CSA End-of-Life Planning 4 — Questions and Answers
Question 1: A client wants to leave assets to a grandchild with a disability without disqualifying the grandchild from Medicaid. The best tool is:
- A simple bequest in the will
- A special needs trust (supplemental needs trust) (Correct answer)
- A UTMA account
- A payable-on-death bank account
Correct answer: A special needs trust (supplemental needs trust)
A special needs trust (supplemental needs trust) holds assets for a person with disabilities without counting them toward Medicaid or SSI asset limits.
Question 2: Which statement about a 'springing' durable power of attorney is accurate?
- It becomes effective immediately upon signing
- It takes effect only upon a triggering event such as incapacity (Correct answer)
- It automatically expires five years after signing
- It must be renewed annually to remain valid
Correct answer: It takes effect only upon a triggering event such as incapacity
A springing power of attorney activates only when a specified condition—typically incapacity certified by a physician—is met.
Question 3: Under the Medicaid look-back period, asset transfers made within how many years prior to application may be scrutinized?
- 1 year
- 3 years
- 5 years (Correct answer)
- 7 years
Correct answer: 5 years
Medicaid uses a 60-month (5-year) look-back period to review asset transfers that may have been made to qualify for benefits.
Question 4: A senior's family is in conflict over whether to discontinue life support. Which hospital resource is best suited to mediate this ethical dispute?
- Risk management department
- Social work department only
- Hospital ethics committee (Correct answer)
- State department of health
Correct answer: Hospital ethics committee
Hospital ethics committees are specifically convened to provide guidance and mediation in difficult end-of-life and treatment decision conflicts.
Question 5: What distinguishes a 'testamentary trust' from a 'living trust'?
- A testamentary trust is created and funded during life; a living trust is created at death
- A testamentary trust is created through a will and takes effect at death; a living trust is established during life (Correct answer)
- Testamentary trusts avoid probate; living trusts do not
- A living trust requires court supervision; a testamentary trust does not
Correct answer: A testamentary trust is created through a will and takes effect at death; a living trust is established during life
A testamentary trust is established within a will and only comes into existence and is funded after the testator's death and probate, whereas a living (inter vivos) trust is created and can be funded during life.
Question 6: A senior's advance directive was created in California and they are hospitalized in Texas. Is the directive valid?
- No, advance directives are only valid in the state where they were created
- Generally yes, as most states honor out-of-state advance directives in good faith (Correct answer)
- Only if the directive was notarized by a Texas notary
- Only if the senior re-registers the directive in Texas
Correct answer: Generally yes, as most states honor out-of-state advance directives in good faith
Most states have statutes or practices that honor out-of-state advance directives, especially if they meet the requirements of either state or substantially comply.
Question 7: Which government benefit program is the primary payer for skilled nursing facility care for low-income seniors who have exhausted their assets?
- Medicare
- Social Security Disability Insurance
- Medicaid (Correct answer)
- Veterans Administration benefits
Correct answer: Medicaid
Medicaid, a joint federal-state program for low-income individuals, is the primary payer for long-term custodial care in nursing facilities once a person has spent down their assets.
CSA End-of-Life Planning 4
A client wants to leave assets to a grandchild with a disability without disqualifying the grandchild from Medicaid.
The best tool is: