Online resource center to help you explore these key issues, and others, regarding your estate.

Practice Areas

Mr. Miller has many years of experience in designing and implementing a comprehensive variety of Trusts, Wills, and other estate planning documents, as well as settling estates in the most expedient and appropriate method. Further, he counsels and assists clients on becoming eligible for VA benefits and Medi-Cal.

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VA Pension/Aid & Attendance/Medi-Cal

Mr. Miller has been active in the area of VA Pension and Medi-Cal for well over a decade. He uses various specialized types of Trusts as well as non-trust strategies to gain eligibility for his clients and save the family money.

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Probate & Estate Administration

Mr. Miller has been settling estates (both simple and complex) for well over 40 years. The starting point is always to create a strategy to settle the estate in the most efficient manner possible with a minimum of taxes. Often times the strategy created allows the family to bypass Probate Court proceedings.

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What To Do When Your Spouse Needs A Nursing Home


WHAT TO DO WHEN YOUR SPOUSE NEEDS A NURSING HOME
A step-by-step action guide of what one needs to do to find
and check out good nursing homes.

Answer
Medi-Cal or Private Pay
First Steps
How to Get Inspection Reports
How to Visit and Examine

Dear Mr. Miller: My husband has Alzheimer’s disease. We don’t want to have to sell our home and spend all of our savings when I can’t take care of my husband anymore. Thankfully, I’ve read several of your articles on how to become qualified for Medi-Cal without going broke and when the time is right I’ll come to your office. But a bigger problem exists–how do we choose the right nursing home? There are so many and we hear so many horror stories. How does one go about this seemingly impossible task?– Loving Wife

Dear Wife: You’re right, the money end is only one part of the problem. The other is selecting a facility that will do the job properly. Since you are trusting them with someone who is very dear to you, it only makes sense to put in the effort to make sure everything will go right.

Medi-Cal or Private Pay: But keep in mind. It is very difficult to place a patient in a facility after he is on Medi-Cal. So if you want to have the “pick of the litter” in nursing homes, you’ll want to make the placement when enough money still exists to pay your way as a private pay patient. Once placed in the facility, the patient can usually be converted to Medi-Cal without causing problems.

First Steps: The first step in selecting a nursing home is to obtain a list of possible choices in your area, hopefully with a bit of input on which ones are better and which ones aren’t. This is not as easy as it sounds. But two possible approaches exist. If your family member is moving from a hospital to a long-term care facility, the discharge planner at the hospital may be able to give some suggestions. Some may even indicate which ones are worth looking at and which aren’t. Another approach is to contact the County Ombudsman for information. (To find the Ombudsman for your county, you can call the California State Ombudsman at 916-323-6681or go to the California Department of Aging web site.)

These people are the ones who are on the front lines in resolving complaints of nursing home residents. They usually know quite a bit about the facilities in their area and often will steer you toward the better nursing homes.

How to Get Inspection Reports: The next step is probably the most important. State agencies inspect these facilities approximately every 15 months. They issue reports specifying the various problems and legal violations that they find. For any nursing home you are considering, request a copy of the report from the facility. If they are unable to meet this request, it often means they don’t want you to see the report. Sometimes you can get a copy from the Ombudsman. Read the report, but remember, every facility will have some occasional violations. So read reports for several different homes to get a feel for what tends to be typical and what is a clear warning that problems exist. Talk to the staff at the facility about the violations and listen and weigh their explanations.

How to Visit and Examine: Finally, visit several facilities unannounced and take a look around. Notice if any lingering odors exist, the better facilities won’t have this. See if the staff interacts with the residents and whether that interaction is pleasant or not. Note what proportion of residents are restrained. By comparing various facilities you’ll get a feel for which ones are the better ones.

And remember, no one has to go broke to get into a good facility and no one has to be broke to qualify for Medi-Cal.

For a list of state licensed facilities in various metropolitan areas, see the New LifeStyles’ (an advertising concern) web site at http://www.newlifestyles.com/.(Please note that we haven’t checked these facilities ourselves nor have we verified their license status.)

Please keep in mind that no two sets of circumstances are identical and that the answer to any legal problem may change drastically based on even a slight change in the circumstances.

About Living Trusts

About Living Trusts is hosted by the Law Offices of Merwyn J. Miller, as your online resource center to help you explore these key issues, and others, regarding your estate.

Merwyn J. Miller, J.D.

  • Board Certified Specialist in Estate Planning, Trust & Probate Law
  • Co-Author of legal text book and of “Don’t Go Broke in a Nursing Home
  • Teacher of law courses at public and private colleges
  • Continuing Education Instructor for attorneys
  • Columnist for largest regional newspaper in San Diego County and professional journals for 15 years, Contributing author to the book “In Your Service: The Veteran’s Friend”
  • Masters Degree in Financial Services - Estate Planning
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