Blog : Elder Law

How can we preserve some of our life savings and still pay for the nursing home?

The No. 1 question we hear from people who need to obtain Medicaid assistance in order for their spouse to stay in a nursing home is: How can we preserve some of our life savings and still pay for the nursing home?  Most people do not know that Michigan Law allows a married couple to keep 100% of their assets and still qualify for Medicaid assistance.

The Elder Law team at Parmenter O’Toole is committed to educating our community about the programs and services available to nursing home patients through Medicaid.  To learn more about Medicaid Planning visit our website at

Veterans Aid and Attendance

VA Benefits: What is Aid and Attendance?

Aid and Attendance is a monthly pension benefit available to qualifying Veterans and surviving spouses of qualifying Veterans who need the aid and attendance of another person to perform the personal functions required for daily living.  This brochure contains information about the Aid and Attendance qualification requirements, the dollar amount of benefits currently available and how to begin the process for filing a claim.

For information on Aid and Attendance, please download our brochure.

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Protecting the Vulnerable Adult

Recent articles in area newspapers advise us that financial exploitation of vulnerable adults is on the rise, and billboards on the highways advise us to protect the vulnerable adult. Michigan’s current economic conditions may push even the most “trustworthy” person to commit crimes against unsuspecting vulnerable adults. You should be aware of those certain adults that are vulnerable and how you may help.

A vulnerable adult is a person age 18 or over who is in need of protection because of advanced age, physical disability or mental illness. The vulnerable adult is unable to  provide for their own personal care or to manage their property.

Perhaps you are this vulnerable adult and you are afraid to ask for help. Perhaps your parent is a vulnerable adult and you are afraid to offer your assistance for fear of taking away their independence.

Society understands that everyone wants to maintain their independence. And we also understand that people are reluctant to interfere if they just suspect that someone may need assistance. But if you have reasonable cause to believe that a vulnerable adult is in danger you should get involved.

If you have reasonable cause to believe that a vulnerable adult is in danger you may contact the police or the Family Independence Agency in your community. A verbal report to the Family Independence Agency is sufficient to begin an investigation of suspected abuse, neglect or exploitation.

There also are steps a person can take before they become a vulnerable adult. A person can sign a Durable Power of Attorney while still able to make their own decisions. The Durable Power of Attorney is a document that gives another person the power to act for you to assist with your finances and daily living activities. It provides for management of your property when you are not able to make decisions on your own. Parmenter O’Toole can help you with the preparation and signing of this document.

* Nancy Ann Hornacek is an associate attorney with Parmenter O’Toole in Muskegon, Michigan.  Parmenter O’Toole is a full-service business and real estate law firm.  The comments in this article are not intended to be a substitute for legal guidance or advice for a specific situation.  You should obtain informed legal counsel to assist in your decisions relating to any issues which may be raised in this article.  For additional information regarding the above topic, or any other legal issues you may have, Ms. Hornacek can be reached at (231) 722-1621 or

Elder Care Administrators

Long Term Care Planning

We have heard the reports . . . we are living longer than our ancestors. Unfortunately, we cannot guarantee good physical and mental health as we age. The thought of losing our independence because our body is frail or our memory is gone is frightening. Too often we ignore that which may be unpleasant to discuss. Ignoring minor, major or long term disability jeopardizes your well being and is a hardship for your family. Now is the time to plan. Whether you are the one who is aging or the child who is concerned about his or her parent.  Download our paper for some steps to get you started.

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Long Term Care Definitions


Federal government health care program for those age 65 or older and for some disabled individuals. Medicare has many parts: Part A -” hospital coverage and Part B -” physician and outpatient coverage and Part D -” prescription coverage. There is limited coverage for skilled nursing home and in-home care. It does not cover assisted living.


Federally funded but State administered medical and long-term care assistance to the poor. You must meet asset and income limits to qualify. It pays for nursing home care. It does not cover assisted living.

Medicaid In-Home Wavier

Limited program wherein Medicaid pays for in-home care for those who would otherwise qualify for nursing home care. You must meet income and asset limits to qualify.

Skilled Care

Rehabilitation or other treatment by a skilled professional.

Custodial Care

Basic care; room and board.

Long Term Care Insurance

Private insurance obtain to pay for long term care needs ranging from skilled nursing home care to assisted living and in-home care.

Aid and Attendance Pension

Program through the Veterans Administration that provides financial assistance for medical needs of certain veterans and surviving spouses of veterans. Income and assets requirements must be met along with military service requirements. Assisted living is covered. There is a maximum monthly amount that is available to the veteran or surviving spouse.

Medicaid Planning

Enactment of Medicaid Estate Recovery Program – July 25, 2008

By Nancy Ann Hornacek

As an estate planning attorney, I am aware that changes in the law impact a client’s estate plan. The purpose of this article is to familiarize you with Michigan’s recently enacted Medicaid estate recovery program.

Estate recovery is a program by which the State of Michigan collect monies from a decedent’s estate to reimburse the State of Michigan for certain Medicaid services provided to the decedent. The Michigan Department of Community Health (“MDCH”) is responsible for tracking the assets and services of Medicaid recipients subject to estate recovery. Michigan’s Medicaid estate recovery law provides that the assets which may be recovered by the State are the assets of a Medicaid recipient’s “estate.” Under Michigan law, an “estate” includes real and personal property that pass from a deceased person to his or her heirs through probate administration. Examples of real and personal property that are not part of a person’s “estate” and are conveyed without probate administration are jointly owned property, property owned by a trust, property subject to a life estate, and property that passes to a beneficiary under a transfer on death instrument, such as a life insurance policy that names beneficiaries.

Michigan’s estate recovery program only affects people who began receiving Medicaid long-term care services after September 30, 2007. Federal law also limits estate recovery to persons who receive Medicaid services after age 55 or who are permanently institutionalized, regardless of their age.

The timeline when estate recovery takes place is based on the Medicaid recipient. If the Medicaid recipient was single, estate recovery takes place after he or she dies. If the Medicaid recipient was married, no estate recovery takes place during the lifetime of a surviving spouse. And if a Medicaid recipient left a surviving child who is under age 21 or a child who is blind or permanently disabled, as determined by the Social Security Administration, no estate recovery occurs.

There are circumstances when Michigan will not seek estate recovery from a person’s homestead. For instance, if the Medicaid recipient has a surviving spouse or a child who is under age 21 living in the home, then estate recovery of the homestead will not take place.

In addition, there are situations when property is exempt from estate recovery. Under Michigan’s estate recovery law that part of the value of a person’s homestead that is equal to or less than 50% of the average price of a home in the county where the homestead is located, as of the date of the Medicaid recipient’s death, is exempt from estate recovery. Michigan’s estate recovery law also exempts the portion of an estate that is the primary income-producing asset of survivors, including, but not limited to, a family farm or business.

At this time it is uncertain when Michigan will begin its estate recovery program. Before the estate recovery program is implemented the MDCH must establish policy and procedures for estate recovery activities and obtain the federal government’s approval of its program. MDCH must also prepare materials for Medicaid applicants to explain the estate recovery program.

One thing that is certain is you should understand the estate recovery program and how the estate recovery program impacts you.