Half of Seniors Over Age 75 Can't Afford Home Health Care Visits

Most older Americans can't afford home care after accounting for their daily living expenses, according to a new report by the Harvard University Joint Center for Housing Studies.

Roughly 75% of American households ages 75 and older do not have enough income to pay for daily home health aide visits in addition to their basic living expenses (which include housing, transportation, food and healthcare costs). The median cost of daily home healthcare was $41,000 in 2021, making it affordable only for the top 25% of earners, the report found. Just a tiny percentage — less than 5% of American seniors — could afford 24-hour home healthcare.

Black and Hispanic seniors, and those who have trouble completing activities of daily living, were even less likely to be able to afford care, it noted. Only about 14% of Black seniors and 11% of Hispanic seniors are able to afford daily home health aide visits. Roughly 19% of households with a resident who has mobility impairment or trouble completing ADLs could afford daily care.

For older adults with lower income, less frequent home health aide visits may be a more affordable option, according to the report. More than half of senior households in the US can afford one visit per week, and about one-third can afford four weekly visits. 

Still, almost half of US seniors cannot afford any long-term care or home health aide visits whatsoever, the researchers pointed out.

These disparities may continue to widen as the population of older adults in the US grows.

“Without policy changes, many will not be able to afford the long-term care services they need to live in the home of their choice,” the report said. “In our current system, households with low and moderate incomes unable to simultaneously afford their homes and their care may be faced with unwanted moves.”

The researchers urged policymakers to improve both long-term care and housing programs to ensure seniors — particularly those with lower income — can afford care as they age. They also called for better funding of Medicaid home- and community-based services and expanded long-term care coverage within Medicare. 

The study only considered income.  Many seniors are forced to spend down assets to afford long-term care.  Fortunately most seniors don't require daily home health care, and fewer require 24-hour home health care.  

The study underscores the importance of sound legal and financial planning.

Source: Healy, A., "Daily home health visits are unaffordable for 3 in 4 older adults, Harvard study finds," McKnights Home Care.  

Study- Half of All States Approaching a ‘Caregiving Emergency.’

Home care worker shortages and rising care costs in America have pushed nearly half of states to the brink of a “of an unpaid family caregiving emergency,” according to a new study by Columbia University Mailman School of Public Health. “America’s Unseen Workforce: The State of Family Caregiving” is the latest installment in a caregiver research series sponsored by Otsuka America Pharmaceutical, Inc. (Otsuka). Unlike most studies that concern the availability of paid professional caregivers, the new study focuses on unpaid family caregiving.

The good news: Ohio and Missouri are among the list of 20 states categorized as "Safe for Now;" the others are Alaska, Colorado, Connecticut, Delaware, Illinois, Indiana, Kansas, Maine, Massachusetts, Montana, New Jersey, New York, Pennsylvania, Rhode Island, South Dakota, Utah, Vermont, Washington, and Wyoming. The study warns, however, that active monitoring is necessary in these states to ensure that family caregivers remain in control; economic and demograghic pressures are stressing these family caregivers. More, even in states where critical shortages don't yet exist, and family caregivers are generally supported, caregiving is especially challenging in more rural communities.

The challenges are felt most acutely in Alabama, Arkansas, Florida, Georgia, Louisiana, Nevada, South Carolina and Tennessee. In these states, pervasive workforce shortages and large rural populations make it extremely hard for home-based care providers to deliver services, placing an outsized caregiving burden on seniors’ family and friends. Georgia, for example, has one of the largest home care aide shortages in the US and is designated as “critical” in the report.

Nationwide, unpaid caregivers contribute approximately $375 billion in labor each year, the report found. The report also highlighted the high and growing burden of dementia caregiving. Dementia is associated with approximately 40% of the total value of unpaid caregiving in the US, according to the report. This is equivalent to roughly $150 billion annually in unpaid dementia-related care costs.

Given these significant burdens — as well as the federal government’s focus on cost-cutting — the researchers called on state and local policymakers to implement solutions that benefit unpaid family caregivers. John McHugh, PhD, lead researcher for the report, said in a statement:

“At a local level, it is repeatedly the family caregiver who shoulders the immense pressures generated by healthcare shortages and rising dementia cases.Without strategic, state-level initiatives, the strain on our healthcare system and economy will only intensify. It is important for policymakers to recognize the value of family caregivers and consider the long-term savings that can be achieved by acting now.”

Debra Barrett, vice president, corporate affairs at Otsuka added:

“Although caregivers don’t have a choice but to continue their vital work, it is essential that policymakers understand the difficult choices being made by families across their state and assist in supporting the valuable contributions of unpaid caregivers. Progress is being made, but achieving comprehensive change requires strong support and collaboration from both federal and state governments. At Otsuka, our support of this study reflects our broader commitment to advocating for family caregivers everywhere. As we look ahead, we must commit to long-term solutions that uplift and sustain family caregivers, recognizing their critical impact across the country.”

The report findings underscore the need to advocate for more support and resources for unpaid family caregivers:

• In an era of reduced government spending, it’s crucial to establish a consistent and reliable standard of support for unpaid family caregivers at the state level.

• States must advocate for funding to support programs that provide financial assistance, training, and respite care for unpaid family caregivers to meet the growing demand and avoid putting more strain on their local healthcare systems.

• States with a higher rate of dementia care must urgently implement new solutions for unpaid family caregivers to bridge the workforce gap. 

• To get ahead of the rising demand for managing complex, chronic conditions like dementia — traditionally managed by healthcare professionals — training and certification programs for family caregivers are essential.

• States with higher rural populations must implement targeted strategies to support the unpaid caregiving workforce. 

• Where there is a shortage of healthcare workers, states can support family caregivers financially in recognition of their contribution to the healthcare system.Investing in the long-term care workforce at the federal level is crucial. This involves better training, higher wages, and finding long-term solutions for staffing challenges for both institutional and community-based care.

Just the fact that there is a focus on home health caregivers is important- these cargivers are vital in an aging in place plan. Tax, and regulatory reform could better incentivize and support family caregiving.

Otsuka is the lead, founding sponsor of Caregiving, a two-hour documentary for PBS portraying paid and unpaid caregivers navigating the challenges and joys of "this deeply meaningful work." Intertwining intimate personal stories with the untold history of caregiving, the documentary reveals the state and the stakes of care in America today. The project, created with executive producer Bradley Cooper, premieres June 24 on PBS and is available to stream on May 27 on PBS.org and the PBS App. It is the next feature film of the WETA award-winning Well Beings campaign, which addresses critical health needs in America. To learn more about Otsuka’s caregiver commitment visit: otsuka-us.com/caregiver.

Choosing a Nursing Home or Skilled Nursing Facility: Navigating the Long-Term Care Crisis

Choosing a nursing home or skilled nursing facility (SNF) is a critical decision for seniors and families. A recent report from Nonprofit Quarterly, “The Triple Threat Facing Nursing Homes—And How to Overcome It, explains why many residents view nursing home life as being a "Fate Worse than Death." It highlights a crisis driven by private equity ownership, profit-driven care, and COVID-19’s lasting impact. Understanding these risks is essential to selecting a safe facility or planning to age in place with confidence.

This article will break down what the “triple threat” means for you, explain the risk, i.e., the balance of nonprofit versus for-profit facilities, show you how to choose safer nursing homes and how to identify private equity ownership, and why planning to stay out of an institution is more important than ever.

The Triple Threat: What It Means for You

The Nonprofit Quarterly report identifies three interconnected forces threatening nursing home care quality, which directly impact seniors and families considering institutional care:

• Commodification of Elder Care (“Gray Gold”): Nursing homes have shifted from care-focused to profit-driven models. The article references Timothy Diamond’s book Making Gray Gold, which describes how elder care became a marketable commodity, prioritizing financial gain over resident well-being. For you, this means some facilities may cut corners on staffing, resident meals, supplies, or services to boost profits, potentially leading to neglect, medication errors, or infections.

• Private Equity’s Aggressive Expansion: Private equity firms are increasingly acquiring nursing homes, using complex financial strategies like inflated service fees or property leasing to extract wealth. These practices often reduce resources for care, resulting in understaffing and substandard conditions. For seniors, this translates to a higher risk of harm in facilities owned by such firms, as seen in cases like the 2018 bankruptcy of HCR ManorCare, where care quality plummeted under private equity ownership.

• COVID-19’s Lasting Impact: The pandemic exposed and worsened existing flaws, with over 200,000 nursing home deaths highlighting staffing shortages and infection control failures. For families, this underscores the ongoing risk of infectious outbreaks in facilities with inadequate staff or protocols, making safety a top concern.

• What This Means for Quality of Care: These threats increase the risk of harm in nursing homes, particularly in for-profit facilities. A 2014 Department of Health and Human Services Office of Inspector General (OIG) report found that 33% of Medicare beneficiaries in SNFs experienced adverse events (e.g., hospital readmissions, permanent harm, or death), with 59% deemed preventable due to substandard care or errors. The triple threat amplifies these risks, making it essential to carefully evaluate facilities and prioritize alternatives like aging in place. There is significant incentive for executives too; in the case of HCR ManorCare, the final bankruptcy approved a payout to the former CEO of $116 million.

Nonprofit vs. For-Profit Nursing Homes: The Ratio and Why It Matters

Nationwide, there are approximately 15,000 nursing homes, serving over 1.3 million residents. The ownership breakdown is:

• For-Profit: 70-72% (roughly 10,500-10,800 facilities), increasingly dominated by private equity, REITs, and midsize chains.

• Nonprofit: 24% (about 3,600 facilities), often run by faith-based or community organizations.

• Government-Owned: 5-6% (750-900 facilities), typically public or VA facilities.

The vast majority of nursing homes are For-Profit; you may have to work to find a non-profit in your area.                                                                                                       

Why Nonprofits Are Safer: Studies consistently show nonprofits provide better care. A 2011 LeadingAge New York study found nonprofits had fewer hospitalizations, lower antipsychotic use, and higher staffing levels. A 2020 meta-analysis estimated that nonprofit facilities have 7,000 fewer pressure sores and provide 500,000 more nursing hours daily nationwide. For-profits, especially private equity-owned, have more deficiencies and lower quality ratings, as seen in the 2018 HCR ManorCare bankruptcy, where violations soared under Carlyle’s ownership.

What This Means for You: Prioritize nonprofit facilities when possible, as they’re less likely to prioritize profits over care. However, nonprofits are harder to find, with their share dropping from 30% in the 1990s to 24% today due to financial pressures and acquisitions. Use Nursing Home Compare to filter for nonprofit status and verify during tours.

Spotting Private Equity Ownership

Private equity-owned nursing homes are riskier due to profit-driven cost-cutting. A 2023 Good Jobs First report noted that midsize private equity chains often have fines averaging over $100,000 per facility for violations. Determining ownership cab seem a daunting task, particularly when ownership is not transparently offered to individuals considering that home. Here’s how to identify such ownership:

Check Ownership Details: Use CMS’s Nursing Home Ownership Data (go to data.cms.gov for other data sets) or state licensing records to find the facility’s parent company. Private equity firms often use complex structures with multiple subsidiaries (e.g., separate entities for operations and real estate). Look for names like Portopiccolo Group or HCP, Inc., (now known as Healthpeak Properties, Inc. after a 2019 rebranding, known for private equity or real estate investment trust (REIT) ties.

Look for Related-Party Transactions: Private equity firms may contract with affiliated companies for services (e.g., therapy, staffing), charging inflated fees that drain resources. Ask the facility for a list of contracted services and their providers. If multiple services come from related entities, it may signal profit extraction.

Research Recent Ownership Changes: Facilities that changed hands between 2016 and 2021 (over 20% of U.S. nursing homes) are more likely to be private equity-owned. Check news reports or Ziegler Investment Banking data for recent acquisitions. A 2024 KFF Health News article noted that 900 nonprofit nursing homes were sold to for-profit operators since 2015, often to private equity or REITs.

Ask Directly: During tours, ask administrators about ownership structure and whether the facility is part of a for-profit chain or investment group. Be wary of vague answers or reluctance to disclose.

Choosing Safer Nursing Homes: Key Steps

If institutional care is necessary, selecting a safer facility is critical. Here’s how to navigate the process:

Evaluate Staffing Levels: Staffing is the strongest predictor of care quality. Check the facility’s nurse-to-resident ratio on Nursing Home Compare. CMS’s 2024 minimum staffing rule requires 3.48 hours of direct care per resident day (including RNs and aides). Avoid facilities with frequent staff shortages, as these are linked to higher rates of infections and falls. Ask about staff turnover rates during tours—lower turnover suggests better working conditions and care consistency. Check to make sure that there is at least one RN on staff 24 hours each day.

Investigate Infection Control: Post-COVID, infection prevention is crucial. Ask about the facility’s infection control protocols, vaccination rates, and history of outbreaks. A 2024 OIG report found that 24% of for-profit SNFs failed to meet infection preventionist staffing requirements, increasing risks.

Tour and Observe: Visit potential facilities repeatedly, unannounced, if possible, at different times to observe cleanliness, staff responsiveness, and resident well-being. Red flags include unanswered call bells, unclean rooms, or residents appearing neglected (e.g., unassisted with meals or hygiene). Observe whether staff members know the names of residents and each other. Speak with residents and families about their experiences.

Assess Meal Quality: Nutrition is vital for your loved one’s health and well-being in a nursing home, yet some facilities, may cut costs by offering bland, repetitive meals. When evaluating a facility, visit during mealtime, spend time in the dining room, and request to sample a meal. Inquire about options for dietary needs, such as vegetarian, kosher, heart-healthy, or diabetic diets, and ask residents if they enjoy the food. A high-quality nursing home will confidently demonstrate its dining experience, prioritizing flavorful, nutritious meals tailored to residents’ needs. Poor-quality, unappealing food lacking variety can lead to malnutrition, mental decline, and serious health issues, diminishing your loved one’s quality of life. Choose a facility that invests in its dining program to ensure both health and happiness.

Review Inspection Reports: State inspection reports, available via Nursing Home Compare or state health departments, detail violations. Avoid facilities with repeated or severe deficiencies, such as failure to prevent pressure ulcers or medication errors.

Consider and Compare Costs, Expenses, and Fees: When considering a nursing home, meet with the admissions office to thoroughly review costs, fees, and expenses; lack of transparency can lead to unexpected financial burdens. Candor and transparency might reveal the home as less concerned with "getting a contract and starting billing" and more concerned with a transparent, cooperative, mutually rewarding relationship. Request a detailed, written breakdown of costs before deciding, clarifying what’s included in the base price and which services (e.g., therapy, specialized care) incur extra fees. Discuss Medicaid coverage with the facility’s social worker, even if it’s not immediately needed; some facilities guide families through the application process, potentially saving thousands in legal fees, while others offer little or no support. Inquire about policies for scenarios like hospitalization or hospice care, as these can trigger additional costs. 

Many families are unprepared for the complexity of long-term care financing, and facilities may not fully disclose fees upfront. Medicare and Medicaid often don’t cover all services, and some facilities may not accept both programs, leaving families to face out-of-pocket expenses, disputes, or even discharge. Proactive planning, including exploring Medicaid asset protection with an elder law attorney, can safeguard your finances and ensure your loved one’s care.

Use Multiple Rating Tools: Start with Medicare’s Nursing Home Compare to review a facility’s star rating (1-5 stars) based on health inspections, staffing, and quality measures, but recognize its limitations; you can read multiple articles about the these limitations and weaknesses by selecting the label "Nursing Home Compare" at the lower right of this page (or simply click on the link to perform the search). Complement it with: 

• U.S.N&W.R.:  U.S. News & World Report’s Nursing Home Ratings evaluates nearly 15,000 nursing homes annually, rating them for short-term rehabilitation and long-term care based on CMS data but with a proprietary methodology that emphasizes outcomes like rehospitalization rates (ideally below 20%) and resident satisfaction.

• NusingHome411: NursingHome411’s Problem Facilities Dataset, sponsored by the Long Term Care Community Coalition, this rating service and dataset flags Special Focus Facilities and one-star homes, often for-profits. Use this tool to avoid low performers.

• State-Specific Tools: Many states host their own alternatives to the federal CareCompare, some simply reporting CareCompare information, but many providing more granular data for specific homes in that state.  State-specific tools like Minnesota’s Nursing Home Report Card or Massachusetts’ Survey Performance Tool offer local insights. These alternatives provide a fuller picture of care quality, and align with the need to prioritize nonprofits, offering potentially better outcomes.

• Ohio Nursing Home Quality Navigator: Offers a searchable map, CMS star ratings, staffing stats, resident satisfaction, and violation counts for Ohio’s 960 nursing homes.

• Ohio Long-Term Care Consumer Guide: Offers inspection summaries, satisfaction surveys, and costs, ideal for nonprofit comparisons (24% of facilities, 7,000 fewer pressure sores).

• Missouri DHSS Facility Search: Delivers detailed inspection reports and deficiencies for 1,111 facilities, helping identify risky for-profits.

These tools help prioritize nonprofits and high-quality homes.

Leverage User Reviews: Check the name of a home or institution against the Blog for the National Association to Stop Guardianship Abuse.  The Blog has a convenient search tool, and is one of the most comprehensive sources for news about nursing home cases of abuse and neglect.  Check Yelp, Facebook, or similar platforms for resident and family feedback or stories on staff responsiveness and care quality, but cross-reference with data-driven tools due to potential bias.

Monitor Consumer Feedback and News: Check X for resident/family posts using hashtags like #NursingHomeAbuse or #ElderCare. In Ohio, I was able to identify posts describing lawsuits against Majestic Care of Fairfield (March 2025) regarding alleged staffing-related deaths, and a Warrensville Heights death (January 2025), exposing monitoring failures. In Missouri, one-star Kansas City homes (March 2025) face abuse citations, and a 2024 report noted unnecessary confinement of mentally disabled residents. On the other hand, nonprofits like Friends Care Community, Ohio, earn praise on X for resident satisfaction. These are, of course anecdotal, and like all social media subject to bias, misinformation, misunderstanding, and misattribution. In some cases, though, you may find information critical to your decision.

Beware of Guardianship Abuse: Even if unnecessary you should ask the nursing homes how it handles guardians and conservators, and whether it has an affiliated entity that can serve as a guardian or conservator if needed.  You should ask what percentage of its residents have court appointed guardians/conservators.  Some nursing homes have made guardianship a separate business. For-profit nursing homes may exploit guardianship petitions to collect debts or secure Medicaid payments, overriding valid Powers of Attorney (POAs) or family wishes. A 2024 report noted New York facilities coercing payment through guardianship, costing families up to $10,000 in legal fees.  Facilities may refer petitions to attorneys or nonprofit “guardianship mills,” not formal subsidiaries, to manage finances, but this practice—seen in 12% of Manhattan cases (2002-2012)—is profit-driven, and not resident-focused.  Be wary if the institution has a close relationship with a guardianship business or non-profit, particularly if it is directly affiliated with the nursing home.  A nursing home that prefers working with court-appointed guardians and conservators is possibly a threat to your independence and decision-making, and a possible threat to family directed care and financial management.

   

Choosing Safer Nursing Homes: What to Avoid

Don't Overestimate the Value of Proximity- While proximity is often a top priority for seniors and families selecting a nursing home—wanting a facility close to the senior’s home or a family member’s residence—it shouldn’t overshadow care quality. Being nearby makes it easier to visit and monitor your loved one’s treatment, but a closer facility with frequent lapses in care, such as injuries, staff conflicts, or resident disputes, can lead to more unexpected trips and stress, reducing meaningful time with your loved one. A higher-quality nursing home, even if farther away, may require a longer drive but offer better care, fewer emergencies, and more rewarding visits. Balance proximity with quality to ensure your loved one’s safety and well-being.

Avoid Crisis Decision-making: When a parent or loved one’s Medicare hospital benefit nears its end, families often face intense pressure to find a nursing home quickly, tempting them to settle for the first available bed. This crisis-driven approach can lead to choosing a facility with substandard care, especially in for-profit homes influenced by private equity or REITs where quality may suffer. Instead, plan ahead while your loved one is healthy, researching and shortlisting high-quality, preferably nonprofit facilities. Alternatively, explore options at the onset of a hospitalization or a chronic condition diagnosis. By proactively evaluating choices, you can avoid risky “last resort” facilities and ensure safer, more compassionate care.

Look Beyond the Surface- Don't Be Fooled By Appearance: When selecting a nursing home, don’t be swayed by appearances alone. A sparkling new facility with elegant decor and cutting-edge technology may catch your eye, but true quality lies in the care provided. Older, less glamorous nursing homes with low patient-to-staff ratios, dedicated staff, and a genuine commitment to residents often offer safer, more compassionate care than luxurious but poorly managed homes. Fancy furnishings and white linen tablecloths mean little if a facility is overcrowded or understaffed. While modern infrastructure is a one-time investment (plus ongoing maintenance), quality staff, effective management, and continuous training are daily expenses that profit-driven facilities might skimp on. Focus on the bigger picture—prioritize the care your loved one will receive over superficial charm.

Why Plan to Age in Place

The triple threat underscores why avoiding institutional care through aging in place is a smarter strategy. Here’s why and how to plan:

Lower Risk of Harm: Nursing homes carry inherent risks, with 20-23.5% of Medicare patients rehospitalized within 30 days, often due to preventable issues like infections or medication errors. Home-based care reduces exposure to institutional risks, as shown by Medicare’s Independence at Home program, which cut hospitalizations and saved $2,700 per beneficiary annually.

Better Quality of Life: Aging in place allows seniors to stay in familiar surroundings, maintaining independence and emotional well-being. The Nonprofit Quarterly article emphasizes amplifying resident voices, which is easier at home with family or caregiver support.

Cost Savings: Nursing home care is expensive, averaging $8,700/month for a semi-private room (2024 NPR report). Medicaid covers costs for eligible seniors but requires depleting assets, threatening family legacies like farms or homes. Home care, while not cheap, can be more affordable with Medicare home health benefits or long-term care insurance.

How to Plan To Age in Place

Legal Planning: Work with an elder law attorney to create an Aging in Place Planning Trust and/or Medicaid Asset Protection Trust or update your estate plan from a simple will or simple probate avoidance revocable trust to state your wishes, and protect your assets and decision-making. Powers of attorney and advance directives for health and dementia help ensure your care preferences are honored.

Home Modifications: Install grab bars, ramps, or stairlifts to make your home safer. A certified aging-in-place specialist can assess needs.

Care Coordination: Explore home health aides or telehealth services (e.g., virtual care hubs like Good Samaritan’s 2022 initiative) to manage medical needs. Medicare covers skilled home health for qualifying conditions.

Financial Planning: Purchase long-term care insurance early (ideally in your 50s-60s) to cover home care costs. Budget for private-pay caregivers if needed.

Community Support: Engage family, friends, or local senior services (e.g., Area Agencies on Aging) to build a support network, reducing reliance on institutional care.

Additional Considerations

Advocacy and Oversight: The Nonprofit Quarterly article suggests advocating for stronger regulations and ombudsman programs. Families should connect with Long-Term Care Ombudsmen (available in every state) to report concerns or monitor facility quality. Joining resident or family councils empowers you to demand better care.

Medicaid Funding Gaps: Low Medicaid reimbursement rates strain facilities, especially for-profits, leading to closures or quality cuts. Support policies increasing Medicaid funding to improve care options.

For-Profit Risks: Beyond private equity, for-profit chains like Skyline Healthcare (bankrupt in 2018) have left residents stranded. A 2024 CBS News investigation found neglect patterns in for-profit facilities, with cases like a 92-year-old left alone and injured. Scrutinize for-profit facilities, especially midsize chains with opaque ownership.

Conclusion: Plan Smart, Stay Safe

The triple threat—commodification, private equity, and COVID-19’s fallout—has made nursing homes riskier, particularly for-profit facilities, which dominate 70-72% of the market. For seniors and families, this means, in the worst case, prioritizing nonprofit facilities, thoroughly vetting ownership, and checking staffing and quality metrics before choosing a nursing home. The safest and most fulfilling option is to plan for aging in place, leveraging legal, financial, and home modifications to stay independent. By working with elder law professionals and exploring home-based care, you can avoid the risks of institutional care and protect your health, assets, and legacy.

For personalized guidance, contact our office to discuss aging in place planning, Medicaid planning, long-term care options, or home safety assessments. Visit Medicare.gov for facility comparisons, and reach out to your state’s Long-Term Care Ombudsman for support. Your future deserves careful planning—start today.

The Hidden Cost of Supporting Adult Children: Implications for Seniors Aging in Place

A recent report from Savings.com reveals a startling trend: 50% of American parents with adult children are providing regular financial support, averaging $1,474 per month. This figure, which has risen to a three-year high, underscores the economic pressures many young adults face in today’s cost-of-living crisis. For Generation Z, the average monthly support is $1,813, while millennials receive about $863. While parents may feel compelled to help their children navigate these challenges, this generosity could have significant consequences for their own financial security—particularly for seniors planning to age in place.

The Financial Strain on Parents

The Savings.com report highlights that parents are often prioritizing their adult children’s financial needs over their own retirement savings. On average, parents who provide this support contribute just $673 per month to their retirement funds—less than half of what they give their children. This imbalance is particularly concerning given the broader retirement crisis in the U.S. According to AARP, nearly 20% of adults over 50 have no retirement savings, and 61% worry about outliving their funds. A 2024 survey by the National Council on Aging adds that 80% of seniors are either financially struggling now or at risk of economic insecurity in retirement.

For seniors aiming to age in place—remaining in their homes as they grow older—this trend raises red flags. Aging in place often requires careful financial planning to cover costs like home modifications (e.g., ramps, grab bars), periodic in-home care, medical expenses, and general living costs. Diverting funds to adult children can erode the savings needed to sustain independence and comfort in later years.

Implications for Aging in Place

Reduced Retirement Savings: The most immediate impact of supporting adult children is the depletion of retirement funds. Seniors who prioritize their children’s financial needs may find themselves with insufficient savings to cover essential expenses later in life. For those aging in place, this could mean forgoing necessary home modifications or cutting back on in-home care services, potentially compromising safety and quality of life.

Increased Financial Dependence on Children: Ironically, parents who support their adult children now may inadvertently create a cycle of dependency. If young adults remain reliant on parental support, they may struggle to build their own financial stability. This could leave them less capable of providing financial or caregiving support to their aging parents in the future. For seniors aging in place, the expectation that children will “step up” later may not materialize, leaving them vulnerable to financial hardship.

Emotional and Relational Stress: The Savings.com report notes that 77% of parents attach conditions to their financial support, such as encouraging employment or education. While these boundaries are practical, they can strain family relationships. For seniors aging in place, maintaining strong family ties is often crucial for emotional support and occasional assistance. Financial disagreements could weaken these connections, leaving seniors more isolated.

Long-Term Economic Insecurity: With 18% of parents reporting that their support for adult children may continue indefinitely, the long-term financial outlook for these seniors is precarious. Aging in place requires a sustainable financial plan, but ongoing support for adult children could drain resources, increasing the risk of economic insecurity or even forcing seniors to relocate to more affordable (and less desirable) living situations.

Hidden Risks of Financial Dependency

Beyond immediate financial strain, supporting adult children can spark deeper risks that threaten seniors’ ability to age in place safely and securely.

Fomenting Crisis Desperation:  Adult children who rely heavily on parental support may face intense financial and emotional strain when that support diminishes, especially in today’s economic climate. This desperation can cloud decision-making and disrupt the mutual support families often expect. For instance, a child struggling to maintain their lifestyle might delay or forgo a parent’s necessary medical treatment to preserve funds. Others may keep a parent at home, despite lacking the ability to provide adequate care, prioritizing financial stability over safety. In extreme cases, desperation could lead to coercion, such as pressuring a parent to alter an estate plan to ensure continued support, or, in the worst scenarios, even result in elder abuse or violence.

Risk of Assets: Financial dependency also exposes seniors’ assets to significant legal and financial risks. Joint ownership of property or accounts with a child, often seen as a way to provide support, can expose those assets to the child’s liabilities, such as debts or lawsuits. Cash transfers to or for the benefit of children may later impair eligibility for government assistance programs like Medicaid or Passport, which have strict asset and income limits. In the most troubling cases, dependency can lead to theft or misappropriation, where a child intentionally or recklessly depletes a parent’s resources, leaving them unable to afford aging in place expenses.

Broader Consequences: The National Center on Elder Abuse reports that financial exploitation affects 5-10% of seniors annually, often by family members under financial stress. Untrained or overwhelmed children providing care may neglect critical needs, like medication management, increasing risks of falls or health declines. The mental health toll is also significant—seniors may feel anxious or coerced into continued support, while children face guilt or resentment, straining family bonds essential for aging in place.

Strategies for Balancing Support and Security

To protect their financial future while supporting their children, seniors can adopt these strategies:

Set Clear Boundaries: Discuss financial support openly with children, setting limits like a fixed monthly amount or a cutoff age (e.g., 25 or 30). The Savings.com report shows 77% of parents use conditions to encourage independence, a model others can follow.

Prioritize Retirement Savings: Financial planners emphasize saving for retirement first. Seniors should ensure monthly retirement contributions at least match or exceed support given to children.

Offer Non-Financial Support: Instead of cash, provide help like job search assistance, temporary housing, or financial literacy resources to foster independence without draining savings.

Protect Assets Legally: Work with an elder law attorney to safeguard assets through trusts, powers of attorney, or other tools. Avoid joint ownership or large cash transfers that could jeopardize Medicaid eligibility or expose assets to a child’s liabilities.

Plan for Aging in Place: Budget for home modifications, explore long-term care insurance, and apply for programs like Medicaid or HUD’s Section 202 for low-income seniors. An elder law attorney can ensure plans align with long-term goals.

Foster Family Communication: Hold family meetings to align expectations and prevent desperation-driven conflicts. Mediation or financial planning sessions can help maintain healthy dynamics.

Monitor for Exploitation: Stay vigilant for signs of financial abuse, such as unauthorized withdrawals or pressure to change estate plans. Regular check-ins with a trusted advisor or attorney can provide oversight.

A Call to Plan Ahead

The Savings.com findings are a wake-up call for seniors and their families. While helping adult children is natural, it must not compromise financial security or expose seniors to exploitation. For those committed to aging in place, preserving savings, protecting assets, and fostering healthy family dynamics are critical to maintaining independence.

By setting boundaries, prioritizing savings, and seeking legal guidance, seniors can support their children without sacrificing their future. Aging in place is a rewarding goal, but it demands discipline and foresight—starting with today’s decisions.

For personalized guidance on aging in place or elder law matters, consult a qualified elder law attorney or financial planner to ensure your plan aligns with your long-term goals.

Understanding Survivorship Claims and Medicaid Liens in Wrongful Death Cases

When navigating elder law, families often focus on protecting assets, ensuring healthcare coverage, and maintaining an independent quality of life. A lesser-known issue that can significantly impact families—especially those relying on Medicaid for long-term care—is how Medicaid estate recovery and liens interact with wrongful death lawsuits, particularly with survivorship claims. A recent case sheds light on this complex intersection, raising important considerations for families and their legal strategies. This article will explore survivorship claims, other components of wrongful death claims, and the implications of Medicaid liens, which can discourage families from pursuing such cases.

The Case: Survivorship Claims Vulnerable to Medicaid Estate Recovery

The case, In re Estate of Leonor R. Dizon, No. A-1724-23 (Apr. 8, 2025), a New  Jersey appellate court ruling,  addressed whether a survivorship claim, part of a wrongful death lawsuit, is considered an estate asset subject to a Medicaid lien. Leonor Dizon received Medicaid benefits from August 2006 to March 2018. She died after falling from her bed and fracturing her neck at the Trinitas Regional Medical Center. In August 2018, the surrogate’s court issued letters of administration to Teresa Finamore, Leonor’s daughter. The Division of Medical Assistance and Health Services (the Division) advised Leonor’s estate (the Estate) of a lien and asserted a claim against the Estate’s assets under 42 U.S.C. § 1396p and New Jersey’s estate asset statute for $214,391.00 expended by the state’s Medicaid program for medical and health-related services on Leonor’s behalf.

In 2019, the Estate filed a medical malpractice complaint that included survivorship claims, and the Division filed a lien against the Estate’s assets, including any award from the pending survivorship actions. The Estate petitioned the court to issue an order extinguishing the lien claim asserted against the Estate’s assets pursuant to the estate asset statute. It argued that a survivorship award was not subject to the Division’s lien under the estate asset statute because the survivorship claims were not assets of the Estate at the time of Leonor’s death. It claimed the Division was only entitled to reimbursement from an award for Leonor’s tort-related medical expenses from third-party medical malpractice defendants under another statute that specifically addressed third-party liability recovery. The court denied the Estate’s application to extinguish the lien, and the Estate appealed.

On appeal, the New Jersey Superior Court, Appellate Division, determined that the estate asset statute broadly defines an estate asset as all interests a Medicaid recipient possesses at death, including any interest in the Medicaid recipient’s medical malpractice claims. The administrator of Leonor’s Estate had the same standing to sue that Leonor had prior to her death; thus, Leonor’s interest in her medical malpractice claims passed to the Estate at her death, and the survivorship claims were estate assets.

The court also found no merit in the Estate’s argument that the third-party liability statute dictated the amount that the Division could recover on its lien because the source of the funds limited its ability to collect through its lien. Rather, a Medicaid recipient’s status as living, not the source of the funds, governs the Division’s authority to attach a lien for reimbursement: The federal anti-lien statute prohibits a lien from being imposed against a Medicaid recipient’s property prior to their death. Under the estate asset statute, the Division was authorized to seek reimbursement against the Estate’s assets for all Medicaid benefits paid on Leonor’s behalf after she turned 55, and it was not limited to reimbursement from recovery for tort-related medical expenses. As a result, the court ruled that the Division’s lien was valid against all the Estate’s assets, including any survivorship action award, under the estate asset statute and affirmed the lower court’s order denying the Estate’s application to extinguish the lien.

This ruling underscores the importance of understanding the components of wrongful death lawsuits and how Medicaid recovery rules apply, especially for families of Medicaid recipients.

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What Is a Survivorship Claim?

A survivorship claim, also known as a survival action, is a legal claim brought by the estate of a deceased person to recover damages the deceased suffered before their death. These damages may include:

• Pain and suffering endured by the deceased due to the injury or negligence that led to their death.
• Medical expenses incurred for treatment of the injury.
• Lost wages or earning capacity if the deceased was unable to work due to the injury.

Unlike a wrongful death claim, which compensates surviving family members for their losses, a survivorship claim seeks to address the harm the deceased experienced. Because these claims belong to the estate, any proceeds are distributed according to the estate’s probate process, making them vulnerable to creditors, including Medicaid liens.

A Wrongful Death Claim Distinguished From a Survival Action

A wrongful death claim, by contrast, is brought by the heirs or beneficiaries of the deceased to recover damages for losses they suffered due to the death. These may include:

• Loss of financial support: Compensation for the income or financial contributions the deceased would have provided to family members.

• Loss of companionship or guidance: Damages for the emotional and relational impact of the loss, such as the absence of a parent’s guidance or a spouse’s companionship.

• Funeral and burial expenses: Costs incurred by the family for the deceased’s funeral.

In many states, wrongful death claim proceeds are not considered estate assets because they belong directly to the heirs, not the deceased’s estate. However, as the New Jersey case illustrates, survivorship claims are treated differently, creating a potential financial risk for estates subject to Medicaid recovery.

Medicaid Liens and Estate Recovery: A Growing Concern

Medicaid, a critical lifeline for many aging adults who require long-term care, is a joint federal and state program that covers nursing home care, home-based care, and other medical services. Federal law requires states to recover certain Medicaid costs from the estates of recipients aged 55 or older after their death, a process known as the Medicaid Estate Recovery Program (MERP). This includes costs for nursing facility services, home and community-based services, and related hospital and prescription drug services. States may also recover additional expenses at their discretion, depending on local laws.

A Medicaid lien is one tool states use to recoup these costs. Liens can be placed on estate assets, including real property (like a home) or monetary assets (like lawsuit proceeds). In the context of survivorship claims, the New Jersey ruling clarified that because these claims are estate assets, they are subject to Medicaid liens. This can result in significant portions of a settlement or award being used to repay Medicaid, potentially leaving little for heirs or other estate beneficiaries.

The size of Medicaid liens can be substantial, especially for recipients who received years of long-term care. For example, monthly Medicaid payments for nursing home care can range from $6,000 to $12,000 or more, accumulating to hundreds of thousands of dollars over time. When a survivorship claim’s proceeds are subject to such a lien, families may find that the financial recovery they expected is drastically reduced.

Implications for Pursuing Wrongful Death Cases

The potential for large Medicaid liens to consume survivorship claim proceeds can discourage families from pursuing wrongful death lawsuits, even when they have a strong case. It may even deter trial attorneys, who work on a contingency fee basis from taking on such cases.  

Here are some key implications:

• Financial Disincentive: If a significant portion of a survivorship claim’s proceeds will go to Medicaid, families may question whether the emotional and financial cost of litigation is worthwhile. This is particularly true for smaller claims, where legal fees and Medicaid recovery could outweigh the net recovery.

• Complexity in Litigation Strategy: Families and their attorneys must carefully structure wrongful death lawsuits to distinguish between survivorship and wrongful death claims. Emphasizing wrongful death damages (which are often exempt from Medicaid liens) over survivorship damages may help preserve more of the recovery for heirs. However, this requires skilled legal counsel familiar with both elder law and personal injury law.

• Impact on Aging in Place Planning: For families planning to age in place, the threat of Medicaid estate recovery can complicate asset protection strategies. For example, a home owned jointly with right of survivorship may bypass probate and avoid Medicaid recovery in some states, but lawsuit proceeds from a survivorship claim do not enjoy the same protection. Families must work with elder law attorneys to anticipate these risks and explore options like trusts or exempt transfers during the Medicaid recipient’s lifetime.

• Emotional and Ethical Considerations: Pursuing a wrongful death lawsuit is often about seeking justice and closure, not just financial compensation. However, the prospect of losing much of the recovery to Medicaid may feel like an additional injustice, discouraging families from holding negligent parties accountable.

Strategies to Mitigate Medicaid Liens

To protect assets and maximize recovery in wrongful death cases, families can consider the following strategies, ideally with the guidance of an elder law attorney:

• Consult an Elder Law Attorney Early: Before applying for Medicaid or pursuing a lawsuit, consult an attorney to understand your state’s Medicaid recovery rules and plan asset protection strategies. For example, transferring assets to a disabled child or setting up a joint bank account with right of survivorship may shield certain assets from recovery.

• Structure Lawsuit Claims Carefully: Work with a personal injury attorney to emphasize wrongful death damages over survivorship damages, as the former are less likely to be subject to Medicaid liens. Ensure that settlement agreements clearly delineate the allocation of proceeds.

• Explore Hardship Waivers: Some states allow heirs to apply for an undue hardship waiver if Medicaid recovery would cause significant financial distress, such as displacing a dependent relative. For example, if a Medicaid recipient’s child provided caregiving and has no other residence, they may qualify for a waiver to protect the home or other assets.

• Use Non-Probate Assets: In states that limit Medicaid recovery to probate assets, titling assets like homes or bank accounts as joint tenants with right of survivorship, or using payable-on-death (POD) or transfer-on-death (TOD) designations, can help assets bypass the estate and avoid liens.

• Consider Medicaid Disenrollment: In cases where Medicaid benefits are minimal, particulalrly on a monthly basis (e.g., limited in-home care), families may consult an attorney about voluntarily disenrolling from Medicaid to avoid a large estate recovery claim later. This decision requires careful analysis of care needs and costs.

Conclusion: Planning Ahead to Protect Your Legacy

The New Jersey case highlights a critical intersection of elder law, Medicaid recovery, and wrongful death litigation. Survivorship claims, as estate assets, are vulnerable to Medicaid liens, which can significantly reduce the financial recovery families expect from a lawsuit. This reality can discourage families from pursuing legitimate claims, impacting both their financial security and their pursuit of justice.

Understanding these risks is essential. By working with an elder law attorney, families can develop strategies to protect assets, navigate Medicaid rules, and structure legal claims to minimize the impact of estate recovery. Proactive planning—whether through exempt transfers, non-probate asset titling, or careful litigation strategies—can help preserve your legacy and ensure that your family’s needs are met, even in the face of complex legal challenges.

If you’re concerned about Medicaid liens or planning for long-term care, contact a qualified elder law attorney in your state to discuss your options. 

PostScript- The Subject No One Wants To Discuss: Impact on Case Value

Before diving into the subject of values of awards and settlements, and how Medicaid Estate Recovery affects these, there is one thing to keep in mind: contingency fees for trial lawyers are usually paid from the gross settlement before satisfaction of any claims or liens.  This means, simply, that your lawyer is not dissuaded, financially, from pursuing a claim simply because a lien or claim against the proceeds exists.  This is very good news. 

The question arises: does Medicaid Resource Recovery potentially impact the more valuable possible recovery?  

Determining whether survivorship claims or wrongful death claims are likely to result in larger judgments depends on the specific circumstances of the case, including the nature of the damages, the evidence presented, and the jurisdiction’s laws. The age and impairment of the injured party, though, play significant roles in shaping the potential value of each type of claim. Below, we explore the factors influencing the size of judgments for each claim type, how age and impairment impact these awards, and practical implications for families navigating these waters.

Survivorship Claims vs. Wrongful Death Claims

Survivorship Claims: Factors Driving Larger Judgments

Survivorship claims are likely to result in larger judgments when the deceased endured significant suffering or incurred substantial costs before death. Key factors include:

• Duration and Severity of Pain and Suffering: If the deceased experienced prolonged or intense pain due to the injury (e.g., weeks or months of suffering from medical malpractice or a severe accident), juries may award significant damages. Pain and suffering awards are often subjective and can be substantial if the evidence is compelling (e.g., medical records or witness testimony).

• Medical Expenses: High medical costs, such as extended hospital stays, surgeries, or specialized care, can increase the claim’s value. For example, a case involving months of ICU care could lead to a large award.

• Lost Earnings: If the deceased was working or had earning capacity before the injury, lost wages from the injury to death can add to the claim. This is less relevant for elderly or fully retired individuals towards judgment amounts in most cases.  

• Evidence of Negligence: Strong evidence of egregious negligence (e.g., a nursing home’s failure to prevent severe bedsores) can lead to higher awards, including punitive damages in some cases.

Wrongful Death Claims: Factors Driving Larger Judgments

Wrongful death claims tend to yield larger judgments when the deceased was a primary financial or emotional provider for their family. Key factors include:

• Economic Dependency: If the deceased provided significant financial support (e.g., a breadwinner supporting a spouse and children), the loss of future earnings or benefits can result in a substantial award. Calculations often consider the deceased’s income, life expectancy, and the duration of dependency (e.g., until children reach adulthood).

• Loss of Companionship or Guidance: Non-economic damages, such as the loss of a parent’s guidance for minor children or a spouse’s companionship, can be significant, especially if the family can demonstrate profound emotional impact. These awards are often higher for younger decedents with long-term familial roles.

• Funeral Expenses: While typically a smaller component, funeral and burial costs can add to the award.

• Jurisdictional Caps: Some states impose caps on non-economic damages (e.g., pain and suffering or loss of companionship), which can limit wrongful death awards. For example, California caps non-economic damages in medical malpractice cases at $500,000 for wrongful death as of 2025 (adjusted for inflation under Medical Injury Compensation Reform Act (MICRA). Cal. Civ Code  § 3333 et seq.

General Trends

Survivorship Claims may yield larger judgments when the deceased suffered extensively before death, particularly if medical costs or pain and suffering were significant. These claims are often stronger in cases of prolonged injury, such as medical malpractice or nursing home neglect, where the deceased endured months of documented suffering.

Wrongful Death Claims often result in larger awards when the deceased was young, employed, or a primary caregiver, as the financial and emotional losses to survivors are greater. These claims are typically more valuable when the deceased had a long life expectancy and significant dependents.

Many cases are include combined claims.  In many wrongful death lawsuits, both survivorship and wrongful death claims are pursued together, maximizing the total recovery. The relative size of each component depends on the case’s facts.

Impact of Age and Impairment

The age and impairment of the injured party significantly influence the potential value of both survivorship and wrongful death claims, as they affect the types and extent of damages.

Younger Deceased: 

• Survivorship Claims: Younger individuals may have smaller survivorship awards if the injury led to a quick death, limiting pain and suffering or medical costs. However, if the injury caused prolonged suffering, awards can still be significant. Lost wages are more relevant for younger, working individuals.

• Wrongful Death Claims: Younger decedents typically lead to larger wrongful death awards because their dependents (e.g., spouse, minor children) face a longer period of lost financial support and companionship. For example, the death of a 40-year-old parent supporting a family could result in millions in lost future earnings, far outweighing a survivorship claim.

Older Deceased: 

• Survivorship Claims: Older individuals, especially those in nursing homes or receiving long-term care, may have stronger survivorship claims if they endured prolonged neglect or malpractice (e.g., untreated infections or falls). Pain and suffering awards can be significant, as elder abuse cases often involve egregious negligence. However, lost wages are rarely a factor for retirees.

• Wrongful Death Claims: Wrongful death awards for older decedents are often smaller because they are less likely to have dependents relying on their income. Loss of companionship damages may still apply (e.g., for a surviving spouse), but these are typically lower than for younger decedents with minor children. Jurisdictional caps on non-economic damages can further limit awards.

Pre-Existing Impairments: 

• Survivorship Claims: If the deceased had significant impairments (e.g., dementia, mobility issues), defendants may argue that their pain and suffering or life expectancy were already limited, potentially reducing awards. However, severe neglect or injury exacerbating these impairments (e.g., untreated pressure ulcers in a bedridden patient) can still lead to substantial pain and suffering damages.

• Wrongful Death Claims: Impairments may reduce wrongful death awards if they limited the deceased’s ability to provide financial support or companionship. For example, if the deceased was fully disabled and not contributing financially, economic damages may be minimal. However, emotional damages for loss of companionship can still be significant, especially for close family members.

Injury-Related Impairments:

• Survivorship Claims: If the injury caused severe impairments before death (e.g., paralysis or cognitive decline from a medical error), pain and suffering damages can be substantial, as the deceased endured significant harm. Medical costs for treating these impairments also increase the claim’s value.

• Wrongful Death Claims: Injury-related impairments may have less direct impact on wrongful death claims, as these focus on the survivors’ losses. However, if the impairment reduced the deceased’s ability to interact with family before death, it could strengthen claims for loss of companionship.

Practical Examples:

• Young, Healthy Deceased: A 35-year-old worker killed in a car accident after a brief hospital stay may have a modest survivorship claim (e.g., $100,000 for pain and suffering and medical costs) but a large wrongful death claim (e.g., $2 million for lost earnings and companionship for a spouse and children).

• Elderly, Impaired Deceased: An 85-year-old nursing home resident with dementia who suffered months of neglect before dying from untreated infections may have a large survivorship claim (e.g., $500,000 for pain and suffering and medical costs) but a smaller wrongful death claim (e.g., $150,000 for a surviving spouse’s loss of companionship).

• Middle-Aged, Disabled Deceased: A 60-year-old with pre-existing mobility issues who died due to medical malpractice after a prolonged ICU stay may have a balanced claim, with a significant survivorship award (e.g., $400,000 for pain and suffering and medical costs) and a moderate wrongful death award (e.g., $300,000 for loss of companionship and limited financial support).

Implications of Medicaid Liens

Survivorship claims are estate assets and thus subject to Medicaid liens, which can be substantial (e.g., hundreds of thousands of dollars for long-term care). This reduces the net recovery for heirs, potentially discouraging families from pursuing these claims, especially if the survivorship component is the primary basis for the lawsuit. Wrongful death claims, often exempt from Medicaid liens, may be more appealing to pursue, as heirs retain more of the proceeds. For elderly or impaired Medicaid recipients, families must weigh the potential award against the lien’s impact, particularly for survivorship claims.

Conclusion

Neither survivorship nor wrongful death claims consistently yield larger judgments; the outcome depends on the case’s facts. Survivorship claims are stronger when the deceased endured prolonged suffering or high medical costs, often seen in elder abuse or malpractice cases involving older, impaired individuals. Wrongful death claims are typically larger for younger, financially active decedents with dependents, due to significant economic and emotional losses. Age and impairment shape these outcomes by affecting life expectancy, earning capacity, and the nature of damages.

For families navigating elder law, the threat of Medicaid liens on survivorship claims can discourage litigation, particularly for elderly Medicaid recipients. Consulting both personal injury and elder law attorneys is crucial to maximize recovery, protect assets, and make informed decisions about pursuing justice.

Original Source: ElderLawAnswers.com, “Survivorship Claims Are Estate Assets Subject to Medicaid Lien.” 

Ohio’s Proposed Property Tax Abolishment: Implications for Aging in Place and Elder Law Planning

On May 9, 2025, Ohio Attorney General Dave Yost certified a proposed constitutional amendment to abolish property taxes by adding Section 14 to Article XII of the Ohio Constitution, as announced by the Ohio Attorney General’s Office. This development marks a significant step in a citizen-led effort to reshape Ohio’s tax landscape, with potential impacts on seniors aiming to age in place. For readers of this Blog, understanding this amendment, its benefits, and the arguments surrounding it is crucial for planning long-term financial stability and maintaining independence at home. This article explores the purpose of the amendment, its potential benefits for Ohio citizens—particularly seniors—and the published arguments for and against this bold proposal.

The Proposed Amendment: Purpose and Process

The proposed amendment, spearheaded by the group Citizens for Property Tax Reform, seeks to eliminate property taxes in Ohio by adding a new section to the state constitution. Property taxes are a primary source of funding for local governments, including schools, public safety, and infrastructure. Abolishing them would fundamentally alter how these services are financed, potentially shifting the burden to other revenue sources like sales or income taxes.

Attorney General Dave Yost’s role in this process was to certify that the petition’s summary is a “fair and truthful representation” of the proposed amendment, a procedural step required under Ohio law. Yost’s certification, announced on May 9, 2025, clears the way for the next phase: review by the Ohio Ballot Board. On May 14, 2025, the board will determine whether the proposal constitutes a single amendment or multiple amendments—a decision that affects how organizers proceed. If approved as a single issue, Citizens for Property Tax Reform can begin collecting signatures. They need 413,487 valid signatures (10% of the votes cast in the last gubernatorial election) to place the amendment on a future ballot, potentially as early as November 2025.

Purpose of the Amendment

The primary purpose of the amendment is to relieve Ohio property owners of the financial burden of property taxes, which have risen sharply in recent years due to increasing home values and inflation. According to a May 11, 2025, article by Cleveland.com, the group behind the amendment, Citizens for Property Tax Reform, argues that property taxes are fundamentally unfair because they tax unrealized wealth. Spokesperson Beth Blackmarr told Cleveland.com: “We’re being taxed on money that we have not realized,” highlighting the strain on homeowners, especially those on fixed incomes like seniors, who may struggle to keep up with rising tax bills while their actual income remains static.

For seniors aiming to age in place, property taxes can be a significant barrier. Many older adults own their homes outright but face financial pressure from annual tax assessments, which can force them to sell their homes and move into more institutional settings, such as assisted living facilities. By abolishing property taxes, the amendment aims to alleviate this burden, allowing homeowners to retain more of their income and assets to cover other expenses like healthcare, home modifications, or in-home care—all critical for aging in place.

Benefits to Ohio Citizens, Especially Seniors

The potential benefits of abolishing property taxes are particularly pronounced for seniors and others on fixed incomes:

1. Financial Relief for Fixed-Income Households: Seniors often rely on Social Security, pensions, or savings, which may not keep pace with rising property tax bills. Eliminating property taxes could save the average Ohio homeowner thousands of dollars annually. For example, the median home value in Ohio as reported by Zillow.com exceeds $238,000.00, making the average property tax bill in Ohio more than $3000.00 per year, according to the Tax Foundation. For a senior couple on a fixed income of $60,000.00 annually, this represents over 5% of their income, for a single widow on a fixed income of $30,000.00, this represents 10% of their—a significant burden.
2. Supporting Aging in Place: The financial relief from abolishing property taxes could enable more seniors to afford home modifications (e.g., installing ramps or stairlifts), in-home caregiving, or other expenses that support independent living. This aligns with the core goal of aging in place: remaining in one’s home safely and comfortably for as long as possible.
3. Protecting Homeownership: Rising property taxes have forced some seniors to sell their homes, often leading to a move to more expensive care facilities. By removing this tax burden, the amendment could help seniors retain their homes, preserving their independence and emotional connection to their communities.
4. Broader Economic Impact: For all Ohio citizens, the amendment could increase disposable income, potentially stimulating local economies as homeowners redirect funds to other expenses or savings. This could indirectly benefit seniors by fostering more robust community services and resources.

Published Arguments Supporting the Amendment

Proponents of the amendment, as reported in various sources, argue that property taxes are an outdated and inequitable system:

• Unfair Taxation on Unrealized Gains: Beth Blackmarr stated in Cleveland.com (May 11, 2025), property taxes penalize homeowners for the rising value of their homes, even if they haven’t sold or realized that value. This is particularly burdensome for seniors who may have lived in their homes for decades and now face tax bills that far exceed their original purchase price.
• Relief for Vulnerable Populations: A May 9, 2025, article by 13abc.com notes that the amendment aims to address the “skyrocketing” homeowner bills driven by inflation and home value increases. Supporters argue that this relief is critical for vulnerable groups on fixed incomes, including seniors, who are disproportionately affected by these rising costs.
• Encouraging Homeownership: Advocates suggest that abolishing property taxes could make Ohio more attractive for homebuyers and long-term residents, potentially stabilizing communities and reducing turnover in neighborhoods—a benefit for seniors who value community ties.

Published Arguments Opposing the Amendment

Opponents of the amendment, while less vocal in the immediate aftermath of Yost’s certification, have raised significant concerns about its broader implications, as noted in related coverage:

• Impact on Local Services: Property taxes are a primary funding source for schools, police, fire departments, and other local services. A May 11, 2025, Cleveland.com editorial references critics who warn that abolishing property taxes could lead to severe budget shortfalls, potentially reducing the quality of public services that seniors rely on, such as emergency response or community programs. For example, in 2023, property taxes accounted for approximately 70% of local school funding in Ohio.
• Shifting the Tax Burden: Critics argue that eliminating property taxes will likely shift the burden to other taxes, such as sales or income taxes, which may disproportionately affect lower-income residents, including some seniors. Sales taxes, for example, are inherently regressive, meaning they take a larger percentage of income from lower earners, potentially offsetting the financial relief for some seniors.
• Uncertainty in Replacement Funding: Opponents note that the amendment does not specify how local governments will replace the lost revenue, creating uncertainty. A Cleveland.com editorial questioned, “What happens to the services that keep our communities safe and functional if property taxes are eliminated without a clear alternative?” This uncertainty could impact seniors who depend on stable local infrastructure to age in place.
• Potential for Increased Rents: While the amendment benefits homeowners, renters—including some seniors—may face higher rents if landlords pass on increased tax burdens (e.g., higher sales or income taxes) to tenants.

Implications for Aging in Place and Elder Law Planning

For seniors and their families, the proposed amendment presents both opportunities and challenges that should inform aging-in-place and elder law strategies:

1. Financial Planning: If the amendment passes, seniors could redirect funds previously spent on property taxes to other priorities, such as home modifications or in-home care. However, families should prepare for potential increases in other taxes by consulting with financial advisors to optimize their budgets.
2. Estate Planning: The abolishment of property taxes could increase the value of owning a home as part of an estate, potentially affecting inheritance planning. Seniors should work with an elder law attorney to update their estate plans, ensuring that their assets are protected and distributed according to their wishes, especially if local tax structures change.
3. Monitoring Local Services: Seniors who rely on local services (e.g., Meals on Wheels, public transportation) should stay informed about how municipalities adapt to the loss of property tax revenue. Advocacy may be necessary to ensure that essential services remain funded and accessible.
4. Contingency Planning: Given the uncertainty around replacement funding, seniors should have contingency plans in place, such as savings or long-term care insurance, to cover potential gaps in services or increased costs in other areas.

Conclusion: A Double-Edged Sword for Aging in Place

The proposed constitutional amendment to abolish property taxes in Ohio, certified by Attorney General Dave Yost on May 9, 2025, offers significant potential benefits for seniors aiming to age in place. By eliminating a major financial burden, the amendment could make it easier for older adults to afford staying in their homes, supporting their independence and quality of life. However, the potential downsides—reduced funding for local services, a shifted tax burden, and uncertainty about replacement revenue—could create new challenges, particularly for seniors who rely on community support to age in place safely.

As the Ohio Ballot Board prepares to review the amendment on May 14, 2025, and organizers gear up to collect signatures, this issue will likely spark robust debate. For now, seniors and their families should stay informed, weigh the pros and cons, and consult with elder law professionals to ensure their aging-in-place plans remain resilient, regardless of the outcome. Whether you support or oppose the amendment, one thing is clear: proactive planning is key to navigating the evolving landscape of aging in Ohio.

For more insights on aging in place and elder law, subscribe to our blog or reach out to an elder law attorney to discuss how this amendment might affect your future.