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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.

5 Long-Term Care Medicaid Myths You’ll Want to Know the Truth About

6/10/2025

Did you know what the largest source of funding for nursing home care is? It’s Medicaid. Medicaid, which is often called Medical Assistance or Title 19, has many confusing rules that create serious frustration for those needing to access benefits. Processes by which one can protect their assets and still be eligible for Medicaid either through pre-planning or emergency planning can be even more perplexing without finding the right guidance down that path.

I often hear clients share things they have heard about Medicaid. “My neighbor told me … ,” or “my aunt’s experience was … ,” but normally as we speak, there are missing
pieces of information to the puzzle. Everyone’s situations are different, and without the details, it’s hard to apply the Medicaid rules. Not knowing the details and the rules has led to many myths about exactly who qualifies for Medicaid, what coverage it provides, what assets can be protected, and when.
I’d like to share with you five myths regarding Medicaid’s Long-Term Care Coverage followed by “the truth of the matter.”

1. Myth: “Medicare will pay for my nursing home stay.”
Well, let’s talk about this. Medicare is the federal health insurance program for people 65 years of age and older, certain people under age 65 who are receiving Social Security Disability Insurance, and people with End-Stage Renal Disease. Medicare’s coverage of nursing home care is very limited. Medicare covers up to 100 days of “skilled nursing care” per “spell of illness” (20 full pay days and an additional 80 co-pay days). To qualify, there are three primary requirements. First, you must enter a Medicare-approved “skilled nursing facility” within 30 days of a hospital stay that lasted at least three days (meaning admission as an inpatient; “observation status” does not count). Second, the care in the nursing home must be for the same condition, or a condition that is medically related to the condition, that caused the hospital stay. Third, the care received must be daily care at a “skilled” level which cannot be provided at home or on an outpatient basis. The care must be ordered by a physician and delivered by, or under the supervision of, a professional such as a physical therapist, registered nurse, or licensed practical nurse. What does this mean? Medicare coverage is minimal, so alternate plans are needed to pay for long-term care in an assisted living facility, community based residential facility, or nursing home.

2. Myth: “Only people who are broke qualify for Medicaid.”
Most of my clients don’t want to spend their entire life’s savings to be eligible to utilize Medicaid as a payment option for long-term care. Medicaid is a “means tested” state-run program intended to help low-income individuals pay for long-term care. That said, I regularly explain to people that you do not need to be completely penniless to qualify. In Wisconsin, a single Medicaid applicant can have no more than $2,000 in “available” assets to be eligible to receive benefits. The spouse of a Medicaid applicant, also called the “community spouse,” may retain as much as $157,920 without jeopardizing the Medicaid eligibility of the spouse who is receiving long-term care. Certain “exempt assets” (a house, a car, and personal possessions such as clothing, furniture, and jewelry) do not impact eligibility. Different planning options can be recommended based upon your individual situation. More specifically, my recommendations depend on whether you are proactively anticipating the need for future assisted living or nursing home care vs. emergency planning for imminent care needs.

3. Myth: “If I gift my assets to my children, then Medicaid can’t take it from me.”
While technically true, there are holes in this methodology. Medicaid staff will look at all gifts you’ve made within the five years before you apply for Medicaid. This is known as the “Five-Year Look-Back.” After a gift is made (i.e., giving your children your money, house, or other assets for less than fair market value), which Medicaid calls a “divestment”, Medicaid will impose a penalty period – meaning a period of time that Medicaid will not pay for your care and you will need to find an alternative way to pay for your care. The length of the penalty period depends, in part, on the amount of money you give away. This often means self-paying. But wait a minute, if you’ve given away your assets, you no longer have the money that you would need to self-pay. Now what? This could mean asking for the gifts back or seek alternative options, which are often even less desirable. This doesn’t mean that you can’t transfer assets at all — there are limited exceptions (for example, you can transfer money to your spouse without incurring a penalty). I highly encourage my clients to speak to me before transferring any assets, so their planning will continue to work as intended. Pre-planning your asset protection will avoid, or greatly reduce, the impact of the Five-Year Look-Back.

4. Myth: “I can gift up to $19,000 a year under Medicaid rules.”
Incorrect. What’s happening here is confusion between gift tax rules and Medicaid rules. You can give away up to $19,000 a year without incurring a gift tax. Unfortunately, under Medicaid law, as noted earlier, gifts are considered divestments. A gift of $19,000, or any other significant amount of money, could trigger a penalty period if it was made within the Five-Year Look-Back.

5. Myth: “My spouse and I have a prenuptial agreement, so my assets won’t be counted if my spouse needs Medicaid.”
This too is a myth. A prenuptial agreement works to keep property separate in the event of death or divorce, but for Medicaid eligibility purposes, a prenuptial agreement does not keep your property separate. Medicaid deems the assets owned by either spouse as available resources.

Unfortunately, these 5 myths are only the tip of the iceberg when it comes to understanding Medicaid’s long-term care coverage. It’s important to consult an elder law attorney before making assumptions based upon comments you hear in passing or information you find on the world wide web. Planning early and seeking the guidance of an experienced elder law attorney can help you down the path that’s right for you.

Life Estate Deed vs. Transfer on Death Deed

12/31/2024

Estate planning offers choices in how to structure your plan. In an effort to avoid probate, clients often want to discuss using a deed to automatically transfer real estate to their children. The choice is whether to use a Life Estate Deed (“LE”) or Transfer on Death Deed (“TOD”).

Both deeds will transfer the real estate upon death without probate. This may be problematic, however, if there are multiple beneficiaries on the deeds or a beneficiary with legal or financial issues when the property is transferred. Both deeds will allow for a cost basis adjustment on death to help eliminate any capital gain. Both deeds require the current owners to pay for all taxes, insurance, utilities, etc., related to the property.
The TOD works like a beneficiary on a life insurance policy. The beneficiary of a TOD has no ownership in the property until the current owner dies. This means that if the current owner wishes to sell the property, the TOD beneficiary does not take part in the sale or receive any of the proceeds of the sale.

A TOD is a good choice if you are looking to keep full ownership and have flexibility to sell the property and not share the sale proceeds. It also avoids unexpected tax issues for the beneficiaries if the property is sold during lifetime.

A LE actually splits the ownership of the property so that the current owners (the “life tenants”) own the property during their lifetime. The value of this interest is a percentage of the total value of the property, determined by the life tenant’s age. The future ownership of the property is actually owned by the “remaindermen.” This means that the owners, whether life tenants or remaindermen, can sell or encumber their individual interest in the property without consent by the other owners. Because the property has multiple owners, if the property is sold, all owners must take part in the sale and receive their share of the sale proceeds. The transfer of the remainder interest when the deed is made is a gift, so gift tax consequences must be analyzed, too.

A LE is helpful if the current owner needs to reduce the value of the property they own without giving up control. The life tenant may also want to shift some capital gain to the remaindermen when selling the real estate during the life tenant’s lifetime.
If you think one of these deeds may help carry out your estate planning goals, or whether one of these deeds would be a good alternative to a trust, please contact our office to schedule a consultation today.

What is a special needs trust?

9/10/2024

A special needs trust (SNT) may go by different names (e.g., special needs trust, supplemental needs trust, d(4)(A) trust, pooled trust). What makes a trust and SNT is not its name, however, but what it is designed to do.

An SNT is a trust that enables someone with disabilities to hold assets without affecting their eligibility for means-tested public benefits such as Medicaid or Supplemental Security Income. While assets held by the trust are not “countable” for the purpose of qualifying for such programs, there are strict regulations about disbursements from an SNT. SNTs are meant to supplement the funds and services available through government programs.
There are two main categories of SNTs: i) first-party SNTs; and ii) third-party SNTs. The distinction is who the assets belonged to prior to transferring them to the trust.

A first-party SNT (also called a self-settled or d(4)(A) trust) is created with assets belonging to an individual with disabilities. These assets are typically funds from a personal injury settlement or inheritance. To create a first-party SNT, the disabled individual must be under 65 at the time that the trust is established; the trust must be used only for the disabled beneficiary; and any funds remaining in the trust at the beneficiary’s death must reimburse Medicaid for services to that individual before distributions to anyone else.

A third-party special needs trust (also commonly called a supplemental need trust) is created by someone other than the disabled individual and funded with assets owned by anyone other than the disabled individual (e.g., parents or grandparents). These trusts can be created and funded during the life of the creator or upon creator’s death as part of the creator’s Will or Trust. Other than where the assets come from, the other main distinction between a third-party and first-party trust is what happens at the beneficiary’s death. A third-party trust does not need to reimburse Medicaid, so any remaining funds can be distributed to other beneficiaries.

A pooled SNT can be either a first-party or a third-party SNT. A pooled SNT is distinguished by who manages the trust. A nonprofit corporation manages a pooled SNT, working closely with a corporate trustee. A pooled SNT is made up of multiple sub-accounts, each sub-account belongs to an individual beneficiary, who must be disabled in accordance with Social Security Administration guidelines. The ability to “pool” together multiple sub-accounts make a pooled SNT a great alternative for small trusts or trust where finding a suitable trustee may be difficult.

If you would like to discuss how an SNT may be useful for your estate plan, please contact our office today.

Why would I even want a Will?

3/14/2024

There is a trend to try and avoid probate at all costs. Yet probate need not be feared, and avoiding probate is not always advised. Here are three situations (here may be more) where you should at least consider probate.

Cost. There are costs to probate, but those are incurred after your death. Although trusts are a great way to avoid probate, they come with an upfront cost that may be too much for you while living. Spending money now means it will not be there for you down the road. You may benefit from keeping your hard-earned money for your use while you are living. In addition, trust administration is not automatic or free. There will still be cost your trust bears after your death, although they are often less than the cost of probate.
Medicaid. If you are married and your spouse is receiving Medicaid benefits, then probate is necessary to help protect the Medicaid benefits in case you die before your spouse. Probate in this scenario is worthwhile because it helps preserve your spouse’s Medicaid benefits.
Family dynamics. Some families benefit from a referee. Going through probate allows the court to make sure things run smoothly and give your heirs easy access to the court to settle disputes. A trust, by design, is meant to be private. There is no oversight of the trustee by a third party.

As with all estate planning, there is no one-size-fits-all plan. Each person has particular goals and desires. Each family has its own unique relationships and history. If someone tells you that you “must have a trust” or “no one should go through probate,” you should get a second opinion. Contact our office today to schedule your initial consultation or to have your current plan reviewed. We look forward to meeting with you.