Episode Transcript
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(00:00):
And good morning everyone, Welcome toLife Happens Radio, a steamy, sultry
July day. Where July sixth acouple days past the fourth of July.
But we're going to keep the themeof independence going today, and not just
independence as a nation, not justthe declaration of independence, but personal independence,
individual independence. How do we planso that we can maintain our lives,
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live the best life, and notjust live it today, but live
it throughout our aging process. Becausewhen a lot of the programs we have
today, and we're going to talkabout those programs, Medicare and Medicaid and
all the things that were put inplace over fifty years ago now almost sixty
years ago now, and you lookback and you think, wow, nineteen
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sixty five, what was life likein nineteen sixty five. What did it
mean to be independent? Well,it meant that you worked, you retired
in your sixties, and you died. And the average age and life expectancy
at that point in time was lessthan seventy it was about sixty eight years
old. So when you have aprogram like Medicare, they said, okay,
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we're going to take care of allof our seniors all the way through
their aging process, and that wasthree years from sixty five to sixty eight.
How do the programs fare now whenlife expectancies are into the eighties,
when we're expected to live And I'mgoing to go to my aunt's birthday.
God bless Aunt Nettie talk about aroundthe show all the time. But in
a few weeks we're going to celebrateant Nettie's one hundred and second birthday.
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And yes we're having it at abar and restaurant, and yes, you
will probably have a cosmo at ageone hundred and two. So how do
we plan for that? How dowe live good lives throughout that process?
And it's not always pretty because thingshappen. You know what this show is
called life happens for a reason becauseas we age, as we live our
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lives and we want to live ourbest lives, things happen, and so
we need to be prepared. Weneed to have a plan for independence.
How do we plan for our independence? And today we have a couple of
guests that I'm very happy to havewith us, Diane mikel Gotta Biowski,
and I'm gonna just call you Dianefrom now on, but it's Diane Mikkel
Gotta Biowski if you want to writeit all down. And Diane is with
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ever Home Care Advisors. Good morning, Diane, and we'll introduce everhome and
what you do as a care coordinatorand what the organization does. And I'm
very happy to have on again fora repeat performance. Our associate from our
New York City office, Tom Morasco, Good morning, Tom, Good morning
everyone. And Tom is an attorneywho practices down in the Five Boroughs in
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Long Island, Downstate primarily, buthe works with a lot of our clients
in preparing a legal plan, gettingthe documents, getting the planning in order
that helps you stay independent. AndDiane, I'm working off of an article
planning ahead long term care options foraging in place, and the first two
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are preserving independence and preserving quality oflife. Your background is as a physical
therapist, so you've worked with individualsthroughout disabling conditions trying to bring them back
to health. Now you're part ofEverhome. What's the mission of ever Home
Care Advisors. The mission of everHome Care Advisors is to meet individuals and
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discover what they want out of theirlife and their aging process, what's important
to them, and how we canhelp them navigate the system and put resources
in place to meet their goals.It's very individualized. It's very important that
we find out what people want toaccomplish and what is important to them.
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And so a lot of people don'tthink about this until what an event,
right, What happens to people?What does life happen? What happens mean
for people throughout this aging process,and what kinds of things do you see
families falling into that trap? Sure, if you wait until there's infirmity and
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injury, a disease, a financialdisaster, if you will, then you're
operating in a panic mode. You'renot. You don't have the time to
sit back and say what do wewant and what can we put in place?
And that could mean you can't livewhere you want to live. It
could mean if you haven't put certaindocuments in place, that you can't even
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make your own decisions. So ifno one knows what you want, it's
very hard to move forward and giveyou what you want if you haven't shared
that with someone. So we're aboutlistening and finding that out and connecting to
the right resources. And for foreverHome and I work with ever Home on
a very regular basis full disclosure,folks. I am affiliated with ever Home
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Care Advisors, and it's a companythat our law firm works very closely with
because these are needs that our clientshad and we kind of have moved into
not just the legal practice, butthe care coordination practice because they go hand
in hand and they are so intertwined. And the ever Home process starts die
in with an assessment. Tell ourlisteners a little bit about that process and
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what your care coordinators that the professionalsin ever Home, what they bring to
the table. Okay, so thecare coordinators are life care coordinators as we
call them, and I have socialworkers, a nurse, and an occupational
therapist currently on the team, andmyself as a physical therapist. We will
go to the home, we'll conductan interview, but we will also look
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at safety because it is based onwhat you want to accomplish as well.
If you live in a townhouse that'sthree levels and the bedrooms are on the
third floor and the laundry is onthe first floor and you want to stay
there, those are just the kindof things we might take into consideration.
Also, what's your financial abilities,what are your resources there? What kind
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of insurance do you have? Again, what do you want to accomplish?
We're going to look at who areyour caregivers and a lot of them might
not identify as caregivers, or youmight think not think of them as a
caregiver. Who's going to be therewhen you need help? And how do
we set up a plan? Soagain it's not crisis mode. Oh no,
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what do we do? But wehave a plan in place and we
can execute that plan. And Ilearned this lesson folks the hard way,
as most people do, because mymom had a condition wasn't an event per
se, but she developed Alzheimer's.And we were sitting at a kitchen,
our kitchen table one day, andI looked over at my mother and she
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wasn't there. Her eyes were open, but there was that vacant look,
and I knew that her life hadchanged dramatically. In our lives as her
children, my sister and I hercaregivers. Our lives had changed dramatically,
and that led us on a journey, and a journey for me took me
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down all kinds of avenues. Iwas at the time the chair of the
Elderlaw Section of the New York StateBar association. That's what we do.
We practice elder law. I hadresources all across New York State. I
had resources right here in the CapitalDistrict. What I didn't have was resources
in my mother's house. And mymother wanted to be independent. She said
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to me, son, the onlyway I'm leaving this house is feet first.
She was fiercely independent, loved herhome, wanted to be in that
home for the rest of her life. So then it was up to my
sister and I, Michelle, toput a plan together. I called every
number under the sun, and whatI got was a run around. Every
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number I called said, oh,well, we can't give you services today,
but call this number. Well,I called the next number. Well,
we don't have anything right now,but call this number. And I
did a circle so that the lastnumber I called was the first number I
called. And that eternal loop oflip service without service, not getting anybody
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that could help me get care formy mom, to keep her at home,
to keep her independent. I reachedout. I did some research,
and I found a gentleman. Ihad to go all the way to Lenox,
Massachusetts. Now my mom lived inHudson, New York, which is
kelembe County, not far from Lenox, But I had to go all the
way to Lenox back then because therewere no care coordinators or care managers in
this area. That goes back twentyfive years, but it's not that different
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today. And I found a guynamed Joe Jackson and I met with Joe.
Joe came to the house. Joeassessed my mom in the home.
He put a plan together, Hewent out and helped us find caregivers.
He helped us pay those caregivers,showed us how to do it, set
up the books, put the plantogether, monitored the play and my mom
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was able to stay at home andthese two women and she didn't want anybody
in her home because I'm independent.I don't want anybody in my home.
These two women became her best friends, took her to lunch, made sure
she was safe, took care ofher for several years with Alzheimer's in her
home. And Diane that for mesold I was done. And you know,
I needed to have an ability tosay to my clients, this is
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what's the best practice, this iswhat you need to do. And ever
home fulfills that mission. Absolutely,You're a son, You're part of the
family and you want to preserve thatrole, and ever home care advisors or
geriatric care managers can help do thatlegwork for you. Make those phone calls,
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get tough when they need to gettough, dig where they need to
dig, and you don't have tospend all of your time doing that as
well. So you can be theson or you can take on the role
of the family member and be therefor your loved one in that way,
which is so important. And that'sthe caregiver's role, folks, And don't
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underestimate it. Don't deny it.When your parents start to age and you
get those little signs, don't wait, step in, do it gently,
and we'll talk about how to doit. But have the crucial conversation to
say, do we have a plan? Are we prepared for what life might
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bring as we age and as thoseloved ones have needs? And Tom,
one of the main tenets of elderlaw is finding care and helping people pay
for it. And just talk alittle bit about why asset protection is so
important in this realm. Yeah,I mean those are I mean very important
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points that you guys have made usfar. But as far as being able
to stay in home, for longer, Lou as you pointed out what the
cims were in place decades ago andhow they were intended to be used.
As you just said, people areliving well into their eighties nineties, and
you said you had your aunt who'sone hundred and too. My neighbor actually
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just turned one hundred and one abouttwo weeks ago, so it is not
unusual. And Willard Scott used tobe the weatherman on one of the national
news networks, and he used toshout out to people who turned one hundred.
Well, he would take up twentyfour hour programming if he said hello
to everybody that was turning one hundred, because there are just so many people
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aging into that realm. Yeah,and as medic medicine advances and technology advances,
that's going to become more common.And so how do we preserve what
we have to stretch that to thatlength to make sure, as you said,
that we have the means to beable to provide ourselves, to provide
for our loved ones and even ourselvesas we age. So acid protection is
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crucial in order to even obtain certainprograms able to assist with us. Because
even though we would love to workand some people do. They they're able
and they have the ability to workfor a very long time. That's not
realistic for everyone. So a mixtureof financial planning and asset protection is going
to be crucial to make sure thatyou can continue to have that independence moving
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on into your later years. Sothe two programs we're gonna come back after
short break and talk about are Medicareand Medicaid and Medicare. People get I'm
on Medicare. Hey, I'm sixtysix. Yant just pointed to herself,
We're on Medicare. But what doesMedicare actually provide and what coverage can you
count on? Unfortunately, a lotof people who get on Medicare and buy
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Medicare supplement or Medicare advantage plans togo along with that, think that they
have it covered, but they don't. Stay with us. We'll tell you
why. We'll open up the phonelines when we come back and we'll talk
about independence for life. Stay withus. You're listening to Life Happens Radio
on Talk radio WGHY. We'll beright back. Welcome back to Life Happens
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Radio. I'm a Lou Piro,your host for this Morning with a law
firm of Pier O'Connor and Strauss.We bring you Life Happens every Saturday morning
at eleven am. Thanks for listening. Hope you're a longtime listener, and
if you're a first time listener,hope you can stay with us. Today.
I have with me two very specialguests, Diane mikeel Gottabiowski from ever
Home Care Advisors and Tom Morasco fromthe New York City Office. Because we
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have an office down in Manhattan,we have an office in Garden City,
Long Island, and we do elderlaw and estate planning. That is our
boutique practice. So we're happy tobe here with you today. I'm going
to give out the phone number ifyou have a question on independence in terms
of staying independent for life, giveus a call eight hundred and eighty two
five nine. That number is eighthundred talk WG why again, eight hundred
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eight two five fifty nine forty nine. And Tom, we have someone in
our office who can talk about Medicareand the enactment of Medicare and Medicaid because
he was there practicing law in nineteensixty five. And that's none other than
Peter Strauss, our partner in theNew York City Office. And I've had
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Peter On lamenting the fact that whenLynda Johnson created the Great Society Program in
nineteen sixty five, he created aMedicare program that was intended to take care
of seniors. In the preamble,in essence says, never again will seniors
in America have to worry about healthcare. And that may have been true in
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nineteen sixty five, but fast forwardto twenty twenty four, and that just
hasn't kept pace. So what doesmedicare provide? And we're the big holes
in Medicare, tom So. Medicareis really more short term insurance coverage.
They will provide certain resources if there'srehab stays, but where it fails mainly
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is in long term care, whichis really what we're talking about today on
the show, about being able tostay and remain independent and having that care
in home services or even out ofhome in a facility. But that does
not cover that long term care.And so if Medicare cuts out, and
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for most people, Medicare provides nolong term care benefit. If you happen
to go to a hospital and you'rein a hospital for three days and you
get discharged to a rehabilitation facility andyou get rehab physical therapy, Diane,
which you practiced, yes, ptOT. Just to talk a little bit
about the Medicare benefit and what itdoes provide and doesn't provide, because you've
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had experience both as an independent physicaltherapist and also in home health care in
a home health agency and in skillednursing facility as well. So if as
Lu said, your three days inthe hospital or three overnights as they call
it, you become eligible for posthospital rehabilitation that Medicare will cover. And
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there are a lot of misnumbers andmisunderstandings out there. People say they hear
it will cover one hundred days,and that could be true in very certain
situations, it could cover one hundreddays, But there's a very complicated and
we know, right Tommy, thatMedicare is not simple. It's a complicated
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and highly health care plan and issue. Because there was a class action lawsuit
Jimo, and that was a classaction lawsuit that was won by Medicare advocates
and then the government didn't follow sothey have to sue again, right,
So this is a big game,folks. You have to qualify, you
have to meet certain qualifiers to getMedicare coverage for that rehabilitation. It isn't
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a given. So you may goto a skilled nursing facility, or your
loved one may and rehab is theintention. And something changes or goals aren't
met, or they choose not toparticipate, or their condition plateaus or declines,
their Medicare benefit may be cut andthen they'll be given a notice of
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discharge. My experience is an averageof about two weeks, and they start
thinking about terminating and discharging in abouttwo weeks. Right. The methodology is
twenty days if you qualify, twentydays is paid for at one hundred percent
day twenty one to conceivably day onehundred would be with a co insurance or
a co payment, And that's overtwo hundred a day per day. Yeah,
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that's right, that's right. Sothat's your co payment, folks,
two hundred dollars a day if yourMedicare qualified. Correct and correct, Diane,
what happens once you terminate from Medicare? You have your team meeting and
our ever home advocates go to thatteam meeting in the nursing home and folks,
you're a sheep among wolves at thatmeeting, and I'm a blazing Saddles
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mel Brooks fan, and I likenmyself to Mango, and Mango's line is
Mongo only pawn in game of life, and you're a pawn in the healthcare
system. The system is not builtfor the patient. It's built for everybody
else. It's making money off thesystem. So what happens at that meeting,
Basically they'll say, what's your dischargeplan? Where you're going to go?
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Now, there is a requirement thatit is a safe discharge, but
there's a lot of scrambling. Sowhen we talk about planning ahead and we
talk about not having to act ina time of crisis, that becomes a
time of crisis because the facility issaying you need to be discharged, and
you're saying I can't, or yourfamily is saying we're working, we can't
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be there twenty four to seven becausethere is that they need. The person
needs twenty four to seven care.That will often be the recommendation. And
then what does that mean? Twentyfour to seven care? And that's a
much bigger conversation. And folks,this is the revolutionary war. This is
where the cannons are going off thehealthcare providers, the hospitals, the nursing
homes, the discharge planners. They'reshooting their big guns and telling you where
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you should go. And your independenceis what's being fought for and what's at
risk. And tom when Medicare cutsout, what happens to the cost of
that nursing home when you go fromrehab to just being in the nursing home.
Well, I can speak for atleast the averages in New York.
Definitely in the Boroughs and Long Islandregion, you're talking fifteen sixteenth thous and
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plus per month. It's the samehere. Actually it's not any different.
I think it might even be higherdown there now and here it's creeping up.
But sixteen thousand a month is whatwe're seeing on a regular basis.
So, folks, that is notanything that anybody's prepared to take a check
book out and say, Okay,you have to number one, put a
deposit down to stay in that nursinghome. And that's usually a month.
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So you're going to write one checkfor sixteen thousand just as a deposit.
You're going to write a second checkfor sixteen thousand for the next month,
and you're going to put out thirtytwo thousand dollars because your Medicare coverage just
kicked out, and tom, whatdo you do in that situation? So
this is why we talk about havinga plan in place ahead of time and
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having the proper ASCID protection plan andso this way, if we require the
assistance, Let's face it, notmany people have the ability to be able
to have that kind of capital tothat. Then you can try to leverage
resources such as Medicaid, or ifyou plan ahead, perhaps you have some
type of long term care insurance inplace that could assist in most costs as
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you get your plan up and running. Unfortunately, far too few people have
long term care insurance and most ofthe policies people don't know how to access.
So another thing, Diane, thata care coordinator does. Care coordinator
can look at your long term carepolicy, can communicate with the people at
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that insurance company to help you access, understand and access what those benefits are.
This is a very time consuming tobe a person that's coordinating benefits and
knowing and understanding healthcare insurance reimbursement andwhat your rights are. And oh,
by the way, that caregiver hasa spouse, they have a job,
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a boss, and re little kidswith Little League games and recitals, and
they have a life that this justbecomes a full time job. And how
do the care coordinators fit in there? Start with an interview, gathering that
information and setting up a timeline ofhow they're going to act on that information.
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So setting goals, what do weneed to accomplish, what do we
need to access? What information?The individuals, the family, the patient
or client will have to provide someof that information. But if you know
what you're looking for, it's alot easier than just saying I don't know
what to do now, I don'tknow what you need. So we can
help take some of that stress awayand then do the next step or go
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to the next step. Now,if this person is still in a skilled
nursing facility, can attend meetings,can communicate with the discharge planners and social
workers at that skilled nursing facility,or perhaps arranged for home care, or
start investigating home care services and analternate plan. And Diana Tom, I'm
going to throw out a loaded questionthat I know the answer to, but
I'm going to ask it anyway.And I usually save this for the end
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of the show. When is theright time to do a plan for long
term care? Go ahead, Tomwell as honestly, I don't think there's
any time that's too soon. I'llput it that way, as you said,
And it's unfortunate, but most ofthe cases, a lot of the
clients that I've seen, it's always, as you pointed out, there is
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an event, something happened and therewasn't a plan previously in place, and
now everybody's at that scramble and it'schaotic and it's going to no matter what,
even with the plan, it isalways going to be a situation that
is going to cause that type ofanxiety just because your loved one just went
through something traumatic and you're trying toget them help. But it's a lot
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easier to navigate when there is aplan. We know what the proce is,
we know who we're going to reachout to, we know the documents
that we have and how to doit. So even though we still have
that stress, it's a lot easierto manage once you know what to do,
because if you're trying to start fromscratch while also trying to handle those
emotions, it's not going to bevery effective because you don't know where to
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start. Absolutely, you start now. Now there's the answer. Absolutely.
We're going to take a break forthe news. When we come back,
we're going to unravel how to constructthat plan. What are the planks in
the plan? How do you buildit? How do you make sure it's
the right plan, How do youmake sure it stays effective? And we're
going to do this both from acare perspective and a legal perspective, kind
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of a unique perspective for you hereon Independence weekend. I'm Blupiro. We'll
give you the phone number again whenwe come back, hopefully you'll give us
a call. But right now,the news we're better, better than ever.
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You're listening to Life Happens Radio.Are you prepared? I'm Lupiro,
your host for this Morning in StudioLive with Diane Mikkel Gottabiewski. And we
didn't make Tom drive up, sohe's down at home on Long Island.
But Tom morasco one of our associateattorneys who has experience in this area and
works with clients doing long term careplanning. Diane is with ever Home Care
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Advisors, also dealing with long termcare planning. And I want to give
you an alert that we have anupcoming webinar. We have a series of
webinars we call them Medicaid Mondays,And as we unravel the second half of
the show, we're going to talka lot more about Medicaid because that is
the only game in town when itcomes to paying for long term care.
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If you don't have insurance privately,and you don't have two three hundred thousand
dollars a year that you can applytowards long term care costs, Medicaid becomes
the target and the goal. Sowe have Medicaid Mondays and lo and behold,
it's this Monday, July the eighth. It's going to be on Medicaid
home care. A lot of peopledon't even know that Medicaid provides care in
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your home, and under the rightcircumstances, it can provide twenty four to
seven care to you or your lovedone at home, paid for by Medicaid.
Now, that is a benefit thatis very unique nationally. New York
is way out in front has been. It's also a very expensive benefit for
New York. So there are somehurdles you have to cross to get Medicaid
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eligibility to get the number of hoursyou want and to preserve your income and
your assets. So this Monday,Frank Haming and Aaron Connor are going to
talk about financially qualifying for Medicaid homecare. That's at noon to twelve thirty.
It's a thirty minute webinar. Andthen the following month, the second
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Monday in August, Frank and Iwill be talking about the process for getting
the care in home. How doyou find care, how do you coordinate
it, how do you go throughthe assessment process to make sure when it
comes time, Medicaid is providing thecare that you need. So you can
sign up for the series Medicaid Mondaysand we get a good crowd. We
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get about three hundred people on thewebinars every second Monday of the month.
So join us July the eighth,twelve to twelve thirty, and you can
sign up at any time on ourwebsite purolaw dot com. It's pie r
R l awpurolaw dot com. Youcan just email us info at pyrolaw dot
(27:48):
com if you want us to signyou up, or call our office five
one eight four five nine twenty onehundred. Frank Hemming. Our Medicaid master
at Pire. O'connoran Strauss and AaronConnor will be doing this Monday, and
then we'll go back the following monthin August to talk about the process for
accessing care at home. A bigpart of what our theme today is on
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Life Happens Radio. So join usfive one, eight four or five nine
twenty one hundred for Medicaid Monday.That phone number, folks, if you
have a question, please pick upthe phone, give us a call.
Diane is here, I'm here,Tom's here. We're talking about independence,
how to plan, how to prepare, how to get care in home.
A lot of times, far toomany times, the plan is not a
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plan, it's a crisis intervention.So how do we get out in front
of this. We're going to talkabout that now, But give us a
call and ask your questions. Eighthundred eighty two five five nine four nine,
eight hundred eight two five fifty nineforty nine. That's eight hundred talk
WG. Why hope to hear fromyou and Tom. I'm going to come
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back to you because when we lookat Medicare, and we've explored the deficiencies
in Medicare and why that program fromnineteen sixty five that has not changed dramatically
is not keeping pace with the agingpopulation and the needs of the aging population,
and so many more people used tobe. You got lived to sixty
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five, you had a retirement,you had a heart attack, and you
died. Today, with modern medicine, that heart attack is just a blip
on the screen, and you havea brief period of recovery. You may
have, like me, a bypass. I had a quintuple bypass. They
put me back together again. I'mback out playing tennis and doing all kinds
of good stuff. But science,modern science and medicine keep you alive.
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And these chronic conditions start to creepin Alzheimer's, Parkinson's, all the things
that people have as they age,and medicare stops paying and we're talking now
two hundred thousand to two hundred andfifty thousand dollars a year for care.
How does medicaid here? So Medicaidwill step in again. There are certain
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qualifications that you must meet, andwith the proper planning in place, we
can make sure that you meet thoseneeds. But so long as you qualify,
they will provide the coverage that youneed. Now, as you pointed
out lubi's home care, it's slightlydifferent because there are certain hours and days
in which they were going to approve. So making sure you have the right
plan and team in place when youare putting in for that application to make
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sure and like you said, pleasetune into the Medicaid mondays, it's going
to be very insightful, but makingsure you get those requisite hours. But
for long term care facilities, theywill cover the cost for your long term
meets. So talk a little bitabout Medicaid eligibility. I know that you
have restrictions on income and assets.Just tell our listeners how that works.
(30:55):
Yeah. Absolutely, So with homecare and nursing home care alike, there
is an asset requirement, okay.An individual is not allowed to have more
than around thirty and seventy five dollarsin assets and their name were held jointly,
okay. So and also for homecare, because we're talking about remaining
independent and staying at home, there'san income requirement and you cannot make more
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than around seventeen hundred dollars per monthroughly in income. But there are ways
that you can plan to make surethat you could still qualify and meet the
needs in order to qualify for theprogram. So, as lawyers and as
elder law attorneys, trusts are abig part of our practice. And I
think Tom, there are two maintrusts when it comes to medicate home care.
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And again today's theme is independence.You want to be at home,
you want to get the care thatyou need. And you know, Diane,
before we get into the finances,being independent doesn't mean being alone.
Absolutely, it's very important what doesindependence mean to you as an individual or
your loved one, and that independencereally should have and usually has a lot
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to do with your decisions and desiresand what you want. So independent might
be living in a senior community.Independence might be living in your home with
twenty four to seven live in help. It could be patchworking, and patchworking
isn't always bad. So independence meansmaking those decisions and looking at what's what
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your safety is, what keeps yousafe, maintaining your self respect, and
again carrying out wishes that you madein a time of non crisis. And
so Tom, we have a caller. We have Jim and Rotterdam. Good
(32:50):
morning, Jim, Welcome to lifehappens Raady morning, Thank you. I
listened to these shows and very thankfulfor them. But one of the other
ones on another channel, I don'trecall who it is. And this was
recently said that those of us whohave the New York State long term care
(33:15):
nursing home policies that when we getif we're in a nursing home for three
months, I'm sorry, three years, and at that point we are automatically
Medicaid eligible with no means testing,and the nursing home is required to accept
(33:44):
whatever Medicaid is paying for the dailyrate. And I believe that's what I
read in my contract language and mypolicy. He's saying that he knows of
a case and I've heard this fortwo weeks in a row where the I
guess the government was actually able togo after some of their assets specifically in
(34:09):
IRA. Do you think that wasan outlier or have you heard of stuff
like this happening? Yeah? Idid hear, and it was actually in
a Renstler County here locally, andit did come to our attention, and
the state was notified and the stateDepartment Health, I believe, told county
(34:29):
that that was an unavailable asset.And it's a complicated thing. You were
right on everything you said. Ilove the partnership. It was one of
the best policies ever put out inlong term care. The woman who designed
that policy is a good friend ofmine, Gail Hollabinka, And the partnership
was the hot policy in the ninetiesand the two thousands. But unfortunately you
(34:52):
can't even buy that policy anymore.And so for clients to come in and
say, well, I just gota premium increase, it's another thousand dollars
a year pay because you cannot replacewhat you get in a New York state
partnership policy. It is one hundredasset protection and there is absolutely no requirement
(35:14):
that they that they have you tryto maximize income. It's a whole game
that the state plays. When youhave an IRA, you have something called
the required minimum distribution an RMD,and that's calculated based upon the table that
applies to iras go figure, it'san IRS table, and that table is
(35:36):
calculating your required distribution what you haveto take each month from your IRA,
and if you take the right amount, that IRA is exempt. Well,
many counties now in the state ofNew York is trying to push this are
saying, well that table isn't theright table even though it applies to your
IRA. We want you to useour table, the Social Security table,
(35:58):
to push more income so that moreincome goes to the nursing home and Medicaid
pays less for you. And wefight that fight with our clients, and
right now the state is winning mostof those battles, but not with the
partnership because you don't have to exemptthe IRA, it's already exempt. So
they are one wrong Jim on thisissue. And you know, if a
(36:21):
case comes along where somebody is gettingtold that they have to take more money
out of their IRA to make itan exempt asset, the State of New
York has actually stepped in on certaincases and forced and enforced the partnership rules.
There is an office for the Partnershipof the State that we'll actually look
at this issue. We have alsoadvocated and made the county aware that they're
(36:43):
just dead wrong on that issue.Okay, I, my wife and I
bought ours twenty four years ago andwe're we're we bought the five percent per
year and it's built up to whereit almost equals what they're getting for a
(37:05):
nursing home. Like you said,fifteen sixteen yearAnd a month. Yeah.
I mean if you bought it inthe nineties, you're probably six hundred dollars
a day. That's almost exactly whatit is. Yeah. Yeah, we
bought it, I think in ninetyseven. Yeah. But that thing I
heard about, you know, thestate trying to go after stuff really bothered
(37:27):
me. Another question is, forthe first time, and since I've turned
sixty five, I've actually read theMedicare book. It's actually a pretty good
book. Different if I read Iread it years ago for clients, but
I just read it for myself.Then it's it's accurate information. It's good
information. Yeah, but it's withthe with the paradigm I had of Medicare.
(37:52):
It's very frightening because I didn't realizeafter a certain number of days in
the hospital, you're cut off.That's right. Does my long term care
policy kick in for hospitalization or isthat just for a nursing homebine. No,
that's just long term care. Butwhat you want to long term care,
(38:13):
and it's crazy that you have todo this in between Medicare and your
long term care policy is something calleda Medicare supplement policy, and it's an
additional insurance that will pay additional daysdepending upon your contract. But you buy
a supplemental policy to Medicare to coverthose gaps, the hospital gap, and
(38:37):
some of them cover that co paymentwe talked about earlier in the show,
where once you get to day twentyone, there's a co payment of two
hundred dollars a day. Some ofthe policies actually cover that two hundred dollars
a day for you if you continueto be skilled care. This is mind
numbingly complicated, and that's why wehave have a care coordinator and an attorney
(39:01):
trying to break it all down.But when it comes to the point where
those big cannons are being shot offby the healthcare provider, the hospital,
the nursing home, the rehab,you got to have somebody on your side
that can navigate through this minefield.And it is a minefield. So hopefully
today's show can put a little lighton it, shed a little clarity.
(39:24):
But there are resources out there,Jim. If that comes to pass,
I would go and shop Medicare supplementpolicies at this point and look at how
to cover those gaps in Medicare,and if you have the partnership, your
long term care needs are very verywell covered. This is a little bit
of little gap that still exists.Okay, I'm seventy one now, so
(39:46):
I've had supplemental for six years now. Is that what you're talking about?
Like in my case is United Healthcare? Every arp YEP, that contract,
that's the contract you have to readnext to see what coverages? Okay,
you have? Is there a multiple? Okay? If I get too long,
(40:08):
win to just shut me off.Okay, But either yourself or the
other guy listened to said, there'sonly one thing worse than not having a
trust, and that is having thewrong trust attorney. And with the trust
attorneys out there are all you know, saying they're qualified from a consumer point
of view, how do I know? You know? I guess it's improper
(40:32):
to ask you this, But howdo I know that? No? There
are ratings you can go to.There's Martindale. Hubble is a rating service
that reads attorneys. And we getraided on elder law, trust and the
states. And we just got bestlawyers, myself, my partner Aaron Connor,
(40:57):
several of us. Tom, whatdid you qualify for in the lawyers?
The similar Yeah? Really in realestate, these are peer review rated
publications, so they rate other attorneysrate you in your abilities. The firm
that we've put together with Peter Strauss, Peter has sixty years of experience.
(41:22):
I have forty one years of experience. We've been doing elder law since it
started, and I've created a companycalled Elder Council that has served the country's
elder law attorneys in how to createMedicaid asset protection trusts. So, you
know, I think I could goon, but I won't, but I
(41:43):
think our firm is pretty well positioned. You can go to our website and
you can see all the different thingswe have there to show what our experience
is, and we do it ina way that we hope is catering to
our client's needs. We always tryto put the client first and be empathetic
to their needs and create a planthat fits what their particular situation is.
(42:07):
Because this isn't a trust that youjust take off the shelf and say,
oh, here's a Medicaid asset protectiontrust. It doesn't work that way.
It has to be tailored to individualcircumstances. So that's how we do it.
It's a very thorough process. Clientscome out of that initial consultation saying
you asked me twenty five questions Inever anticipated. So that's the part of
(42:30):
it that isn't just a document.It's really a process of digging into where
that plan is going to make sensefor you. Okay, one quick one,
because I know I'm monopolizing your time. I'm going to be on the
road Monday. Is there anyway Ican get a online copy of that webinar?
(42:52):
All of our webinars are posted onour website. It takes a couple
of days they are ye, soyou can go to pure law dot com
and our whole library of webinars ison the website. Oh that's great,
Well, thank you very much.All Right, Jim, thanks for the
call. We have to take ashort break. When we come back,
Tom is going to really dig intothe trusts that put the pre plan in
(43:16):
place. Jim has an asset NewYork State Partnership policy that very very few
people have. If you don't havethat, stay tuned, because you need
to recreate the protections that New YorkState gave to Jim through this policy,
we can put back for you throughthe Medicaid Trust. You're listening the life
(43:37):
happens. Radio, be right backafter this short break. If everybody had
then everybody, all right, getout there today. It's warm, sunny
day. Might have a couple ofshowers here and there, but the sun
(43:57):
is shining here in the Capitol region. Tom, how's a we down there
on Long Island? It started offa little rough, but it looks like
the sun's starting to peak around downhere as well. All Right, it's
warm, it's muggy, it's humid. Get to a pool, get to
some water, have your favorite beverage, and enjoy this beautiful Saturday. I'm
Lou Piro in studio with Diane MikkelGottabiowski of Everholm Care Advisors. On the
(44:21):
line with us from Long Island isTom Morasco. Also with Pierre O'Connor and
Strauss, and we had someone callin who was signing up for the Medicaid
Monday webinar that I talked about earlierand Medicaid Mondays again we break down in
depth and thirty minute increments every secondMonday the Medicaid program and this Monday coming
up July eighth, is Medicaid HomeCare. If you go to the website
(44:45):
and you want to sign up atpurolaw dot com. Go to the events
tab. If it asks you whatgroup you're with or what company you're with
and you're just a consumer, justput in consumer. We do have a
lot of professionals that follow our firmand follow our advice. So if you
are from an organization, that wouldgo in there. But if you're a
consumer, just tell us that andthat would be great. We'd love to
(45:07):
have you join us and hopefully youcan benefit from the webinar. So,
Tom, we got about seven minutesleft to dissect the trusts, medicate asset
protection and medicate income protection. Let'sstart with assets. How much can you
keep and how do you get itout of your name to be eligible for
medicaid? Those are both great questions. So for an individual, you allow
(45:31):
to have up to thirty one hundredand seventy five dollars in assets in both
your personal name or held jointly.So there are a couple of ways that
we can handle this. If you'rethankfully in an immediate situation and you're in
home care, there is not whatis known as the five year look back
that applies, so that if youwere in a predicament, you have a
(45:53):
few more options available to you.But ideally the way we would do this
is we would set up and establisha dedicated asset protection trust, whereby we
would deposit those assets that exceed theresource limit and deposit that into the trust
to protect it. Once that's done, it effectively creates some separation between you
(46:13):
and those assets so that when thereis the analysis done from Medicaid, they
do not view those excess assets asbelonging to you. As far as yes,
Frank and I like to say,you have two ways to get to
medicate. You can either be poor, meaning you're you've spent all of your
own money, or you can lookpoor, meaning you've created a trust where
(46:37):
the assets are still there. Youcan still live in your home, you
can still get the income from thetrust, but the assets themselves are preserved
and protected and Medicaid doesn't count them. And I think it's important to point
out most people have heard of thefive year look back, but that doesn't
apply to every medicaid program, doesit. No, it is not was
(47:00):
what we were talking about for communitybased medicaid, For home care based medicaid,
there is not currently any look backperiod, meaning that if in the
event a crisis should happen, butyou were able to get care at home,
we would still be able to establisha trust, put the assets inside
of the trust, and then thefollowing month be eligible for community Medicaid.
(47:22):
So again we do this in greatdepth and detail. We have a Medicaid
guide that you can access off ofour website at purola dot com Medicaid mondays.
There are episodes thirty minute episodes thatbreak down the Medicaid Asset Protection Trust.
If you need more information, thewebsite is a great place to go.
(47:42):
Let's flip it to income though,Tom, what are the income limits
if I'm at home? I wantto stay independent. I don't want to
go to a facility. I don'twant to be in a nursing home.
If I want to stay at homeand I need care at home, how
much income can I keep? Youcan keep roughly around seventeen hundred and fifty
dollars per month an income alone.However, as you pointed out, there
(48:04):
are other means of being able tohandle this. So if you do it
because I can't afford to live athometome, I'm seventeen and fifty dollars a
month, I mean I can't eveneat for that, I'm hungry, I
eat a lot car, I haveto pay taxes, I have a mortgage.
How do I live on seventeen tofifty? So that's that's a that's
a great point, and I thinkeverybody in New York State can can relate
(48:27):
to that sentiment. So what youwould establish in that situation if you were
qualifying for medicaid is what's known asa pooled income trust. Now, the
way this operates is that any amountof income that exceeds the allowable limit would
get placed into the specific type oftrust, and then you utilize this trust
as a bill paying program, wherebyyou would send bills and all the other
(48:50):
things and expenses that LU pointed outthat we have to pay for, and
then that trust pays directly for thoseexpenses from the amount that you depot it
in there on multi basis. So, Diane, we now have our assets
sheltered in an asset protection trust,and you've worked with us enough to know
how that works. We have ourincome sheltered in an income protection trust.
(49:14):
We still have access to all theincome and the kids can access the principle
of the trust. How does thatrelate to you as a care coordinator.
Now we're looking for care. Nowwe're looking for what are the needs and
how we're going to pay for it. So you're going to decide what organizations,
how much care is needed, whatthe insurance will cover, what the
(49:37):
gaps and the opportunities are there.So what do you need, who's going
to pay for it, what arethe different revenue streams, what are the
insurance coverages? And then we putthat plan together and then we can help
you. We can make those phonecalls, we can do that work for
(49:59):
you and keep you abreast of thatprogress as needs change. And Neverhome is
actually a pioneer in this area inthat it's bringing technology into the home and
resources that didn't exist before. Talkfor the next minute or so about that.
Okay, Ever Home partners with acompany, our sister company, Viva
(50:19):
Links, which helps to bridge someof those gaps where you might have a
few hours that are unattended, oryou might be a remote caregiver. Remember,
not everyone's immediate family lives within tenminutes of them. Some people are
miles, hundreds of miles away,or states away. We have technology that's
an app for a caregiver, adevice in the home sensors monitors. I
(50:45):
can talk about this for a longtime, and I don't have a long
time, so I would just sayyou could go to our website vivalinks dot
com. At this point, howdo you spell that v I VA l
y n X dot com and youcan find out there are demos there.
You can call us and get information. You can get us through ever Homecare
(51:06):
Advisors eight four four six three threethree eight five two. Thank you Diane,
Thank you Tom for sharing your Saturdaywith us, and we hope they
all benefited from this. I thinkit was a great conversation. Every time
I talk about this stuff, Ilearn a lot, and I hope you
did too. So we'll be backnext week on the radio. Listen in
for Medicaid Monday this Monday at noon, and we hope that you all have
(51:28):
a very independent, happy and healthyweekend. Thanks
And good morning everyone, Welcome toLife Happens Radio, a steamy, sultry
July day. Where July sixth acouple days past the fourth of July.
But we're going to keep the themeof independence going today, and not just
independence as a nation, not justthe declaration of independence, but personal independence,
individual independence. How do we planso that we can maintain our lives,
(00:25):
live the best life, and notjust live it today, but live
it throughout our aging process. Becausewhen a lot of the programs we have
today, and we're going to talkabout those programs, Medicare and Medicaid and
all the things that were put inplace over fifty years ago now almost sixty
years ago now, and you lookback and you think, wow, nineteen
(00:50):
sixty five, what was life likein nineteen sixty five. What did it
mean to be independent? Well,it meant that you worked, you retired
in your sixties, and you died. And the average age and life expectancy
at that point in time was lessthan seventy it was about sixty eight years
old. So when you have aprogram like Medicare, they said, okay,
(01:11):
we're going to take care of allof our seniors all the way through
their aging process, and that wasthree years from sixty five to sixty eight.
How do the programs fare now whenlife expectancies are into the eighties,
when we're expected to live And I'mgoing to go to my aunt's birthday.
God bless Aunt Nettie talk about aroundthe show all the time. But in
a few weeks we're going to celebrateant Nettie's one hundred and second birthday.
(01:34):
And yes we're having it at abar and restaurant, and yes, you
will probably have a cosmo at ageone hundred and two. So how do
we plan for that? How dowe live good lives throughout that process?
And it's not always pretty because thingshappen. You know what this show is
called life happens for a reason becauseas we age, as we live our
(01:55):
lives and we want to live ourbest lives, things happen, and so
we need to be prepared. Weneed to have a plan for independence.
How do we plan for our independence? And today we have a couple of
guests that I'm very happy to havewith us, Diane mikel Gotta Biowski,
and I'm gonna just call you Dianefrom now on, but it's Diane Mikkel
Gotta Biowski if you want to writeit all down. And Diane is with
(02:16):
ever Home Care Advisors. Good morning, Diane, and we'll introduce everhome and
what you do as a care coordinatorand what the organization does. And I'm
very happy to have on again fora repeat performance. Our associate from our
New York City office, Tom Morasco, Good morning, Tom, Good morning
everyone. And Tom is an attorneywho practices down in the Five Boroughs in
(02:40):
Long Island, Downstate primarily, buthe works with a lot of our clients
in preparing a legal plan, gettingthe documents, getting the planning in order
that helps you stay independent. AndDiane, I'm working off of an article
planning ahead long term care options foraging in place, and the first two
(03:02):
are preserving independence and preserving quality oflife. Your background is as a physical
therapist, so you've worked with individualsthroughout disabling conditions trying to bring them back
to health. Now you're part ofEverhome. What's the mission of ever Home
Care Advisors. The mission of everHome Care Advisors is to meet individuals and
(03:30):
discover what they want out of theirlife and their aging process, what's important
to them, and how we canhelp them navigate the system and put resources
in place to meet their goals.It's very individualized. It's very important that
we find out what people want toaccomplish and what is important to them.
(03:53):
And so a lot of people don'tthink about this until what an event,
right, What happens to people?What does life happen? What happens mean
for people throughout this aging process,and what kinds of things do you see
families falling into that trap? Sure, if you wait until there's infirmity and
(04:15):
injury, a disease, a financialdisaster, if you will, then you're
operating in a panic mode. You'renot. You don't have the time to
sit back and say what do wewant and what can we put in place?
And that could mean you can't livewhere you want to live. It
could mean if you haven't put certaindocuments in place, that you can't even
(04:36):
make your own decisions. So ifno one knows what you want, it's
very hard to move forward and giveyou what you want if you haven't shared
that with someone. So we're aboutlistening and finding that out and connecting to
the right resources. And for foreverHome and I work with ever Home on
a very regular basis full disclosure,folks. I am affiliated with ever Home
(05:00):
Care Advisors, and it's a companythat our law firm works very closely with
because these are needs that our clientshad and we kind of have moved into
not just the legal practice, butthe care coordination practice because they go hand
in hand and they are so intertwined. And the ever Home process starts die
in with an assessment. Tell ourlisteners a little bit about that process and
(05:24):
what your care coordinators that the professionalsin ever Home, what they bring to
the table. Okay, so thecare coordinators are life care coordinators as we
call them, and I have socialworkers, a nurse, and an occupational
therapist currently on the team, andmyself as a physical therapist. We will
go to the home, we'll conductan interview, but we will also look
(05:47):
at safety because it is based onwhat you want to accomplish as well.
If you live in a townhouse that'sthree levels and the bedrooms are on the
third floor and the laundry is onthe first floor and you want to stay
there, those are just the kindof things we might take into consideration.
Also, what's your financial abilities,what are your resources there? What kind
(06:08):
of insurance do you have? Again, what do you want to accomplish?
We're going to look at who areyour caregivers and a lot of them might
not identify as caregivers, or youmight think not think of them as a
caregiver. Who's going to be therewhen you need help? And how do
we set up a plan? Soagain it's not crisis mode. Oh no,
(06:28):
what do we do? But wehave a plan in place and we
can execute that plan. And Ilearned this lesson folks the hard way,
as most people do, because mymom had a condition wasn't an event per
se, but she developed Alzheimer's.And we were sitting at a kitchen,
our kitchen table one day, andI looked over at my mother and she
(06:51):
wasn't there. Her eyes were open, but there was that vacant look,
and I knew that her life hadchanged dramatically. In our lives as her
children, my sister and I hercaregivers. Our lives had changed dramatically,
and that led us on a journey, and a journey for me took me
(07:13):
down all kinds of avenues. Iwas at the time the chair of the
Elderlaw Section of the New York StateBar association. That's what we do.
We practice elder law. I hadresources all across New York State. I
had resources right here in the CapitalDistrict. What I didn't have was resources
in my mother's house. And mymother wanted to be independent. She said
(07:34):
to me, son, the onlyway I'm leaving this house is feet first.
She was fiercely independent, loved herhome, wanted to be in that
home for the rest of her life. So then it was up to my
sister and I, Michelle, toput a plan together. I called every
number under the sun, and whatI got was a run around. Every
(07:55):
number I called said, oh,well, we can't give you services today,
but call this number. Well,I called the next number. Well,
we don't have anything right now,but call this number. And I
did a circle so that the lastnumber I called was the first number I
called. And that eternal loop oflip service without service, not getting anybody
(08:16):
that could help me get care formy mom, to keep her at home,
to keep her independent. I reachedout. I did some research,
and I found a gentleman. Ihad to go all the way to Lenox,
Massachusetts. Now my mom lived inHudson, New York, which is
kelembe County, not far from Lenox, But I had to go all the
way to Lenox back then because therewere no care coordinators or care managers in
this area. That goes back twentyfive years, but it's not that different
(08:41):
today. And I found a guynamed Joe Jackson and I met with Joe.
Joe came to the house. Joeassessed my mom in the home.
He put a plan together, Hewent out and helped us find caregivers.
He helped us pay those caregivers,showed us how to do it, set
up the books, put the plantogether, monitored the play and my mom
(09:01):
was able to stay at home andthese two women and she didn't want anybody
in her home because I'm independent.I don't want anybody in my home.
These two women became her best friends, took her to lunch, made sure
she was safe, took care ofher for several years with Alzheimer's in her
home. And Diane that for mesold I was done. And you know,
I needed to have an ability tosay to my clients, this is
(09:24):
what's the best practice, this iswhat you need to do. And ever
home fulfills that mission. Absolutely,You're a son, You're part of the
family and you want to preserve thatrole, and ever home care advisors or
geriatric care managers can help do thatlegwork for you. Make those phone calls,
(09:45):
get tough when they need to gettough, dig where they need to
dig, and you don't have tospend all of your time doing that as
well. So you can be theson or you can take on the role
of the family member and be therefor your loved one in that way,
which is so important. And that'sthe caregiver's role, folks, And don't
(10:05):
underestimate it. Don't deny it.When your parents start to age and you
get those little signs, don't wait, step in, do it gently,
and we'll talk about how to doit. But have the crucial conversation to
say, do we have a plan? Are we prepared for what life might
(10:26):
bring as we age and as thoseloved ones have needs? And Tom,
one of the main tenets of elderlaw is finding care and helping people pay
for it. And just talk alittle bit about why asset protection is so
important in this realm. Yeah,I mean those are I mean very important
(10:50):
points that you guys have made usfar. But as far as being able
to stay in home, for longer, Lou as you pointed out what the
cims were in place decades ago andhow they were intended to be used.
As you just said, people areliving well into their eighties nineties, and
you said you had your aunt who'sone hundred and too. My neighbor actually
(11:11):
just turned one hundred and one abouttwo weeks ago, so it is not
unusual. And Willard Scott used tobe the weatherman on one of the national
news networks, and he used toshout out to people who turned one hundred.
Well, he would take up twentyfour hour programming if he said hello
to everybody that was turning one hundred, because there are just so many people
(11:31):
aging into that realm. Yeah,and as medic medicine advances and technology advances,
that's going to become more common.And so how do we preserve what
we have to stretch that to thatlength to make sure, as you said,
that we have the means to beable to provide ourselves, to provide
for our loved ones and even ourselvesas we age. So acid protection is
(11:54):
crucial in order to even obtain certainprograms able to assist with us. Because
even though we would love to workand some people do. They they're able
and they have the ability to workfor a very long time. That's not
realistic for everyone. So a mixtureof financial planning and asset protection is going
to be crucial to make sure thatyou can continue to have that independence moving
(12:16):
on into your later years. Sothe two programs we're gonna come back after
short break and talk about are Medicareand Medicaid and Medicare. People get I'm
on Medicare. Hey, I'm sixtysix. Yant just pointed to herself,
We're on Medicare. But what doesMedicare actually provide and what coverage can you
count on? Unfortunately, a lotof people who get on Medicare and buy
(12:39):
Medicare supplement or Medicare advantage plans togo along with that, think that they
have it covered, but they don't. Stay with us. We'll tell you
why. We'll open up the phonelines when we come back and we'll talk
about independence for life. Stay withus. You're listening to Life Happens Radio
on Talk radio WGHY. We'll beright back. Welcome back to Life Happens
(13:18):
Radio. I'm a Lou Piro,your host for this Morning with a law
firm of Pier O'Connor and Strauss.We bring you Life Happens every Saturday morning
at eleven am. Thanks for listening. Hope you're a longtime listener, and
if you're a first time listener,hope you can stay with us. Today.
I have with me two very specialguests, Diane mikeel Gottabiowski from ever
Home Care Advisors and Tom Morasco fromthe New York City Office. Because we
(13:39):
have an office down in Manhattan,we have an office in Garden City,
Long Island, and we do elderlaw and estate planning. That is our
boutique practice. So we're happy tobe here with you today. I'm going
to give out the phone number ifyou have a question on independence in terms
of staying independent for life, giveus a call eight hundred and eighty two
five nine. That number is eighthundred talk WG why again, eight hundred
(14:05):
eight two five fifty nine forty nine. And Tom, we have someone in
our office who can talk about Medicareand the enactment of Medicare and Medicaid because
he was there practicing law in nineteensixty five. And that's none other than
Peter Strauss, our partner in theNew York City Office. And I've had
(14:26):
Peter On lamenting the fact that whenLynda Johnson created the Great Society Program in
nineteen sixty five, he created aMedicare program that was intended to take care
of seniors. In the preamble,in essence says, never again will seniors
in America have to worry about healthcare. And that may have been true in
(14:50):
nineteen sixty five, but fast forwardto twenty twenty four, and that just
hasn't kept pace. So what doesmedicare provide? And we're the big holes
in Medicare, tom So. Medicareis really more short term insurance coverage.
They will provide certain resources if there'srehab stays, but where it fails mainly
(15:15):
is in long term care, whichis really what we're talking about today on
the show, about being able tostay and remain independent and having that care
in home services or even out ofhome in a facility. But that does
not cover that long term care.And so if Medicare cuts out, and
(15:37):
for most people, Medicare provides nolong term care benefit. If you happen
to go to a hospital and you'rein a hospital for three days and you
get discharged to a rehabilitation facility andyou get rehab physical therapy, Diane,
which you practiced, yes, ptOT. Just to talk a little bit
about the Medicare benefit and what itdoes provide and doesn't provide, because you've
(16:02):
had experience both as an independent physicaltherapist and also in home health care in
a home health agency and in skillednursing facility as well. So if as
Lu said, your three days inthe hospital or three overnights as they call
it, you become eligible for posthospital rehabilitation that Medicare will cover. And
(16:25):
there are a lot of misnumbers andmisunderstandings out there. People say they hear
it will cover one hundred days,and that could be true in very certain
situations, it could cover one hundreddays, But there's a very complicated and
we know, right Tommy, thatMedicare is not simple. It's a complicated
(16:45):
and highly health care plan and issue. Because there was a class action lawsuit
Jimo, and that was a classaction lawsuit that was won by Medicare advocates
and then the government didn't follow sothey have to sue again, right,
So this is a big game,folks. You have to qualify, you
have to meet certain qualifiers to getMedicare coverage for that rehabilitation. It isn't
(17:10):
a given. So you may goto a skilled nursing facility, or your
loved one may and rehab is theintention. And something changes or goals aren't
met, or they choose not toparticipate, or their condition plateaus or declines,
their Medicare benefit may be cut andthen they'll be given a notice of
(17:32):
discharge. My experience is an averageof about two weeks, and they start
thinking about terminating and discharging in abouttwo weeks. Right. The methodology is
twenty days if you qualify, twentydays is paid for at one hundred percent
day twenty one to conceivably day onehundred would be with a co insurance or
a co payment, And that's overtwo hundred a day per day. Yeah,
(17:56):
that's right, that's right. Sothat's your co payment, folks,
two hundred dollars a day if yourMedicare qualified. Correct and correct, Diane,
what happens once you terminate from Medicare? You have your team meeting and
our ever home advocates go to thatteam meeting in the nursing home and folks,
you're a sheep among wolves at thatmeeting, and I'm a blazing Saddles
(18:22):
mel Brooks fan, and I likenmyself to Mango, and Mango's line is
Mongo only pawn in game of life, and you're a pawn in the healthcare
system. The system is not builtfor the patient. It's built for everybody
else. It's making money off thesystem. So what happens at that meeting,
Basically they'll say, what's your dischargeplan? Where you're going to go?
(18:45):
Now, there is a requirement thatit is a safe discharge, but
there's a lot of scrambling. Sowhen we talk about planning ahead and we
talk about not having to act ina time of crisis, that becomes a
time of crisis because the facility issaying you need to be discharged, and
you're saying I can't, or yourfamily is saying we're working, we can't
(19:10):
be there twenty four to seven becausethere is that they need. The person
needs twenty four to seven care.That will often be the recommendation. And
then what does that mean? Twentyfour to seven care? And that's a
much bigger conversation. And folks,this is the revolutionary war. This is
where the cannons are going off thehealthcare providers, the hospitals, the nursing
homes, the discharge planners. They'reshooting their big guns and telling you where
(19:36):
you should go. And your independenceis what's being fought for and what's at
risk. And tom when Medicare cutsout, what happens to the cost of
that nursing home when you go fromrehab to just being in the nursing home.
Well, I can speak for atleast the averages in New York.
Definitely in the Boroughs and Long Islandregion, you're talking fifteen sixteenth thous and
(20:00):
plus per month. It's the samehere. Actually it's not any different.
I think it might even be higherdown there now and here it's creeping up.
But sixteen thousand a month is whatwe're seeing on a regular basis.
So, folks, that is notanything that anybody's prepared to take a check
book out and say, Okay,you have to number one, put a
deposit down to stay in that nursinghome. And that's usually a month.
(20:25):
So you're going to write one checkfor sixteen thousand just as a deposit.
You're going to write a second checkfor sixteen thousand for the next month,
and you're going to put out thirtytwo thousand dollars because your Medicare coverage just
kicked out, and tom, whatdo you do in that situation? So
this is why we talk about havinga plan in place ahead of time and
(20:48):
having the proper ASCID protection plan andso this way, if we require the
assistance, Let's face it, notmany people have the ability to be able
to have that kind of capital tothat. Then you can try to leverage
resources such as Medicaid, or ifyou plan ahead, perhaps you have some
type of long term care insurance inplace that could assist in most costs as
(21:11):
you get your plan up and running. Unfortunately, far too few people have
long term care insurance and most ofthe policies people don't know how to access.
So another thing, Diane, thata care coordinator does. Care coordinator
can look at your long term carepolicy, can communicate with the people at
(21:33):
that insurance company to help you access, understand and access what those benefits are.
This is a very time consuming tobe a person that's coordinating benefits and
knowing and understanding healthcare insurance reimbursement andwhat your rights are. And oh,
by the way, that caregiver hasa spouse, they have a job,
(21:57):
a boss, and re little kidswith Little League games and recitals, and
they have a life that this justbecomes a full time job. And how
do the care coordinators fit in there? Start with an interview, gathering that
information and setting up a timeline ofhow they're going to act on that information.
(22:22):
So setting goals, what do weneed to accomplish, what do we
need to access? What information?The individuals, the family, the patient
or client will have to provide someof that information. But if you know
what you're looking for, it's alot easier than just saying I don't know
what to do now, I don'tknow what you need. So we can
help take some of that stress awayand then do the next step or go
(22:48):
to the next step. Now,if this person is still in a skilled
nursing facility, can attend meetings,can communicate with the discharge planners and social
workers at that skilled nursing facility,or perhaps arranged for home care, or
start investigating home care services and analternate plan. And Diana Tom, I'm
going to throw out a loaded questionthat I know the answer to, but
I'm going to ask it anyway.And I usually save this for the end
(23:11):
of the show. When is theright time to do a plan for long
term care? Go ahead, Tomwell as honestly, I don't think there's
any time that's too soon. I'llput it that way, as you said,
And it's unfortunate, but most ofthe cases, a lot of the
clients that I've seen, it's always, as you pointed out, there is
(23:33):
an event, something happened and therewasn't a plan previously in place, and
now everybody's at that scramble and it'schaotic and it's going to no matter what,
even with the plan, it isalways going to be a situation that
is going to cause that type ofanxiety just because your loved one just went
through something traumatic and you're trying toget them help. But it's a lot
(23:56):
easier to navigate when there is aplan. We know what the proce is,
we know who we're going to reachout to, we know the documents
that we have and how to doit. So even though we still have
that stress, it's a lot easierto manage once you know what to do,
because if you're trying to start fromscratch while also trying to handle those
emotions, it's not going to bevery effective because you don't know where to
(24:18):
start. Absolutely, you start now. Now there's the answer. Absolutely.
We're going to take a break forthe news. When we come back,
we're going to unravel how to constructthat plan. What are the planks in
the plan? How do you buildit? How do you make sure it's
the right plan, How do youmake sure it stays effective? And we're
going to do this both from acare perspective and a legal perspective, kind
(24:42):
of a unique perspective for you hereon Independence weekend. I'm Blupiro. We'll
give you the phone number again whenwe come back, hopefully you'll give us
a call. But right now,the news we're better, better than ever.
(25:11):
You're listening to Life Happens Radio.Are you prepared? I'm Lupiro,
your host for this Morning in StudioLive with Diane Mikkel Gottabiewski. And we
didn't make Tom drive up, sohe's down at home on Long Island.
But Tom morasco one of our associateattorneys who has experience in this area and
works with clients doing long term careplanning. Diane is with ever Home Care
(25:33):
Advisors, also dealing with long termcare planning. And I want to give
you an alert that we have anupcoming webinar. We have a series of
webinars we call them Medicaid Mondays,And as we unravel the second half of
the show, we're going to talka lot more about Medicaid because that is
the only game in town when itcomes to paying for long term care.
(25:55):
If you don't have insurance privately,and you don't have two three hundred thousand
dollars a year that you can applytowards long term care costs, Medicaid becomes
the target and the goal. Sowe have Medicaid Mondays and lo and behold,
it's this Monday, July the eighth. It's going to be on Medicaid
home care. A lot of peopledon't even know that Medicaid provides care in
(26:18):
your home, and under the rightcircumstances, it can provide twenty four to
seven care to you or your lovedone at home, paid for by Medicaid.
Now, that is a benefit thatis very unique nationally. New York
is way out in front has been. It's also a very expensive benefit for
New York. So there are somehurdles you have to cross to get Medicaid
(26:42):
eligibility to get the number of hoursyou want and to preserve your income and
your assets. So this Monday,Frank Haming and Aaron Connor are going to
talk about financially qualifying for Medicaid homecare. That's at noon to twelve thirty.
It's a thirty minute webinar. Andthen the following month, the second
(27:03):
Monday in August, Frank and Iwill be talking about the process for getting
the care in home. How doyou find care, how do you coordinate
it, how do you go throughthe assessment process to make sure when it
comes time, Medicaid is providing thecare that you need. So you can
sign up for the series Medicaid Mondaysand we get a good crowd. We
(27:25):
get about three hundred people on thewebinars every second Monday of the month.
So join us July the eighth,twelve to twelve thirty, and you can
sign up at any time on ourwebsite purolaw dot com. It's pie r
R l awpurolaw dot com. Youcan just email us info at pyrolaw dot
(27:48):
com if you want us to signyou up, or call our office five
one eight four five nine twenty onehundred. Frank Hemming. Our Medicaid master
at Pire. O'connoran Strauss and AaronConnor will be doing this Monday, and
then we'll go back the following monthin August to talk about the process for
accessing care at home. A bigpart of what our theme today is on
(28:11):
Life Happens Radio. So join usfive one, eight four or five nine
twenty one hundred for Medicaid Monday.That phone number, folks, if you
have a question, please pick upthe phone, give us a call.
Diane is here, I'm here,Tom's here. We're talking about independence,
how to plan, how to prepare, how to get care in home.
A lot of times, far toomany times, the plan is not a
(28:34):
plan, it's a crisis intervention.So how do we get out in front
of this. We're going to talkabout that now, But give us a
call and ask your questions. Eighthundred eighty two five five nine four nine,
eight hundred eight two five fifty nineforty nine. That's eight hundred talk
WG. Why hope to hear fromyou and Tom. I'm going to come
(28:55):
back to you because when we lookat Medicare, and we've explored the deficiencies
in Medicare and why that program fromnineteen sixty five that has not changed dramatically
is not keeping pace with the agingpopulation and the needs of the aging population,
and so many more people used tobe. You got lived to sixty
(29:18):
five, you had a retirement,you had a heart attack, and you
died. Today, with modern medicine, that heart attack is just a blip
on the screen, and you havea brief period of recovery. You may
have, like me, a bypass. I had a quintuple bypass. They
put me back together again. I'mback out playing tennis and doing all kinds
of good stuff. But science,modern science and medicine keep you alive.
(29:41):
And these chronic conditions start to creepin Alzheimer's, Parkinson's, all the things
that people have as they age,and medicare stops paying and we're talking now
two hundred thousand to two hundred andfifty thousand dollars a year for care.
How does medicaid here? So Medicaidwill step in again. There are certain
(30:06):
qualifications that you must meet, andwith the proper planning in place, we
can make sure that you meet thoseneeds. But so long as you qualify,
they will provide the coverage that youneed. Now, as you pointed
out lubi's home care, it's slightlydifferent because there are certain hours and days
in which they were going to approve. So making sure you have the right
plan and team in place when youare putting in for that application to make
(30:30):
sure and like you said, pleasetune into the Medicaid mondays, it's going
to be very insightful, but makingsure you get those requisite hours. But
for long term care facilities, theywill cover the cost for your long term
meets. So talk a little bitabout Medicaid eligibility. I know that you
have restrictions on income and assets.Just tell our listeners how that works.
(30:55):
Yeah. Absolutely, So with homecare and nursing home care alike, there
is an asset requirement, okay.An individual is not allowed to have more
than around thirty and seventy five dollarsin assets and their name were held jointly,
okay. So and also for homecare, because we're talking about remaining
independent and staying at home, there'san income requirement and you cannot make more
(31:18):
than around seventeen hundred dollars per monthroughly in income. But there are ways
that you can plan to make surethat you could still qualify and meet the
needs in order to qualify for theprogram. So, as lawyers and as
elder law attorneys, trusts are abig part of our practice. And I
think Tom, there are two maintrusts when it comes to medicate home care.
(31:41):
And again today's theme is independence.You want to be at home,
you want to get the care thatyou need. And you know, Diane,
before we get into the finances,being independent doesn't mean being alone.
Absolutely, it's very important what doesindependence mean to you as an individual or
your loved one, and that independencereally should have and usually has a lot
(32:06):
to do with your decisions and desiresand what you want. So independent might
be living in a senior community.Independence might be living in your home with
twenty four to seven live in help. It could be patchworking, and patchworking
isn't always bad. So independence meansmaking those decisions and looking at what's what
(32:30):
your safety is, what keeps yousafe, maintaining your self respect, and
again carrying out wishes that you madein a time of non crisis. And
so Tom, we have a caller. We have Jim and Rotterdam. Good
(32:50):
morning, Jim, Welcome to lifehappens Raady morning, Thank you. I
listened to these shows and very thankfulfor them. But one of the other
ones on another channel, I don'trecall who it is. And this was
recently said that those of us whohave the New York State long term care
(33:15):
nursing home policies that when we getif we're in a nursing home for three
months, I'm sorry, three years, and at that point we are automatically
Medicaid eligible with no means testing,and the nursing home is required to accept
(33:44):
whatever Medicaid is paying for the dailyrate. And I believe that's what I
read in my contract language and mypolicy. He's saying that he knows of
a case and I've heard this fortwo weeks in a row where the I
guess the government was actually able togo after some of their assets specifically in
(34:09):
IRA. Do you think that wasan outlier or have you heard of stuff
like this happening? Yeah? Idid hear, and it was actually in
a Renstler County here locally, andit did come to our attention, and
the state was notified and the stateDepartment Health, I believe, told county
(34:29):
that that was an unavailable asset.And it's a complicated thing. You were
right on everything you said. Ilove the partnership. It was one of
the best policies ever put out inlong term care. The woman who designed
that policy is a good friend ofmine, Gail Hollabinka, And the partnership
was the hot policy in the ninetiesand the two thousands. But unfortunately you
(34:52):
can't even buy that policy anymore.And so for clients to come in and
say, well, I just gota premium increase, it's another thousand dollars
a year pay because you cannot replacewhat you get in a New York state
partnership policy. It is one hundredasset protection and there is absolutely no requirement
(35:14):
that they that they have you tryto maximize income. It's a whole game
that the state plays. When youhave an IRA, you have something called
the required minimum distribution an RMD,and that's calculated based upon the table that
applies to iras go figure, it'san IRS table, and that table is
(35:36):
calculating your required distribution what you haveto take each month from your IRA,
and if you take the right amount, that IRA is exempt. Well,
many counties now in the state ofNew York is trying to push this are
saying, well that table isn't theright table even though it applies to your
IRA. We want you to useour table, the Social Security table,
(35:58):
to push more income so that moreincome goes to the nursing home and Medicaid
pays less for you. And wefight that fight with our clients, and
right now the state is winning mostof those battles, but not with the
partnership because you don't have to exemptthe IRA, it's already exempt. So
they are one wrong Jim on thisissue. And you know, if a
(36:21):
case comes along where somebody is gettingtold that they have to take more money
out of their IRA to make itan exempt asset, the State of New
York has actually stepped in on certaincases and forced and enforced the partnership rules.
There is an office for the Partnershipof the State that we'll actually look
at this issue. We have alsoadvocated and made the county aware that they're
(36:43):
just dead wrong on that issue.Okay, I, my wife and I
bought ours twenty four years ago andwe're we're we bought the five percent per
year and it's built up to whereit almost equals what they're getting for a
(37:05):
nursing home. Like you said,fifteen sixteen yearAnd a month. Yeah.
I mean if you bought it inthe nineties, you're probably six hundred dollars
a day. That's almost exactly whatit is. Yeah. Yeah, we
bought it, I think in ninetyseven. Yeah. But that thing I
heard about, you know, thestate trying to go after stuff really bothered
(37:27):
me. Another question is, forthe first time, and since I've turned
sixty five, I've actually read theMedicare book. It's actually a pretty good
book. Different if I read Iread it years ago for clients, but
I just read it for myself.Then it's it's accurate information. It's good
information. Yeah, but it's withthe with the paradigm I had of Medicare.
(37:52):
It's very frightening because I didn't realizeafter a certain number of days in
the hospital, you're cut off.That's right. Does my long term care
policy kick in for hospitalization or isthat just for a nursing homebine. No,
that's just long term care. Butwhat you want to long term care,
(38:13):
and it's crazy that you have todo this in between Medicare and your
long term care policy is something calleda Medicare supplement policy, and it's an
additional insurance that will pay additional daysdepending upon your contract. But you buy
a supplemental policy to Medicare to coverthose gaps, the hospital gap, and
(38:37):
some of them cover that co paymentwe talked about earlier in the show,
where once you get to day twentyone, there's a co payment of two
hundred dollars a day. Some ofthe policies actually cover that two hundred dollars
a day for you if you continueto be skilled care. This is mind
numbingly complicated, and that's why wehave have a care coordinator and an attorney
(39:01):
trying to break it all down.But when it comes to the point where
those big cannons are being shot offby the healthcare provider, the hospital,
the nursing home, the rehab,you got to have somebody on your side
that can navigate through this minefield.And it is a minefield. So hopefully
today's show can put a little lighton it, shed a little clarity.
(39:24):
But there are resources out there,Jim. If that comes to pass,
I would go and shop Medicare supplementpolicies at this point and look at how
to cover those gaps in Medicare,and if you have the partnership, your
long term care needs are very verywell covered. This is a little bit
of little gap that still exists.Okay, I'm seventy one now, so
(39:46):
I've had supplemental for six years now. Is that what you're talking about?
Like in my case is United Healthcare? Every arp YEP, that contract,
that's the contract you have to readnext to see what coverages? Okay,
you have? Is there a multiple? Okay? If I get too long,
(40:08):
win to just shut me off.Okay, But either yourself or the
other guy listened to said, there'sonly one thing worse than not having a
trust, and that is having thewrong trust attorney. And with the trust
attorneys out there are all you know, saying they're qualified from a consumer point
of view, how do I know? You know? I guess it's improper
(40:32):
to ask you this, But howdo I know that? No? There
are ratings you can go to.There's Martindale. Hubble is a rating service
that reads attorneys. And we getraided on elder law, trust and the
states. And we just got bestlawyers, myself, my partner Aaron Connor,
(40:57):
several of us. Tom, whatdid you qualify for in the lawyers?
The similar Yeah? Really in realestate, these are peer review rated
publications, so they rate other attorneysrate you in your abilities. The firm
that we've put together with Peter Strauss, Peter has sixty years of experience.
(41:22):
I have forty one years of experience. We've been doing elder law since it
started, and I've created a companycalled Elder Council that has served the country's
elder law attorneys in how to createMedicaid asset protection trusts. So, you
know, I think I could goon, but I won't, but I
(41:43):
think our firm is pretty well positioned. You can go to our website and
you can see all the different thingswe have there to show what our experience
is, and we do it ina way that we hope is catering to
our client's needs. We always tryto put the client first and be empathetic
to their needs and create a planthat fits what their particular situation is.
(42:07):
Because this isn't a trust that youjust take off the shelf and say,
oh, here's a Medicaid asset protectiontrust. It doesn't work that way.
It has to be tailored to individualcircumstances. So that's how we do it.
It's a very thorough process. Clientscome out of that initial consultation saying
you asked me twenty five questions Inever anticipated. So that's the part of
(42:30):
it that isn't just a document.It's really a process of digging into where
that plan is going to make sensefor you. Okay, one quick one,
because I know I'm monopolizing your time. I'm going to be on the
road Monday. Is there anyway Ican get a online copy of that webinar?
(42:52):
All of our webinars are posted onour website. It takes a couple
of days they are ye, soyou can go to pure law dot com
and our whole library of webinars ison the website. Oh that's great,
Well, thank you very much.All Right, Jim, thanks for the
call. We have to take ashort break. When we come back,
Tom is going to really dig intothe trusts that put the pre plan in
(43:16):
place. Jim has an asset NewYork State Partnership policy that very very few
people have. If you don't havethat, stay tuned, because you need
to recreate the protections that New YorkState gave to Jim through this policy,
we can put back for you throughthe Medicaid Trust. You're listening the life
(43:37):
happens. Radio, be right backafter this short break. If everybody had
then everybody, all right, getout there today. It's warm, sunny
day. Might have a couple ofshowers here and there, but the sun
(43:57):
is shining here in the Capitol region. Tom, how's a we down there
on Long Island? It started offa little rough, but it looks like
the sun's starting to peak around downhere as well. All Right, it's
warm, it's muggy, it's humid. Get to a pool, get to
some water, have your favorite beverage, and enjoy this beautiful Saturday. I'm
Lou Piro in studio with Diane MikkelGottabiowski of Everholm Care Advisors. On the
(44:21):
line with us from Long Island isTom Morasco. Also with Pierre O'Connor and
Strauss, and we had someone callin who was signing up for the Medicaid
Monday webinar that I talked about earlierand Medicaid Mondays again we break down in
depth and thirty minute increments every secondMonday the Medicaid program and this Monday coming
up July eighth, is Medicaid HomeCare. If you go to the website
(44:45):
and you want to sign up atpurolaw dot com. Go to the events
tab. If it asks you whatgroup you're with or what company you're with
and you're just a consumer, justput in consumer. We do have a
lot of professionals that follow our firmand follow our advice. So if you
are from an organization, that wouldgo in there. But if you're a
consumer, just tell us that andthat would be great. We'd love to
(45:07):
have you join us and hopefully youcan benefit from the webinar. So,
Tom, we got about seven minutesleft to dissect the trusts, medicate asset
protection and medicate income protection. Let'sstart with assets. How much can you
keep and how do you get itout of your name to be eligible for
medicaid? Those are both great questions. So for an individual, you allow
(45:31):
to have up to thirty one hundredand seventy five dollars in assets in both
your personal name or held jointly.So there are a couple of ways that
we can handle this. If you'rethankfully in an immediate situation and you're in
home care, there is not whatis known as the five year look back
that applies, so that if youwere in a predicament, you have a
(45:53):
few more options available to you.But ideally the way we would do this
is we would set up and establisha dedicated asset protection trust, whereby we
would deposit those assets that exceed theresource limit and deposit that into the trust
to protect it. Once that's done, it effectively creates some separation between you
(46:13):
and those assets so that when thereis the analysis done from Medicaid, they
do not view those excess assets asbelonging to you. As far as yes,
Frank and I like to say,you have two ways to get to
medicate. You can either be poor, meaning you're you've spent all of your
own money, or you can lookpoor, meaning you've created a trust where
(46:37):
the assets are still there. Youcan still live in your home, you
can still get the income from thetrust, but the assets themselves are preserved
and protected and Medicaid doesn't count them. And I think it's important to point
out most people have heard of thefive year look back, but that doesn't
apply to every medicaid program, doesit. No, it is not was
(47:00):
what we were talking about for communitybased medicaid, For home care based medicaid,
there is not currently any look backperiod, meaning that if in the
event a crisis should happen, butyou were able to get care at home,
we would still be able to establisha trust, put the assets inside
of the trust, and then thefollowing month be eligible for community Medicaid.
(47:22):
So again we do this in greatdepth and detail. We have a Medicaid
guide that you can access off ofour website at purola dot com Medicaid mondays.
There are episodes thirty minute episodes thatbreak down the Medicaid Asset Protection Trust.
If you need more information, thewebsite is a great place to go.
(47:42):
Let's flip it to income though,Tom, what are the income limits
if I'm at home? I wantto stay independent. I don't want to
go to a facility. I don'twant to be in a nursing home.
If I want to stay at homeand I need care at home, how
much income can I keep? Youcan keep roughly around seventeen hundred and fifty
dollars per month an income alone.However, as you pointed out, there
(48:04):
are other means of being able tohandle this. So if you do it
because I can't afford to live athometome, I'm seventeen and fifty dollars a
month, I mean I can't eveneat for that, I'm hungry, I
eat a lot car, I haveto pay taxes, I have a mortgage.
How do I live on seventeen tofifty? So that's that's a that's
a great point, and I thinkeverybody in New York State can can relate
(48:27):
to that sentiment. So what youwould establish in that situation if you were
qualifying for medicaid is what's known asa pooled income trust. Now, the
way this operates is that any amountof income that exceeds the allowable limit would
get placed into the specific type oftrust, and then you utilize this trust
as a bill paying program, wherebyyou would send bills and all the other
(48:50):
things and expenses that LU pointed outthat we have to pay for, and
then that trust pays directly for thoseexpenses from the amount that you depot it
in there on multi basis. So, Diane, we now have our assets
sheltered in an asset protection trust,and you've worked with us enough to know
how that works. We have ourincome sheltered in an income protection trust.
(49:14):
We still have access to all theincome and the kids can access the principle
of the trust. How does thatrelate to you as a care coordinator.
Now we're looking for care. Nowwe're looking for what are the needs and
how we're going to pay for it. So you're going to decide what organizations,
how much care is needed, whatthe insurance will cover, what the
(49:37):
gaps and the opportunities are there.So what do you need, who's going
to pay for it, what arethe different revenue streams, what are the
insurance coverages? And then we putthat plan together and then we can help
you. We can make those phonecalls, we can do that work for
(49:59):
you and keep you abreast of thatprogress as needs change. And Neverhome is
actually a pioneer in this area inthat it's bringing technology into the home and
resources that didn't exist before. Talkfor the next minute or so about that.
Okay, Ever Home partners with acompany, our sister company, Viva
(50:19):
Links, which helps to bridge someof those gaps where you might have a
few hours that are unattended, oryou might be a remote caregiver. Remember,
not everyone's immediate family lives within tenminutes of them. Some people are
miles, hundreds of miles away,or states away. We have technology that's
an app for a caregiver, adevice in the home sensors monitors. I
(50:45):
can talk about this for a longtime, and I don't have a long
time, so I would just sayyou could go to our website vivalinks dot
com. At this point, howdo you spell that v I VA l
y n X dot com and youcan find out there are demos there.
You can call us and get information. You can get us through ever Homecare
(51:06):
Advisors eight four four six three threethree eight five two. Thank you Diane,
Thank you Tom for sharing your Saturdaywith us, and we hope they
all benefited from this. I thinkit was a great conversation. Every time
I talk about this stuff, Ilearn a lot, and I hope you
did too. So we'll be backnext week on the radio. Listen in
for Medicaid Monday this Monday at noon, and we hope that you all have
(51:28):
a very independent, happy and healthyweekend. Thanks
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