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Do Medicare Benefits Cover Nursing Home Stays?

3/3/2026

Hospital stays are often unexpected and almost always stressful. Whatever incident precipitated the hospitalization causes intense emotions that few people are prepared for and they are even less prepared to make the decisions they’ll be faced with next when it includes discharging to a Skilled Nursing Facility (“SNF”). Discharging from a hospital is often a “hurry up and wait" process fraught with the balancing act among choosing the best care, finding “an open bed”, and deciding how to pay for it. Understanding Medicare’s rules for SNF care is essential because confusion about SNF coverage can lead to unexpected bills.

What Is Skilled Nursing Facility Care?
SNF care is short-term, medically necessary care provided in a licensed facility following a hospital stay. SNFs offer a higher level of care than community based residential facilities or assisted living communities. Care must be provided by, or under the supervision of, licensed medical professionals such as registered nurses (RNs).
Why might someone need SNF care?

Recovery after surgery
Rehabilitation following a stroke or serious illness
Wound care or IV therapy
Physical, occupational, or speech therapy
Monitoring and treatment of complex medical conditions

SNF care helps individuals recover and regain functioning with the goal of safely returning home or transitioning to a lower level of care.

When Does Medicare Cover SNF Care?
Medicare Part A (hospital insurance) covers SNF care only if specific conditions are met. To qualify for Medicare-covered SNF care, generally the following requirements must be met:

A qualifying inpatient hospital stay. The person must have been admitted to a hospital as an inpatient for at least three consecutive days, not counting the day of discharge. Time spent in the hospital under “observation status” does not count toward this requirement.
Admission to the SNF shortly after hospital discharge. The SNF stay usually must begin within 30 days of leaving the hospital.
A medical need for skilled care. The care must be medically necessary and require skilled services, such as daily nursing care or rehabilitation therapy that can only be provided by trained professionals.
A Medicare-certified skilled nursing facility. The facility must be certified by Medicare.

If these criteria are met, Medicare Part A may help pay for SNF care on a limited, short-term basis.

What Services Does Medicare Cover in a SNF?
When Medicare covers SNF care, it generally includes:

A semi-private room
Meals
Skilled nursing services
Physical, occupational, and speech therapy
Medical supplies and equipment used during care
Qualifying medications related to the SNF stay
Ambulance transportation to the nearest provider of necessary services if other modes of transportation would pose a health risk

When Does Medicare Not Cover SNF Care?
In some situations, Medicare will not cover SNF care.
Medicare does not cover:

Long-term or custodial care, such as help with bathing, dressing, or eating when no skilled medical care is required
SNF stays that do not follow a qualifying three-day inpatient hospital admission
Care in facilities that are not Medicare-certified
Continued SNF care once the patient no longer needs skilled services

How Much Does SNF Care Cost Under Medicare?
Medicare-covered SNF care is limited to up to 100 days per benefit period (as defined by Medicare), and costs depend on how long a person is approved to stay.

Days 1 to 20: You pay $0 each day after paying the $1,736 Part A deductible amount in 2026.
Days 21 to 100: Part A covers part of the cost. You pay a coinsurance of $217 per day in 2026.
After day 100: You pay all the costs of SNF care.

Medigap (Medicare Supplement) plans may cover some or all the daily coinsurance for days 21 to 100, depending on the plan.

Why Understanding SNF Coverage Matters
Misunderstanding about SNF coverage can lead to financial strain and difficult decisions during an already stressful time. Many people assume Medicare will cover a stay in a skilled nursing facility indefinitely, when in reality, coverage is limited and tied strictly to skilled medical needs.
Before a hospital discharge, patients and caregivers should ask:

Was the hospital stay at least three consecutive days and classified as inpatient rather than observation?
Does the recommended SNF provide Medicare-certified SNF care?
What services will be considered “skilled” and for how long?
What happens when Medicare coverage ends?

What Happens When Medicare Stops Paying?
Often patients and their families are caught off guard when SNF staff approach them and share that Medicare coverage is ending. Unfortunately, this often happens well before the 100 days that was expected to be covered. Payment for care will need to transition to either private payment (this could be use of long-term care insurance benefits or personal cash reserves and retirement funds) or Medicaid (means tested government benefits that pay for long-term care). Finding oneself needing to privately pay for care, or unexpectedly apply for Medicaid, adds substantial stress to an already overwhelming situation.

Is There A Way To Plan Ahead In Case I Am In This Situation?
Beyond knowing what Medicare will cover, proactive planning to protect your assets now and decide how to fund your long-term care later will help to decrease the strife when the unexpected happens. If you are interested in assessing options customized to your situation, contact our office to schedule a time to talk to one of our elder law attorneys about protecting your life savings should nursing home care be needed in the future. We are here to help you and your family be prepared.

My Will Means I Avoid Probate, Right?

2/16/2026

Unfortunately, having a Will does not automatically allow you to avoid probate. This is a common question clients ask. They often have a Will and believe that merely naming a child as the personal representative will give that child the ability to carry out their wishes after death.
Most clients want to avoid probate. Their family has either had a bad probate experience, or they’ve heard horror stories. They are surprised when I tell them their Will does not do what they think. Just the opposite: their plan actually forces their loved ones to go through probate.
Why does a Will require probate? Because by itself, a Will does not give legal authority to anyone. Probate is the process by which the court authorizes someone (the personal representative) to actually carry out the wishes in your Will. Without the court’s authority, the personal representative does not have legal authority to sell real estate or vehicles.
If you are not afraid of probate, I still recommend having a Will. A Will helps streamline the probate process. It also allows you to clearly state your wishes. Without a Will, you are left to the mercy of Wisconsin’s law of intestacy, which sometimes have a plan much different than what you would like to do. For example, a child you would rather not receive anything would automatically be included under Wisconsin intestacy law.
If you’d rather not have your family go through probate, there are ways to avoid it. Naming beneficiaries on accounts or incorporating a trust in your plan are common ways to avoid probate. In addition, Wisconsin law allows married couples to use marital property agreements to avoid probate, and anyone to utilize a general nonprobate transfer document under chapter 705, providing tremendous flexibility, often at a cost that is less than a trust.
Whether you prefer a Will or a probate-avoiding option, you should consult with an experienced estate planning attorney to make sure your plan will carry out your wishes. Contact our office today to set up an appointment to discuss your unique planning needs.

Why Does Probate Take So Long?

1/14/2026

A common reason clients want to avoid probate is the time it takes to settle an estate (typically 9-12 months). When probate is unavoidable, what are some things to avoid?

Contested Wills. Clients can contest who is named personal representative, the fairness of distributions, and even the validity of the Will. These contests take time. Often, lawyers get involved, increasing the costs.
Incomplete Documentation. Not providing complete information slows down the process. Each time our office must contact a client or beneficiary of an estate takes time. It also increases fees. To help speed things along, answer questions promptly and completely.
Cleaning Up Titles. It is not uncommon for a married couple to assume nothing needs to be done when the first spouse passes away. That is not always the case. If the surviving spouse (or family) didn’t update account titles, car titles, or real estate deeds, extra steps may need to be taken when going through probate for the second spouse. These extra steps add to the probate process.
Beneficiary Disputes. Grudges, hurt feelings, and unresolved issues commonly bubble to the surface, causing delays to sort through the issues beneficiaries may have with each other. In addition, trying to do what “Mom and Dad wanted,” even though Mom and Dad didn’t put it in writing can cause significant delays and costs. Every conflict can’t be avoided, but trying to keep the focus on carrying out Mom and Dad’s written plan can go a long way to making the probate process more streamlined. Remember, if it is not in writing, it generally is not enforceable.

Probate delays can be frustrating for families who just want to move on. To avoid them, it's smart to plan. Talk to one of our lawyers about making your intentions clear, as well as ways to carry out your plan without the need for probate. We are here to help you and your family.

Will vs. Trust: Which do I need?

12/15/2025

When planning for the future, there seems to be an ongoing battle between two important tools: wills and trusts. Both documents allow you to determine what happens to your things after you pass away, but they work in different ways.
A will is a written document that explains who should get your belongings when you die. It can also name a guardian for young children. A will only takes effect after you pass away. But there’s something important to know: a will must go through a legal process called probate. Probate can take months, sometimes longer. It can also cost money. During probate, your will becomes part of the public record, which means people can see what you owned and who you left it to. A will is simple and useful, but it does not avoid probate.
A trust is also a written document that explains who should get your belongings when you die. However, a trust becomes the actual owner of your things. Ownership can be transferred to the trust while you are living by changing the title of your things to be the trust (e.g., home, bank accounts, or investments). Alternatively, you can direct the ownership change to the trust upon your death via a marital property agreement or beneficiary designation. Because the trust is the owner, there is no need for the court to be involved through probate. When you pass away, the person you choose to manage the trust (your successor trustee) can immediately follow your instructions.
How do they compare?

Cost: A will usually costs less to set up. A trust costs more upfront, but may save money later.
Privacy: A will becomes public in probate. A trust stays private.
Speed: A trust transfers things faster because it avoids probate.
Control: Both let you control who gets your things, but a trust gives more options—such as giving money to children over time instead of all at once.

Which One Should You Choose? There is no one-size-fits-all, so it is important to meet with an attorney who specializes in estate planning to discuss the best way to design your estate plan to carry out your wishes.
Contact our office today to meet with one of our attorneys to start putting your plan in place.

My Spouse Is In The Nursing Home - Am I Going to Go Broke?

11/4/2025

Paying for long-term care, especially nursing home care, can seem daunting when the cost can be $10,000 to $12,000 per month – or more. When a married couple in Wisconsin is no longer able or interested in privately paying out of pocket for care and they choose to apply for Medicaid, they learn quickly that it’s not a simple process.

Who can apply for Medicaid? A Medicaid applicant is someone residing in a nursing home, a community-based residential facility or an assisted-living facility, or receiving in-home care, who would like public assistance to help pay for their care.

What makes someone eligible to be on Medicaid in Wisconsin? To be eligible for Medicaid benefits in Wisconsin, a single applicant’s asset limit is $2,000 in addition to various “exempt assets.” However, Medicaid law provides special protections for the spouse of a Medicaid applicant – also known as the “community spouse” – to ensure the spouse has the minimum support needed to continue residing at home and to not be financially strapped while the other spouse is receiving long-term-care benefits.
In 1988, Congress enacted the Medicare Catastrophic Coverage Act which includes the Medicaid law that protects community spouses from being forced to utilize all of the couple’s assets on only one of the spouse’s long-term care costs. Those rules are now known as the “spousal-impoverishment rules.” Spousal-impoverishment rules include the community-spouse resource allowance (“CSRA”). In Wisconsin, the CSRA is also known as the community-spouse asset share (“CSAS”). The CSRA/CSAS is the total “countable assets” the community spouse is allowed to keep in addition to the applicant spouse’s $2,000. They may include cash, stocks, bonds, life insurance, cars, tractors, ATVs, UTVs, boats, snowmobiles or any other assets not deemed exempt or unavailable. The community spouse is allowed to keep as much as one-half of the couple’s total countable assets. The most a community spouse is allowed to keep without a hearing or a court order is $157,920. The federal government set a standard in 2022 that the least a state may allow a community spouse to retain is $27,480. Some states are more generous to the community spouse; in Wisconsin, the minimum is $50,000.

When does a couple’s assets get counted? In order to assess if a couple is under the CSRA/CSAS, a couple’s assets are analyzed on a specific date, and this date can affect two major issues:

How much money the couple needs to spend, or plan with, before qualifying for benefits, and
How much a community spouse is allowed to keep.

This date is called the “snapshot date,” and is when Medicaid is taking a picture of the couple’s assets as of that specific date.
In Wisconsin the snapshot date is one of two dates:

The date of “institutionalization” – meaning the date on which the Medicaid applicant enters either a hospital or a long-term-care facility (i.e. a nursing home or assisted living facility), in which he or she then stays for at least 30 consecutive days
The date the Medicaid applicant was first determined functionally eligible by the applicant’s local Aging and Disability Resource Center for the home and community-based waivers program. This includes care in a community-based residential facility, assisted-living facility or in-home care.

On the snapshot date, the couple’s total assets is determined, excluding the couple’s house and other “exempt” or “unavailable” assets. After that, the agency determines how much the community spouse can keep according to the calculation of the CSRA/CSAS, as previously described. If the couple’s asset level is over the CSRA/CSAS, this will stop them from qualifying for benefits. They will need to “spend down” assets, or engage in planning to address, the address the excess funds.

Can you give me an example of how this works? Of course! Bill needs nursing-home care. Bonnie is Bill’s wife, so she is Bill’s “community spouse.” Living in Wisconsin, Bill and Bonnie have three possible outcomes based upon their assets on the snapshot date.

If Bill and Bonnie have $100,000 or less in assets, Bonnie will be allowed to keep $50,000 – the minimum CSRA – and Bill will be allowed to keep $2,000.
If Bill and Bonnie have $200,000 in countable assets, Bonnie will be allowed to keep half of the couple’s assets. Bill will be eligible for Medicaid once their assets have been reduced to a combined figure of $102,000 – $100,000 for Bonnie and $2,000 for Bill.
If Bill and Bonnie have more than $315,840, Bonnie will be allowed to keep $157,920 – the maximum CSRA – and Bill will be allowed to keep $2,000.

When the CSRA/CSAS calculation occurs Bill and Bonnie may be told that they have too much money and they need to “spend down” before being eligible for benefits. That would be the case in the above scenarios with the extra 1.) $48,000, 2.) $98,000 and 3.) $155,920. We work with families to create plans that will aid the community spouse in preserving their “extra” assets to maintain their standard of living.

Proactive planning can help determine the best time to apply for benefits, how to maximize assets the couple is allowed to keep, and how to preserve assets for the community spouse in order to not experience financial hardship paying for long-term care.

October is National Special Needs Law Month

10/13/2025

Families caring for loved ones with disabilities often face complex legal and financial decisions. Special needs planning goes beyond legal documents — it’s about protecting futures, ensuring quality of life, and providing peace of mind for families. Special needs planning attorneys help families navigate these complex issues, including public benefits, long-term care, powers of attorney, and guardianships, special needs trusts.
Your loved one’s future deserves careful planning, not uncertainty. During Special Needs Law Month in October, take steps to protect what matters most — access to benefits, long-term care, and quality of life. Thoughtful legal planning brings peace of mind today and security for tomorrow. Additional information can be found here.
Call us today to schedule your consultation.

Do You Have an Advance Directive?

9/23/2025

During client meetings, I am often asked if I will prepare an Advance Directive. There is often confusion regarding what exactly is an Advance Directive. In Wisconsin, there are three main documents commonly referred to as Advance Directives: Health Care Power of Attorney, Living Will (officially called a Declaration to Health Care Professionals), and a Do-Not-Resuscitate Order (a DNR).

A Health Care Power of Attorney is an extremely important document to have. In your Health Care Power of Attorney, you appoint someone (your “Agent”) to make medical decisions for you if you are unable to make them on your own. Care should be taken in selecting your Agent, as they will be speaking for you after you have been declared incapacitated and unable to make medical decisions.

A Living Will expresses your wishes related to life sustaining procedures if you are in a persistent vegetative state or have a terminal condition. It does not replace your Health Care Power of Attorney. Your Agent under your Health Care Power of Attorney will always override your Living Will when there is a contradiction between the two. This is why we highly recommend having conversations with your Agent about your end of life and other medical wishes.

A DNR is only issued by a doctor. You must qualify to have the DNR based on your current medical condition. The DNR is a written document you sign that becomes part of your medical record.

An Advance Directive, and in particular A Health Care Power of Attorney, should be part of your estate plan. Without one, your loved ones will be forced to have the court appoint a guardian for you should you become incapacitated. Planning ahead will save you and your loved ones the time, expense, and emotional toll associated with a guardianship appointment. Please contact us to discuss your Advance Directive needs.

5 Reasons to Make a Will during August’s National Make-A-Will Month

8/19/2025

Is it really August already? Are you mentally in June, but still working on your to-do list from March? Or maybe making a will has been on your to-do list for the last few years?
Make-A-Will Month is a reminder each August to hopefully motivate busy folks to create an estate plan or crack out their old one, knock the dust off it, and see if it matches with their current wishes. For those that don’t have an estate plan, the following are 5 great reasons to take this opportunity to get your affairs in order:

Everyone needs an estate plan! – If you are 18 years of age or older, you should have an estate plan. This means not only a will or a trust, but also power of attorney documents. Without power of attorney documents, if something happens and you are unable to make your health care of financial decisions, your loved ones will likely be forced to seek a guardianship for you so they can make your decisions for you. Without a will or trust, your wishes for where your assets go after you are gone may not be followed.
Avoiding the State’s Intestacy Law – Without an estate plan, the state intestacy laws dictate who receives your assets when you pass away. If your intestate heirs are not who you want to receive your assets, you need to take affirmative action and create an estate plan that memorializes your wishes. Simply telling your family and friends what you want is not legally binding.
Makes it Easier for Family and Gives Peace of Mind – We see families on a regular basis who are caught off guard by a loved ones passing. They don’t know what to do. We also see families who knew the time was near, but for a myriad of reasons didn’t plan. By having an estate plan, you are giving your loved ones a guidebook of your wishes – making it easier and taking away the guess work and strife. Planning ahead can give you the opportunity to explain your choices, allow you to nominate legal guardians for minor children, and even outline who you want to care for your pets.
Aids in Inventorying of Assets – Some people know where every penny of theirs is; others, not so much. The estate planning process typically includes reviewing your assets and considering your intent and plan for them when you’re gone. Not only does inventorying assets help you know what you have, but it also helps you to know if you have enough of what you need, say for instance for retirement planning or for long-term care planning. It may also lead you to think about protecting your assets.
Provide for Unique Beneficiaries – Many individuals I work with have beneficiaries who they are looking to protect in some way. They might have a child with special needs, a sibling who is already in a care home, a grandchild that has mental health concerns, or a niece or nephew that’s a spendthrift. They may not want someone to inherit from them at all, or they want reassurance that a pet is well provided for. Sometimes charitable giving is a priority or protecting assets from the costs of long-term care is at the forefront. Ultimately, when there are special circumstances, an estate plan is essential.

What if I already have a will? Is it time to revisit my plan? At Grosskopf & Burch Law Firm, we encourage our clients to review their estate plan at least every 3-5 years or any time they experience a major life change (birth, death, marriage, divorce, major illness or diagnosis). Assets change, relationships change, family and individual circumstances change – life changes! Reviewing your plan allows you to confirm what is in your documents is not only what you wanted when they were initially constructed, but it’s also what you want today.
Taking time to craft an estate plan, or update the one you have, is an act of love. Easing the burdens of administration for your loved ones while giving yourself peace of mind and accomplishing a vital task is a meaningful way to leave a legacy to be remembered. Our team is here to help when you are ready.

POAs Before The Next Adventure

7/10/2025

It’s not the most exciting thing to talk about, but it is important: powers of attorney for your recent graduate. As your recent graduate and newly minted adult child gets ready to take on the world, make sure that if anything unexpected happens you will be able to be there to help them.

The financial power of attorney document will make sure you can still step in to help your child by making financial decisions for them, if an unexpected incapacity occurs. You would be able to deal with banking, rent, or school loan issues that may arise. Having the financial power of attorney will help avoid any unintended delays, cancellations, or late fees from derailing your child’s plans.

A health care power of attorney document will make sure your child can receive the medical attention they need in the event they are unable to make medical decisions on their own. Having this document in place can help put you and your child at ease, knowing you can still be there to help in times of crisis.

Although powers of attorney are not exciting to discuss, they do help avoid the need for you to become your child’s guardian in the case of incapacity. Guardianship would require time to petition the court to be appointed, which may prohibit you from making decisions immediately. In addition, as guardian, you would be required to report to the court each year; a burden avoided by being named as your child’s agent.

Take time to discuss the need for your adult child to have their own powers of attorney. It’s an easy step that can help avoid hardships in the future.

Is a Revocable Trust Right for You?

6/30/2025

You may have friends or family who say you should have a revocable trust (also referred to as a living trust). It is true that many people use a revocable trust as part of their estate plan. However, is having one as the cornerstone of your plan right for your family? Here are some of the main reasons why many use a revocable trust. See if they are right for you and your family.

Avoiding Probate. Probate is the court’s legal process that happens after someone dies. It can take a long time (typically 9-12 months) and cost a lot of money. If you have a revocable trust, your family can skip probate for the assets in the trust. This means your loved ones can get what you left them faster and with less stress.
Staying in Control. When you create a revocable trust, you’re still in charge. You can change it, add or remove things, or even cancel it at any time—as long as you still have the legal capacity to do so. This gives you the freedom to update your plan if your life changes.
Planning for Illness or Injury. If you ever get very sick or hurt and can’t make decisions, having a revocable trust may help. In addition to a financial power of attorney, your revocable trust allows you to choose someone you trust to take over and manage your money and property (called the trustee). This way, your bills get paid and your affairs stay in order without needing a court to step in and appoint a guardian.
Keeping Things Private. Wills go through probate, which is a public process. This means anyone can ask to see your Will to see what you owned and who got what. A revocable trust is private. It does not get filed with the court. Only the people involved need to know the details.
Managing Property in Other States. If you own property in more than one state, a trust can save your family from going through probate in each state. Everything in the trust is handled by the trustee regardless of location, which saves time and money.

A revocable trust is a helpful way to protect your property, plan for the future, and make things easier for your family. It gives you control now and peace of mind later. If you think a trust might be right for you, contact our office today to schedule a time to talk with our estate planning attorneys.