unable to enter into a binding contract, such as an agreement to list or sell the home. When this happens, one option may be to use a general durable power of attorney or a real estate power of attorney to sell the home.  But that can only be successful where there is already a valid general durable power of attorney or real estate power of attorney in place.  If there is a power of attorney, and the homeowner is able to make decisions, the home cannot be sold through a power of attorney without the homeowner’s consent to the sale.  Giving a power of attorney to a trusted adult child or friend is like giving them an extra set of keys to the car. You can always take back the keys when you wish.

More to the point, a power of attorney is an important legal document by which the principal (i.e., the person signing the power of attorney) gives authority to an agent to carry out the affairs of the principal.  The catch-22 is that in order to make a power of attorney, the principal must have legal capacity.  Unfortunately, there are many incapacitated persons who never bothered to obtain a power of attorney before they lost capacity.   Another risk is that there may be a valid power of attorney, but the agent named may be deceased, very ill, or no longer available to serve.  Once again, there is no one with legal authority to sign the home sale agreement and the house cannot be sold even if there is a buyer.

The solution is to seek a court order for authority to sell the home.  This involves filing a lawsuit in the Superior Court for a judgment of incapacitation and award of guardianship.  The guardianship process is not a simple one. There are several different types of guardianships and the correct type must be selected.  Various court rules, required information and forms must be complied with.

The guardianship process requires doctor’s reports and an investigation into the finances and health of the alleged incapacitated person. As part of the process, the Superior Court judge appoints an independent attorney to investigate these matters and to write a report.  This attorney is referred to as the court-appointed attorney.  Often, that attorney’s report carries great weight with the court.  Testimony by the doctors may be waived, or if the guardianship is disputed, there may be an adversarial hearing.  If the evidence, any testimony and the court-appointed attorney’s report indicates that the alleged incapacitated person cannot make any significant decisions as to his person or property, then a plenary guardianship may be awarded.

But this is only the first step in obtaining court-authority to sell the home of the incapacitated person, who may urgently need the anticipated net home sale proceeds to pay for long-term care.  The next step is to file a motion with the court to sell the home through the guardianship.  The court can potentially award the requested order.  Only when such an order is in place, can the home be legally sold.

Not surprisingly, this process requires additional legal work and documentation.  The guardian must show that the proposed sale is fair and reasonable and in the “best interests” of the incapacitated person. In deciding whether this standard is satisfied, the judge may consider whether the incapacitated person will ever be able to return to the home to live there independently or with the assistance of paid caregivers, provided there are sufficient funds.  The fair market value and the tax-assessed value of the home will also be considered, as will the outcome of any prior attempts to sell the property, the cost of continued homeownership, and whether the anticipated net house sale proceeds are needed to pay for long-term care. In many cases, the home must be sold as a condition of Medicaid eligibility for the former homeowner in a nursing home.

This process takes time.   In limited cases where the safety of the alleged incapacitated person is endangered, or a very good purchase offer may be lost without swift court approval, the guardianship process can be expedited in New Jersey.

The bottom line, is that when capacity is in issue, selling the home a general durable power of attorney or a real estate power of attorney is much more efficient than through a guardianship. However, selling the home through a guardianship can be done in the difficult cases where there is no legal authority in place to sell the home.

Questions, or if you need help clearing title to sell a home through a guardianship? Let Jane know.

Seniors, Mental Health and Firearms: A safety plan.

On By Jane Fearn-Zimmer, Esq.In Caregivers Resources, UncategorizedLeave a comment

As of July 16, 2022, the suicide prevention and crisis hotline can be reached by dialing 988 in New Jersey (and nationwide.) There is also a chat feature. The 1-800-273-8255 hotline will continue in effect.   You can find additional details online at Department of Human Services | 988 Suicide & Crisis Lifeline (nj.gov).

Sadly, suicide affects people of all ages. It is a leading cause of death among white males over the age of 65.  Approximately 15 individuals pass away from this daily. The use of firearms is a leading contributing factor.  See James H. Price, Jagdish Khubchandani, Firearm Suicides in the Elderly:  A Narrative Review and Call to Action, Journal of Community Health 46:1050-1058 (February 5, 2021).  The full study is available online at Firearm Suicides in the Elderly: A Narrative Review and Call for Action | SpringerLink. Letters Against Isolation | Write letters to Self-isolating seniors.

This is not a political statement. Many seniors have firearms for protection and sport. When not in use, guns should be locked away, preferably in a gun case. You may want to reconsider keeping a firearm in the home of a senior with a serious vision impairment (i.e., blindness or macular degeneration), a condition which will impair coordination (i.e., multiple sclerosis, Parkinson’s Disease, cerebral palsy, stroke with paralysis, traumatic brain injury, and brain tumors) or a diagnosis or signs of dementia, confusion and/or cognitive impairment (i.e., Alzheimers and/or vascular dementia). Article for Gun Ownership & Safety Tips for Seniors

What are the societal factors driving these grim statistics? The elderly are confronted with physical and mental illness, isolation, loss of independence in the home, family and friendships, and must navigate life without any sense of meaning or productivity usually provided by gainful employment. They must face their struggles with limited income, limited financial resources and limited social support.  They are often invisible in our media.  Unlike younger adults, older individuals facing overwhelming challenges may be less likely to hang in there, until the situation improves for them. 

What You Can Do To Help.

These problems are a wake-up call.  What can we do to better the situation?   A good place to start is with little things. If you are so inclined, you could make a donation to non-profits that fight hunger, such as Feeding America and Meals on Wheels. Some churches have casserole programs, where you can prepare an extra meal, freeze in a foil container, and donate it to your local church or soup kitchen. Fostering a sense of connection is another way to help. It doesn’t take much to make a telephone or Facetime call, send a short note or card, share a meal, or to express your thanks to a loved one who helped shape you into who you are today. If your parents and grandparents are no longer with us, I am sorry for loss, but you are not off the hook! If you want to help and are inclined to write, consider volunteering with a cause like Letters Against Isolation, which fights senior loneliness with letters to bring joy. For more information, visit https://www.lettersagainstisolation.com/.