Steven Covey, in his best seller “The Seven Habits of Highly Effective People,” maintains that to be highly effective you must take time to “sharpen the saw.”  Last week I sharpened the saw.  Three intense days of immersing myself, along with 29 other lawyers from around the country, in the issues, planning and implementation of practices, procedures and techniques designed to help someone legally qualify for Medicaid benefits to pay for nursing home costs, while preserving assets and income for the spouse who is not in the nursing home, or for other family members so they can provide additional support for the parent or spouse in the nursing home beyond what Medicaid provides.

I’ve been helping people qualify for nursing home Medicaid benefits for about the past 15 years.  I’ve read the cases, read the Medicaid manual and the applicable state and federal legislation. I thought I was pretty well “on top” of the Medicaid world for planning and implementing planning techniques for qualifying someone for Medicaid benefits to pay for nursing home costs.

It is nothing short of amazing how much was covered in those three days. Thanks to Valerie Peterson, the Executive Director of ElderCounsel, LLC, Marty Wormer, one of the preeminent elder law attorneys in the country from the Maine Center for Elder Law, and Steve Riley, an attorney coach with Atticus, for providing one of the most informative, intensive, and action oriented continuing legal education workshops/seminars that I have ever attended.


We covered every possible technique available for planning, preserving assets and creating eligibilty for Medicaid benefits for nursing home care for someone who is already in, or about to enter, a nursing home; and we learned how to proactively plan for potential long term care costs that might occur in the future.

All of the current state of the art planning options involving personal care contracts, qualified income trusts, irrevocable income only trusts, and many other tools and techniques were presented during the conference.

When to properly use enhanced life estate deeds (“lady bird deeds”), and when not to use them, were thoroughly examined.  We learned more about how to ensure that a Medicaid spend down plan achieves its objectives in accordance with the legal requirements of the Medicaid law.

Of particular importance is the extreme difficulty incurred by some, and sometimes the complete loss of benefits for others, that arises out of not having a proper durable power of attorney that allows the attorney in fact (your agent) to sign various documents, including a qualified income trust.  Without those specific powers set forth in the power of attorney, it sometimes becomes necessary to establish a court supervised guardianship so that appropriate documents can be signed on behalf of the nursing home resident.  The guardianship can result in substantial costs, loss of control, and loss of assets.  A properly drafted durable power of attorney can help avoid the guardianship and allows the nursing home resident to qualify for Medicaid benefits to pay for the cost of the nursing home.

We learned about nuances of the Medicaid laws, which are second in complexity only to the Internal Revenue Code, how to arrange assets to meet the requirements of the law, to reduce or eliminate penalties that might have been incurred, and overall how to provide relief for family members who are stressed out over the potentially devastating cost of nursing home care for their loved one.  We also learned how to protect the financial security of the spouse who is living in the homestead from the cost of the nursing home care for the other spouse.

I know that as a result of this program, I will provide a higher level of planning expertise and implementation for my clients than ever before, which will be of obvious and signficiant value to them and their families.  Thank you Valerie, Marty and Steve!

Copyright 2008-2014 – The Coleman Law Firm, PLLC

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