Susan Geffen

Susan B Geffen

- Elder Law Attorney
- Gerontologist, Master's USC
- Former Elder Law Professor


I would recommend Susan Geffen to anyone seeking guidance on elder care and law/financial issues. I told Susan when we first met that my father was....
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Susan Blog

Veterans Aid and Attendance Scams


This week I met with two families (adult children) who were extremely concerned about their parents running out of money to pay for the care (this does not count the third call that I received).


These were not children who were concerned about their inheritance. Coincidentally, the parents involved in both families were entitled to the Veteran’s Aid and Attendance benefit which exists to offset the cost of care with a monthly stipend.


Both families were told by a certain organization that did at seminar at a local assisted living facility to put their money into an annuity to hide their assets. In both cases, it was only one spouse who needed care.


This idea of having your money put into a VA qualifying annuity really bothers me. It is irresponsible and a huge money maker for the insurance salesman who lands such a deal.


Why is it irresponsible?


It is irresponsible because anything that an individual does with their money can impact their ability to get Medi-Cal should that type of long term care be necessary. These salesmen do not have any understanding of a person’s physical or cognitive functioning, their life’s goals, what environment would better suit the person whose money they are locking up, etc.
Additionally, a VA qualifying annuity will not pass muster for overcoming the look back period for Medi-Cal. That application specifically asks if the applicant has transferred assets during the last thirty months to qualify for Medi-Cal.



Placing funds in a VA qualifying annuity will be considered a non-qualifying transfer for purposes of getting Medi-Cal benefits. There are Medi-Cal annuities, but they are very difficult to come by.



Moreover, what if the well spouse needs money? The cost of taking that money out of such an annuity will be prohibitively expensive. Suffice it to say, I have helped countless families obtain these benefits (last week I won a Medi-Cal Appeal and got an award for a client retroactive to January), without sacrificing the at home spouse or my ethics.



The VA allows a veteran (or the widowed spouse) to do almost anything he or chooses to avail themselves of this benefit. And why not? Our Veterans –you, your father, your brother, your uncle, risked their lives for us.
On the same note of buyer beware is the “estate planning workshop.” These are trust mills. I see this ad in my local newspaper all the time. Living Trusts for an unbelievably low price… like $400.



Should you choose to go in this direction, you will get a living trust. This document without all of the bells and whistles such as a certification of trust, pour-over will, durable power of attorney, advance health care directive, deed transfer, review of your assets, binder, notarization of all documents is like having a dental hygienist clean your teeth by having you gargle and spit.
If you do not believe me, click onto some of the links below and read some of these articles on the topic!

Also, check out what the State of California Department of Justice has to say about trust mills.

If you have kids and assets, you probably need a Living Trust Estate Plan

Individuals who want to get their affairs together seek out an estate planning attorney who creates either a will or a trust.  If you don’t know if you need an estate plan, ask yourself this questionDo you want the State of California to seize your property and distribute according to its whim?


If you die without a will (known as “intestate”), the state, and not you, will decide how your property is to be distributed. Come on, are you really going to leave that decision to “The Terminator?”


If you have not done an estate plan and you love your children, they will have to endure a relatively burdensome and costly legal process upon your death in order to “inherit” from you, their mom or dad.


The upshot is that an estate plan can save your estate thousands of dollars and endless hours of time. Many people do not realize that the probate process takes an average of three years to complete. During this time assets depreciate in value while attorney fees escalate. Basically, for every $100,000 in assets, the probate process will take $4000.00 of your estate’s money.


Estate planning is important regardless of your age, income, assets or health. Many people procrastinate about planning for the distribution of assets in the event of their death.


Some people feel they don’t have enough money or personal belongings to justify executing an estate plan. Others think they are too young or in too good of health to start planning for their death. However, estate planning involves more than deciding who you want to inherit your belongings when you die.


If you have young children, do you want the State of California to decide with whom your children should reside should something happen to you and your spouse? When my husband and I traveled to Thailand without our children, we established a family trust. For us deciding who would care for our children was an agonizing process, but we could breathe easy. Well, not in Bangkok as you can see the air and cut it with a knife in that city.


If you are older, and you do not have an estate plan, then you are at risks of not only having your property disbursed amongst people thrice removed (yes, this is a real term), you risk having a conservatorship imposed upon you. Yes, that is right. Why? Because if you become demented or get Alzheimer’s disease and are making decisions that are harmful to you, Adult Protective Services or your children can petition the court for a third party conservator to take over your medical and financial affairs.


Within a trust document you have the ability to dictate who can make decisions about you should you lose your capacity to do so yourself and you can name, in advance who you choose to be a conservator over yourself or your estate.


When an estate plan is being contemplated, it is important to address the needs of an individual and family across time and settings. This process is enhanced by utilizing a professional who understands the familial conflicts that present themselves as a person ages and the adult children’s roles in their lives become more involved.


Geriatric care managementrepresents a specialization focus in aging issues. As a lawyer with a master’s degree in gerontology, I recognize the interest of individuals to be able to age in place using community and private based resources and services such as Veteran’s Benefits, Medicaid and Medicare. However, the delivery system is fragmented, and there are many limitations on eligibility requirements for entitlement programs.


The GCM’s role is to assure an optimal plan of care for elderly clients in the least restrictive environment. This requires a care plan to assure quality of care for the recipient of services consistent with personal values, wishes, and preferences.


A gerontologist understands the differences between all of the long term care options along the spectrum such as in home care, assisted living, continuing care retirement community, board and care, skilled nursing, hospice and the like.


When wine is paired with chocolate, it is best to visit an establishment that understands not only that chocolate pairs well with wine, but that also understands that wines have many different tannins, flavors and costs.


When you need to plan for your future, it is best to seek out an attorney who implicitly understands the different facet of the aging process, is able to forecast your needs into the future, and who can bring otherwise divided families to consensus.

Susan Outside


If you have not done an estate plan yet, call or email me and I will let you know if you are a good candidate for one. You can reach me at 310-897-7434 and my email is I have offices in Orange County and Los Angeles County.

Do you have to take care of your parents?



What happens if they need of long term care but cannot pay for it? Currently 28 states (listed at the end of this article) have laws which can make adult children financially responsible for their parents’ necessities of life.


Typically this happens when the parents do not have the means to pay for such necessities.


These laws are referred to as “filial responsibility laws” and have been used by nursing homes and other long term care facilities located in the states that recognize them as a means to seek reimbursement for unpaid bills.


Sixteen of these states impose civil penalties – they can come after your assets or income if you fail to support your parents.


In the eight states where filial responsibility entails criminal penalties, a prosecutor could actually put you in jail. Four states take both approaches.


In Massachusetts, for instance, someone who “unreasonably neglects” to support a parent who is destitute or too infirm to maintain himself could face up to a year in prison plus a $200 fine.


But filial responsibility laws are very rarely enforced; 11 of the 28 states that have them have never used them. I have never seen any adult child get in hot water either civilly or criminally here in California.


However, a recent case in Pennsylvania may indicate a new trend which could influence how other states proceed. In Health Care & Retirement Corporation of America v. Pittas(Pa. Super.Ct., No. 536 EDA 2011, May 7, 2012), the Pennsylvania Superior Court upheld a lower court decision which made the adult son of a woman who had received skilled nursing care and treatment at a Pennsylvania facility for a period of six months liable for the $93,000 bill.



The court concluded that the state did not have the duty to consider the woman’s other possible sources of payment, including a husband and two other adult children, or the fact that an application for Medicaid assistance was still pending. Instead, since the facility had adequately met its burden of proof that this particular son had the means to pay the $93,000 bill, the trial court was correct in holding the son responsible for paying it.


I personally do not believe that this is the right result. The rationale, which you can trace back as far as ancient Roman law, is that children have a duty to care for parents. The law sees this as a matter of ethics and reciprocity: Your parents took care of you as children; now it’s your turn to take care of them. The Pennsylvania case and the potential reverberations demonstrate how important it is to plan for your long term care needs.


Most parents do not want to be a burden to their children. For a court to impose that burden is downright scary to me.  Without proper planning and legal advice from an experienced elder law attorney, children may very well be on the hook for thousands of dollars of care required by their aging parents.


At least there are some legal defenses. What if you will be impoverished if you were forced to foot the bill for your parent’s care. Statutes commonly make exceptions for a child who can’t afford to maintain a parent, such that enforcing the law simply impoverishes the child. What if you were abandoned or abused as a child? In such a case, there’s no reciprocal duty for the grown child to support the parent.


For an in depth look at the history of filial responsibility laws and a chart which lists the current state statutes, see Filial Support Laws in the Modern Era: Domestic and International Comparison of Enforcement Practices for Laws Requiring Adult Children to Support Indigent Parents, by Dickinson Law Professor Katherine C. Pearson. Note that the article can be downloaded for free.


(Alaska, Arkansas, California, Connecticut, Delaware, Georgia, Idaho, Indiana, Kentucky, Louisiana, Maryland, Massachusetts, Mississippi, Montana, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oregon, Pennsylvania, Rhode Island, South Dakota, Tennessee, Utah, Vermont, Virginia and West Virginia)



Why I Wrote “Take that nursing home and shove it!”

I am an elder law attorney and gerontologist.

Many ask why I chose to write a book that picks on the nursing home industry. Many have suggested that I am committing career suicide by choosing to go down this path because the nursing home lobby is very large and powerful. I am leaving myself vulnerable to attacks from many stakeholders. Yet, for me it was a no brainer.

Why? Because a significant portion of us soon-to-be-older adults will end up in nursing homes if we don’t start to formulate our plans. They are not the best place for you or me. This book will help you stay out of a nursing home or choose the right one, should that be your only option.

I want people to understand that the term “nursing home” is an oxymoron. Nursing homes smell bad. Does your home smell like sick people and Fabuloso, the dollar store disinfectant?

Nursing homes look like a hybrid of high school and the hospital. I could not wait to escape from the former as it was terribly boring and oppressed my freedom to engage in the most basic of rights (such as going to the bathroom without first raising my hand); I never want to be in the latter.

© Copyright 2019, Susan B Geffen, All Rights Reserved.