In its most recent survey, the State of Connecticut determined the average monthly cost of a Connecticut nursing home is $9,464.00. This adds up quickly as some people put off implementing life savings protection for months or even years, and others put it off until it is just too late. There is a much less expensive alternative, but before we get to that we have to take a look at what many families are experiencing out there.

Connecticut nursing home costs are among the highest in the nation. Every day I see families stuck writing checks to nursing homes in amounts of $10,000 or more - with no end in sight. These families failed to plan ahead, and they are paying a costly price now. In many cases, these families lose all or a significant portion of their life savings to Connecticut nursing home costs. I wish there was more we could do, but when it is too late it is just too late.

Some families I see try to create their own life savings protection plan. I’ve never seen it work out the way they intend or think it will when people act without an experienced attorney. I see people all the time that have transferred their parent’s money to family members or themselves and for some reason many of these individuals think these transfers will not be a problem when they go through the 5 year look-back period while applying for Connecticut Medicaid nursing home benefits.

Every single financial transaction during the 5 year look-back period is subject to audit and assessment of a penalty if the State deems it a penalizing transfer. You may have the greatest rationale in your own mind , but if you have no evidence and no support in the regulations or case law you really have nothing except a big mess that will cost more to clean up than if you got professional help in the first place.

If what I described above sounds acceptable to you, then you may want to run down to casino and bet everything on black because you are quite the gambler. If you are not the gambling type, and want a strategy you can count on to protect your life savings, keep reading.

The other families I see are looking for solid protection for their hard earned life savings. I am proud to say that I help these families on a regular basis achieve their goals of protecting assets not only for children, but also for their spouse and themselves. It can be done.

You have options to protect your family against a Medicaid required “spend-down”. These options expire, and when they are gone they are gone for good. When you are within five years of needing Connecticut Medicaid nursing home benefits you will not be able to take advantage of these proven techniques. Nobody knows when their 5 year window will start, so most people choose to act sooner rather than later.

One popular option is The Connecticut Medicaid Asset Protection Trust which helps families protect amounts from $50,000 - $1,000,000.00. There are many other techniques that may or may not available depending on your unique situation. You can schedule a free consultation by clicking on this box:



Doing nothing in July of 2008 just cost you $9,464 in lost asset protection. August is coming to add on another $9,464. See a trend here? The clock is ticking.

For July, there are only 10 Connecticut Medicaid Asset Protection Trusts available for purchase at the reduced rate through SheaLawOnline.com. I do not expect to increase that number, so once they have all been ordered they may not be available again for a while. And remember, a free $50 gas card is provided upon completion of your Connecticut Medicaid Asset Protection Trust.

Find out more about The Connecticut Medicaid Asset Protection Trust.

In too many cases, families have transferred funds, made purchases, or otherwise acted on the annecdotal advice of people. I guess people start out with the assumption that obtaining Connecticut Medicaid nursing home benefits is really no big deal.

In most cases, applying for Connecticut Medicaid nursing home benefits is a very big deal. At the bare minimum, the process is an audit of the last 3+ years of financial activity for the applicant and the applicant’s spouse. The more assets and transactions a person has within that look-back period, the more complicated the eligibility process is going to be. And contrary to what many people think, nobody is entitled to receive Connecticut Medicaid nursing home benefits. It is the responsibility of the applicant to prove to the Department of Social Services that you qualify for benefits.

The Real Cost

Mistakes and delays during an application for Connecticut Medicaid nursing home benefits are costly. The nursing home bill and other medical expenses continue to pile up every month even when the Connecticut Medicaid application is pending. You may not see the bill until after your application is denied, but it is still there. A Connecticut Medicaid attorney can help get you through the process promptly while protecting your assets. Get started with a free consultation today.

Today we will look at a recent case highlighting how a seemingly simple issue can go horribly wrong. Before we get into the legal discussion, let’s review the facts of the case.

1.    [FB] has been in a nursing home since September 13, 2004.

2.    [The plaintiff, FB's spouse and conservatrix] resides at home in the community.

3.    When determining Medicaid eligibility. . . an assessment of spousal assets is completed using the assets that existed as of the date of the beginning of the initial continuous period of institutionalization…

5.    On February 28, 2005 an application for Medicaid was submitted to the Department on behalf of [FB].

6.    In August 2005, [the plaintiff] hired an attorney to help her complete the Medicaid application process.

7.    The attorney assumed the Department had already completed the spousal assessment when [the plaintiff] hired him.

8-12. Between March 28, 2005 and July 24, 2006, the Department sent numerous requests for documentation to [FB] and [when retained, the attorney] … [Until June 2006], the spousal assessment could not be completed because the Department did not have sufficient verification to complete the assessment.

13.    On June 27, 2006, the Department had sufficient verification to complete the assessment of spousal assets and sent the results to [FB and the plaintiff]. The Department determined that in order for [FB] to be eligible for Medicaid, the couples assets would need to be reduced to $38,468.

14.    On August 24, 2006 the Department approved Medicaid for [FB] effective June 1, 2006. The Department denied Medicaid coverage for the time period February 2005 through May 2006 because [FB's] assets exceeded the allowable limit.

15.    [FB] reduced his assets within the allowable limits in June 2006.

18.    [FB] exceeded the Medicaid asset limit for the months of February 2005 through May 31, 2006. The hearing officer concluded:

The Department is not at fault for not specifically directing the reduction of assets until June 2006, when the assessment of spousal assets was completed. The Department met its obligation to inform [FB] of what had to be done to establish eligibility, once it received the requested asset verification.

Although [FB] retained counsel six months into the application process, the attorneys and [FBs] lack of knowledge that a spousal assessment had not been completed does not preclude the counting of those assets toward the asset limit. The record reflects that the attorney did not inquire to the Department regarding the results of the spousal assessment. In addition the record reflects that [the spouse and the attorney] were advised beginning in February 2006 that an assessment had not yet been completed due to insufficient evidence.

The Issue

The issue in this case is what is the starting date for receiving Connecticut Medicaid nursing home benefits? The Department of Social Services determined the plaintiff’s spouse can receive benefits starting June 1, 2006 - the date the spousal assessment was completed revealing eligibility for benefits. The plaintiff family argued that they should receive benefits from earlier than June 1, 2006 because either (1) it was the Department of Social Services’ responsibility to complete the spousal assessment since April of 2005 or (2) they were eligible for benefits before June of 2006 even if the spousal assessment was not completed to document eligibility.

The Spousal Assessment

The assessment of spousal assets is a crucial step in the application process. It is critical to determining who gets to keep what when one spouse applies for Connecticut Medicaid nursing home benefits. The regulations provide: “The Department provides an assessment of assets. . . at the time of application for Medicaid whether or not a request is made.” The request for a spousal assessment in this case was filed in April 2005.

Case closed - right? After all, the family requested an assessment of spousal assets in April of 2005 yet the Department of Social Services did not provide the assessment until June of 2006.

The court did not agree with that interpretation. The court relied on procedural regulations created by the Department of Social Services that provides in part: “If you did not get information or verification of assets, do not complete an assessment.” §1507.05.6. Further §1507.10.4 provides: “Complete the evaluation of the assessment within 45 days of the receipt of all the required documentation.”

So, even though the assessment of spousal assets to determine eligibility for Connecticut Medicaid nursing home benefits was requested in April of 2005, the family - and later the family’s attorney - failed to provide the Department of Social Services with the information needed to complete the assessment of spousal assets until June of 2006.

When that argument was lost, the plaintiff family attempted to argue that there was no meaningful change in assets from April of 2005 through June of 2006. Specifically, the plaintiff family claimed at the administrative hearing that the verification went on too long and that the assets were the same in early stages of application as they were when the assessment was issued in June 2006.

The court did not find the plaintiff family’s assertion supported in the record. The DSS worker testified that there were additional bank accounts to run down, and there was an issue of when FB entered into continuous care. The plaintiff’s own attorney contributed to the delay when he claimed there was a probate proceeding needed to develop “what was what.”

The court also found the record supported the conclusion of the hearing officer that the attorney for the plaintiff assumed that the spousal assessment had been completed before he became involved in the case. If the attorney had contacted the worker after being told that the spousal assessment was not completed, he would have been able to gather preliminary figures to assist in paying down assets.

The Conclusion

The family lost their case. The court upheld the Department of Social Services’ decision to provide benefits retroactive to June of 2006 rather than earlier as they had sought to obtain. The family is responsible for paying the nursing home bills for those months of delay as well the costs incurred in appealing the decision.

How To Avoid the Same Fate

Know what you are doing. If you are not up on the latest Connecticut Medicaid cases and regulations, then  hire an experienced Connecticut Medicaid attorney to guide you through the process. The family in this case hired an attorney who unfortunately made a costly assumption to the detriment of his client. This family may have enjoyed a different fate if their attorney took five minutes to confirm the assessment of spousal assets was actually completed when he was hired or took steps to complete the assessment shortly after he was hired.

A lot of people are denied for Connecticut Medicaid benefits after their initial application.  The reason why their application is denied could be any number of reasons.  In some cases the application is incomplete or inaccurate.  In some cases assets may be attributed to the applicant when they should not be.  In some cases you may be entitled to Connecticut Medicaid benefits but the way the system is set up, it is just not within the power of the case worker to approve your application.  This last case is very common with married couples.

Whatever the reason, if you have been denied Medicaid benefits the clock starts ticking.  You can accept the decision and spend down your assets, perhaps more than you need to; or you can appeal the decision and request a hearing.  If you plan to appeal, you only have a limited amount of time.  At the appeal stage you are facing a hearing with an administrative law judge that will base their decision to approve or deny your application on their interpretation of the relevant laws and administrative regulations.  A Connecticut Medicaid Attorney can represent you and help present your case at this hearing.

Connecticut had only two facilities on the most recent Special Focus Facility report. Chelsea Place Care Center is included in the list of nursing homes that have shown improvement while being a Special Focus Facility for 11 months. The Wethersfield Health Care Center is also identified as showing improvement while being in the SFF program for 37 months. Hopefully Wethersfield Health Care Center will graduate from the program soon after such a prolonged stay.

Additional information on what the Special Focus Facility program is and what it means to you as a consumer can be found here.

Well, if you attempt to complete a legal transaction or act without the advice of an attorney who knows if you have done everything you need to do? A common example is formation of LLCs and other business entities. Many people filled out their generic forms to create their entity and thought that was all they needed to do.

Those people are going to find a surprise in their mailbox soon.

You see, LLCs and other entities have to pay a “Business Entity Tax” in Connecticut. The generic forms sold at Staples and office stores might not tell you that, but I hope a competent attorney would. The Connecticut Department of Revenue Services (DRS) is catching up with everyone that created a business entity but neglected to pay their business tax the last few years. The DRS is sending out 23,000 letters to notify people of their non-compliance.

The lesson for today is: if your goal is to achieve a certain legal result or status it is generally a good idea to obtain the opinion of someone licensed to practice law. Sometimes a fill in the blank form just doesn’t tell you everything you should know before signing it.

Additional information: fill in the blank forms gone wrong in Florida.

This post is directed to them. The content of this site is copyrighted with all rights reserved. If you scrape or cut and paste something I have created on to your site you are dancing on a fine line that I take very seriously. I hope you don’t trip up.

Please create your own content rather than steal someone else’s.

Unfortunately this report highlights why many families choose to have an attorney involved in their nursing home advocacy. A family member in a nursing home is vulnerable and rarely in a position to protect their own rights.

Source: WTNH Report