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In today’s episode, I sit down with Lori Sumekh of the New York Elder Law Group to discuss Medicaid home care planning, protecting senior assets, and navigating the financial realities of long-term care. Lori shares how her career evolved from mortgage banking into elder law, and how working on guardianship cases led her to specialize in Medicaid planning.
Throughout our conversation, Lori breaks down complex Medicaid income and asset rules in a way families can understand. She explains how pooled income trusts work, what expenses are allowed (and not allowed), and why planning early can make a significant difference. We also discuss the emotional side of caregiving, the cost of home health aides, inheritance misconceptions, and the importance of using a senior’s resources to enhance their quality of life.
Lori provides practical guidance for families trying to balance protecting assets with ensuring their loved ones receive proper care at home.



🕒 Timeline Summary
00:07 Introduction and Lori’s background.
00:20 – Why professional guidance matters and common mistakes families make alone.
00:35 – Preparing documentation: doctor notes, medical history, and required assessments.
00:51:54 – 24-hour care process overview: vendor coordination, assessments, six-month reviews, care hours, overnight coverage, and follow-up strategies.
00:52:03 – Explanation of Medicaid’s six-month care renewal process.
00:54:51 – Securing 24-hour care, cost comparisons, and value of expert support.
00:55:55 – Typical care setups and long-term care insurance considerations.
00:57:50 – Caregiver workload, qualifications, and professional expectations.
00:58:54 – Private vs. Medicaid-contracted agencies and coordination challenges.
01:02:34 – Step-by-step Medicaid process: eligibility, income trusts, documentation, assessments, approvals, and care initiation.
01:03:21 – Why attempting the process alone can lead to delays and errors.
01:04:54 – Introduction of A Home Guide to Medicaid as a structured resource for families.
01:06:00 Emphasis on Medicaid planning as a specialized field requiring expertise.


5 Key Takeaways

Medicaid Planning Is Strategic: Proper planning allows seniors to qualify for home care benefits while preserving assets legally.
Pooled Income Trusts Are Powerful Tools:
These trusts allow excess income to be redirected toward approved expenses without disqualifying Medicaid eligibility.
Care Costs Add Up Quickly: With home health aides often costing $30–$35+ per hour, early planning is essential.
Quality of Life Comes First: Laurie emphasizes that a senior’s money should support their care, comfort, and dignity—not just inheritance goals.
Transparency Prevents Crisis: Understanding income, assets, and potential estate recovery helps families avoid surprises later.


Links & Resources

Learn about Elder Law, Trust and Estate Attorneys in New York at:

Website:
https://www.nyelderlawgroup.com

Phone Number: 718-740-3300

Location:
Garden City Office
401 Franklin Avenue
Suite 312
Garden City, NY 11530

Learn about Leave The Key Homebuyers Senior Transition Service at:

Phone Number: (631) 837-2898
Website: leavethekey.com/seniors


Final Thoughts
If this conversation with Lori provided clarity around Medicaid and home care planning, please take a moment to subscribe, review, and share this podcast. These conversations help families make informed, proactive decisions rather than reactive ones during times of crisis. Lori’s expertise highlights how strategic planning can protect both assets and peace of mind while ensuring seniors receive the care they deserve.