Retirement Living

RETIREMENT LIVING

AN ADVERTORIAL RESOURCE GUIDE

FAIRFIELD COUNTY BUSINESS JOURNAL | WESTCHESTER COUNTY BUSINESS JOURNAL | SEPTEMBER 14, 2020

S2 | RETIREMENT LIVING ADVERTORIAL RESOURCE GUIDE | SEPTEMBER 14, 2020

DISCOVER THE FINEST IN SENIOR LIVING

The Bristal Assisted Living has been serving seniors and their families in the tri-state area since 2000, offering independent and assisted living, as well as state-of-the-art memory care programs. We are committed to helping residents remain independent, while providing peace of mind that expert care is available, if needed.

Designed with seniors in mind, each of our communities feature exquisitely appointed apartments and beautiful common areas that are perfect for entertaining. On-site services and amenities include daily housekeeping, gourmet meals, a cinema, salon, plus so much more. Discover a vibrant community, countless social events with new friends, and a luxurious lifestyle that you will only find at The Bristal.

SCHEDULE YOUR VISIT TODAY! ARMONK

WHITE PLAINS

914-229-2590

914-215-5820

For a list of all locations in the tri-state area, visit: THEBRISTAL.COM

AN ENGEL BURMAN COMMUNITY

Licensed by the State Department of Health.

Eligible for Most Long Term Care Policies.

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THE KENSINGTON ASSISTED LIVING RESIDENCE We are here. We are open.

And our commitment to you is stronger than ever.

We recognize that choosing a senior living community for your loved one is never an easy decision. It’s even more difficult today due to COVID. If you’re caring for a loved one who needs more assistance than you can provide at home, then you might be asking yourself: What’s the right thing to do? Or the best thing to do?

Our promise is to love and care for your family as we do our own. That starts with getting to know you and those you love. Whether you need a listening ear, connection to resources or information about our services, we are here to provide support.

For example, our first-rate clinical team can address the complexities of care that many families find challenging to manage at home.

• Our two-tiered memory care programs keep residents involved and moving about in a secured environment.

• Activities that provide socialization-which is an important contributor to wellness-are happening daily with in person one-on-one sessions or through virtual forums.

• And, our Executive Chef and dining team make sure that the mealtime experience is delicious in every way.

We’re standing by, eager to listen and ready to help.

Please give us a call to answer any questions you may have.

100 Maple Avenue, White Plains, NY 10601 www.TheKensingtonWhitePlains.com • 914-390-0080 S4 | RETIREMENT LIVING ADVERTORIAL RESOURCE GUIDE | SEPTEMBER 14, 2020

NEW MEDICAID ELIGIBILITY RULES MAKE ASSET PROTECTION PLANNING AN URGENT NEED!

By Anthony J. Enea, Esq. For the longest time New Yorkers were eligible for Medicaid home care services without worrying about the five (5) year look back period for non-exempt asset transfers which is imposed for Medicaid nursing home eligibility.

Commencing on January 1, 2021, and as part of the New York State Budget enacted on April 3, 2020, there will be a thirty (30) month look back period applied to eligibility for home care services for transfers effectuated on or after October 1, 2020. This lookback period is to be calculated the same way the penalty period is calculated for skilled nursing home level Medicaid (using the regional rate as the divisor). The Regional rate for the Northern Metropolitan area for the year 2020 is $12,805.00 per month.

Thus, for all home care applications filed on or after January 1, 2021, any transfer of assets on or after October 1, 2020 (gifts/non-exempt transfers) will create a thirty (30) month lookback period.

The new lookback period will not “lookback” prior to October 1, 2020. The lookback will be phased in, meaning effective January 1, 2021, the lookback will be three months to October 1, 2020 and effective February 1, 2020, the lookback will be 4 months. This phase in will continue until thirty (30) months have lapsed, on April 1, 2023.

The new thirty (30) month lookback period will also not apply to the following programs: Nursing Home Transition and Diversion Waiver (NHTDW), Office for People with Developmental Disabilities (OPWDD) Waiver, Mainstream Managed Care, Traumatic Brain Injury Waiver and Acute, primary care in a hospital.

This is a devastating turn of events for Medicaid home care applicants who do not have a spouse, minor child or disabled child to whom they can make an exempt transfer of their nonIRA assets, or a spouse, minor child, disabled child, caretaker child or a sibling with an equity interest to whom they can make an exempt transfer of their home. Additionally, the applicant can still argue that the non-exempt transfer of assets was made for purposes other than to qualify for Medicaid.

Anyone who anticipates needing home care services in the next two or three years it is now imperative that they make an uncompensated transfer of assets to a Medicaid Asset Protection Trust and/or an outright transfer of assets to others before October 1, 2020, should said transfers be exempt from the lookback period and in order to protect their assets.

Fortunately, the new rules left spousal refusal untouched. Thus, a married person can still transfer assets to their spouse and if the spouse has assets and/or income above the permitted amounts, the spouse can execute a spousal refusal, allowing the ill spouse to be eligible for Medicaid. While this is advantageous if a married person needs Medicaid home care and/or Medicaid nursing home coverage, executing a spousal refusal gives the Department of Health (DOH) the right to sue the refusing spouse for the value of the services provided by Medicaid.

In recent years Medicaid has been much more aggressive in pursuing spousal refusal cases.

Irrespective of one’s marital status the changes in the rules illustrate the need for se-

niors to be proactive in making asset transfers, and starting both the thirty (30) month lookback for Medicaid home care and the sixty (60) month lookback period for Medicaid nursing home before October 1, 2020. Without nonexempt transfers being made the clock never begins to run and the ability to shelter one’s assets from the cost of long-term care becomes significantly more difficult, exposing a greater percentage of one’s life savings to the cost of care.

Medicaid applications must be decided within forty-five (45) days (90 days if a determination of disability is needed for use of a pooled trust). An “immediate need” Medicaid application must be decided in twelve (12) days. There are numerous concerns of delays due to the thirty (30) month lookback for immediate need applications. We are awaiting guidance from the Department of Health whether applicants

can attest to transfers made within the lookback as to not delay the processing time.

Additionally, as part of the new law, for one to be eligible for the Consumer Directed Home Care Program (CDPAP) (where one can hire a family member (non-spouse) and / or friend) to provide home care and Personal Care Services (PCS), Medicaid has tightened the eligibility requirements. For example, after October 1, 2020, new applicants for CDPAP program must need physical maneuvering with more than two activities of daily living (ADLs). Additionally, a person with a dementia or Alzheimer’s diagnosis is required to need “at least supervision with more than one ADL.” These requirements only apply to individuals applying for these two programs on or after October 1, 2020. At the time of this writing and pursuant to the New York State Budget enacted on April 3, 2020, prior applicants are grandfathered.

One other significant change enacted by the New York State Budget enacted on April 3, 2020 is that the treating physician prescribing the personal care and CDPAP services must be a qualified independent physician selected or approved by the Department of Health (DOH).

One’s own treating physician cannot be utilized.

The DOH will also have the ability to conduct an “extra review” of individuals whose

need for home care services exceeds a specified level to be determined by the DOH (probably those receiving 12 hours or more per day) and whether they can safely remain in the community if they need such a high level of care.

Although we are hopeful that there may still be other options available for a single applicant once these new provisions are fully digested, it appears that the need to utilize the Medicaid Asset Protection Trust before October 1, 2020 or soon thereafter, has reached critical mass for a single person needing or anticipating the need for Medicaid home care and/or nursing home care in the near future.

Anthony J. Enea is a member of Enea, Scanlan and Sirignano, LLP of White Plains, New York. He focuses his practice on Wills, Trusts and Estates and Elder Law. Mr. Enea is the Past Chair of Elder Law and Special Needs Section of the New York State Bar Association (NYSBA).

He is the current Chair of the Senior Lawyer Section of the NYSBA. Mr. Enea is the Past President and Founding member of the New York Chapter of the National Academy of Elder Law Attorneys (NAELA). Mr. Enea is the President of the Westchester County Bar Foundation and a Past President of the Westchester County Bar Association. Mr. Enea can be reached at (914) 948-1500 or at a.enea@esslawfirm.com.

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I FEEL SO POWERLESS. WE HAVE TO WATCH HER EVERY MINUTE. FAMILY AND FRIENDS STOPPED COMING AROUND. HE KEEPS SAYING: “THERE’S NOTHING WRONG WITH ME.” IT’S DESTROYING OUR FAMILY. I FEEL SO GUILTY WE HAVE TO MOVE HER INTO A HOME. IT’S SO HARD TO CARE FOR SOMEONE WHO’S MEAN TO YOU. HE HIDES THINGS ALL THE TIME. I’M GRIEVING THE LOSS OF SOMEONE WHO’S STILL ALIVE. WE DON’T EVEN KNOW WHERE TO START.

LIVING WITH FTD IS HARD. LIVING WITHOUT HELP IS HARDER. THERE’S COMFORT IN FINDING OTHERS WHO UNDERSTAND. WE FINALLY FOUND A DOCTOR WHO GETS IT. I GOT SO MUCH ADVICE FROM OTHER CAREGIVERS. UNDERSTANDING MORE HELPS ME DEAL WITH HER SYMPTOMS. SEEING THAT OTHERS MADE IT THROUGH, I KNEW I COULD TOO. WE HONOR HIM BY ADVOCATING FOR A CURE. NOW I’M BETTER AT ASKING FOR HELP. NO MATTER HOW BAD IT GETS, WE KNOW WE’RE NOT ALONE. It can feel so isolating and confusing from the start: Just getting a diagnosis of FTD takes 3.6 years on average. But no family facing FTD should ever have to face it alone, and with your help, we’re working to make sure that no one does.

The Association for Frontotemporal Degeneration (AFTD) is dedicated to a world without FTD, and to providing help and support for those living with this disease today. Choose to bring hope to our families: www.theAFTD.org/learnmore S6 | RETIREMENT LIVING ADVERTORIAL RESOURCE GUIDE | SEPTEMBER 14, 2020