Be Well, Feel Good.
After locating and phoning the specialty lawyers, the waiting game begins. None of the attorneys that we located actually picked up the phone and spoke to my friend on the first call. It was all about leaving a message, and then the lawyer would call back several hours later. Most of the lawyers my friend spoke with were not interested in handling the case themselves. Rather they would then give my friend another lawyer that they recommended. I really feel that these lawyers are all on board for a piece of a settlement pie, if there is a cash settlement at the end of this process. Anyway day 2 was uneventful. My friend gave all the lawyers contacted his information on his court case that was listed on PACER. This is an electronic record of the case that can be accessed easily by anyone having a PACER account. At the end of Day 2, 2 different attorneys made plans to review the PACER file on the case and call him back on Day 3....Lets see where this goes!
Be Well, Feel Good.
Recently a friend asked me to find him an attorney with a certain specialty. My first reaction was to google the specialty. Well that produced no real leads, just lots of ads.
So then I emailed the attorneys I work with, mostly Elder Care specialists. Although they did not practice outside their own specialty, I did receive referrals from the Elder Care attorneys to the specialty attorney my friend needed. These leads were more concrete than the google search.
I also searched my linkedin account for lawyers, and sent them a message on the specialty attorney my friend needed. The linkedin search produced many responses and many referrals. It was by far the best search engine.
Finally I filled out a form on a site that matches litigants with specialty attorneys. This seemed like an online dating site, but for lawyer/client matches. This search produced 3 attorneys from outside the New York area. Each of these attorneys would have to hire local counsel in NY to work on the case. So my friend decided he may as well hire his own New York based attorney.
(to be continued......) Be Well...Feel Good...Holly
I had a client living in Brooklyn who had no close family. Her lawyer called me and asked if I would take on this woman as a weekly case management client. I agreed and began visiting her weekly in her home. I assigned two home health aids. These care-givers were cousins, and worked well together and covered the case 24 hours a day, 7 days week. I billed the lawyer at the beginning of the month for living expenses for the client. I would drop off this expense money weekly throughout the month, and pick up change and receipts from the prior week during each visit. I arranged and accompanied the client to physician appointments and was watchful that her medication was purchased and administered as prescribed. For about a year there were no real incidents on the case and the client was living happily and safely in her own home. The client was medically stable, merely needed custodial help with bathing, dressing, toileting, shopping, cooking and cleaning. She
had no skilled nursing needs. (I say “merely” because custodial care does not required a nurse).
The client was fine in her home and could have lived many years with this present arrangement. Unfortunately things started to slowly unwind. The attorney was slow on paying the case management bills, behind on the home care workers pay, and was not paying the invoices for medical supplies. I found myself bringing the weekly expense money from my own personal assets as the client still needed her food and medicine weekly. The medical supplies were from my husband’s DME store (Durable Medical Equipment). As a favor to me he continued to supply the diapers, bed liners, rubber gloves, etc. even though he was not getting paid for past invoices. I phoned the lawyer and he always had a plausible excuse for the tardy payments. As the months passed, he continued to pay my client’s bills slowly and late. If I didn’t know that the client had over half a million dollars, I would have thought that this lawyer was paying her bills from his own pocket. This lawyer had an assistant lawyer assigned to this case. As the payments continued to be in arrears, the lead lawyer stopped taking my calls or returning calls to me. The assistant lawyer didn’t want to take my calls either. The funny thing was that the assistant lawyer’s wife was also named Holly and our voices were similar. So when I called the assistant lawyer, I told his secretary that it was Holly. I never used my last name. He took my calls thinking I was his wife, but then realizing it wasn’t the right Holly. Anyway after several months of late payments, the home care workers threatened to quit. The home care workers couldn’t afford to pay their own bills when they were not receiving their salaries in a timely fashion. Since the lead attorney refused to return my calls, I contacted a different law firm that specialized in Guardianship proceedings. I petitioned Supreme Court to assign a Guardian to my client’s case and take over the control of her estate from her present lawyer.
The court immediately appointed a temporary guardian who contacted the lead attorney. Suddenly after months of not returning my calls, he was on the phone to me. This lawyer begged me to let his own law firm pursue the guardianship proceedings. I refused to change, and noted that his firm was so busy that my client was last on the list for attention to her legal needs and at risk of losing her home care workers. The case proceeded and eventually it was discovered that the lead attorney had pilfered away the client’s entire estate. In fact he had been paying the client’s bills with his own assets for the past 6 months. This lawyer was also the campaign manager for a prior mayor and also stole $150,000 from the campaign fund. Eventually the lawyer was convicted of tax evasion, as he didn’t pay taxes on the stolen money and contacted me prior to his sentencing hearing. He asked me to speak to the judge on his behalf for leniency. I refused, and told him that my client suffered as a result of this theft. The lawyer was sentenced to 4 years in prison.
The court hearing for my client resulted in a guardian being appointed to over see her estate of half a million dollars, which was reimbursed by the law firm’s insurance policy. Unfortunately this lawyer didn’t care about my client’s happiness and welfare either. Court appointed guardians are reimbursed annually based on the income and expenses of the estate. They receive a % of all income and assets flowing in or out of the estate. It’s takes less effort to pay one nursing home bill monthly than to pay and supervise the client’s household. My client was immediately removed from her life long home and placed into remote nursing home in the Bronx. She had lived her entire life in Brooklyn and suddenly was living in the Bronx with no nearby friends able to visit. The lawyer refused to reimburse me for my out of pocket expenses for the months I used my personal assets to pay the weekly living expense money. The lawyer refused to pay the receipts for the medical supplies to my husband. I received legal papers requiring me to appear in Supreme Court with an “order to show cause” for approval from the judge to pay my case management fees as well as reimburse me for months of my own private assets used to fund this client’s household bills. I was pregnant with my second child at the time all of these proceedings were happening. My income was low because I wasn’t able to work the long hours in my condition. I was placed on bed rest when I went into premature labor. I ended up delivering my child one month prematurely. My infant had to remain in the hospital as a boarder baby for a week after his birth. Eventually I was reimbursed for the money owed to me, and the guardianship lawyer was court ordered to pay the past due bills of the client.
It was very disheartening to go through this procedure for myself as well as my client. In the end the client was prematurely placed into a nursing home even though she could have afforded to spend the rest of her life in the comfort of her own home. The average stay/survival in a nursing home is under 2 years. People live longer and happier in their own surroundings with their friends, families, pets and personal items. Nursing Home placement is needed for patients who have bedsores, therapy needs, tube feedings, respirators, and skilled nursing tasks. For most people in nursing homes though, they merely need custodial care not skilled nursing care. Any child or care giver can provide custodial care. We do it for our own parents and grandparents. My client passed away earlier than she should have. In the nursing home she no longer had the choice of what she ate, when she ate, when she was bathed and toileted. She was put on a schedule for all her needs and lost control of choice in her life for even her most basic needs. I discovered later in my career that it is commonplace for guardians to immediately place wards into nursing homes as they consider it a safe setting and easier to manage. The fees are much higher for cost of care in nursing homes as conpared to staying home with private home care. But the guardian many times chooses the higher cost of care as they make more money. Remember they are paid based on a percentage of the income and expenses of the case. So if they only pay $4,000 a month to keep a client home, it behooves them to place the client in a $15,000 a month nursing home. I thought I was helping my client by requesting a guardianship. Unfortunately the guardian was just as bad as the original attorney, but her conduct was legal.
Be well, feel good...Holly
Copyright 2013. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
Obama care is here and many people without health insurance are signing up. Please find below information to help everyone interested to understand the impact on the Medicaid program.
1. Expands Medicaid to our Nation’s poorest in order to cover nearly half of uninsured Americans
2. Supreme court ruling allows States to opt-out of Medicaid Expansion without losing federal funding but leaving millions without coverage. At this time eligibility for Medicaid varies from State to State.
3.This ruling affects taxpayers by forcing us to pay for States that choose not to help their poorest. Those who fall through the cracks will either use emergency services or purchase subsidized health insurance through the marketplace. The problem is that this will likely raise everyone’s health insurance, including those with private insurance.
4. Medicaid expansion expands Medicaid eligibility to all individuals and families below the 138% Federal poverty level. This includes many groups who were not previously eligible. By the previous guidelines, only children, disabled and adults over 65 were eligible for Medicaid in NY. Most people between 18 and 65 were not eligible.
5. In States that do expand Medicaid, all legal residents that earn less than $15,302 for individuals and $31,155 for a family of 4 can receive Medicaid under Medicaid expansion.
6. New York already expanded Medicaid between 2000 and 2005. Rates of uninsured residents dropped, access to care improved, and more people reported being in very good or excellent health.
7. Medicaid Expansion will raise the amount doctors get paid to the same level of Medicare and increasing payment so Medicaid programs that offer preventive services for free or little cost.
8. New free preventive services include tests for high blood pressure, diabetes, and high cholesterol. Many cancer screenings, including colonoscopies and mammograms are now free. Also counseling to help people lose weight, quit smoking and reduce alcohol use, and routine vaccinations and flu shots are free of charge.
9. The Federal government will pay 100% of the cost of Medicaid expansion in the first year, and 90% moving forward.
10. If Medicaid Expansion is opted-out by too many States, it will greatly diminish the effectiveness and affordability of Obama care.
Be Well, Feel Good. Holly
Every U.S. citizen or permanent resident over age 65 qualifies for Medicare, so there is rarely any need for anyone to research what private health insurance company the elderly have in order to scam them out of some money. The scam artists already knows. The perpetrator may impersonate a Medicare Representative in order to obtain personal information such as birth dates and social security numbers of the senior citizen. The scam artist may provide fraudulent services in makeshift mobile offices or clinics and then bill Medicare for services never provided.
Several years ago a nursing home owner in Brooklyn opened a medical clinic. He would have people on the payroll approach elderly and ask them if they wanted tickets to go to the movies. In exchange for their birth dates and social security numbers, he gave them free tickets to the local Loews complex. He then began billing Medicare and Medicaid for ongoing physical therapy and expensive medical procedures. At one point his little clinic in Brooklyn was billing 3/4 of the entire charges budgeted for New York. Needless to say after monitoring him for several years he was indicted and found guilty of tax evasion. Evidently the mistake he made was not paying taxes on the money he fraudulently billed....
Family Values and Family Financials Need a Monthly Checkup, Just Like Workplace Performance Evaluations
“Oh, we’re just like family here...” That’s a catchphrase heard in many a workplace: Still, periodically—at least annually if not monthly—workplace personnel and operations need an itemized review. It should checklist financial accountability and quality control plus records management as well as work flow. In between regular reviews, it’s especially crucial (weekly, if not daily) to keep an eye on cash flow. That’s regardless of its being a cash-register business, a shopping-cart enterprise, or other kind of establishment. If such annual audits and interim supervision are lax or, worse, lacking...even dependable longtime workers can succumb to a stock way of doing things, or to sloppy work, or to the temptation of stealing...a little at first, nothing noticeable, but eventually a lot. Too many times, we hear stories of the trusted gray-haired bookkeeper of 20 years suddenly running away to Paris, absconding with the bank account.
So, too, in families: All of the above is applicable to managing the affairs of the elderly.
Typically the elderly entrust their financials, entirely and exclusively, to one family member or financial adviser rather than dividing financial responsibilities among two or more parties. Whether that (for example, the appearance of favoring one child over another) leads to hurt feelings, the elderly may still become a victim of mishandled financial affairs, not because they chose the wrong son or daughter or professional fiduciary—accountant, lawyer, or so on. Rather, as years go by, the elderly may be victimized when no one else is reviewing that aspect of the family financials in either a friendly or formal way. As the Romans put it, “Who shall guard the guards?”
In a household setting, where there’s no calendared financial review or reminders, there’s risk—real risk—of money loss. It arises from a trusted fiduciary’s poor decision-making or bad investing, from occasional or emergency “borrowing,” or from benign neglect or worse...from a secret resentment long-held since childhood or from a costly addiction like alcoholism or gambling or substance abuse or an extravagant lifestyle and so on. Any of that may lead to misappropriating / embezzling an elderly person’s funds or misusing / exhausting that person’s assets.
Case in point: Elderly parents transfer the title or deed, for their home, to one of their children. Usually this is done to obtain Medicaid for medical help. One or both of the elderly parents may already be ill and in need of expensive home care or nursing home care. The parents trust the child to keep the residence in order, pay the bills, and ensure that they will always have a place to live. But if there is no standard scheduled accountability for such financial management, the child could eventually be tempted to take out a mortgage on that house and pilfer away the equity in the parents’ home. As a worst-case scenario, the mortgage is not paid. The bank forecloses on the property. Or if the “adult child” as a debtor (in debt to others) doesn't personally mortgage the house, his or her creditors may force a sale of the house to recover money they’re owed. And then where are the elderly residents to go?
That’s why the role of Financial Caretaker for the Elderly must also involve a regular Financial Accounting, meeting Financial Calendars for the Elderly. Sure, it would be an additional safeguard to have more than one family member as a Financial Manager for the elderly in a family—for an absentminded parent or aging aunt or retiree seeking to be carefree at last. But too often it’s not practical or plausible to delegate a shared management of those financial affairs. Sibling rivalry or geographic distance and so on may interfere with setting up a joint power of attorney bestowed on two or more family members. But at the very least, such financial power must be subject to periodic—at least annual if not monthly—checklists of financial accountability and records management.
Who should review the financial paper trail of the person whose been entrusted as a fiduciary for the elderly? First and foremost, that person himself or herself should have easy access to well-kept records for the elderly person whose care they have undertaken. It may be prudent for that person to enroll online or onsite in a short program on Being a Financial Caretaker and Meeting Financial Calendars for the Elderly. I am happy to announce that an entertaining and informative record-keeping tutorial program is being introduced online by The National Chamber of Commerce for Women in Elder Care™—NCCWEldercare.com.
Just as important...the elderly person, too, should be able to ask for the peace of mind in seeing an annual if not monthly financial statement though, in many a case, the elderly person may be too embarrassed or intimidated to ask for that kind of documentation.
And that’s where a third-party reviewer should not only be available, but also named in the fiduciary paperwork (in the power of attorney, etc) as having that right of review—to review at least an annual financial statement issued in regard to an elderly person’s funds. That third party’s right of review should be enforceable, if necessary, in a court of law. The third party may be a trusted professional like an accountant, lawyer, or Private Geriatric Care Manager. Or he or she may be another family member. Or it can be a representative from an organization named as a beneficiary in a charitable bequest (as, for instance, in a “legacy” donation specified in a last will and testament). Or, again, it can simply be a third-party monitoring organization like The National Chamber of Commerce for Women in Elder Care™—NCCWeldercare.com—who contracts to review, at least as a once-a-year checkup, the financial affairs of an aging or elderly person who wants that little bit of extra financial assurance, who wants that peace of mind.
When the third-party reviewer comes to sit down and look at the financials (the paperwork)... he or she—as part of a home-visit “consult”—can also assess the physical needs and well-being of the elder. That may include whether the elder needs a home attendant...a review or recommendation regarding assignment of a home attendant, supervision of a home attendant... whether the elder needs doctor appointments and or an escort to doctor’s appointments... following up on doctor’s prescriptions, making sure that prescriptions are filled and that the home attendant administers the treatments, as prescribed, to the elder...assessment of eligibility for entitlements, whether the elder qualifies for food stamps, medicaid, or transportation like Access-a-Ride (a form of private bus not limited to regular bus routes, at a very nominal cost)...
Next week Tuesday as part of our Home Risk Management™ Agenda:
How “ObamaCare” affects the elderly
Meantime, Be Well, Feel Good...
If you have email, you know what spam mail is. There are many spam filters, some better than others. Unfortunately unwanted emails, spam, still somehow manages to get through to our inbox. I just realized today that if I don't delete the email immediately and choose to open the mail, things get even more complicated. I opened a spam email a few days ago on Reverse Mortgages, as I have a client mentioned yesterday that is interested. As soon as I realized it was spam mail, I deleted it. But ever since opening the spam mail on Reverse Mortgages, telemarketers have been calling me trying to sell me a Reverse Mortgage. So be aware that the Spam mail you open is monitored closely by the senders and your interest is being noted and probably sold. Just my thoughts. Be Well, feel good. Holly
Yesterday a client asked for my thoughts on a Reverse Mortgage. I immediately phoned a colleague who was knowledgeable in Reverse Mortgages, and we have an appointment for next week. My client has a fairly common dilemma facing many elderly couples. Her husband is ill and presently in a nursing home. Her income is barely covering her basic living expenses monthly. Her husband's income is partially paid to the nursing home monthly, and the wife is receiving a portion of her husband's income. Unfortunately the portion that is assigned to the nursing home each month was used for household expenses prior to the husband entering the nursing home. My client was crying yesterday, at her wits end, trying to make ends meet monthly on her meager living expenses. She can't even afford to go to a movie or out to dinner. My client does own a home with an appraised value of $300,000. My thoughts are that she should take out a reverse mortgage for half the value, $150,000. A reverse mortgage does not have a monthly bill, merely the interest is paid. My client will receive a certain amount of money monthly, based on her age and life expectancy. I will update you on the status of this case next week after we sit with the mortgage broker.
Holly T. Gemme
I am a private Geriatric Care Manager, Social Worker and Psychologist practicing in the NYC area for the past 30 years. I specialize in services to the elderly which include Case Management, Home care Services, Assisted Living Placement, Nursing Home Placement and Medicaid eligibility counseling and Medicaid applications.