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Senior Planning Services Interview on 77 WABC Radio (770 AM)


​Senior Planning Services was featured on ​WABC ​“Mind Your business with Yitzchok Saftlas”​.

We’re going to open with Michael Steinberg, the Director of Business Development at Senior Planning Services. Michael, thank you for joining me here on Mind Your Business.

Michael: Thank you for having me.

Q: Yes, okay. Let’s talk about Medicaid – the world of Medicaid. We’ll talk about what’s going on with the health care system and the fact that a couple of days ago, Trump didn’t get his way and Obamacare is still in effect, let’s move that to the side for a second. What’s the first step for someone who is seeking to apply for Medicaid.

MS: The first step and the most important step when somebody is seeking to get Medicaid for their loved one is to get educated. The Medicaid rules and guidelines are forever changing and the smallest mistake can really cost you tens of thousands of dollars.

Q: That much?

MS: Yes, absolutely. I mean the cost of care, whether you’re in the community or in a skilled nursing facility, especially in a skilled nursing facility, you’re running about anywhere between $10,000 and $15,000 a month, so the smallest mistake can really cost you a lot of money and I encourage everybody that the first step you should do is get that education.

Q: Wow! Now, what’s some of the documentation that a person would need?

MS: So the basic documentation that somebody would need is, first and foremost, they need to provide documentation showing that they are a US citizen, so whether that’s a birth certificate or a passport, some type of photo identification, Medicare card, Social Security card and, of course, the financial statements from the past five years.

Q: Okay. Now, what are some of the basic requirements for Medicaid eligibility?

MS: As far as whether somebody needs to be clinically eligible and financially eligible – on the clinical side, they need to be 65 years or older and/or permanently disabled or permanently blind and then, obviously, there is the whole financial piece of it, but, ultimately, initially they need to be 65 or above or permanently disabled.

Q: Now, you touched on this a moment ago, what are some of the common pitfalls that applicants face? You touched on the 5-year look-back. Maybe you could discuss that. What is that all about?

MS: Okay, so I’ll answer both of your questions, the common pitfalls and the 5-year look-back. Some of the common pitfalls, first and foremost, is trying to gather the documentation which is needed, which we’ll get into in a moment, which is the 5-year look-back, but just getting out there, doing the legwork, gathering all the documentation, whether you’re dealing with vital statistics or the financial institutions, gathering all the statements that are needed. Number one: It’s extremely time-consuming, it’s extremely frustrating when you have to wait on hold with these financial institutions, you try to do it on your lunch break and then you have to wait on hold for a half hour…..

Q: And they are on their lunch break!

MS: Correct, so that gets extremely frustrating and that is a pitfall where you cannot gather all the documentation that you need. As far as the 5-year look-back, in order for somebody to be financially eligible for Medicaid, and let’s just use a single individual because that’s really the simplest way to go for now, but the threshold for a single individual to be eligible for nursing home Medicaid is $14,850.

Q: Okay.

MS: Once somebody hits that magic number, they are financially eligible for Medicaid; however, it’s not as simple as just going to the Medicaid office and say, “Hey, look. I have $14,850, now give me Medicaid.” Medicaid says it’s very nice that you have that today but how did you get there. And we want to see, and they do a full financial audit on every individual for five years going back. So that means you need to gather every statement from every checking account, savings account, money market, stocks, bonds, annuities, IRAs, life insurance policies, anything that has any kind of cash value, they want to see a full 5-year financial look-back on that. And once they do that, then they will determine your eligibility to see if those funds were properly spent down, which means, when they’re going through the 5-year look-back, those funds can only be spent on the applicant or the applicant’s spouse. So that’s another tremendous pitfall that individuals face because if you fail to provide the proper verifications to Medicaid and showing where your money went to and how it was spent with the proper verifications, they’re going to either impose a penalty or even a denial. That’s a tremendous pitfall that people do get into.

Q: Now, what is the concept of Medicaid allowable expenses?

MS: Okay, so Medicaid allowable expenses, which means, again, we’re going back to that 5-year look-back, they’re reviewing everything, to put it in a nutshell, anything that’s for the benefit of the applicant or the applicant’s spouse is a Medicaid allowable expense, so just to give you a couple of examples: For a single individual, they can set up what’s called a prepaid funeral, where they pay for their funeral in advance, so long as it’s irrevocable; they can pay for their care or loved one in skilled nursing facilities; they can hire a company like Senior Planning Services to assist them with the Medicaid application. In the case of spousals, there’s a whole lot more that you can do and that’s why I get back to that first point, the most important piece here is to make sure that you’re educated on the do’s and don’ts of Medicaid.

Q: Now, what is this issue of a Medicaid spend-down?

MS: The issue is, again, unfortunately, some people are not well versed and not well educated. Many people are giving their children Christmas presents or birthday presents or just giving money to their loved ones, and, they’re not doing anything illegal but when it comes time for Medicaid, they didn’t know that they weren’t allowed to do that and that’s a cause of a tremendous issue. Spend-down really again varies for a single individual or a spousal, like I mentioned before, a single individual has to get down to that $14,850. If you have a spousal, the spouse in the community gets to keep a minimum of approximately $74,000 and a maximum of $120,000. So there are a lot of different options once you get into the spousal scenario, but I definitely encourage everybody to get that education and we at Senior Planning do offer a 100% free Medicaid education and consultation to anybody, regardless of their situation, whether they would like to retain our services or not, it doesn’t matter. They can give us a ring at 516-500-7364. We will answer all your questions, go through your scenario, getting a good understanding of what’s going on today, what has been going on over the past 5 years, and then give you a clear understanding of what you need to do to make sure that your loved one gets Medicaid quickly and efficiently and you get the right results that you are looking for.

Q: You know, what I love about the feedback that I get on the show is the variety of guests and topics and this is such a critical topic for everyone, for really everyone out there. I mean, is there a particular time that you find that people wake up and then they like, “Oh, if I only knew, I would have done this right.”

MS: Absolutely, I mean we meet with hundreds of families a month and it’s time and time again where it’s unfortunate where people are just waking up too late and if only they would have known a couple of years back or even a little sooner, there’s so much more money that they were able to preserve, so many different options that they were able to do. And, yes, it’s sad because we hear it all the time, you know, Mom or Dad has worked so hard their whole life and now they have to spend everything down to the nursing home. So when you’re being proactive and you get started early on, you’ll see those better results and everybody will be happier at the end of the day.

Meir Kaplan – Marketing Manager at Senior Planning Services

Q: Let’s talk about, if I may, someone putting their loved one in a facility. Obviously, that’s fraught with so many complications and is such a difficult decision, but what are some of the common challenges that people face when they take that step?

MK: One of the biggest challenges that families face that we hear on a daily basis is choosing the right facility for their Mom or Dad, for their loved one, picking the right facility that will suit their needs. You know, there’s not that much time when picking a facility, picking a nursing home. Nobody plans to ever go into a nursing home. Somebody ends up in a hospital, you know the hospital keeps them for 24 or 48 hours and then the discharge planner says, “Well, guess what? Now you got to go ahead and pick a facility.” You try to pick somewhere where they live, or where the hospital is or just the closest distance that they’re able to go ahead and visit, so on and so forth. But, again, all this process comes into a shock. You know, they went into a hospital, they thought they were coming home and now they end up having to go into a long-term skilled facility – what is the next step? Where do I go? Who can I turn to?

Q: So how does Senior Planning Services handle and help people with that?

MK: At Senior Planning Services, we have a division, a placement division, that gets involved, that we help the families navigate the process. When somebody does end up in a hospital and then they end up having to go to a nursing home, they don’t know where to go, they don’t know what to choose from, the different costs that go into a facility as well, that the families were not ready to go ahead and just jump into. Senior Planning Services – what we do is we come in and pretty much handle the entire burden for that family, from A to Z.

Q: I’m overwhelmed – it’s such a complicated process!

MK: This is a very, very complicated process. Two or three weeks ago, I was dealing with my own grandfather that was in an adult home and, all of a sudden, just had an issue breathing, ended up in a hospital, ended up having to go to a nursing home and my aunt, who was very involved, didn’t even know where to turn, didn’t know how to choose what to do. She knew that I was dealing with Medicaid. She knew that I helped families get on to the Medicaid application process, she did know that I was familiar with all the facilities and knowing which one would suit my grandfather best. But it ended up all working out, thank G-d.

Q: Well, certainly, because she had a nephew who knew the industry! Wow! Before I get into more questions, how could someone reach you or reach the firm in order to access your great depth of knowledge in this area?

MK: Senior Planning Services – there’s a telephone number – 516-500-seniors. They can go onto our website which is www.senior-planning.com. They can call us, again, at any one of these telephone numbers.

Q: Now, you’re also on social media? Let’s say someone wants to follow…

MK: Sure, we’re on Facebook, Linked-In, Instagram, you name it, we are all over the Internet, very, very accessible to anybody.

Q: Now, let’s talk about gifting. Can you explain what is the concept of gifting?

MK: So the concept of gifting is a very, very scary process when it comes to Medicaid in general. The Medicaid philosophy is that your funds are to be spent on your care. What’s right or wrong is irrelevant to Medicaid. Medicaid is not interested in hearing, “Well, I felt the holiday came around, I wanted to go ahead and gift out funds.” It’s irrelevant. Your funds are to be spent on your care. But like I said before, nobody ever stops and says, “Wait, hold on one second, I’m about to give a gift, let me plan for Medicaid, let me not give that gift.”

Q: Right, it doesn’t even enter the mind.

MK: Correct. Now on the flip side of giving the gift, nobody, I mean I don’t, I can’t say anybody else does, ever holds onto a gift in order to go ahead and give that gift back. So when it comes to gifting…..

Q: Like most people.

MK: Like most people. So when it comes to Medicaid, Medicaid gifting is one of the scariest things to go into and the reason for that is, and I believe Michael touched on this before, is that Medicaid gifting can cause a penalty on a Medicaid application for somebody going long-term in a facility. And if a facility ends up seeing a Medicaid application coming along with a penalty, it can possibly jeopardize the admission when trying to place a loved one in a facility.

Q: Which is why, it really brings to mind, I just have to bring this up, this is kind of the elephant in the room – how important it is for someone to reach out to a firm like Senior Planning Services, as opposed to trying to wing this on their own.

MK: We try to stress it to the families, we speak in different community centers, we speak in the community, we do family nights, we do seminars in different counties, in different areas, to express to the families that are planning for the future – get an education, get an understanding of what’s coming down the line, what’s coming down the pipeline. I can tell you that every single day that a family comes to us and says, “How come I didn’t know about you guys a few months ago. If I would have known, if I would have, should have….” These type of things can be prevented by getting an education, getting an understanding of this Medicaid process and what you’re about to face.

Q: I have to add, how special does it feel to be in a business that aids people in such a meaningful way, it’s really special.

MK: There is no better feeling, when we finish a Medicaid application, whether it’s somebody that’s going long-term in a nursing home or somebody that’s going short-term in the community, getting set up with home care and all of a sudden you see a testimonial come in from the family ranting and raving and praising all the different parties that were involved in assisting that family getting onto the Medicaid application process. There’s no better sense of accomplishment, by receiving that testimonial to help that family.

Q: Now, Medicaid has strict policies regarding asset limits. This was touched on but is there any way that someone can retain their assets for the family? Could they protect their home?

MK: So, yes. Without getting into too many details, and again, if somebody would like more information on protecting their home or protecting assets and the few different types of trusts, again, we could be reached at the 516-500-seniors or on our website, we can be reached at any time to go ahead…..

Q: And, again, what’s the web address?

MK: It’s www.senior-planning.com for the free education.

Q: And, again, the phone number one more time?

MK: 516-500-seniors. One of the ways, like I said before, is the gifting. You’re not allowed to go ahead and gift in the 5-year look-back period. Any amount that was gifted for somebody in the 5-year look-back period when going into a nursing home can be a penalty. It’s not a percentage. It’s a dollar-for-dollar amount. Whatever amount was gifted is the amount that has to go ahead and be paid back in order to prevent the penalty. In our situation usually which comes to us is that there’s no funds left to go ahead and repay a gift. So what happens is, there is a legal way today, which is called a promissory note. You could look it up online. It’s either called a __________ rule or a split rule, however you want to go ahead and call it, which Medicaid in New York allows somebody to split half of their assets. Half of the assets the family gets to go ahead and keep. The remaining part of the assets which covers the penalty period, gets paid back, but not to the family, gets paid back to the long-term care facility which covers the penalty period. Once that penalty period is up, then Medicaid will go ahead and then pick up in full. So you can look at the status of the resident as a Medicaid penalty period or you could it look at it as private pay, but that period of time is the penalty period from the gift that was given.

Q: I’m just going to, again, repeat the obvious. For some people that want to try to do this on their own, it just, they’re navigating something that’s near impossible, not impossible.

MK: I don’t want to say that a person might end up needing a nursing home themselves after dealing with this process. You know what I mean?

Q: So what does Senior Planning Services do to prevent spousal impoverishment?

MK: Spousal impoverishment which does come up on a daily basis. You know we have a lovely couple living in the community and, all of a sudden, let’s just say the husband, in our case, slipped on the ice and ended up having to go to a nursing home and now, all of a sudden, this sweet, little woman, living in the community doesn’t know how to start to pay bills and how to deal with all the finances as well as she was living off her husband prior to him going into the facility, how can she protect her home, how can she live, what’s the process?

Q: Right.

MK: So the way Medicaid allows her to do is something called a spousal refusal which enables the community spouse to, pretty much, the way I like to explain it, to financially separate herself from her loved one going into a nursing home. Medicaid looks at it now as almost like a single case. So if it’s a single case, the community spouse gets to keep most of the assets. As a single case, he would be Medicaid eligible as of today. Medicaid would then go ahead and pick up his bill entirely and the community spouse would not be affected too much. Now, there are little, minute details that do end up coming in along the line with doing a spousal refusal. I don’t want to scare anybody. We’re going to leave those off. So when going ahead and doing a spousal refusal, you do have to be a little bit cautious. Like I said before, Medicaid and the philosophy of Medicaid is that it’s irrelevant what the situation is at home prior to needing Medicaid, is your funds are to be spent on your care. So the fact now that Medicaid is allowing you to do a spousal refusal to protect the community spouse with the assets and the income that she needs to go ahead and live, Medicaid still comes after and says, “Well, we’d like our piece. We’re paying x amount of dollars out for your loved one’s care in the facility, that’s fine. You’re getting to keep, let’s say $2-300,000 of the assets. We would like to take a certain part of those assets, at least to cover the outstanding bill that we went ahead and paid for your husband to go into the facility.”

Q: My guest now is none other than Ben Mandelbaum. He is the COO of Senior Planning Services. Ben, thank you for joining me here on Mind Your Business.

B: Thank you for having me.

Q: Thank you. Again, we’re having some incredible conversation so far with your team. Senior Planning Services is an incredible company which provides many critical services. Perhaps you could describe in a nutshell the scope of services.

B: Okay, well there are many but we do work with healthcare providers as well as the individuals who ultimately need coverage to have the healthcare services that they medically need or whatever their current life circumstance may be. But, basically, we help individuals understand what Medicaid and the various Medicaid programs provide so that they can set themselves up for the appropriate care whether it be at home or in a nursing home, assisted living facility and so on.

Q: Does Senior Planning Services work primarily with individuals or companies? Now, this might seem like a stupid question but for someone who has not gone through it, they may not get it. That is, why should someone use Senior Planning Services rather than attempt to navigate the system on their own?

B: That’s not a stupid question at all. That’s actually a good question. Clearly, you’re a pretty smart guy. Our company is set up in a way that we offer an initial consultation to whoever it may be wherever they may be and specifically for that reason because many people don’t understand why should I utilize this service, why should I pay somebody a couple of thousand dollars to go ahead and help me get my benefits in place, and the reason we start with an initial consultation is because once we get to talk to them they could understand that there are various Medicaid programs, that Medicaid is a government program, government insurance, long-term care insurance, but you have to be eligible. There are criteria, there’s a process to apply and, ultimately, the government offices are extremely overwhelmed with an unbelievable amount of applicants that come their way and, naturally, they don’t get to everything timely and it can be difficult. If you apply wrong you can get denied. If you present the wrong information or not enough information, again, you can get hit with a denial. If you’re not clear with certain information, you can get hit with a penalty that they won’t cover certain dates of service for you. There are so many factors that can ultimately inhibit your coverage and getting what you need out of this program that the government is ready to offer you if you don’t go through the process in the right way. So, ultimately, the free consultation really helps us get good information about the potential applicant and helps us guide them. Now, many of the people that have a very straightforward case, we would actually just give them the free information and tell the families that it’s really straightforward and they could do it on their own. So, that’s why we offer the free consult, because not every person is a good candidate for us to actually help through the process. But at least we could guide them from the onset how to do it.

Q: Ben, thank you so much for joining me here on Mind Your Business.

B: Thank you so much for having me and I look forward, any time.

My final guest of the evening is none other than Isaac Itzkowitz, the executive director of SCS Pooled Trust. Now, again, it’s part of the LTC suite of services. Senior Planning Services, as we discussed earlier on with the various guests that we’ve had and one thing is very clear – don’t try doing this on your own. You could forfeit so much, so much at stake, so much is there that people are going to need to rely on and they need a company like Senior Planning Services in order to navigate this very complicated process.

Isaac, first of all, thank you for joining me here on Mind Your Business.

I: Thank you for having me.

Q: Maybe you can explain to our audience, what is SCS Pooled Trust. What is that all about?

I: Okay, so I’m going to defer that question for about 10 seconds and I’m going to explain a little bit and then we’ll go back into that.

Q: Sure.

I: So, SCS Pooled Trust is actually, like we mentioned, a sister company to Senior Planning Services. I know that some of the other guests touched on the nursing home regulations, how to navigate the nursing home process, coming out of a hospital or if you’re in the community. Now, there’s another kind of Medicaid which, I believe, one of the other guests touched on, which is home care Medicaid. Home care Medicaid has a very different set of rules for the look-back periods and it allows people who may not qualify for the nursing home application or the nursing home coverage, to get care to some level in their house. So, as was stated, the nursing home application has a five-year look-back with a full financial audit of your five-year history. With home care Medicaid, which is referred to as community Medicaid, there is a 30-day look-back period. So it gives people the option, not only who don’t qualify for the nursing home application but for those who want to remain at home to the best that they can, age in place, it gives them an option to stay in the comfort of their home, keep their dignity intact and continue to live, hopefully, for the rest of their life in the home they’ve been in for so many years.

Q: Amazing, because if someone is not dealing with a company like Senior Planning Services, they wouldn’t necessarily know that, they may have gotten rejected on the 5-year look-back and then say, “Okay, all is lost,” without realizing that this option is available for them.

I: Correct. We do a lot of seminars, a lot of education in the community and the first thing out of the mouths of the people attending is, “Well, I don’t qualify because I had assets for the last 5 years,” and I try to explain to them that with home care we don’t have that issue. Then, that opens them up to an entire new world that they were not aware of prior to that session. So, there’s the 30-day look-back period. It gives people the option to transfer. Now, as a company which deals with both sides of the coin, we want to make sure that we’re not setting people up for failure should they ever need a nursing home down the road. So when we tell them how to transfer assets, whether it’s to children, irrevocable trust, whatever it might be, we kind of guide them, “Hey, if you’re going to need the nursing home application in the next five years, you’re still going to run into a lot of these issues. So if you are transferring assets to any method that is available today, don’t spend that money, hold onto it.” Because as one of your guests said, it’s dollar-for-dollar that needs to be paid back. So we try to educate them in both regards. Obviously, as a child, they want their parent to remain at home, they’ll try their options. If it doesn’t work, they’ll go to the second option, but, for the most part, it gives people that whole new world that they haven’t heard about before.

Q: Now, let’s come to the other question, what is SCS Pooled Trust?

I: Very good. So in a nursing home setting, which I don’t know if it was touched on, we talked about assets a lot, which is really the big concern. When it comes to somebody’s monthly income, Social Security, pension and IRA distribution or something of that sort, when you’re in a nursing home that income is due to the facility and Medicaid covers the balance of that bill. Again, it could be a significant amount, as I think Michael said, the nursing homes cost between $10,000 and $15,000. So if you have $2,000-$3,000 a month of income and you’re going to be there long-term, the facility has the right to retain that and Medicaid wants you to be impoverished to that degree. But out in the community, people have mortgages, people have utilities, maintenance, rent, phone, food, groceries, all the different kinds of daily expenses, so Medicaid gave an option that if you have income, for example, let’s say a person makes $2,000 a month and Medicaid sets your income limit at $845, so how are you going to qualify and you definitely cannot afford to pay for private care on that kind of income. So Medicaid says, “Well, if you need the care, not a problem. You pay me everything above the $845, you pay me about $1100 and change a month, kind of like a deductible, and we’ll pay the rest.” So you are getting kind of a fair trade but then you’re left with $845 monthly to pay all of your expenses. I don’t know about you but I don’t know anybody that can live on that, and it’s a very big issue that comes up. So about 30 years ago, there was a lawsuit about this and it went to the Federal Supreme Court and they designed something called the Supplemental Special Needs Trust. There are some individuals, you know, if there’s family and there’s a disabled sibling or whatnot, that they can manage it. Some attorneys will do it, but strictly for income, for Medicaid, for SSI and other types of welfare benefits, there was a law that was enacted that these types of trusts, or any funds that go into these trusts are exempt from these programs. So what happened was in New York, where you have one of the largest home care populations across the US, just from the disabled and age standpoint, there’s about 200,000 seniors, it became a very big issue for the state. So the state put that into their Medicaid laws. The way I view it is if the State didn’t do that, you would have that many more people in nursing homes and that would cost the State a lot more money in Medicaid dollars and they would ultimately go bankrupt which is where they kind of were on the verge of that in 2011 when Governor Cuomo signed the new Medicaid regulations into law and cut spending by two billion dollars. So that was an option that Medicaid gave. New York had adopted it to their Medicaid law and it gave people the option of sheltering their excess money every month in this kind of trust. So, the first thing people tell me when I tell them that is, “Okay, so great, I didn’t pay it to Medicaid but I put it into this trust. Now what? What do I do? I lost the money anyway and I’m still living on $845?” So here’s the greatest catch of all time. The greatest catch is that the money that goes into that trust can be utilized to pay for a member of the trust everyday living expenses, rent, utilities, groceries, credit cards, parking, car insurance, life insurance premiums. The trust has very few limitations. The trust cannot pay for items that are covered under other insurances, Medicare, Medicaid, private insurance and the trust cannot pay for alcohol, tobacco, firearms, gambling. You know, the State wants you to keep this so you can stay at home so it will cost them less money but they’re not going to support any bad habits that a person might have. And it comes up. People tell me, “I can’t take that bus to Atlantic City anymore.” I’m like, “Well, you could with your $845.” So it’s definitely a very, very valuable option. We do hundreds of Medicaid applications for home care style patients a month and we see that about 9 out of 10 people who clearly understand it, especially if there’s a family member involved, will go through with the option because the alternative is really not feasible for getting the care.

Q: Now, how could someone get in touch with you or the people at SCS Pooled Trust.

I: So you could utilize the same number as Senior Planning if you wish. It’s 516-500-seniors. The direct number for SCS Pooled Trust is 718-971-2509.

Q: Now, as far as the website, is it the same site?

I: The website for SCS Pooled Trust specifically is www.scspooledtrust.org.

Q: Now, perhaps you can clarify, why is it that so many on Medicaid, you touched on this previously, but this is such a fundamental concept, they just don’t have sufficient funds for living expenses? Again, you explained this, but they have to hear it straight.

I: And it comes up very often and sometimes it takes two or three tries to get them to understand how the process works, because it is a separate process from the Medicaid application. We always have to start off with what the worst off option is which is Medicaid is going to take whatever their balance above their limit is and that’s going to leave you with no money. I come across people today in my daily travels through the trust, and I see people all the time that are paying extremely large amounts to Medicaid every month and they tell me they’ve been doing this for so many years. And now I understand why they are barely paying their rent and they’re on all of the programs to pay to get food and whatnot and the family is struggling to put it on the table for them and that’s where I see a lot of these members don’t have those funds. So, it’s a very big struggle for them and once we introduce the trust, it changes their world. We have countless stories of people that have been doing this for so long and they never knew, they just never knew.

Q: It just ate away at all their life’s savings.

I: Everything they had just gone. It’s a very tough thing for them. And to hear about it later on, it was a nice thing to hear but it was also a tough thing to hear that they spent thousands of dollars…

Q: Hundreds of thousands of dollars burned right through.

I: Correct.

Q: I feel it’s worth repeating because, like you said, people are just not getting it. How, at the end of the day, how does a pooled trust solve this problem?

I: Pooled trust is very simple. It solves the problem by ensuring that your funds that you make on a monthly basis from Social Security or pension, you worked your whole life and this is what you have to retire on, you do need benefits which you’ve paid into the system your whole life as well, you want to ensure that you don’t have to contribute to that system. You should be a recipient of that system 100% in its entirety and you should not have to contribute. And I get a lot of people that tell me, “Well, why should I have to circumvent some of my income to the trust and then you pay some of my bills? Why can’t I just show Medicaid that I’m paying my bills?” And the answer is that Medicaid wants it to be managed. There are certain laws that have to be adhered to as far as what can be paid, what cannot be paid, who it can be paid for. Unfortunately, if someone has a family who is still living with them and they are disabled, the trust can only pay for expenses that are for that disabled beneficiary. So we have to be very careful when we’re paying the bill directly to Verizon or the rent or whoever it’s going to be that it’s for the specific needs of that disabled individual. So we’re solving that problem by making sure that they can retain their money for their expenses and we advise them to use the money in the trust before you go dip into whatever else you have. Clear out the trust on a monthly basis. Everybody has their own account. It’s monitored through a regular banking system and we want you to clear it out because what happens is that Medicaid says, “You can utilize this throughout your life.” Once a person passes away, any money left Medicaid wants to try to recoup some of the funds they’ve laid out which could be, like you said, in the hundreds of thousands. So what happens is, they don’t really know how to use the trust and they start using their funds at home. So we do a lot of that education to say, “No. Use your funds in the trust before you touch any other monthly expenses. Once that’s clear and you’re at a 0 point until the next month’s deposit, then you can dip into your own savings.

Q: So all the people that have reached out to SCS Pooled Trust, is there a customer service number which they could reach with questions they may have on a daily basis?

I. Yes, our main number is 718-971-2509. We have a few different options there for someone who may want to learn about the trust. Once somebody is enrolled in the trust, we have a case management department that specializes where we have one person to talk to about questions you have. We’re not going to throw you around from department to department and that’s kind of what puts us apart and it gives somebody the personal relationship to their case manager and, thankfully, we have that relationship with our members.

Q: Just a final question here. What are some of the benefits of home care versus nursing facilities?

I: That’s kind of like – we’re put in a little bit of a tough position with that. Most people we know want to remain at home. Nobody wants to be in a skilled nursing facility. Unfortunately, there is sometimes a level of care – you just can’t be at home. There are people that should be in a skilled nursing facility and they are at home. They are grandfathered in from the old Medicaid system. They have two 12-hour shifts. They have a 24/7 live-in at their home. They have all sorts of equipment. You know, times have changed and, unfortunately, with all the cuts in 2011 and continuously going on, it’s making it a lot harder for people to remain at home, especially with the family’s involvement because somebody who normally maybe would have gotten full-time help is now only getting 8 or 10 hours, that means somebody has to be there at night, somebody has to be there the rest of the time and it’s a very difficult thing for a child who has their own family and their own job and it makes it very difficult and although it’s the hardest decision to make, in my opinion, it sometimes is the most necessary to maintain a healthy lifestyle for yourself, your family although you hate to see your parent or your loved one go into a facility like that.

Q: What’s so precious here is that it’s such a tense period of time for a family but, at least, to have a company like Senior Planning Services and SCS Pooled Trust to kind of hold their hand along the way, makes it so much easier, if you will, to at least navigate that complicated part of life, I should say.

I: Correct. I mean, you know we get a lot of our referrals to the trust are when somebody is ready to come home from a short-term stay in a rehab or a hospital stay and there are a lot of arrangements going on. You have the ambulette, the home care, and everything going on together, the nursing assessments for this agency, for that agency and it kind of all has to piece together well and it often doesn’t because you’re dealing with multiple different vendors and it’s a very stressful time. So we try to get to their home before everybody else comes in. Let’s get this off the table. Let’s explain how this plays into all the home care which it does in a very big way and let’s resolve this before you have to start with actually getting somebody home.

Q: That was Isaac Itzkowitz, the Executive Director of SCS Pooled Trust. Thank you so much for joining me on Mind Your Business.

Catch Mind Your Business with Yitzchok Saftas on 77WABC every Sunday at 11pm.

Yitzchok Saftlas is the founder and president of Bottom Line Marketing Group, an award-winning marketing agency helping hundreds of corporate, political and non-profit clients since 1992. Yitzchok’s new book: “So, What’s the Bottom Line?” published by Morgan James, contains timeless advice for marketers, seasoned executives and entrepreneurs. He is the host of the weekly business radio show, “Mind Your Business” on 77WABC in the New York / New Jersey metro area as well as on C-Suite TV and C-Suite Radio. Additionally, Yitzchok is a featured columnist in the Yated newspaper and Mishpacha Magazine, both international weekly publications.

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Health and Wellness

Study: Hour-Long Nap May Improve Brain Function in Seniors

A daily hour-long nap may improve brain function in seniors, according to a recent study, which was published in the Journal of the American Geriatrics Society.

Led by Junxin Li of the University of Pennsylvania, the study examined the sleep habits of nearly 3,000 Chinese adults aged 65 and older, including whether or not they took afternoon naps.

The goal was to determine if this extra sleep during the day had any effects on brain function. The participants were asked to undergo several mental status tests, including basic math problems and answering simple questions.

The volunteers were also asked to memorize certain words and copy drawings of simple geometric objects.

More than half of the participants – nearly 60 percent – took regular naps after lunch, the duration of the naps ranging between 30-90 minutes. The majority of them slept for one hour.

The participants who napped for an hour after lunch performed better at their tasks than those who didn’t nap at all.

Those who napped for one hour performed better than those who slept for less or more than an hour.

For those who took short naps, long naps or no naps at all, the declines in their mental abilities measured up to six times greater than for those who slept for an hour in the afternoon.

Note: although the study found a relationship between an hour-long nap in the afternoon and improved brain function, it was unable to prove a cause-and-effect relationship.

An important goal for older people is to maintain their memory and decision-making abilities. Researchers are paying more attention to the role of sleep and rest in healthy mental function.

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Health and Wellness

The First Sign of Alzheimer’s May Not Be Memory Loss, But This

Researchers at Massachusetts General Hospital have linked an inability to recognize and recall odors as a possible early sign of the onset of Alzheimer’s disease. Massachusetts General Hospital is the largest teaching hospital of Harvard Medical School.

The elder care services study was reported in the Annals of Neurology, published on November 14, 2016.

A study of 183 patients indicates that those with the disease were less likely to identify smells. Brain scans showed early signs of Alzheimer’s based on patients’ inability to recognize scents such as menthol, clove, leather, strawberry, lilac, pineapple, smoke, soap, grape or lemon. Of the 183 patients, ten of them had possible or probable Alzheimer’s disease, researchers said.

Lead investigator Dr. Mark Albers, who is an assistant professor of neurology at Harvard Medical School, reports that a hindered sense of smell caused by Alzheimer’s could be detected as early as a decade before patients begin to experience memory loss.

Albers and his team are currently recruiting participants for a larger-scale study to validate the results.

Alzheimer’s disease is an irreversible, progressive brain disorder that slowly destroys memory and thinking skills, which leads to the inability to perform even simple tasks. Alzheimer’s Foundation of America calls it a “progressive, degenerative disorder that attacks the brain’s nerve cells, or neurons, resulting in loss of memory, thinking and language skills, and behavioral changes.” It’s estimated that over 5 million Americans suffer from the disease, which often appears in patients’ during their mid-60s.

The disease is currently ranked as the sixth leading cause of death in the United States, but more recent estimates indicate that it may be the third leading cause, behind heart disease and cancer.

Scientists are still not completely sure what causes Alzheimer’s disease. What they do know: it’s a result of complex brain changes that occur over decades, and symptoms often vary from person to person. It’s still a mystery as to why it mostly strikes older people.

Several previous elder care services studies have shown that patients with the disease had a reduced ability to identify odors.

If these results continue to prove themselves, they could lead to inexpensive, noninvasive screenings to identify early onset of Alzheimer’s Disease.

The most effective therapeutic elder care services strategy for Alzheimer’s disease is early detection, diagnosis and intervention. For more information about Alzheimer’s disease and elder care services, visit the National Institute on Aging.

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Health and Wellness

Niche Senior Living Redefines Retirement

As 78 million Baby Boomers age their way into retirement, the increasing understanding is that these retirees are not looking for an ”old folks home,” offering a rocking chair and a quiet porch.

Unlike the usual cliché of older people in retirement, Baby Boomers remain active and engaged in life. They want socialization, stimulation – even partying. Moreover, not only do they need quality senior planning with access to information about Medicare and Medicaid eligibility, they also need viable senior housing options for retirement.

Senior housing developers are responding to the trend with properties that cater to their varied interests, which can include anything from sports to creative expression to lifelong learning.

These communities, called “niche senior living”, are not the average retirement communities and serve as a place for mom to grow old in happiness. They feature theaters, art galleries, dance studios, classrooms and even recording studios. There is housing that caters to the LGBT community, retired postal workers, lovers of classic cars, and even college alumni (giving new meaning to the term “senior on campus”).

The old, out-of-date understanding of senior living retirement homes is that they’re a fate worse than death, forced upon seniors by their children; the seniors are warehoused there along with other tenants who they would rather not spend time with. Now, with niche living, seniors are eagerly opting for specialized senior living communities offering programs that interest them; they want to be part of the action and continue to be involved in a purposeful life.

In fact, similar preferences actually exist among the old and the young. What seniors share with Millennials: a desire for more communal living.

Like younger people, seniors are opting for community (including common spaces both inside and outside) as opposed to personal space and isolation. Smaller apartments – with lots of natural light and access to nature — are preferred to larger ones. More quality time is spent in common areas, with other residents. These spaces can include cyber cafes, wellness centers, coffee bistros, hip lounges (serving alcohol) and a variety of dining options so that residents don’t feel like they are always eating in the same room.

Millennials are also paving the way for seniors when it comes to retail: out of style are the boring, cookie-cutter suburban malls of recent past – and the stale idea that senior living properties need to be built near shopping malls. Instead, seniors are opting for smaller specialty and artisan shops, mixed-use developments, and a more urban, live-work-play-styled landscape. Transit-oriented, walkable environments also allow seniors to get around more easily.

Of course, a compromise may have to be considered, due to factors like high costs, and the type of senior living communities available nearby. It’s important to research the property in advance, and have an attorney review all of the paperwork and contracts before making a decision.

The bottom line: seniors today are defining themselves not by age, but by interest. And where they live is all about living, not dying.

Niche housing is growing in popularity. These communities include: Chiefland Astronomy Village (Chiefland, FL), which features 15 astronomical observatories; Spruce Creek Fly-In (Daytona Beach, FL), providing runways and hangars for aviators; Rocinante (Summertown, TN), featuring 100 acres for “aging hippies,” where tenants often build their own cabins; Kendal (near Oberlin College in OH and offering many connections to the school), featuring concerts, recitals, and a chance to audit university classes at no cost; and The Ridge at Chukker Creek (Aiken, SC) catering to equestrians and providing miles of horse trails.

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Health and Wellness

Are you looking to Downsize and Close Out the Family Home?

The children are gone, and your retirement is ahead. You’ve managed to get your retirement accounts in order, and you’ve decided on whether you’re going to work part-time a bit for a little extra income. But what about that big family home? Do you really need such a big space, now that the children have all moved out? If you’ve decided selling is the best option, here’s a few things to keep in mind as you begin the downsizing process.

1. Decide What to Bring with You

Because you’ll likely be moving somewhere with much less space than the family home, you’ll want to carefully consider what to take with you.  For years you’ve been used to certain amounts of space and storage. Now you’ll have much less space. Probably less than half the square footage you’ve been living in. That means some tough decisions will have to be made.

If you’re having a hard time deciding on what to keep and what to donate, take it slow and consider how useful or sentimental items are. You’ll probably need to part with some possessions that you only use infrequently. Many seasonal decorations and home repair items will need to be sold or given away. Sharon Greenthal from Empty House Full Mind also suggests “a small storage unit for things you simply can’t part with.”

2. Budget the Benefits

Selling the family home will bring financial and budget changes.  Whether it’s eliminating a monthly mortgage, lowering home repair and upkeep costs, reducing utility bills, or changing insurance costs and requirements, selling the family home and moving somewhere new will warrant a review of your housing budget.

Before you downsize you’ll want to make sure that your new arrangements fit within your planned budget. Some retirement living scenerios are more expensive than others. Much depends on how much help you’ll receive. Independent living is much less expensive than assisted living in most cases.

3. Consider Your New Lifestyle

When you move out of the family home, your new space will definitely be different.  You’ll have less to clean, and you may have little or no yard maintenance.  Both of those are benefits, but you’ll also have less space. If you’re retired you’ll spend much more time at home than when you were working. You might also take up a hobby now that you have the time. All that affects what you’ll want and need in a new residence.

If you’re moving from a single family home to an adult community or an apartment, you’ll probably be dealing with neighbors who are closer than you’re accustomed to. Consider any privacy issues before you make a move.

Comfortable and safe areas for playing may be an important factor as you start spending more time with grandchildren. Depending on the age and number of grandchildren, it could be wise to think about how much room you’ll need both inside your home, as well as outside in your yard. Sharon Greenthal also suggests “if you don’t have grandchildren now, or you might in the future, you might wish you had more room when they come along.”

Closing out the family home can be a big decision. By considering the important issues before you move you’ll make a decision that will make your new home a joy!

 

Paige Estigarribia contributes to The Dollar Stretcher.com. The site has helped readers “live better…for less” since 1996. They have an active section for baby boomers and a free email newsletter After 50 Finances.

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Health and Wellness

National Alzheimer’s Disease Awareness Month

In 1983, President Ronald Reagan designated November as National Alzheimer’s Disease Awareness Month. At the time, fewer than 2 million Americans suffered from Alzheimer’s. Since then, that number has climbed substantially: nearly 5.4 million Americans currently suffer from Alzheimer’s. Alzheimer’s Disease, or AD, is a condition caused by changes in the brain that deeply affect memory and other mental abilities. As the individual’s mental capacity decreases, it offers increasing challenges both to the one with the disease and the loved ones who assume caretaking duties. Reagan’s decision to institute an awareness month for this disease helps call attention to it and the problems faced by those who suffer from it.

How It Started

As an increasing number of Americans are impacted by Alzheimer’s disease, either as sufferers or as caregivers, it’s critically important to raise awareness about this disease and discuss its impact on the families impacted by it. Reagan acknowledged the suffering of families who watched their loved ones fade a bit further away every day. While at the time, a cure was a long way away, many strides have been made since 1983. Today, the National Plan to Address Alzheimer’s Disease seeks to find a cure by 2025. While the disease is still considered to be fatal, many strides in treatment have been made.

Raising Awareness

Many people are standing up for their loved ones with Alzheimer’s Disease and continuing to raise awareness about its symptoms, the diagnosis, and the issues faced by those who have it and their loved ones. Wearing purple for Alzheimer’s is considered to be a sign of support for sufferers and their families. Raising awareness also takes on several other facets: increasing funding to research, improving the understanding of brain functioning, and offering tangible support to families who take care of those who suffer from Alzheimer’s. Awareness is critical, not only for helping families, but for raising funding for the research to help find a cure.

Alzheimer’s Statistics

As the aging population increases, the number of patients with Alzheimer’s increases along with it. Alzheimer’s Disease occurs primarily in the elderly. The older a patient is, the greater the odds that they will suffer from Alzheimer’s: one in nine people over the age of 65 is estimated to have the disease. That increase in age isn’t necessarily the only thing that signifies an individual’s odds of contracting Alzheimer’s, however: it’s estimated that over half a million individuals under the age of 65 already suffer from Alzheimer’s or another form of dementia. Family caregivers often spend as much as $5,000 a year caring for an individual with Alzheimer’s.

Honoring Family Caregivers

For most individuals with Alzheimer’s, particularly in the early stages of the disease, family caregivers are the ones who provide the majority of the care. This means sacrificing time, money, and energy. In 2015 alone, it’s estimated that there were 15.9 million Americans providing caregiving duties for loved ones with Alzheimer’s, including an estimated 18.1 billion hours of unpaid care. 41% of those caregivers are estimated to have a household income that is less than the national average of $40,000 per year, which means that caregiving often comes at a substantial sacrifice. 74% of caregivers also report that they have some level of concern about maintaining their own health since becoming a caregiver due to the strain placed on them by those responsibilities. Nevertheless, family caregivers continue to give their all to family members who have been diagnosed with Alzheimer’s disease. It’s a difficult and often thankless job, particularly as memory and cognitive function decrease, but love provides the incentive they need.

An aging population means that an increased number of cases of Alzheimer’s Disease are coming to light. It’s clear that a deeper understanding of this disease is increasingly necessary. Not only that, the aging population will require continuing care, including services that are put in place to ensure that both those diagnosed with the disease and their family members receive the support they need during this difficult stage of life. November is the month that you can get involved! Help raise awareness and add your support to individuals suffering from Alzheimer’s this month.

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