nursing homes medicaid planning york pa

A Financial Success Story for a Nursing Home Resident


A family was recently referred to us by a local nursing home because the wife had a stroke and she is going to need care for the foreseeable future. The nursing home social worker was talking with the husband, who was scared because he had a modest amount of money that he has accumulated during his lifetime, but was nervous that it would not take long at $11,400 a month for him to not be able to provide for himself in the future.  

For help with that problem, the Pennsylvania Medicaid spousal rules are certainly a great start and provide that as the community spouse, the husband would be allowed to keep the house, his car, his retirement account, and one-half of the remaining assets, up to a maximum in 2019 of $126,420.00 and no less than $25,284.00 (those amounts change each year).  The social worker explained this to the husband and he still had some trepidation, being only in his late 50s, wanting to know if that would be enough for him to live another 50 years of his life. He loved the nursing home that he was able to get his wife into and was excited about the care that she will receive.

After several sleepless nights for him, the social worker told him to give us a call and I met with him recently.  The husband is an absolute joy to work with and was very appreciative of the care that his wife was receiving. He was ecstatic when I was able to tell him that we would be able to not only protect the aforementioned items, but also the additional $350,000 on top of the $124,000 that was guaranteed under the law.

We were able to put the plan in place and did get approval on the Medicaid application.  It is very rare in our profession that family members hug or show outward affection toward their lawyers.  I will never forget the moment when we received the application and I was able to tell my client that we were able to protect the items that he knew about, but in addition to that, the other monies that he had feared of losing.  

With tears in his eyes, he hugged me and said, Jeff I will never be able to repay you. I appreciate everything that the nursing home has done for me and for my wife, but it is also comforting to know that now I don’t have to worry about how I’m going to live for the remainder of my life and the care that I receive.

We are pleased to report that this outcome is a very common for our clients; we have been able to secure this result for hundreds of clients in and around York, Pennsylvania.  If you or a family member have a loved one in a nursing home and need assistance, please call us (717-845-5390) or click here and give us a little information and we’ll call you, and it will be our pleasure to make this success story yours.

Jeffrey Bellomo

What Estate Plans do Parents Need?

This is a question that I’m often asked by young clients with young children.  The basics of the plan are very similar to what a lot of individuals would expect.  I always encourage people to have a financial power of attorney, a medical power of attorney, a living will, and Last Will and Testament.  

Incapacity is something that often occurs, and older age is not always a factor. Even young individuals should have a financial power and medical power of attorney in place if they are over 18.  I have gone at length in other blogs and in my workshops to explain the importance of financial powers of attorney, and I certainly cannot stress them enough. However, this article is specifically going to discuss whether a family with young children needs more than just a base Will.  

Our office offers both base and enhanced Will plans for families.  Our base wills are approximately 23 to 25 pages and typically will cover everything that a family would need from an understated age trust to a trust in case anyone has a loved one with special needs who upon inheriting assets would be disqualified from receiving benefits, which is called a special needs trust.  We put both of those on standby, or “what if”, trusts in every document to ensure that families will be protected in the unlikely event that they were to die with beneficiaries under a specified age (at a minimum 18) and/or with any beneficiaries who are incapacitated or disabled.

These plans are able to cover most situations, but our enhanced Will plan provides something that our base plan cannot, which is the ability to protect inherited retirement accounts and other assets for children.  Although our base plan provides an understated age trust in it, which allows a family to be able to set the age at which a child is able to receive a lump sum distribution, it cannot put a retirement account into that trust without triggering tax consequences.  

In order for a retirement account to be inherited by a child and still be able to stretch out the tax benefits, it has to be put into a qualified trust called a see-through trust. Our enhanced plans are equipped with qualified see-through trusts which allow you to protect your retirement accounts without triggering any negative tax consequences.  This is essential when dealing with young children because, if we use a base plan, then we must name the beneficiary outright in the retirement account.

Once we name a beneficiary outright, the beneficiary is able, at the age of 18, to force liquidation of the entire account, pay all the tax consequences, and do what they wish with the remainder of the retirement account.  This is often not what parents want; rather, they want the money to be able to stretch out over the child’s life expectancy from a tax perspective, but also keep it asset protected so that an 18-year-old cannot force distribution. Such trusts also protect the retirement account from the child’s creditors.

We at Bellomo and Associates have had great success at protecting young families with our enhanced plans so that we can stretch out tax benefits over the children’s life expectancy and also keep the money protected from any unforeseen creditors.  Please come to one of our workshops or contact our office to learn more about these benefits.

Jeffrey Bellomo, Esq.

retirement planning york pa

Retirement planning with long-term care


Qualified retirement plans (IRAs, 402(k)s, 403(b)s and the like) are a great way for families to be able to grow their wealth for the future and do so tax-deferred. There are numerous research articles that have proven that the tax deferral is extremely impactful when it comes to being able to accumulate wealth for a family.

Unfortunately, we often see clients who have spent their entire lives accumulating their retirement accounts but are now faced with the reality of long-term care costs.  Families of those who are going or have gone into a nursing home quickly discover that retirement plans such IRAs, 401(k)s, 403(b)s are countable resources when it comes to long-term care and Medicaid planning. Although many states allow different ways to protect retirement plans, currently Pennsylvania is not one of them.

One of the more difficult conversations that we have to have with financial professionals who represent our clients is that when a loved one enters a nursing home the only way to be able to protect assets for the spouse or for the family is to liquidate a retirement account.  Obviously, liquidation of a retirement account is not an ideal situation because not only will it trigger immediate tax consequences, but there are also other unintended consequences such as potential increases in Medicare premiums, etc.

Of all of the things that we do at Bellomo and Associates, the concept of a retirement plan and crisis planning is probably the most difficult and toughest conversation we need to have.  It does not make logical sense to liquidate a retirement account and trigger tax consequences and other consequences that are unintended, but if a person will likely remain in a nursing home for an extended period of time, it is often the only way to preserve that asset to ensure that it is there for the spouse or loved ones.

When this conversation comes up, we often talk to the family and to the advisor about not making an emotional decision but rather a decision based on data. Certainly, there is no way to know how long a loved one will live in a nursing home, but depending on the diagnosis and prognosis for the person, we can often make an educated guess.  If it is expected that the person will live for several months to several years, we often end up liquidating the retirement account because then we are able to protect either 100% of the assets for the spouse or 50% for the family members. 

These calculations are done not only by our office but also by the accountants and financial advisors who work with our families. We are very lucky to work with many competent professionals, and often are able to take a very difficult conversation and make it simple.  Although not ideal, preserving those assets for the family and for the future is often better than trying to save a few tax dollars in the short-term and losing it all in the long term.

If you or your family member is faced with this difficult decision, please contact your professionals immediately to help guide you through that conversation.

long term care planning york pa

The Five Must-Knows of Long-Term Care Planning

Long-term care is often a very overwhelming and scary time of a person’s life.  Having specialized in helping families through this tumultuous process for over 15 years, I have learned several things that I pass on to clients on a daily basis.  I call them the Five Must-Knows of Long-Term Care Planning, and they are as follows:

  1.    It is never too late.
  2.    Preplanning is always better than crisis planning.
  3.    Long-term care is a team sport.
  4.    You must work with a qualified professional.
  5.    It is stressful, but planning is worth it.
  1.  It Is Never Too Late.  The one thing that I cannot stress enough is that, even if a loved one is in a nursing home or is going to need skilled-level care in his or her own home, options are still available.  Pennsylvania is a very generous state when it comes to allowing individuals to protect assets for families in crisis, to the tune of 100% for a spouse who is at home or 50% for a single widow or widower family member.  We often hear, “Well, we weren’t able to do anything ahead of time and our loved one already needs skilled-level care, so, therefore it’s too late.” It is essential to understand that it is never too late and that you should seek professional advice immediately.
  1. Preplanning is Always Better.  Although it is never too late, preplanning is much less expensive, and also much less stressful.  Although things can still be done in crisis, it is a very emotional time for a family, and asset protection can be very expensive.  In a perfect world, the planning would be done five years before an individual needs skilled-level care in a nursing home or in his or her own home.  I realize that timing is not something that anyone can control, but, certainly, the earlier, the better.
  1. Long-Term Care Planning is a Team Sport.  In our weekly workshops, we stress to our families that we want them to include their team, which often consists of other family members, financial professionals, accountants, and other important key people.  This can be a very stressful time and, oftentimes, very technical and important decisions have to be made. I never recommend going alone down this path, as having your family members and your other professionals there with you will provide not only peace of mind but also support and great advice.  Therefore, when you start thinking about long-term care planning, always remember it is a team sport, and the better the team, the better the decisions.
  1. You must work with a qualified professional. Asset protection planning and Medicaid planning are two very technical areas of the law. Most estate planning attorneys do not understand the intricacies of Medicaid and asset protection. I recently received a call from a client who was going to use another elder law attorney and I told him to ask the individual how many asset protection trusts Medicaid files that they did in the past month. I told the client that we did 10 asset protection trusts the month before and had 60 active Medicaid files. When the client called me back, she was laughing because she said that the individual told her that they hadn’t done any of either but that didn’t mean that they were not an elder law attorney. It is very easy to make a major mistake in these areas and causes major tax, financial, and other losses to a family. Be sure to use a firm that has a certified elder law attorney to make sure that the person knows the intricacies of the law.
  1. It is stressful but planning is worth it. Pre-planning is the best planning because it is done ahead of time without a lot of stress and it is much less expensive. However, even crisis planning is worth it. For a single individual or a widow or widower, if he or she is in a nursing home we can still protect 50% of their assets for a loved one. If there is a spouse, we are able to protect 100% of all assets, and qualify the person for Medicaid so that the state is paying for his or her nursing home stay. Sure, the process of collecting the required information, such as five years of bank and financial statements, and getting through the process is stressful and overwhelming, but the end result is well worth it.

Remember these five tips to protect your family and your assets. If you need further information, please come to one of our workshops or call the office.

estate planning attorney york PA

Grief: Coping with the loss of a loved one

Coping with the loss of a close friend or family member may be one of the hardest challenges that many of us face. When we lose a spouse, sibling, or parent, our grief can be particularly intense. Sadly, loss is a natural part of life, but we can still be overcome by shock and confusion, leading to prolonged periods of sadness or depression. The sadness typically diminishes in intensity as time passes, but grieving is an important process in order to overcome these feelings and continue to embrace the time you had with your loved one.

Everyone reacts differently to death and employs personal coping mechanisms for grief. Research shows that most people can recover from a loss on their own through the passage of time if they have social support and healthy habits. It may take months or a year or longer to come to terms with a loss. There is no “normal” time period for someone to grieve. Don’t expect to pass through phases of grief either, as new research suggests that most people do not go through stages as progressive steps.

If your relationship with the deceased was difficult, this will also add another dimension to the grieving process. It may take some time and thought before you are able to look back on the relationship and adjust to the loss.

Human beings are naturally resilient, considering most of us can endure loss and then continue on with our own lives. But some people may struggle with grief for longer periods of time and feel unable to carry out daily activities. Those with severe grief may be experiencing complicated grief. These individuals could benefit from the help of a psychologist or another licensed mental health professional who specializes in grief counseling.

Mourning the loss of a close friend or relative takes time, but research tells us that it can also be the catalyst for a renewed sense of meaning that offers purpose and direction to life.

Grieving individuals may find it useful to use some of the following strategies to help come to terms with loss:

  • Talk about the death of your loved one with friends and colleagues in order to understand what happened and remember your friend or family member. Denying the death is an easy way to isolate yourself, and will frustrate your support system in the process.
  • Accept your feelings. People experience all kinds of emotions after the death of someone close. Sadness, anger, frustration and even exhaustion are all normal.
  • Take care of yourself and your family. Eating well, exercising and getting plenty of rest helps us get through each day and move forward.
  • Reach out and help others dealing with the loss. Helping others has the added benefit of making you feel better as well. Sharing stories of the deceased can help everyone cope.
  • Remember and celebrate the lives of your loved one. Possibilities include donating to a favorite charity of the deceased, framing photos of fun times, passing on a family name to a baby or planting a garden in memory. What you choose is up to you, as long as it allows you to honor that unique relationship in a way that feels right to you. If you feel stuck or overwhelmed by your emotions, it may be helpful to talk with a mental health professional who can help you cope with your feelings and find ways to get back on track.

Psychologists and mental health professionals are trained to help people better handle the fear, guilt or anxiety that can be associated with the death of a loved one, and can help people build resilience and develop strategies to get through their sadness. Mental health professionals often use a variety of treatment modalities to help with grieving. A commonly used treatment is psychotherapy to assist people to improve their lives by better coping with grief.

If you need help the next steps to take when a loved one passes away, click here and download our FREE guide.

This article was adapted from a March 2011 post by Katherine C. Nordal, PhD on the APA’s Your Mind Your Body Blog.

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