Defending Our Elders: Unmasking Nursing Home Exploitation and Ensuring a Secure Future

Nursing homes, in their ideal form, are meant to be sanctuaries of care, compassion, and respect for our loved ones. These facilities are entrusted with the responsibility of providing a safe and nurturing environment for elderly individuals who may require assistance with daily activities, medical care, and emotional support. However, reality often falls short of this noble ideal. Unfortunately, we often hear horror stories about what can occur behind closed doors, where only the vulnerable elderly bear witness. Every so often, stories of physical neglect, emotional isolation, abuse, medication mismanagement, financial exploitation, and more creep into mainstream media. Most recently, following an investigation by the Office of the Attorney General’s Medicaid Fraud control unit, a lawsuit was filed in the State Supreme Court of Manhattan against the owners of four nursing homes throughout New York State.

What happened?

Kenneth Rozenberg and Daryl Hagler have been accused of defrauding taxpayers of $83 million dollars, according to the lawsuit. The two men illegally used taxpayer money for personal benefit, even purchasing an airline, while neglecting their duties as nursing home managers. Due to severe underfunding and understaffing, the homes deteriorated and became health hazards. Without necessary funding, patients could not get their medication. Without necessary oversight, cases of elder abuse skyrocketed within these facilities. According to testimonies by family members, they were unable to reach their parents who resided in the facilities. In addition, they were not notified of severe injuries they had faced, such as brain bleeding. Another woman said that her father had been so severely neglected that he passed away from sepsis before she was able to pull him out of the home.

According to the Attorney General’s office, Rozenberg and Hagler created LLCs that they used to receive payments from the government and then spent these funds at their personal discretion. Investigations revealed that throughout the COVID-19 pandemic, Rozenberg and Hagler understaffed their facilities to earn more profit. They have also been accused of paying themselves exorbitant salaries for nonexistent work, charging steep amounts for rent which they did not report, and paying their family members $10 million dollar salaries while underpaying their actual staff. It is tragically common to see our most vulnerable population being exploited. There have been many stories throughout the years regarding the nursing home industry being a for-profit scheme that does not have regard for those who rely on the homes. Seeing stories like this one is shocking and it instills in us fear for our aging loved ones. While justice is being pursued in this case, it is important to be informed of steps that you can take to protect not only your loved ones but their assets as well if they end up in a nursing home.

The Benefits of Long-Term Planning

While not much could have been done to prevent these incidents from the perspective of the victims, there are still helpful conversations that you can have with your aging loved ones, or as you yourself age. Nursing homes are known to exhaust all residents’ individually owned assets before turning to government aid. This strategy, while legal, can leave families grappling with financial burdens and undermine one’s ability to pass down valuable assets to future generations.

One effective way to safeguard your valuable assets is by creating an irrevocable trust. An irrevocable trust allows you to continue the use of your assets during your lifetime while ensuring that they will be passed down to the beneficiary of your choosing. This type of trust establishes a distinct barrier between the ownership and control of assets. Since you are no longer the legal owner of property held in the irrevocable trust, nursing homes cannot target those assets, whether it be residences, liquid assets, or other valuable holdings. These trusts also have tax benefits because the assets held in the trust are often excused from estate taxes. It is important to note that Medicaid has a “look back” period to determine eligibility based on assets, typically spanning five years, so it is necessary to transfer assets well before you anticipate requiring long-term care. Creating an irrevocable trust to become eligible for Medicaid later in life is referred to as “Medicaid planning” and is a very common method of avoiding exorbitant nursing home costs.

Designating your healthcare power of attorney is another critical step in setting up your estate plan. This document empowers someone that you trust to make your medical decisions for you in the event that you are incapacitated or unable to make those decisions due to medical conditions. Within the realm of medical care, decisions ranging from treatment options to end-of-life choices can be intricate, sensitive, and emotionally charged. Entrusting someone with your healthcare power of attorney is akin to selecting a guardian for your health-related interests, someone who comprehends your values, beliefs, and healthcare preferences. This chosen individual, known as your agent or proxy, is armed with the legal authority to consult with medical professionals, review medical records, and ultimately make decisions aligned with your wishes when you are unable to articulate them yourself.

In addition to safeguarding assets through irrevocable trusts and appointing healthcare proxies, comprehensive long-term planning encompasses a spectrum of critical measures. Advance healthcare directives, financial power of attorney, and guardianship arrangements ensure holistic protection in times of incapacity. Estate tax planning and probate avoidance strategies optimize the legacy you leave behind, while asset protection methods and special needs planning address unique financial considerations. Beyond the financial aspects, the peace of mind derived from knowing that your loved ones are cared for and your values are upheld is an invaluable benefit of robust estate planning. This comprehensive approach not only safeguards assets but also reflects the commitment to providing a secure and dignified future.

As you craft your estate plan, it is necessary to have an experienced, knowledgeable attorney by your side. If you have any further questions concerning nursing home fraud, Medicaid fraud, or estate planning, please call the Trust and Estate Planning Law Office at (718) 333-2395 to take your next steps.

How To Suspect If You Will be Investigated for Medicaid Fraud

Medicaid is a service that many people use in the U.S. It allows for those in low-income homes to have access to affordable healthcare. However, people sometimes find that they are under investigation for Medicaid fraud and abuse without knowing why. When investigators contact you, they believe that you are guilty of committing fraud from the evidence they have collected based on your income. It is possible to catch yourself before you are framed for being guilty for Medicaid fraud by accident.

Fraud and Abuse Laws — heap of dollars with stethoscope

You do not receive any other form of government benefits

- Medicaid is only available to those who are low-income which means that it is common to have other benefits such as food stamps. Those who qualify for Medicaid often have other forms of social welfare programs that assist in daily aspects of life. If you don’t have food stamps or another form of government benefit, it can indicate that you don’t actually qualify for Medicaid.

Your reported income does not match your lifestyle

- When investigating recipients of Medicaid, investigators match every aspect of your life to your reported income. Medicaid fraud investigators compare what you’ve reported with other aspects of your life such as housing. If they find that you own a home, investigators have the ability to check your mortgage as it is public record. From there, they can check how much you pay monthly to your bank or mortgage company. If the payment is significantly higher than what your reported income is, it can raise suspicions. You can own a house and still receive Medicaid but even if you live in a high rent neighborhood, they can look into it.

The same can happen if your car payments are quite high in comparison to your reported income. Similar to how they check on your house ownership, the same can happen with car payments. If the information is not consistent, they will look at your provided information deeper and possibly contact you.
You receive financial assistance from family members

- People usually defend themselves when under investigation for Medicaid by claiming that they receive financial assistance from family members. Unfortunately, that is an extremely poor excuse as it is required to disclose if your family provides financial assistance for you when applying for Medicaid. By saying this, you may be claiming that you are not actually eligible for Medicaid.

Before panicking, be sure to double check your documents and payments to ensure that the information you are submitting is correct and consistent. Without double checking, you may face up to ten years in prison and fines up to $500,000 without meaning to. If you or a loved one needs assistance in Medicaid fraud help, please contact the Law Office of Inna Fershteyn at (718) 333-2395.

The Importance of an Elder Law Attorney

As we get older, we come to see some obstacles that our aging family members face. Oftentimes, no one prepares you for what to do when you reach your late stages of life. Healthcare, financial well-being, and long term care are commonly thought of when considering the next steps for your aging loved ones. However, it may be overwhelming to figure out all this on your own. At times like this, it is extremely helpful to visit an elder law attorney. But what exactly is an elder law attorney?

An elder law attorney focuses on assisting the older population and their loved ones. They focus on covering a wide variety of issues that the aging population face or will face. Going to an elder law attorney for a consultation to discuss future needs and what seems to be the best for you or your family may help you gain further insight on what may be needed to better your lives. They can help evaluate your current situation as well as exploring options for the future. Some common work elder law attorneys do is:

Trusts and wills
Estate planning and probate*
Nursing home planning and long term care
Medicaid and Social Security assistance
Elder abuse

* Most elder law attorneys are also esteemed at estate planning but not all estate planning lawyers are accomplished elder law attorneys so make sure to check out client reviews

By having an elder law attorney by your side, you can save time, money and avoid getting into future legal trouble. Since the laws surrounding the elderly are different in each state, it is pivotal to find an elder attorney that is knowledgeable and well-versed in their field. A skillful elder law attorney should be able to alleviate your worries about your future and you should feel as if you are in good hands. Follow this link to see some actual cases that have been alleviated by elder law attorney, Inna Fershteyn.

In addition, it is also important to know that there is no right or wrong age to meet with an elder law attorney. It is a common assumption that people have when thinking about elder law attorneys. For those in their thirties to fifties, visiting an elder lawyer may help with protecting your wealth and assets for the future. They can also have more options for you since you have the benefit of a head start. You do not necessarily have to be “old enough” or a senior to seek an elder law attorney.

If you or a loved one is looking for guidance to put your mind at ease for the future, a consultation from an adept elder law attorney should help. Please contact the Law Office of Inna Fershteyn at (718) 333-2395 to secure your road for the future today.

How to include children from prior marriages in a will?

When remarrying, it is a time to celebrate and be joyous of a new chapter in your life with a new family. However, most people do not think about estate planning during times of celebration. Having a blended family may make room for some unexpected challenges as you may want both families to take part in your estate plan. In the case that you have children from a previous marriage that you want in your estate plan, it may seem confusing and overwhelming to tackle.

If possible, you can leave your assets to your newly married spouse and hope that they will divide your assets among all your children. However, it is also possible that your spouse will not respect your wish. Before getting remarried, it is important to review or redo your estate plan. By doing so, it can clear up any possible future confusions.

Take Inventory of your Assets

- With your new spouse, you can take an inventory of your assets and debts. This can include your retirement plans and insurance policies. By being fully honest and open, you will allow your family to have better conversation and no possible hard feelings.

Decide Where You Want your Assets To Go To

- You can decide with your new spouse if you want to combine your assets or not before you get married again. By doing so, it can be clear to everyone on where the assets are going to and who it is going to.

Decide on what option you would like to secure your children’s inheritance

- There are multiple options to ensure that your children will get their designated share of inheritance:
  - Creating a trust specifically for your children
    - This allows you children to have exclusive and specific rights to hold and manage whatever benefits they will get from you.
  - Making your children beneficiaries of life insurance policies
    - Life insurance payouts will go to those who are listed as your beneficiaries when you pass away so that gives them a portion of the money.
  - Giving your children joint ownership of property
    - By doing this, your children will be able to have full ownership after you pass away- which also secures their portion of their share of your assets.

In a perfect world, you can simply leave your assets to your newlywed spouse but as always, the options for assuring your children allows for certainty. A mutual understanding between you and your new spouse will make it easier for the future and your marriage. It is important to talk about estate planning with your family. If you or a loved one wants more information about estate planning, contact the Law Office of Inna Fershteyn at (718) 333-2395.

What Are My Responsibilities As My Parent’s Guardian?

As parents reach their elderly years, sometimes people may find themselves in the position of being their parent’s guardian. Before obtaining guardianship for your parent (or parents), it can be helpful to know the responsibilities you will have to take on when you become a full-time guardian. Learning more about the possible incoming responsibilities can also help be a deciding factor for if you would rather take full responsibility of your parent or move them into a nursing home.

In some cases, you will be appointed to be a guardian if your parent:

Has dementia or Alzheimer’s
Has suffered from a stroke
Has cognitive issues
And a variety of other reasons

Oftentimes, it is common to seek guardianship of your parents after they have become somewhat incapacitated. It is easiest to be appointed guardian if both parties (you and your parent) are able to file notice with the court. The court takes into account age, mental/physical impairment, as well as the risk of harming themselves or others when considering guardianship. As long as your parent can display a reason for wanting guardianship, it is more likely that the court will grant the request.

So what will being your parent’s guardian actually look like?

After being appointed a guardian, there are some basic responsibilities to overlook:

Handling finances (such as paying bills, keeping financial records, etc.)
Consenting to medical treatment
Managing the estate and assets
Deciding on long-term care as well as end-of-life care

These responsibilities mentioned are just some of the many responsibilities that will eventually come to be. Being a guardian is a huge responsibility and takes a significant amount of time and energy. This position should only be done by someone who has the time and care for the parent. Remember, there are always other options for taking care of your elderly parent and that you don’t have to shoulder all the struggles on your own.

During your time as a guardian, you should always make sure that you are following your parent’s wishes to the best of your ability. If your parent still can, be sure to ask for their input and what they want. When choosing to be your parent’s guardian, you choose to give them the best life you can. Guardians are usually family and do not get compensated. For some people, being and taking care of their parent is more reassuring than leaving them in the care of a nursing home.

Being a guardian is not an easy job nor is it a role for everybody. In order for your elderly parent to live the best remaining life they possibly can, you can make the decision of if being their guardian will fulfill that or not. If you or a loved one is considering guardianship or options for elderly care, contact the Law Office of Inna Fershteyn at (718) 333-2395.

How to Avoid Conflict Between Your Power of Attorney and Health Care Proxy

When assigning people to be your power of attorney agent or health care proxy, you are bound to choose the people who you deem to be the most fit for the role. A health care proxy is someone who you assign in advance to carry out your medical decisions when you are deemed unable to. A power of attorney agent is someone who is also assigned to make financial decisions for you in the situation that you’re unable to. In some cases, they can be the same person for both positions but in other cases, they can be different people. Although a power of attorney agent has different responsibilities from those of a health care proxy, it is not uncommon for the two to occasionally have some overlapping decisions. When this happens, the possibility that there will be conflicts between the two is not surprising. So what are some ways to prevent these conflicts?

1.) Choosing One Person For Both Roles.

This is the simplest and most popular choice when deciding on who will be responsible for both roles. It allows for just one person to make your decisions for you (both medical and financial) in your best interest without having to go through the trouble of talking- and possibly arguing with another person.

2.) Pick Two People Who Can Get Along With Each Other.

Sometimes, it’s not reasonable to choose just one person for both roles. Not everybody is good at everything. For example, you may have an ideal person in mind for being your health care proxy but that same individual may not be a good choice to represent your finances. In this case, you would have to get another person to be your power of attorney agent. Although “getting along” may seem self-explanatory, people tend to choose others who are simply suited for the role while overlooking clashing personalities. This can lead to arguments down the line so it is best to ensure that the two representatives can get along and sort out issues in a calm manner.

3.) Assign a Third Person With The Power To Settle Disputes.

If necessary, adding a third person to be a mediator of the two can decrease the number of conflicts that may arise. Additionally, this person’s name should also be included in the documents indicating what their role is. It is best to discuss with all parties involved about your wishes and what you would want to happen in the case you become incapacitated.

It is never ideal to have people bicker over what you might have wanted. Hopefully, with these tips, disagreements will not occur between your health care proxy and power of attorney agent. If you or a loved on is having trouble figuring out estate planning, please contact the Law Office of Inna Fershteyn at (718) 333-2395.

How to Change a Living Trust?

With life’s ups and downs, it is natural for people to go through many changes throughout their lives. Some of these major changes in your life may make you want to change your living trust. To start, a living trust should not be mistaken for a will. The major difference between the two is that wills go into effect after death while living trusts are effective once they are signed and funded. Most people have revocable living trusts which allows for flexibility and change. However, if you have an irrevocable trust, it would be extremely difficult to make changes as they were made to be permanent and unmalleable.

As mentioned previously, there are many reasons that may lead you to make amends to your living trust. Some reasons may be:

Adding or changing beneficiaries
Getting married
Change in distribution of assets
Major beneficiary dies
Moving to another state

In addition, if the living trust is a shared trust, both parties are required to consent in writing for changes. Only one party is needed if it is decided to revoke the living will. Furthermore, if one spouse dies, the surviving spouse can only make amends to their own property and not the deceased spouse’s property.

The simplest way to make changes to your living trust is to fill out a trust amendment form. This form lets you keep the original trust active while making changes to it. In the situation that you have made changes in the past, you must indicate that these changes override any previous amendments or if you want to keep them in effect. When making these changes, be sure to refer back to your original trust and refer to the changes by which paragraph you are intending to change. This way, it will not cause any confusion and ensure the clarity of your new changes.

If you plan on making major revisions to your living will but you do not want to revoke your trust, a trust restatement is also possible. This redos your entire trust and allows it to be in effect with the new trust restatement document.

In severe cases, it can be more plausible for you to revoke your trust instead of making amendments to it. The reason for this is because if the changes are severe, adding amendments to an already established living trust may cause confusion. Oftentimes, people do not revoke their trusts since it means that all their assets from the trust will have to be transferred back into a new trust. Although it is not recommended and can be more expensive and troublesome to revoke a living trust, it is worth it considering that you would want your assets to fall into the right hands.

Changes in life are bound to happen and it is common that living trusts change with those life turning points. It is important that your assets go where you want them to. If you or a loved one needs assistance on creating trusts or any estate planning, please contact the Law Office of Inna Fershteyn at (718) 333-2395.

When is the Best Time to Write a Will?

The thought of writing a will may seem daunting for people as it brings up a topic that no one wants to talk about: death. However, a will is necessary as it will help prevent conflict and trouble for loved ones in the future. It also allows you to decide where you want your assets, property, and more to go to after you have passed. Without it, your assets may go somewhere you don’t want them to.

As the COVID-19 pandemic gradually comes to an end, it was surveyed that 66% of Americans who had serious COVID cases were more likely to have a will. It was also found that 50% of young adults were now more likely to have a will now when compared to pre-pandemic times. After the pandemic, more people now than ever are thinking about their wills- but a life-threatening situation shouldn’t be the only time to think about writing a will. Any time is a good time, especially these five occasions below:

Occasions to write a will:

1. Turning 18

In the U.S, most states will allow those who are 18 and over to legally write a will for the first time. Why not get started and think ahead? It’s never too early to start writing a will. Even if you are just 18, a will is always available for alterations as life changes and progresses.

2. Change in marital status

Whether you get married, divorced, or separated, it comes with significant changes in financial and personal matters. These changes will influence the decisions you will have to write in your will. It is important to ask yourself if you want your spouse (or ex-spouse) to be part of your beneficiaries or not.

3. Change in financial circumstances

Factors such as starting your own business, getting a promotion, or even buying a house can drastically change your estate plan’s situation. Especially when starting a business or buying a house, it is crucial to consider who the succession of the business or inheritance of the house will go to.

4. Having children

As mentioned previously, it is common that those who have children will leave their property and assets to their children. However, people tend to forget that a will can also dictate guardianship for children who are minors if both parents are deceased.

5. Prolonged amount of time

As time goes on, family dynamics and relationships may change which will alter your estate plan as well. It is also possible that the planned executor of your will dies before you do. Even if you do already have a will, it is essential to update it after major life changes. Regardless, if you have been putting off writing up a will, there’s no better time than today.

For a will to be correctly done and valid after death, it is important to go to an attorney. By executing a valid will, the court will not have to probate the will- saving your loved ones time and trouble. If you or a loved one need assistance or more information on estate planning, please contact the Law Office of Inna Fershteyn at (718) 333-2395.

Should I Create a Life Estate or an Irrevocable Trust?

As you are getting older, Asset protection and Elder Law planning becomes relevant. As you are researching an optimal estate plan to preserve assets from nursing home bills, a life estate deed transfer may initially sound appealing. After all, a life estate deed is a legal means for transferring home ownership rights. However, there are downsides you must fully understand before making this commitment. Prior to making the decision of adopting a life estate, it is crucial to fully understand the risks.

Life estates are characterized by two or more people having ownership over a property for non-overlapping periods of time. These parties are the life tenant and the remainderman. The life tenant owns the life estate and has full control during their life. The remainderman has ownership interest upon the death of the life tenant.

In many circumstances, executing a life estate makes the most sense. It is useful for those looking to simplify estate planning and avoiding the probate process. The transfer of the property to the remainderman is automatic, providing convenience without the need for a will. For example, parents can easily pass homeownership to their children while possessing their property for their entire lives. This provides transparency to the beneficiaries and affirms the life tenant exactly what will happen to their property when they pass away.

Additionally, a life estate deed protects the property from a Medicaid lien and increases the tax basis. If eligible for Medicaid, the government may try to recover the costs of care from their estate once they pass away. A life estate protects the home from being included in the Medicaid recovery process.

Although a life estate may seem appealing, some caveats come with them. There are three main unfavorable aspects. If you consider these reasons as dealbreakers, a life estate will not work for your personal estate goals.

Real Estate Related Challenges

Upon establishing a life estate, obstacles will arise if you plan to sell or mortgage property. The remainderman must agree if you decide to borrow or sell against the property. Nevertheless, this can be solved with a Testamentary Power of Appointment in the Deed. This allows life tenants to change who receives their property by directing its disposition in their will. While it won’t sell the property, it gives the life tenant more leverage in negotiation over the remainderman. An alternative to this is the Nominee Realty Trust, where one or more children act as Trustees for all so that decisions must be followed on a majority vote.

Another obstacle is that if the property is sold, the remainderman is entitled to a portion of the profits equal to what their interest is determined to be at that time. It is also difficult to remove or change a name once it is on a real estate deed.

Legal Responsibility of Remainderman

The problems of the remainderman become your problem as well. If this individual is in any legal predicament, such as being sued, getting a divorce, owing taxes, or filing for bankruptcy, the interest in the home is not protected. However, while claims can be made against the property, nobody can kick you out for the duration of your lifespan.

Medicaid and State Assistance Disqualification

Giving away an interest in the property could result in disqualification from Medicaid assistance, should you need long-term care within five years of the transfer. To add on, that state could file a claim against the income portion of the payments it has made on your behalf. In this case, at least the portion of the proceeds allocated to your child would be protected.

Irrevocable Trust

Irrevocable trust is a much better alternative to protect your property from creditors including Medicaid liens and nursing home costs. For more information on irrevocable trust, please contact the Law Office of Inna Fershteyn at (718) 333-2395.