Understanding Life Care Agreements

Life is a beautiful gift! We get to experience many joyful moments and moments of sadness add to the fullness of life. We gain knowledge and wisdom as we age and pass on our expertise to our loved ones.  However, as we age, we can become forgetful, experience physical ailments, and a deteriorating mental health. There are apparent tell-tale signs when help is needed, such as driving issues, trouble with banking and finances, forgetting medications, multiple falls, and more. For some individuals, assistance in daily living activities may be necessary, or even full-time aid.  In this article, we will talk about personal care and life care agreements.

This blog is for educational purposes only and should not be considered legal advice. The use of the Paths Law Firm website does not constitute a client-lawyer relationship.

What is a life care agreement?

Also called independent care agreements, life care agreements are written contracts stipulating the care given to an elderly person in exchange for compensation.  The two types of life care agreements include personal care agreements and institutional care agreements

What is a Personal Care Agreement?

A personal care agreement, referred to as an elder care contract, personal services agreement, family care contract, caregiver agreement, and several other terms, is a private agreement between an elderly individual and a caregiver. The caregiver can be anyone the senior chooses; however, it is usually a family member or close friend. 

This agreement protects both the care recipient and care provider. This type of agreement also helps family members involved understand all the responsibilities and expectations of the caregiver. A personal care agreement is most often for the life expectancy of the care recipient. These agreements help avoid uncertainties potentially resulting in misunderstandings and disagreements.

Also, they assist in making sure the senior is in compliance with Medicaid in the event long-term care is required through a facility in the future. Having an agreement like this has become essential as the work of caregiving has advanced both legally and socially. Having the caregiver’s responsibilities and expectations in writing will help to keep the family in harmony.

life care agreements

What is an Institutional Care Agreement?

Institutional Care or Continuing care agreements are retirement communities or centers providing seniors with care and broad living choices. Care provided can range from minimal help with independent living, assisted living to full-time care. These communities have various agreements or contracts. There’s generally a significant entrance fee as well as a monthly fee for services. These contracts are also life care agreements because most individuals enter these centers expecting to live out their days there.

What is the value of a life care agreement?

There are a variety of reasons to create a life care agreement. First, most elderly individuals prefer spending their last days at home, and getting into a life care agreement can assist in this endeavor. Additionally, because it’s usually a close friend or family member who gives the care, there’s already a level of intimacy and trust established between the two parties. This agreement defines the boundaries and the type of relationship. Given how there’s payment for services, the arrangement becomes a business arrangement. Lifecare contracts identify payments made to the caregiver are legal business expenses, not just property or a gift of money. 

personal care agreements

What are the components of a life care agreement? 

When drafting a life care agreement, the date services begin must be part of the document. The contract cannot have a retroactive date. Any services administered before the personal care contract is in place cannot be included and therefore not paid. The agreement should provide the length of time services are to be performed. The care recipient may opt for a short-term contract or one lasting the remainder of their life.

The agreement should include detailed descriptions of all services the caregiver is taking on. The list of services should be comprehensive, as well as specific. For example:

  • Preparing food
  • Running errands 
  • Personal care assistance
  • Transportation
  • House cleaning and laundry
  • Companionship
  • Medication management
  • Financial management such as paying bills
institutional care

How much does a life care assistant make?

The amount of compensation a caregiver receives for life care services is dependent on the number of hours worked and the average hourly pay for a care assistant in the area. A reasonable compensation amount for life care assistance is between $12 and $15 per hour, depending on the caregiver’s experience and geographical location. Payment can be daily, weekly, bi-weekly, or monthly. Also, compensation is not limited to money; many contracts include property transfers instead of cash payments.

Clauses to Include in a Life Care Agreement

When creating a life care agreement, it is essential to include specific clauses to protect the parties involved. Below are some examples; however, it is good to work with an experienced elder law attorney to ensure the document is legally sound.

  • Modification Clause: You may want to include a section discussing the terms of altering the agreement. 
  • Termination Clause: Consider including a termination clause if either the elderly care recipient or caregiver is not in terms with the agreement.

How does a Life Care Agreement Impact Medicaid?

A life care agreement can help an older person minimize their assets or income, get care from a loved one, and aid them to qualify for Medicaid-funded nursing home care. What’s more, they help in keeping the financial resources of the family available.

For seniors to qualify for Medicaid, there are asset and income restrictions one will need to pass. These restrictions apply in all 50 states. The income and assets of candidates are required to be under Medicaid’s limits. Medicaid has a 5-year look-back period where they review all transactions the applicant has made. This evaluation occurs once the application is submitted, and the look-back period starts on the application date. If at any time during the 5-year look-back period, the applicant has given cash gifts or transfers assets under market value, it can disqualify them from receiving Medicaid benefits.

If there’s a life care agreement in place, it will indicate the compensation made to family or friends (under market value) for the care given was a reasonable business expense. Thus, one wouldn’t have violated the terms and conditions of Medicaid eligibility.

medicaid and life care

The Pros and cons of a life care agreement

As with any type of agreement, there can be pros and cons. If you decide that a care agreement is the right thing to do for you or your loved ones, it is essential to weigh your options and discuss your plans with an attorney to ensure you are protected.

Pros of a Life Care Agreement 

  1. Flexibility: A life care agreement provides flexibility as needs change to include where the caregiver provides services. The caregiver can provide services in the home of the elderly person or a senior home.
  2. Â Helps Family Members Assist One Another: This type of agreement enables the care recipient to compensate the caregiver for their services. What’s more, there’s a level of comfort and trust that already exists when a family member or close friend provides care.
  3. Legal Spend Down for Medicaid: This contract provides a way to reduce assets or income legally to be eligible for Medicaid. Other than this, it also provides an opportunity to keep those resources inside the family.

Cons of a Life Care Agreement

  1. Can be Vague: If the responsibilities and boundaries are not specific enough in the life care agreement, confusion and misunderstandings may occur.  
  2. Friction between the family member and elderly: Emotions may brew and create issues between the caregiver and senior. For instance, the elderly person may feel the caregiver should render care without reimbursement, or the adult child caregiver may feel they are being coerced.
  3. Can create vulnerability – If the care recipient uses their home as the form of payment to the caregiver, the senior could end up without care or their home if conflicts arise.
agitated elderly woman

In Closing

Aging comes with its fair share of challenges. Understanding life care agreements can mitigate the impact of care as we age. Lifecare agreements can help remove worry and risk for the care recipient. At Paths Elder Law, we have been working with seniors and their families for close to 30 years, helping them protect assets and their future well-being. If you or a loved one needs legal assistance with planning for care or creating a life care agreement, contact Paths Elder Law.  Our caring staff is here to help.

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Community Relations

Jeane M. Fracassa

Community Relations

Jeane M. Fracassa

Jeane Fracassa – a dedicated and accomplished professional who retired with an impressive 38-year service record from the Kansas City Missouri Police Department. Throughout her illustrious career, Jeane served as a Civian Supervisor in the Communications Unit, where she played a pivotal role in ensuring efficient and effective communication within the department.

Even in retirement, Jeane’s commitment to community service remains unwavering. Currently, she serves in various capacities within Community Relations at Paths Law Firm. Actively engaged in the Lee’s Summit and Overland Park communities, she proudly represents the law firm.

In all aspects of her life, Jeane Fracassa exemplifies the values of community, compassion, and family. Her commitment to making a difference and her love for exploration make her a remarkable individual, whose presence brightens the lives of those she encounters. Whether at work, with family, or during her travels, Jeane’s genuine care for others and her zest for life make her a truly remarkable and inspiring person.

Administrative Assistant

Laura E. Messer

Administrative Assistant

Laura E. Messer

Laura is the Law Firm’s marketing assistant, supporting all marketing tasks, including managing calendars, researching upcoming events, updating marketing software and spreadsheets, and partnering with organizations to maintain relationships that benefit Paths Law Firm’s clients.  Laura is also the law firm’s professional photographer as she provides the professional photographs for the headshots, organizations, events, and networking.

Laura has over 10 years of experience as a professional photographer.  She is also Adobe and Microsoft Certified.  She graduated from Columbia College, Columbia, Missouri with her Bachelor of Arts degree, Magna Cum Laude, in Behavioral Psychology (minors in Social Work and Criminal Justice), and her Photographic Craftsman degree from Professional Photographers of America. She is certified as a Qualified Mental Health Professional, Certified Gentle Teacher, Medicaid Billing Certified, Crisis Intervention Counselor, and a Missouri Notary.

Laura has been married more than 26 years and has a daughter and a son. She has four brothers, a niece, and a nephew. Her four spoiled pets that love her attention. A lot of Laura’s off time is spent taking photos and she is an internationally published photographer. Laura owns a studio on the historic Independence Square. 

Administrative Assistant

Holly D. Bramble

Administrative Assistant

Holly D. Bramble

Holly is our newest member of the administrative team. She is hardworking, has proven organizational skills and excellent communication skills. Holly has transitioned to the Estate Planning field from healthcare administration where she gained valuable knowledge that has contributed to her success here at Paths.

Holly enjoys spending time with loved ones, cheering for the Chiefs, and relaxing on the beach.

Administrative Assistant

Tressa L. Purdy

Administrative Assistant

Tressa L. Purdy

Tressa has the important role of being a client’s initial point of contact as the law firm’s receptionist for all locations.  She also welcomes, assists, and cares for clients at the Lee’s Summit office. Additionally, she provides support in an administrative capacity for the attorneys, staff, and clients.  When you meet Tressa, the first quality many note is her readiness to be of assistance.

 

Tressa is a graduate of Park Hill High School with extensive administrative experience and executive level management. Tressa brings a stability and comfort to the law firm experience having worked in a variety of industries and having lived in six different major metropolitan cities.

 

Tressa has a daughter, two sons, and one grandchild.  In her free time, she enjoys her family and friends, loves being outdoors, gardening, bike riding and bird watching. Indoor hobbies include scrapbooking, painting cookies, and cheering on Chiefs football. She is a Kansas City native but enjoys traveling but is always happy to be back in her hometown.  

Attorney

Kathleen E. Overton

Attorney

Kathleen E. Overton

Kathleen Overton is an attorney and owner at Paths Law Firm. She has more than 17 years of experience advocating for those with special needs and navigating the state and federal agencies formed to help the disabled and elderly. At Paths Law Firm, Kathleen’s practice focuses on helping the elderly qualify for nursing home Medicaid, creating estate plans to protect beneficiaries, as well as a lot of time planning and forming businesses. Kathleen also enjoys helping clients form non-profit organizations and obtain 501(c)(3) tax exempt status.

 

After attending law school at the University of Oklahoma, Kathleen began representing clients before the Social Security Administration. Eventually her practice switched to federal court appeals and Kathleen spent years representing clients before the Eastern and Western District of Missouri, the District of Kansas, and the Eighth Circuit Court of Appeals. Kathleen has since focused her practice on estate planning and elder law after watching clients struggle to find ways to financially care for loved ones with special needs or aging parents.

 

Kathleen lives in the Northland with her husband and four children. She spends her free time attending soccer matches and ballet performances with her children and starting endless home improvement projects with her husband. 

Medicaid paralegal

Tena K. Dooley

Medicaid Paralegal

Tena K. Dooley

Tena is a Medicaid Paralegal.  She is very meticulous and organized.  She works closely with the attorneys, clients, and State representatives. 

Tena has an associate in applied science and has over 20 years of office management experience. She has two daughters and one grandson.

Tena enjoys spending time with her family.  She enjoys everything outdoors and her hobbies include fishing and gardening.

PARALEGAL & ACCOUNTANT

Sydney R. Morris

PARALEGAL & ACCOUNTANT

Sydney R. Morris

Sydney is the law firm’s internal accountant and one of their experienced paralegals having been with Paths Law Firm since 2017. She is a primary point of contact for estate planning and business planning.

Sydney graduated with honors from the University of Missouri Kansas City in 2022 with her Bachelor of Science Degree in Accounting. She is a Bloch Launchpad, Phi Theta Kappa, and National Honor Society alumni.

In her free time, Sydney enjoys spending time with her husband, reading, baking and going on long walks. 

SENIOR ADMINISTRATIVE ASSISTANT

Christy L. Phillips

SENIOR ADMINISTRATIVE ASSISTANT

Christy L. Phillips

Christy has three years of experience in elder law working for seniors and their families. She is currently the Senior Administrative Assistant and organizes the day to day functions of the office and makes sure everything runs smoothly. When asked why she loved what she does, Christy said at Paths Law Firm, she gets the opportunity to help clients in more ways than one. Her favorite parts of the job are getting to know the clients and helping them get their questions answered. 

Christy’s experience in the finance industry has been extremely beneficial to her role as the Senior Administrative Assistant. Christy has a special place in her heart for the elderly and attributes this to the relationship she had with her grandparents. 

Christy was raised in Ogden, Utah and moved to Independence, MO, when she was ten years old. She has been with her high school sweetheart for 25 years and they have two beautiful children together. Her daughter works in the medical industry, and her son currently attends High School and plays Baseball. When Christy is not working, she enjoys crafting and spending time with her family and friends.

Christy’s experience in the finance industry has been extremely beneficial to her role as Benefits Coordinator. There have been many influences that went into her decision to select the field of Elder Law. Christy has a special place in her heart for the elderly and attributes this to her relationship with her grandparents.

When asked why she loves what she does, Christy said that at Paths Elder law, she gets the opportunity to help clients in more ways than one. Her favorite part of her job is getting clients approved for Medicaid or VA benefits as it is a huge relief for them and their loved ones.

Christy was raised in Ogden, Utah, and moved to Independence, MO, when she was ten years old. She has two children that keep her busy and fill her life with joy! Christy’s daughter cheers for Avila University, and her son plays competitive baseball for the Bucks and races BMX locally for the Motorcycle Closeout Team.

When Christy is not working, she enjoys crafting and making homemade gifts for her loved ones and raising her kids to be healthy, happy, and positive humans.

 

Practice Areas

  • Medicaid Benefits
  • VA Benefits

 

Professionalc Memberships and Affiliations

  • Missouri Notary

FINANCIAL MANAGER

René A. Fracassa

Rene A. Fracassa, Paths Law

FINANCIAL MANAGER

René A. Fracassa

René is the Financial Manager at Paths Law Firm overseeing all aspects of revenue, expenses, and financial planning. She is also responsible for general office management, including assisting in many of the administrative matters that periodically arise. 

 

René earned her Bachelor of Science in Hotel and Restaurant Management from Central Missouri State University in Warrensburg, Missouri and soon thereafter worked her way through management at The American Restaurant where she worked almost 17 years before relocating to the country of China.

 

René is the Financial Manager at Paths Law Firm overseeing all aspects of revenue, expenses, and financial planning. She is also responsible for general office management, including assisting in many of the administrative matters that periodically arise. 

 

René earned her Bachelor of Science in Hotel and Restaurant Management from Central Missouri State University in Warrensburg, Missouri and soon thereafter worked her way through management at The American Restaurant where she worked almost 17 years before relocating to the country of China.

 

René is the Financial Manager at Paths Law Firm overseeing all aspects of revenue, expenses, and financial planning. She is also responsible for general office management, including assisting in many of the administrative matters that periodically arise. 

 

René earned her Bachelor of Science in Hotel and Restaurant Management from Central Missouri State University in Warrensburg, Missouri and soon thereafter worked her way through management at The American Restaurant where she worked almost 17 years before relocating to the country of China.

 

René is the Financial Manager at Paths Law Firm overseeing all aspects of revenue, expenses, and financial planning. She is also responsible for general office management, including assisting in many of the administrative matters that periodically arise. 

 

René earned her Bachelor of Science in Hotel and Restaurant Management from Central Missouri State University in Warrensburg, Missouri and soon thereafter worked her way through management at The American Restaurant where she worked almost 17 years before relocating to the country of China.

 

In her spare time, René is currently quite active managing multiple generations of her family, including parents and grandkids.  René has had great impact on the lives of many women teaching discipling and teaching and abundance of Bible Studies. Her former career in management and event planning trained her well to juggle all the activity.

MARKETING MANAGER

Hilary R. Tichota

MARKETING MANAGER

Hilary R. Tichota

Hilary plays a vital role in managing the Marketing Department at Paths Law Firm.  She is excellent at bringing new ideas and sharing valuable resources with the law firm and our community. Hilary has been with the law firm since the beginning, working in nearly every role which is invaluable in her marketing endeavors as she brings a unique set of skills into the Marketing Department.

Hilary is nearly complete in her Bachelor’s of Arts Degree in Marketing at Park University.  She has earned the honor of being listed in National Honors Society, Phi Theta Kappa, and the Dean’s List. Hilary is always looking for new and innovative ways to share the law firm’s message.

While not working, Hilary spends her time with her family at their rural home. They tend to their chickens and honeybees and enjoy the solitude of country living.

SR. PARALEGAL & OPERATIONS MANAGER

Jennifer A. Bronson

SR. PARALEGAL & OPERATIONS MANAGER

Jennifer

Jennifer is the Sr. Paralegal and Operations Manager at Paths Law Firm.  She oversees the firm’s probate department as well developing, implementing, and managing all the firm’s administrative processes having been with the law firm almost from the beginning.  She enjoys client contact as well as behind-the-scenes operations.

 

Jennifer began her legal career in 1990 as a legal secretary.  She has worked in small and medium sized firms, as well as court operations.  She has her Paralegal Certificate from Boston University, Law Office Management Certificate from University of Central Missouri, and she is a Master Financial Coach. 

 

Jennifer has two daughters, twin sons, and twin grandsons.  She spends as much time as she can with them.  She enjoys reading, listening to podcasts, and tending her yard. 

ATTORNEY

Russell A. Fracassa (Rusty)

ATTORNEY

Russell A. Fracassa (Rusty)

When asked what he wants to do, his reply was “I just want to sit at the kitchen table and work directly with people.” Rusty enjoys working with clients providing experienced advocacy and supporting them through their unfamiliar and overwhelming situations. Due to all the challenges faced by seniors, it is essential to work with an experienced elder law attorney who has expertise in the law, issues, and concerns affecting seniors and their families.

Rusty brings more than 30 years legal experience and expertise working for seniors and their families as an elder law attorney in Kansas City and surrounding. Prior to law school, Rusty was an accountant and his first couple years practicing law was as a tax attorney. This provides invaluable experience in his current practice of law. Rusty’s focus is helping protect seniors’ assets from taxes and long-term care costs, benefit qualification, and navigating more complex family scenarios in their estate planning.

Rusty has personally experienced the loss every parent fears, caring for a spouse suffering with cancer and the treatment, and working with aging parents through all stages of their lives.  He intimately understands the challenges faced by individuals and their caretakers when capacity or health declines, how to prepare for it, and the legal matters while in the midst of it.  He may not be able to eliminate his client’s grief, but he strives to provide clients with peace of mind.

In 2010, Rusty’s faith and love led him and part of his family to China as Christian missionaries. He and his wife, went permanently, but ended up dedicating 3 years to that ministry. They returned to Missouri to help with grandchildren after a family tragedy and later began anew with Paths Elder Law. The goal is providing compassionate care through legal advocacy.

Rusty has multiple degrees and advanced study spanning his Bachelor’s of Arts in Business Administration – Accounting at Rockhurst College (now Rockhurst University), Masters of Arts in Accounting and in Intercultural Studies, as well as his Juris Doctorate from the University of Missouri at Kansas City School of Law.

When Rusty is not practicing law, he enjoys spending time with his family, grandchildren, and excessive eating at local restaurants.

Practice Areas

  • Wills and Trusts
  • Estate Planning
  • Asset Protection
  • Medicaid Benefits
  • VA Benefits
  • Probate
  • Guardianship and Conservatorships
  • Education

 

BSBA and Master’s in Accounting, Master’s in Inter-Cultural Studies, and Doctorate in Juris Prudence

  • Rockhurst University
  • Liberty University
  • University of Missouri – Kansas City


Admissions to Practice

  • Missouri


Professional Memberships and Affiliations

  • State Bar of Missouri
  • National Academy of Elder Law Attorneys (long-time Member)
  • Elder Counsel (Charter and Ongoing Member)
  • Missouri Association of Trial Attorneys (Past Member)
  • Kansas City Metropolitan Bar Association
  • Missouri State Bar Committees – Elder Law, Estate Planning, Probate