Posts Tagged ‘nursing homes’

Duties of a Trustee

Thursday, November 19th, 2009 by Moore McLaughlin

The elderlaw and estate planning attorneys at McLaughlin & Quinn, LLC frequently prepare trusts for our clients.  In many cases, Attorney Jill E. Sugarman will recommend a trust for various estate planning, Medicaid planning and asset protection planning purposes.  Often times, a spouse, a child, a parent or another close relative or friend will be appointed as the trustee of the trust.Trustee Duties

A trust is a legal arrangement through which one person (or an institution, such as a bank or law firm), called a “trustee,” holds legal title to property for another person, called a “beneficiary.” If you have been appointed the trustee of a trust, this is a strong vote of confidence in your judgment and probity. Unfortunately, it is also a major responsibility. Following is a brief overview of your duties:

  1. Fiduciary Responsibility. As a trustee, you stand in a “fiduciary” role with respect to the beneficiaries of the trust, both the current beneficiaries and any “remaindermen” named to receive trust assets upon the death of those entitled to income or principal now. As a fiduciary, you will be held to a very high standard, meaning that you must pay even more attention to the trust investments and disbursements than you would for your own accounts.
  2. The Trust’s Terms. Read the trust itself carefully, both now and when any questions arise. The trust is your road map and you must follow its directions, whether about when and how to distribute income and principal or what reports you need to make to beneficiaries.
  3. Investment Standards. Your investments must be prudent, meaning that you cannot place money in speculative or risky investments. In addition, your investments must take into account the interests of both current and future beneficiaries. For instance, you may have a current beneficiary who is entitled to income from the trust. He or she would be best off in most cases if you invested the trust funds to generate as much income as possible. However, this may be detrimental to the interest of later beneficiaries who would be happiest if you invested for growth. In addition to balancing the interests of the various beneficiaries, you must consider their future financial needs. Does a trust beneficiary anticipate buying a house or going to school? Will she be depending on the trust income for retirement in 15 years? All of these questions need to be considered in determining an investment plan for the trust. Only then can you start considering the propriety of individual investments.
  4. Distributions. Where you have discretion on whether or not to make distributions to a beneficiary you need to evaluate his current needs, his future needs, his other sources of income, and your responsibilities to other beneficiaries before making a decision. And all of these considerations must be made in light of the size of the trust. Often the most important role of a trustee is the ability to say “no” and set limits on the use of the trust assets. This can be difficult when the need for current assistance is readily apparent.
  5. Accounting. One of your jobs as trustee is to keep track of all income to, distributions from, and expenditures by the trust. Generally, you must give an account of this information to the beneficiaries on an annual basis, though you need to check the terms of the trust to be sure. In strict trust accounting, you must keep track of and report on principal and income separately.
  6. Taxes. Depending on whether the trust is revocable or irrevocable and whether it is considered a “grantor” trust for tax purposes, the trustee will have to file an annual tax return and may have to pay taxes. In many cases, the trust will act as a pass through with the income being taxed to the beneficiary. In any event, if you keep good records and turn this over to an accountant to prepare, this should not be a big problem.
  7. Delegation. While you cannot delegate your responsibility as trustee, you can delegate all of the functions described above. You can hire financial advisors to make investments, accountants to handle taxes and bookkeeping for the trust, and lawyers to advise you on questions of interpretation. With such professional assistance, the job of trustee need not be difficult. However, you still need to communicate with those you hire and make any discretionary decisions, such as when to make distributions of principal from the trust to one or more beneficiaries.
  8. Fees. Trustees are entitled to reasonable fees for their services. Family members often do not accept fees, though that can depend on the work involved in a particular case, the relationship of the family member, and whether the family member trustee has been chosen due to his or her professional expertise. Determining what is reasonable can be difficult. Banks, trust companies, and law firms typically charge a percentage of the funds under management. Others may charge for their time. In general, what’s reasonable depends on the work involved, the amount of funds in the trust, other expenses paid out by the trust, the professional experience of the trustee, and the overall expenses for administering the trust. For instance, if the trustee has hired an outside firm for investment purposes, that expense would argue for the trustee taking a somewhat smaller fee. In any case, it makes sense to consult with a professional experienced with trust work who can guide you on what would be normal fees considering all of the circumstances.

In short, acting as trustee gives you a wonderful opportunity to provide a great service to the trust’s beneficiaries. The work can be very gratifying. Just keep an eye on the responsibilities described above to make sure everything is in order so no one has grounds to question your actions at a later date.

If you have any further questions about the role of a trustee or how to establish a trust, contact Jill E. Sugarman, Esq. at 401-421-5115 or by e-mail at jsugarman@mclaughlinquinn.com.

Cost of Nursing Homes Rising

Thursday, November 5th, 2009 by Moore McLaughlin

Nursing Home  CareAs Jill E. Sugarman, Esq., managing attorney for McLaughlin & Quinn, LLC’s Law For Life elderlaw practice can attest, price rollbacks throughout the U.S. economy during the past year did not apply to long-term care service providers.  According to the 2009 MetLife Market Survey of Nursing Home, Assisted Living, Adult Day Services, and Home Care Costs, private room nursing home rates rose 3.3 percent to $79,935 a year or $219 a day, while assisted living also climbed 3.3 percent on average to $37,572 a year or $3,131 a month.

Home health care aides now cost an average of $21 per hour, a 5 percent jump, and adult day care services now average $67 per day, a 4.7 percent increase over 2008.

The survey also reports on the cost of a semi-private room in a nursing home, which increased 4 percent to $198 a day, or $72,270 a year. The cost of a semi-private room in an Alzheimer’s wing averages $75,920 annually.

Once again, the highest rates for a private nursing home room in 2009 were found in Alaska, where the cost is $584 a day on average. The lowest rates were found in Louisiana (with the exception of Baton Rouge and the Shreveport area), at $132 a day.

The cost of assisted living was the highest in Wilmington, Delaware, at $5,219 a month and the lowest in North Dakota at $2,014 a month. Home health care aide services ranged from a high of $30 an hour in Rochester, Minnesota, to $13 and hour in the Shreveport area. Adult day care services were highest in Vermont at an average $150 a day and lowest in the Montgomery, Alabama, area, at $27 a day.

For the full 2009 report, including listings of average long-term care costs in selected cities, click here.

For more information on how to pay for nursing home care, contact Jill E. Sugarman, Esq. at 401-421-5115 or by e-mail at jsugarman@mclaughlinquinn.com.

Support Services for Family Caregivers

Saturday, October 10th, 2009 by Moore McLaughlin

CaregiverCaring for a family member is hard work, and without support, caregivers can easily get burnt out or overwhelmed. However, there is help available for caregivers if they know where to look. The National Family Caregiver Support Program is a federal initiative that provides money to states to fund programs that support family caregivers. The goal is to help caregivers care for seniors at home for as long as possible.

The National Family Caregivers Support Program supports family caregivers of adults aged 60 or older or anyone with Alzheimer’s disease. It also funds services to grandparents and relative caregivers, age 55 or older, of children 18 years of age or under or who care for a relative with a disability age 19 to 59.

Under the program, states must provide the following five types of services:

  • Information about available services
  • Assistance in accessing services
  • Counseling, support groups, and training
  • Respite care for the caregiver, which could be through companions, home health aides, adult day care, or in-facility care
  • Supplemental services, such as medical supplies, home safety aides, legal assistance, and financial consultation

The exact services vary from state to state, but caregivers can receive anything from training seminars to case management to home-delivered meals. The services provided are supposed to make daily tasks and routines a little easier.

Click here for more information about these services in Rhode Island.

Click here for more information about these services in Massachusetts.

Or, contact Law for Life attorney Jill E. Sugarman by e-mail at jsugarman@mclaughlinquinn.com or by phone at 401-421-5115, for more information.

Another September 17, 2009 Elderlaw Seminar

Wednesday, September 16th, 2009 by Moore McLaughlin

Please join Law For Life attorney Stefanie D. Howell, from McLaughlin & Quinn, LLC for a seminar discussing the how to navigate health insurance
in retirement; long-term care and dependent care; understanding social security; using reverse mortgage to improve financial stability and; estate planning.

Jewish Community Center of RI
401 Elmgrove Ave., Providence, RI
Call 401/331-1244 to reserve your place
Click here for more details.

Upcoming Seminar – September 17, 2009 – Elderlaw

Saturday, September 12th, 2009 by Moore McLaughlin

Jill E. Sugarman, Esq.Please join Law For Life Attorney Jill E. Sugarman, from McLaughlin & Quinn, LLC for a seminar discussing the legal aspects of moving a parent into a child’s home.  This must-see seminar will be held on Thursday, September 17, 2009 at the East Smithfield Public Library at 50 Esmond Street, Smithfield, Rhode Island at 6 p.m.  Click here for more details.

Joining Jill will be:

Jean Allard, Vice President/Sales Associate at Keystone Real Estate Group

Tuie Mellor, RN/Home Health Liason Nurse, Life Care at Home

Steve St. Onge, CGR, CAPS, President, Rhode Island Kitchen and Bath

Joe Parente, Registered Financial Representative, Lighthouse Financial Group/Metlife

Valerie Topp, Chief Operating Officer, Home Instead Senior Care

Call 401-667-2923 to reserve your place for this important event.  If you are unable to attend, but would like more information, contact Jill E. Sugarman, Esq. at 401-421-5115 or by e-mail at jsugarman@mclaughlinquinn.com.  This event is open to everyone.

Resources for seniors and their caregivers

Monday, August 10th, 2009 by Moore McLaughlin

ResourcesThe attorneys at McLaughlin & Quinn, LLC’s Law For Life constantly strive to provide the greatest amount of relevant information to Rhode Island’s seniors and their caregivers.  The following are several links to various governmental websites that can be accessed to learn more about issues affecting seniors.  Bookmark this post as a reference tool.  Also, look at the Resources section of the McLaughlin & Quinn, LLC website for even more links.  As always, feel free to contact Attorney Jill E. Sugarman, Managing Attorney of McLaughlin & Quinn, LLC’s Law For Life with any questions you may have.

Department of Health and Human Serivces Adminstration on Aging

Administration on Aging Elder Rights Protection

Consumer Protection for Seniors

Financial Crimes Against the Elderly

National Long-Term Care Ombudsman Resource Center

Rhode Island Department of Human Services – Services for Elderly Rhode Islanders

Rhode Island Department of Human Services – Division of Veterans Affairs

 You may reach Jill E. Sugarman, Esq. at 401-421-5115 or by e-mail at jsugarman@mclaughlinquinn.com.

Federal Legislation Proposed to Help Seniors

Sunday, August 2nd, 2009 by Moore McLaughlin

Several bills have been introduced in the United States Congress that are intended to help seniors in a variety of ways.  The following is a list of some of the more prominent bills that have been introduced.

H. R. 3040

Senior Financial Empowerment Act of 2009

To prevent mail, telemarketing, and Internet fraud targeting seniors in the United States, to promote efforts to increase public awareness of the enormous impact that mail, telemarketing, and Internet fraud have on seniors, to educate the public, seniors, their families, and their caregivers about how to identify and combat fraudulent activity, and for other purposes.  Click here for full text of bill.

H. R. 3098

Caring for an Aging America Act of 2009

To amend the Public Health Service Act to attract and retain trained health care professionals and direct care workers dedicated to providing quality care to the growing population of older Americans.  Click here for full text of bill.

H. R. 2987

La Cura Act of 2009

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Obama Backing Plan to Include Modest Long-Term Care Insurance in Health Reform

Tuesday, July 14th, 2009 by Moore McLaughlin

President Barack Obama has given his support to a proposal for new national long-term care insurance program that would offer basic help for the elderly and disabled. The President’s support could be key to making long-term care coverage a part of the final health reform legislation.

Proposed by Sen. Edward M. Kennedy (D-MA) as part of his health care reform bill, the plan would set up a new, voluntary social insurance program to help people insure against the high costs of long-term care. Americans would pay a premium of roughly $65 per month, although the Congressional Budget Office has said the premium could end up being as much as $110 a month — still far less than the typical cost of private long-term care insurance. After participants had contributed for at least five years, they would be eligible for a benefit of not less than $50 a day to cover long-term care costs.U.S. Capitol

While the benefit is modest compared to the average cost of nursing home care, it could be used instead to pay for a range of services that would help people remain in their homes. All working Americans would automatically be enrolled in Kennedy’s plan, known as the Community Living Assistance Services and Supports (CLASS) Act, but they could choose to opt out.  Students and the poor would pay only $5 a month.

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New Medicare Nursing Home Guidance to Include Quality of Life and Environment Requirements

Tuesday, July 7th, 2009 by Moore McLaughlin

The Centers for Medicare & Medicaid Services (CMS) recently issued new guidance for nursing home surveyors (inspectors), further defining and clarifying several important dimensions of care to help improve nursing home residents’ quality of life and environment.  Click here for press release.CMS

Click here for full article in the Providence Business News.

Jill E. Sugarman, Esq., managing attorney of McLaughlin & Quinn’s Law For Life states that this new guidance will encourage facilities to adopt policies and procedures that will benefit all nursing home residents in many ways.  She has seen many nursing homes in Rhode Island already adopting many of these ideas.  For more information on nursing homes and other elder law questions, contact Jill at 401-421-5115 ext 215 or by e-mail at jsugarman@mclaughlinquinn.com.

Beware of Generic Health Care Proxy Forms

Monday, June 29th, 2009 by Moore McLaughlin

The attorneys at McLaughlin & Quinn’s Law For Life often hear stories about hospitals giving patients a health care proxy form to sign on being admitted. While it might seem easy to sign a generic health care proxy form, Attorney Jill E. Sugarman suggests that having a document specifically tailored to your needs is vital.healthcareproxy1

A health care proxy allows you to appoint someone else to act as your agent for medical decisions. In general, a health care proxy takes effect only when you require medical treatment and a physician determines that you are unable to communicate your wishes concerning what that treatment should be. Appointing someone to serve as your agent helps ensure that your medical treatment instructions will be carried out.

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