Stanley Dziarcak
Waterford, NY
Medicaid Planning · Fair Hearing
A retired New York State employee needed 16 hours of daily home care and wanted to remain in the home his family had owned for over a century, without spending down his life savings.
$400,000+
In Assets Preserved
“I wouldn’t have been able to succeed without Frank and Gina, Aaron Connor from Pierro Law. It was obviously wrong. I had nothing to lose by fighting it…. The takeaway is that if you stay with it, you will most likely win your case.”
—Stanley Dziarcak, Waterford, NY
Goals and Concerns
When we met with 66 year old Stanley Dziarcak, he had lived in a Waterford, NY home all his life; the house his grandparents bought over a hundred years ago. Retired after 30 years with New York State as a tax auditor, he had managed independently until contracting cerebral palsy and requiring a wheelchair for mobility. Stanley’s doctor determined that he would need 16 hours of home care aides every day to assist him with most daily activities: transferring him to and from bed and his chair, assisting him with using the bathroom; bathing and showering, dressing and preparing all meals.
Stanley’s urgent wish was to remain in his home with the assistance of home care aides without becoming impoverished and being forced to move to a nursing home. He made an appointment at Pierro, Connor & Strauss to learn if he could protect his home and life savings in order to qualify for Community Medicaid, meeting the strict eligibility requirements for income and resources.
The Challenge
Since Medicaid is a means-tested government program for long-term care benefits, the first challenge was Stanley’s income, which consisted of his pension and social security, which totaled over $3,000/month. At the time of application, Stanley’s total monthly income was well over the limit set by New York State for Medicaid. A second challenge was the combined value of his assets which totaled over $400,000. At that time, New York allowed a Medicaid applicant to keep only $16,800 of countable assets in order to qualify for Medicaid assistance.
To qualify for Community Medicaid benefits, Stanley had two options, and the first one he did not like: spending down his life-savings and possibly having to leave his house if he ran out of funds. Instead, our legal team implemented two strategies to make Stanley eligible. The first addressed his assets and allowed Stanley’s asset total to fall below the $16,800 allowance, and the second brought his countable income down to the $934/month limit.
The Strategy
Medicaid Asset Protection Trust (MAPT)
This powerful irrevocable trust acted as a legal ‘holding tank’ for Stanley’s assets. By transferring $285,000 of his available cash into the trust, the cash no longer counted as an asset for Medicaid qualification purposes. His cherished home was also transferred into the name of the trust so if Stan was able to remain in his home for the remainder of his life, Medicaid would have no claim against the property. As there was no ‘lookback penalty’ for asset transfers when applying for community Medicaid: Stanley was able to meet the critical ‘Resources’ limit without any periods of ineligibility.
Pooled Income Trust
Stan’s monthly income of $3,283 exceeded the eligibility limit of $934/month. To combat this problem, we created a Pooled Income Trust, managed by a charity to take the excess funds monthly. Once this process was completed, the trustee could use that money to pay for things that benefit Stanley – such as personal care, home expenses or improvements, or everyday necessities like food and clothing.
With both the Medicaid Asset Protection Trust and Pooled Income Trusts in place, Stanley now met the financial requirements and was approved for Medicaid benefits!
The Outcome
Once approved for Community Medicaid, Stanley underwent an assessment process by New York State to determine the number of hours of care that would be covered. When he was awarded only 5 hours of care instead of the 16 hours/day needed, our attorney Frank Hemming challenged the ruling at a Fair Hearing. After preparing court filings and appearing before an administrative law judge, Stanley won his case! He hires his own caregivers through the Consumer Directed Personal Assistance Program (CDPAP), paid for by Medicaid to ensure individuals who know his case can work as his aides.
Results & Impact
Over $400,000 in assets preserved.
The matter required our attorneys to address several distinct legal challenges: from bringing Stanley’s countable assets and income within strict Medicaid limits, to challenging an inadequate home care award at a Fair Hearing.
What This Real Client Story Demonstrates
Stanley has realized his dream of remaining in his home instead of a nursing home. His prized family home and cash are protected within his Trust, and his long-term care needs are covered by Medicaid.
“The best part of the case for me, personally, was that we were able to achieve a result that was really good for Stan and that he was able to stay at home where he had worked so hard to remain.”
—Frank E. Hemming, III, Esq.
Key Takeaways
- Stay at Home, Not a Nursing Home: With the right plan, Stanley remained in the home his family owned for over 100 years.
- Assets Protected: Over $400,000 of value was preserved using a Medicaid Asset Protection Trust.
- Income Made Eligible: A Pooled Income Trust reduced Stanley’s excess income to meet Medicaid limits without losing use of funds or having to otherwise spend down.
- Medicaid Approved: After planning was completed, Stanley successfully qualified for Community Medicaid to cover long-term home care.
- Advocacy Matters: When care hours were denied, legal intervention secured the full 16 hours/day needed.
- Peace of Mind: Care needs met, independence preserved, and financial security maintained.