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The Plain English Attorney

One of the most difficult, heart-wrenching things I have seen is families struggling with the declining health of a loved one who, one day at a time, needs more help than they can provide. What can make a tough family situation even worse is finding out just how expensive long term skilled nursing care is, and projecting how long it will be until a person’s lifetime of savings are depleted just to pay for this care. Making these difficult calculations even worse may be calculating how long it will be until their spouse is impoverished. I have received quite a large number of requests for information over the past few months from clients and the general public alike, and so to answer these questions I have been doing a lot of research and even taken a Medicaid and Veteran’s Aid and Attendance training course to provide more information. (For more information, please go to the new website at

The fact is there are ways to pay for long term care that involve government programs if a person qualifies. Unfortunately, there are so many myths surrounding Care Assistance Planning, particularly with regard to Medicaid, that people often end up taking the wrong steps, creating a mess, and then not being able to correct things afterwards. Like working with an accountant on your taxes, there are many, many ways to find deductions and arrange your finances in a way that complies with the rules to come out ahead, but it often takes a professional to understand things. That is part of the reason I have launched The NC Care Assistance Center, LLC as a separate entity from my law firm, and I will be the lead person as the Care Assistance Planner. But it is not the only reason I have created this business as a separate entity.

In addition to creating a financial Care Assistance Plan, families often need much more help than just numbers, forms, and changing around assets. They often need general health guidance on living and care arrangements, and that is why we will also be working with a Geriatric Care Manager to provide that guidance, support, and to generate a Care Wellness Plan with recommendations for the individual and their family members. Legal documents are often required in the Care Assistance process, and that is why we will also be working with another Attorney to put those legal protections in place and to assist with any actual Medicaid applications. A large part of the Care Assistance Planning process involves changing account ownership, changing beneficiaries, and retitling assets, and so we have also employed an Asset Transfer Specialist to help make sure these changes are made in the right manner and at the right time consistent with the Care Assistance Plan.

In executing a Care Assistance Plan, there are often tax implications for liquidating or transferring accounts as well as deductions for certain kinds of health care expenses. This is why we have a tax professional provide their input in a Care Assistance Plan so there are no surprises. There are also often other financial and insurance considerations, and while we have professionals familiar with the Care Assistance process and the specific requirements, we can often work with other financial professionals if they have the right knowledge. These are the areas we feel are critical to the Care Assistance Planning process, and so we have gathered these professionals together to work on all of our cases.

Finally, in keeping with the same tradition I have with my law office for most services, we will be providing a package of Care Assistance Planning services for a single flat rate, and we will guarantee that the plan we create will project savings of at least three times the cost of the plan from being spent on long term care expenses. (In accordance with NC State Bar rules, the Attorney will be paid by a separate check, but the Attorney fee is incorporated into the flat rate price. Please call 919-374-0694 for details on this or the price guarantee).

We also have some optional services by other professionals that may be helpful in the Care Assistance process that may be advisable. One area is reviewing home and auto insurance to make sure you are not paying too much. Another is working with the tax professional on tax returns so that any unreimbursed medical expenses are properly deducted. In the Care Assistance Process, we often have to recommend the sale of real estate other than the primary residence (or even the mortgaging of the primary residence in some cases), and we have teamed up with a realtor, real estate attorney, and mortgage consultant to make sure this process is handled smoothly. Finally, getting all of the various paperwork and financial statements organized for any Medicaid or other applications may be too much for the family to handle at this difficult time, and so we also have teamed up with a professional organizer to provide this help if needed.

In order to help educate the public, I have also created various educational materials including a website for The NC Care Assistance Center, LLC at, and people can sign up for a free week-long mini-course of emails at that site. We will also publish the various emails over the next few months as part of the legal newsletters. And, yes, I have written a new book on Care Assistance Planning called Don’t Go Broke! The Truth Behind North Carolina Long Term Care Planning that will be published and available on within the next few weeks.

While my law office has and will continue to focus on providing excellent estate planning documents, services and information, we will also be providing these other Care Assistance services through The NC Care Assistance Center, LLC as a separate entity. Since this information is valuable for my legal clients as well, we will be adding all of our legal clients and prospective clients to automatically receive the separate monthly newsletter from The NC Care Assistance Center, LLC. If anyone does not want to continue receiving the Care Assistance newsletter, then they can unsubscribe from that list without affecting their subscription to the regular law office newsletter and vice versa.

There are already so many difficulties, traps, and pitfalls in life that when the time comes for long term care a family shouldn’t have to go broke. By working within the rules to retain all of the assets the rules allow for an individual and their family, we can help make sure that having the right care doesn’t mean losing everything.

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