New York Hospice and Palliative Care

Hospice and Palliative Care in New York is a subject that can raise a  lot of questions and anxiety,  largely because they are so widely misunderstood. This fantastic article explains the differences between hospice and palliative care in New York and beyond. I worked with hospice and palliative care workers extensively, both as a funeral director and as a volunteer at  Francis House when I was studying for my grief counseling degree. I even interviewed a woman who was both  a midwife and a hospice nurse. By far, one of the biggest sources of frustration I found among those in hospice is that patients and their families wait too long to get hospice involved. There are myriad things hospice and palliative care nurses in New York can do, all of which are aimed at helping the patient live better and more fully in the time they have.  Frequently that includes unique forms of pain management so patients remain as lucid as possible, and sometimes it involves intense therapy, spiritual guidance and antidepressants so patients  can effectively deal with their emotions.  However, when hospice and palliative care is not called in until the last minute, frequently only a few days before the death, there simply isn’t enough time for them to do the many wonderful things for families that they can do. The palliative care portion of hospice and palliative care is frequently misunderstood- it’s simply finding ways to make the patient comfortable, regardless of whether they are dying or not. And yes, medicaid does help cover the cost of hospice and palliative care in New York. Many people who...

PrePaid Funerals: Protecting Your Funds

The FBI recently announced convictions of the top officers of National Prearranged Services. The company worked in 19 states, helping people put money for their funerals aside in trusts and insurance policies, and also purchasing prepaid trusts from funeral homes who needed liquidity, and purchasing life insurance policies instead. What the 92,000 victims didn’t know, was NPS officials invested those funds in risky investments, changed the beneficiaries of the insurance policies to themselves, and just plain kept the money for themselves. Victims included individuals, funeral homes, and insurance companies.  After admitting to the $450 million fraud, the company’s founder was sentenced to 115 months in prison, his son got 60 months.  In total, the six people indicted were sentenced to 46 years in prison. So why would you want to pay for a funeral in advance when scams like this seem so rampant? Fortunately, NY is the most regulated state in the nation with regard to funding in advance. By law, all prepaid funeral funds must be placed in an interest-bearing, FDIC backed- account, for which the planner is the sole beneficiary. The only way a funeral home or funeral director can touch those funds is with a death certificate in hand. Most New York Funeral homes use PrePlan, a non-profit master trust backed by the New York State Funeral Directors Association. All funds and interest remain the property of the planner, but by managing so many trusts, they tend to earn a higher interest return.  It has an A+ rating from the Better Business Bureau, and since the funds are always yours, you can move or remove* them at any time....

New York Medicaid Lookback Period

The New York State Medicaid Lookback Period is one of the most obvious examples of how failing to plan can really hurt a family. More and more, people find themselves and their family members struggling to pay for the costs of long term care.  Sadly, nursing home costs are so high that after a while even the most seemingly “well off” families can find themselves turning to Medicaid to cover the cost of care. The two most frequent problems I’ve seen as a funeral director are this: the family doesn’t understand that, when determining eligibility, New York employs a five year look back period for your assets.  Many people confuse IRS gifting laws with New York Medicaid Lookback Period Laws.  The IRS may allow you to gift away money without penalty, but those gifts are counted against you if they are made during the five year Medicaid lookback. Even more heartbreaking, I see families fail to take funeral expenses into account when doing their “spend down” to become Medicaid eligible. It’s a scenario that plays itself out, over and over again throughout the state.  A parent dies in a nursing home after having exhausted all of their  assets, and instead of getting an inheritance, the children find themselves reaching into their own pockets to cover the cost of funeral and burial expenses. There’s a great article which details how the New York Medicaid Lookback Period affects the estate planning process. No one wants to, but it’s important to have difficult conversations with those you love, long before the need arises. Make sure those conversations include clear statements about what your...