50 THE QUEENS COURIER • HEALTH • JUNE 6, 2019  FOR BREAKING NEWS VISIT WWW.QNS.COM 
  health 
 Elder Law Minute TM 
 Co-op Transfers and Medicaid Planning 
 BY RONALD A. FATOULLAH, ESQ.  
 AND JOSEPH BRENINGSTALL, J.D.  
 ELDER LAW 
 When  it  comes  to  long  term  care  planning, 
 Social Networking and Aging 
 A  classic  study  by  the  researchers  
 Lowenthal and Haven, demonstrated the  
 importance of a caring relationship as a buffer  
 against “age linked social losses”. Th e  
 maintenance of a stable intimate relationship  
 was more closely associated with good mental  
 health and high morale than a high level  
 of activity or elevated role status. 
 In other words, one appears to be able  
 to manage stresses if relationships are close  
 and sustaining, and if they are not, prestige  
 and keeping busy may not always prevent  
 depression. 
 An intimate and confi ding relationship is a  
 buff er against stress and illness. It is increasingly  
 evident that a caring person may be a  
 signifi cant survival resource. Social bonding  
 increases health status, however physiologic  
 pathways are yet to be determined. 
 A  network  of  relatives,  friends  and  
 acquaintances can sustain the old and give  
 life meaning. 
 Social networks are the vehicles through  
 which social support is distributed. For  
 example, married persons tend to have larger  
 and more diverse networks than persons  
 separated, divorced, widowed, or never married. 
 A longitudinal study by Field and Minkler  
 showed that social supports beyond the family  
 decrease over time for the very old and  
 for men, but not for women and the old-old.  
 Th  us satisfaction with support from children  
 tends to increase over time as the elders  
 relinquish involvement beyond the family. 
  According to researcher s, this data is signifi  
 cant because it confi rms the constancy  
 of family in the support network of the old. 
 Families also are a source of emotional  
 support across the generations. 
 Th e shift ing needs for supply and demand  
 among family members helps to establish  
 a reciprocal and comfortable giving and  
 receiving relationship. 
 Too oft en we think of the aged as only  
 recipients. Even into advanced old age they  
 oft en provide emotional and fi nancial  support, 
  child care, and cultural and religious  
 continuity. 
 As the population continues to shift  
 toward increasing numbers of frail aged with  
 multiple problems, there is a danger that this  
 balance will be diffi  cult to maintain. Older  
 family members, who are also impaired, may  
 fi nd themselves taking care of a very old parent. 
  Th  is is already occurring for many but is  
 expected to increase markedly in the future. 
 Further, as the age when “children” leave  
 home continues to increase, it is likely we  
 will again have three generational households. 
 It is important to note that the elderly  
 spouse who is caring for a disabled partner  
 has special needs also. Respite from continuous  
 care is essential. Oft en the spouse has  
 signifi cant health problems that are neglected  
 in deference to the greater needs of the  
 incapacitated partner. Most oft en the woman  
 is in the role as caregiver and may be in dire  
 need of caring and concern for herself. 
 Life satisfaction tends to be limited when  
 illness, low income, multiple demands and  
 the loss of intimacy and companionship converge  
 on a conscientious mate. Counseling,  
 and encouraging all involved family members  
 to discuss their needs and concerns  
 may, in the end, produce satisfactory results  
 for the disabled elderly person. 
 Sometimes people just need an opportunity  
 to share the diffi  culties they are experiencing  
 and by having an attentive listener  
 without any emotional commitment may  
 also allow ventilation and release of storedup  
 feelings. 
 Our greatest contribution to the care of the  
 aged may be to modify temporarily our use  
 of institutional and agency services toward  
 sustaining the natural tendencies of families  
 to care for that dependent family member in  
 a familiar home setting. 
 Th  is may not have to be an around the  
 clock venture. Consider care provided by a  
 part-time caregiver during the peak hours  
 when physical needs can be given along  
 with other essential duties such as preparing  
 a meal. 
 Th  ere may be times when a family can  
 split up the day to prepare a meal while others  
 can perform light shopping or just provide  
 comfort care by reading to that elderly  
 person, or watch television together. 
 I am not suggesting this as an easy solution, 
  considering what ongoing caregiving  
 can cost or if family members might not  
 always be available, but it may delay institutionalization  
 for a more happy elderly person  
 at knowing he is still in familiar home  
 surroundings. 
 Sheldon Ornstein Ed.D, RN, LNHA 
 Dr.  Sheldon Ornstein  
 is a registered professional  
 nurse with a doctoral  
 degree in nursing  
 organization. He has  
 specialized in the care  
 of  older  adults  and  has  
 published  many  articles  
 on the subject. He  
 has  done  post-graduate  work  in  gerontology  
 and  has  taught  at  several  universities.  
 In 2013, he was inducted into the Nursing  
 Hall of Fame at Teachers College, Columbia  
 University. 
   the  asset  that  is  of  primary  concern  
 to many seniors is their primary residence.  
 Many seniors live in homes or apartments  
 that  were  purchased  many  years  ago  and  
 have a low basis, and in many cases there is  
 no debt owed on those properties; therefore  
 for many seniors their home is their single  
 most valuable asset.  
 Provided  the  senior  is  receiving  care  at  
 his/her  home,  or  if  the  the  spouse,  a  child  
 under  21  years  of  age,  a  certifi ed  blind  or  
 certifi ed  disabled  child,  or  other  dependent  
 relative is living in the home, the home  
 remains  an  exempt  asset  for  Medicaid  eligibility. 
   The senior may then transfer title,  
 free of any Medicaid penalty, to the spouse  
 who remains in the community or any of the  
 other categories of people described above.  
 When it comes to advance long-term care  
 planning, there are two widely used options  
 with regard to real property: to transfer the  
 property  to  an  irrevocable  trust  or  gift  the  
 property  subject  to  a  life  estate.  In  a  previous  
 article  we  discussed  the  pros  and  
 cons of these two options. When seeking to  
 eff ectuate this planning with regard to traditional  
 real estate, the process is relatively  
 straightforward. A new deed is drawn up  
 transferring the property to the trust or to an  
 individual subject to a life estate.  
 However,  in  the  New  York  area,  where  
 many  people  own  cooperative  (co-op)  
 apartments,  there  is  another  aspect  to  the  
 transfer process that many people may not  
 be aware of. A co-op diff ers from other real  
 estate  in  that  the  owner  does  not  actually  
 own  the  property  in  which  they  reside.  
 Rather,  they  own  stock  in  the  corporation  
 that owns the property and are given what  
 is referred to as a “proprietary lease”, which  
 gives them the exclusive right to live in the  
 unit.  Co-ops  are  governed  by  their  own  
 unique bylaws, which are set in place and  
 enforced by the co-op’s board of directors,  
 elected by the shareholders.  
 The  fi rst  step  in  long-term  care  planning  
 for  a  co-op  would  be  to  check  with  
 the  co-op  board  or  management  company  
 to see if the bylaws allow for transfers  
 to trusts or transfers subject to a life estate.  
 While co-ops diff er with regard to transfers  
 to  trusts,  virtually  no  co-ops  permit  transfers  
 subject to a life estate.  
 The actual process of getting approval for  
 the transfer of a co-op to a trust also varies  
 from co-op to co-op. Every co-op will want  
 to have their attorneys review the trust and  
 often they will require small changes to the  
 trust to refl ect that the rules of the co-op will  
 supersede the terms of the trust. Co-ops generally  
 require that the current owner guarantee  
 continued  payment  of  the  maintenance  
 and  common  charges  for  the  co-op.  They  
 also  require  that  the  owner  sign  a  use  and  
 occupancy  agreement  ensuring  continued  
 occupancy of the co-op and that no one else  
 will  be  allowed  to  reside  there  or  sublease  
 the unit. Many co-ops require board approval  
 for each individual transfer. There is typically  
 a fee associated with the co-op attorney’s  
 review  of  the  trust  and  the  management  
 company’s facilitation of the transfer.  
 Some  co-ops  treat  transfers  as  they  would  
 new purchases and demand that the current  
 owner and the trustee go through the entire  
 rigorous  application  and  approval  process.  
 They  also  may  charge  a  “fl ip  tax”  and  
 require a new security deposit. Most co-ops  
 will require that a UCC lien search be done  
 to  ensure  there  are  no  liens  on  the  co-op  
 before it is transferred to the trust.  
 The  Medicaid  regulations  with  regard  to  
 co-ops are the same as those for traditional  
 real estate. Thus, these transfers can be very  
 advantageous for those who are looking to  
 preserve  their  assets  as  a  legacy  for  their  
 family. However, it is best to keep in mind  
 the  various  nuances  and  multiple  layers  
 of  approval  that  usually  accompany  these  
 transfers and to allow a fair amount of time  
 for the transfer to be completed. It is advisable  
 to seek out the assistance of a competent  
 estate  planning  or  elder  law  attorney  
 who has experience with the various co-ops  
 and  their  regulations  in  order  to  make  the  
 transfer process as smooth and expeditious  
 as possible.   
 Ronald  A.  Fatoullah,  Esq. is the founder  
 of Ronald Fatoullah & Associates, a  
 law  fi rm that concentrates in elder law,  
 estate planning, Medicaid planning, guardianships, 
  estate administration, trusts, wills,  
 and real estate. Joseph Breningstall, J.D.  is  
 an associate attorney with the fi rm (admission  
 pending).  Th  e law fi rm can be reached  
 at 718-261-1700, 516-466-4422, or toll free  
 at 1-877-ELDER-LAW or 1-877-ESTATES.  
 Mr. Fatoullah is also a partner with Advice  
 Period, a wealth management fi rm that provides  
 a continuum of fi nancial and investment  
 advice for individuals and businesses, 
  and he can be reached at 424-256-7273. 
 RONALD FATOULLAH 
 ESQ, CELA* 
 
				
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