Simple Will- Complex Problems: Will Drafter Does Not Help In Case of Undue Influence

The problem with a Simple Will is that it is simple.  Simple means quick, easy, and, of course, inexpensive.  But, as with all professional services, one gets what one pays for.

Attorneys typically spend little time crafting or supporting simple and inexpensive documents, meaning that the documents are often not worth the paper that they are written on.  Consider the following case, too, when using self-help document creation like on-line services such as legalzoom, where there may be no attorney involved in preparing and executing a legal document.

A New York trial court recently determined that an incapacitated woman was unduly influenced by her agent under a power of attorney, disregarding the testimony of the attorney who drafted a Will for the woman, because the attorney spent little time with the woman and failed to even determine her knowledge of her estate. Matter of Mitchell (N.Y. Sup. Ct., No. 100163/14, June 3, 2016).

Mary Mitchell appointed Gary Shadoian as her attorney-in-fact under a general power of attorney, and health care proxy.   Mary Mitchell, a municipal employee, was entitled to free legal services under a Legal Plan provided by her employer.   Mary Mitchell may have initiated the process of preparing a Will, but after poor follow-up,  Mr. Shadoian contacted the attorney on Ms. Mitchell's behalf to complete the Will. The attorney had one conversation with Ms. Mitchell over the phone and met her once in person. The attorney allowed Mr. Shadoian to be present when Ms. Mitchell executed her will even though Mr. Shadoian was a beneficiary of the will.

After Ms. Mitchell was repeatedly hospitalized, the court appointed guardians for her. The guardians filed suit against Mr. Shadoian, arguing that he unduly influenced Ms. Mitchell. At the trial, the attorney who drafted the will for Ms. Mitchell testified on behalf of Mr. Shadoian that he did not know Ms. Mitchell was incapacitated, but the attorney admitted that he had not made even simple inquiries about her knowledge of her estate.

Mr. Shadoian testified that he and Ms. Mitchell were not romantic, and not social friends, but as a co-worker, he had over time become her caregiver.  Ms. Mitchell was not close to her sisters or other family members, as they admitted, although they testified against Mr. Shadoian that Ms. Mitchell had never given gifts to anyone, never contributed to or been a member of any social organizations, and was a spendthrift unlikely to give anyone gifts or leave her estate to anyone.  

Mr. Shadoian testified that he would drive to Ms. Mitchell's apartment after work nearly every night, and telephone records reflecting scores of telephone conversations between the two were introduced into evidence. For example, between February 17, 2011 and March 16, 2011, more than 60 telephone calls between the IP and George Shadoian were reflected in cell phone records  He testified regarding the actions and efforts he made on Ms. Mitchell's behalf.  By all accounts, Mr. Shadoian was her most intimate and longest existing contact. Those testifying against Mr. Shadoian suggested that his efforts to involve himself in her life were equally successful in discouraging or preventing others from taking an active interest in her care.

The attorney was Mr. Shadoian's only other witness.

The New York Supreme Court ruled that Mr. Shadoian exercised undue influence over Ms. Mitchell. The court determined that Mr. Shadoian's testimony was not credible, and that the testimony of the attorney that prepared Ms. Mitchell's Will "was too threadbare to carry much weight." The court was critical that the attorney "failed to make even elementary inquiries as to the actual size of the estate, her medical condition, her social and familial history. Contrary to usual practice, he allowed an unrelated person, designated as beneficiary, to orchestrate the completion and execution of the will."

The testimony of the person who should have been able to testify competently and independently regarding Ms. Mills wishes and competency was dismissed.  The free Simple Will was unforceable.  Simple.

Income-Only Trust Upheld Notwithstanding Trustee Power to Purchase Annuity

The Massachusetts Court of Appeals recently ruled that the state Medicaid agency erred when it determined that the assets in an irrevocable income-only trust were countable because, in the agency's opinion, the trustee's ability to purchase an annuity with trust assets allowed the trustee to distribute trust principal to the beneficiary.  Heyn v. Director of the Office of Medicaid (Mass. App. Ct., No. 15-P-166, April 15, 2016).

Everlenna Roche transferred her home into an irrevocable income-only trust in 2003.  In 2011, Ms. Roche moved to a nursing home and began receiving Medicaid benefits.  Two years later, the Office of Medicaid terminated Ms. Roche's benefits after determining that the assets of the trust should be considered a countable resource.  Although the trust allowed the trustee to distribute only trust income, not principal, to Ms. Roche, the Office of Medicaid took the position that the trustee's ability to purchase an annuity with trust funds, in effect, allowed the trustee to distribute to Ms. Roche the principal used to purchase the annuity, rendering the trust countable.

Ms. Roche passed away and her estate appealed the Office of Medicaid's decision, but the appeal was rejected at an administrative level and upon review by the Superior Court.  On appeal to the Appeals Court, Ms. Roche's estate argued that state law prohibited the trustee from changing principal payments from the annuity into income and that the returned principal payments from the annuity were required to be retained in the trust. 

The court agreed with Ms. Roche's estate's claim that state law prohibits an allocation of principal to income that would circumvent the trust's prohibition on principal distributions.   The Court also went out of its way to reject two other alternative arguments even though the trial judge did not rely on them: (1) that the ability of the trustee to distribute principal to Ms. Roche’s children made the trust assets countable, and (2) that Ms. Roche’s power under the terms of the trust to direct a substitution of assets made the trust assets countable.  The Court determined that both arguments lacked support in law or logic, as neither would allow for distribution of principal to Ms. Roche which was the only relevant issue.

The Massachusetts Court of Appeals overturned the Office of Medicaid's decision.  The court wrote that:

"[o]ut of each annuity payment, only the investment income portion would be available for distribution to the grantor from the trust; that portion of each payment representing a return of capital would be required by the trust instrument to be retained in the trust.  The income portion available for distribution in such circumstances would be no different in character than interest earned on a certificate of deposit . . . In all events, the trust principal is preserved in the trust, and is not available for distribution to the grantor under the governing provisions of the trust."

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One in Five SNF Residents Abused By Another Resident

McKnight's reports the results of a new study which reveals that at least one in five seniors living in nursing homes has experienced some sort of resident-on-resident abuse:

Researchers tracked reports of resident-to-resident mistreatment over a one-month period at five urban and five suburban New York nursing homes through resident and staff interviews, observations and incident reports. Of the 2,011 residents included in the study, 407 — or more than 20% — said they had experienced at least one abusive event over the course of the month. The study was released Tuesday in Annals of Internal Medicine [hyperlink added].

The most common forms of resident-on-resident mistreatment were verbal at 9.1% and miscellaneous instances, including invasion of privacy or menacing gestures, at 5.3%. Physical and sexual abuse incidents followed at 5.2% and 0.6%, respectively. 

Factors such as a resident's level of cognitive impairment, whether the residents resided in a dementia unit and higher nurse aide caseload were linked to higher rates of resident-on-resident mistreatment, results showed.

The findings indicate that traditional efforts to curb nursing home abuse may be disproportionately aimed at staff mistreatment instead of resident-on-resident events, researchers noted. 

In an editorial article accompanying the study, XinQi Dong, M.D., Ph.D., with the Rush Institute for Health Aging, pointed out that while further research is needed to develop “evidence-based, culturally appropriate” interventions for resident-on-resident mistreatment, providers and government entities “cannot wait” to advocate for better protections for residents. 

“We must recognize that residents may be both victims and perpetrators of [elder abuse], and avoid blaming victims or resorting to interventions of convenience, such as the use of chemical sedation or physical restraints,” Dong wrote. 

Providers also should look into ways that technology like cameras and data collection can help measure and prevent abuse, Dong added.

Resident on resident abuse has recently made headlines in Kentucky, where a resident of a residential care facility was charged with another resident's murder, in Texas, where a nursing home changed its name in the wake of a resident-on-resident double homicide, in New Hampshire, where a resident suffering from Alzheimer's strangled and killed another during an assault, and in Florida, where a resident died from injuries inflicted by another resident suffering from dementia.  In 2014, a female resident in Georgia strangled and killed her resident roommate, and in 2006, a resident in a Toledo, Ohio, nursing home beat and killed his roommate in a dispute over sleeping arrangements.  

Paramedics Often Obstructed, Provided Insufficient Information On Nursing Home Calls

McKnight's reported recently the results of a new survey which finds that paramedics often receive little direction from nurses or medical records when handling end-of-life situations at nursing homes.  Results published in the Emergency Medical Journal conclude that the lack of direction was heavily associated with a lack of clarity in residents' wishes. Paramedics said records providing residents' end-of-life preferences are uncommon and are typically limited to resuscitation. 

Without proper records, paramedics are forced to make decisions based on perceived preferences when a patient is incapable of making a decision.  Differing opinions on how to handle end-of-life situations also were reported to have contributed to paramedics' uncertainty.

Researchers said several paramedics spoke of situations where nursing staffs attempted to influence the paramedics on whether to hospitalize residents. One paramedic mentioned that once he arranged for a patient to be treated at a nursing home and the “staff were unhappy because it meant they had to provide one-to-one care and actually look after someone dying.”

Another paramedic told researchers of a situation where a relative's opposition contributed to a patient being submitted to the hospital against her wishes.  Differing opinions and directives have lead to several deaths, including a 2015 incident in Minnesota, where an unconscious nursing home resident died after her husband told paramedics not to take her to the hospital. Firefighters attempted to resuscitate the resident, and were about to transport her to the hospital when her husband arrived and requested they stop their efforts. The woman was taken back into the nursing home, where she died 20 minutes later, resulting in a police investigation whether the emergency responders met legal requirements when they stopped trying to resuscitate the resident since she did not have a “do not resuscitate” directive. 

Simple Advanced Directives, such as a Living Will, are not enough for patients who are seriously ill of nearing the end of their lives.  Susan Tolle, director of the Oregon Health and Science University Center for Ethics in Health Care agrees, telling Reuter's Health that “[p]atients nearing the end of their lives who wish to set limits on treatments need to turn preferences into action with orders on a POLST,” or Physician Orders for Life Sustaining Treatment.  This is particularly true in Ohio, where Advanced Directives specifically require physician certification of a patient being either permanently unconscious or terminally ill as those terms are defined under Ohio law, in order to permit withholding or withdrawing life sustaining treatment, including CPR.   

"It's important for all nursing homes to clarify residents' preferences regarding resuscitation and intubation,” The Hastings Center research scholar Nancy Berlinger told Reuters. “Even more important: a facilitated discussion of values and goals that can be transcribed into instructions for every employee.”  “It is owed to the patient, the family and to that aide at three o'clock in the morning. It is owed to the paramedic,” Berlinger added.

The survey was conducted by Georgina Murphy-Jones of the London Ambulance Service NHS Trust and Professor Stephen Timmons of the University of Nottingham.

Care Providers for the Disabled Get Reprieve From New Wage Rule

Disability providers are getting extra leeway as the Obama administration moves forward with a new rule that many worried could force service cuts for people with special needs.

The U.S. Department of Labor said this week that it’s finalizing a rule that will require far more American workers to receive extra pay for working over 40 hours per week.

Currently, salaried workers earning at least $23,660 are exempt from overtime pay. Under the new rule, which will take effect Dec. 1, that threshold will double to $47,476 with automatic increases in the future.

But heeding widespread concerns from providers of home and community based services to people with developmental disabilities, the administration is committing to delay enforcement of the new mandate for such providers through March 17, 2019.  The Labor Department said that the non-enforcement period will apply to providers of Medicaid-funded services to people with intellectual or developmental disabilities in residential homes and facilities with 15 or fewer beds.

The special exemption comes after intense lobbying by the American Network of Community Options and Resources, or ANCOR, a trade group that represents over 1,000 private agencies providing disability services across the country.

The group argued that the new rule could prompt service cuts for people with developmental disabilities, because many of the agencies’ workers would be newly eligible for overtime under the rule.  Medicaid payments, however, which account for the agencies’ main source of income have not adjusted to account for the new wage mandate. 

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