Question: My mother was admitted to a Medicare-Medicaid certified nursing facility last October after suffering a stroke. After her Medicare ran out, we applied for Medicaid, and she was approved. She developed other medical problems which required a five day rehospitalization last month. When the doctor said she was ready to go back to the facility, we were told by the nursing home that her bed had been filled and we would have to find another place for her. Not knowing any better, we picked up her belongings and took her home which we now find was a mistake since our father, age 80, is not able to care for her, I work, and we can not afford sitters. Is there anything we can do?

Answer: The Nursing Home Reform Act about which we talk so much provides residents who qualify for Medicaid benefits -- but not Medicare -- with what is called “Bed Hold and Readmission” rights. In other words, Medicaid – but not Medicare – residents who leave the facility for hospitalization or therapeutic reasons have the right to return. This means that the nursing home must hold the bed for a certain period of time and, if the absence exceeds the bed hold period and the resident still requires skilled or intermediate nursing services, he or she is entitled to the first available bed in a semi-private room at the facility.

Here, five days in the hospital does not exceed the bed hold period. At the time of admission, bed hold policies should have been explained to you and provided to you in writing. And, before your mother was discharged from the hospital, you should have been told about this right by the discharge planner, especially since the doctor ordered continued nursing home care. By taking your mother home voluntarily, you have probably relinquished her bed at the facility; however, we believe that the denial of these rights by the facility is sufficiently egregious to justify you asking your state ombudsman and licensing agency to investigate.

You also may wish to contact an elder law attorney to see if you have any options in your state. While we understand that the admission process may seem complicated at a very emotional time, families must take the time to read and understand their rights.

Question: To our surprise, my wife and I have joint assets of more than $1.7 million dollars, mostly due to the stock market surge. We are in our early 70’s, have two grown children, and, for the first time, have begun to think about estate planning. Our wills, which were prepared in the 1980’s, leave everything to the survivor. We went to a lawyer whose explanation was like hearing a foreign language. We want to avoid estate taxes, but we seem to be missing something. Is there a simple solution that will help us?

Answer: If you leave your wills as is, due to the unlimited marital deduction, there will be no estate tax due when the first of your dies; however, when the survivor dies, there could be a substantial tax due because your current wills do not allow either of you to take advantage of the unified credit. The unified credit allows each of you to leave a specific amount to your heirs without estate tax consequences. This year, the unified credit is $675,000, and it is scheduled to increase to $700,000 in 2002, $850,000 in 2004, $950,000 in 2005, and $1,000,000 in 2006. By equalizing ownership of your assets and using wills with credit shelter trusts, you should be able to avoid most of the tax that would otherwise be due at the second death. Be sure to see a lawyer who is trained in these areas and who can provide you with a complete plan including projected tax savings.

CORRECTION: We apologize for inadvertently printing the wrong area code for the National Association of Professional Geriatric Care Managers. The correct area code and number is 520-881-8008. And although the association does not make referrals, you can seek out a geriatric care manager in your area on the Internet at www.caregiver.org. Again, we apologize for the error.