Dave NesbitSchedule Consultation
My interest in Elder Law was not ignited in law school, which I attended in the evening as a middle-aged real estate developer, but when my parents and in-laws’ physical and mental health began to decline suddenly, Elder Law issues became real and personal. My wife, Marcia, and I were the primary caregivers for our four elder parents, who collectively needed nearly constant attention over an eight year period. We experienced the systemic hell that occurs when the elder and their families are confused by the conflicting interests of hospitals, CCRCs, hospices, individual medical professionals, and the emotional needs of other family members.
After the passing of our parents, I began seeking “a better way” to serve my community with a service that would maximize the quality of independent living for elders and reduce the pain of transitioning to alternative care arrangements when needed to assist with activities of daily living. Much research led to the model of the Life Care Planning Law Firms Association, which Keystone Elder Law P.C. has adopted. Our team of experienced Elder Law Professionals shares a profound commitment to this service.
Prior to becoming a principal of Keystone Elder Law P.C., I was an executive of a private corporation and a real estate broker-developer who completed transactions worth hundreds of millions of dollars over three decades in twelve states. I served as a national chair of the Office Condominium Forum and the Private Developers Forum of the National Association of Office and Industrial Properties (NAIOP), and president of the Greater Harrisburg Association of Realtors Industrial, Commercial and Investment Council. I am a former school board member and administrator of federal and state grants on a local level. I received a Bachelor of Arts degree from Wake Forest University, a Master of Public Administration degree from Penn State University, and a Juris Doctor degree from Widener University School of Law, where I also received the American Jurispudence Award for Real Estate Transactions and Education. I retain a Pennsylvania real estate broker’s license and am a “Certified Commercial Investment Member (CCIM)” of the Commercial Investment Real Estate Institute. I believe in continuing professional education and have hundreds of hours of training in real estate, law, management, mediation, and leadership.
I am thrilled and professionally rejuvenated to have the opportunity to organize and be part of a team of experienced and mature professionals who believe that Life Care Planning is a fresh approach to serve elders and their families effectively. We are able to stay on top of the latest changes in law and resources of elder care through active membership with a number of national organizations including the Life Care Family Planning Law Firms Association, the National Academy of Elder Law Attorneys, and Elder Counsel. Although I wish that my parents and in-laws could have benefited from having such a Life Care Planning service available to them, my wife and I feel blessed to have the opportunity to initiate the service in Central Pennsylvania.
Back to Our Mission
Power of Attorney
A Power of Attorney can be used to give another person the right to sell a car, home, or other property in the place of the maker of the Power of Attorney. A Power of Attorney might be used to allow another person to sign a contract for the maker of the Power of Attorney (the person who makes a power of attorney is called the “principal”). It can be used to give another person the authority to make health care decisions, do financial transactions, or sign legal documents that the principal cannot do for one reason or another. With few exceptions, Powers of Attorney can give others the right to do any legal acts that the makers of the Powers of Attorney could do them themselves. A General Power of Attorney gives the “power of attorney Agent” or simply “Agent” (the legal name of the person who is authorized to act for the principal) very broad powers to do almost every legal act that the principal can do. When Elder Law Attorneys draft general Powers of Attorney, they still list the types of things the Agent can do but these powers are very broad. People often do general Powers of Attorney to plan ahead for the day when they may not be able to take care of things themselves. By doing the General Power of Attorney, they designate someone who can do these things for them.
Normal Powers of Attorney terminate if and when the principal becomes incompetent. Yet many people do Powers of Attorney for the sole purpose of designating someone else to act for them if they cannot act for themselves. It is precisely when persons can no longer do for themselves that a Power of Attorney is most valuable. To remedy this inconsistency, the law created a Durable Power of Attorney that remains effective even if a person becomes incompetent. The only thing that distinguishes a Durable Power of Attorney from a regular Power of Attorney is special wording that states that the power survives the principal’s incapacity. Even a Durable Power of Attorney, however, may be terminated under certain circumstances if court proceedings are filed. Most Powers of Attorney done today are durable.
Yes. At the time the Power of Attorney is signed, the principal must be capable of understanding the document. Although a Power of Attorney is still valid if and when a person becomes incompetent, the principal must understand what he or she is signing at the moment of execution. That means a person can be suffering from dementia or Alzheimer’s Disease or be otherwise incompetent sometimes but as long as they have a lucid moment and are competent at the moment they sign the Power of Attorney, it is valid even if they do not remember signing it at a later date. At the time it is signed, the principal must know what the Power of Attorney does, whom they are giving the Power of Attorney to, and what property may be affected by the Power of Attorney.
Any competent person eighteen years of age and older can serve as an agent. Certain financial institutions can also serve. There is no course of education that agent must complete or any test that Agent must pass. Because a Power of Attorney is such a potentially powerful document, agents should be chosen for reliability and trustworthiness. In the wrong hands, a Power of Attorney can be a license to steal. It can be a big responsibility to serve as an agent.
Medicare is health insurance and covers medical services such as physician appointments, therapy, blood tests, x rays, medical procedures and hospitalization. Medicare will sometime pay for rehabilitation in a long-term care facility for a period of 20 to 100 days, but not longer. In long-term care, Medicaid covers the cost of ongoing support services for daily functioning, such as room and board in a nursing home.
Medicaid is a federal program that is overseen by the Center for Medicare and Medicaid Services (CMS). In Pennsylvania, Medicaid is called Medical Assistance and is administered by the Department of Human Services (DHS).
In Pennsylvania, Medicaid funds are not available to pay for assisted living or personal care.
For Medicaid to pay for care in a nursing home, an individual recipient must be determined to need a nursing home level of care by a physician and the local Office of Aging. An individual whose income is not greater than three times the poverty level may keep up to $8,000 of total resources, but may otherwise keep only $2,400. The cash value of life insurance counts as a resource, but one car and a residential home does not count as a resource.
Empowering Clients with Holistic Planning at
Keystone Elder Law
At Keystone Elder Law, we believe that the physical, social, legal, and financial considerations of our clients all intertwine. We utilize an interdisciplinary approach to evaluate each area, which allows for the creation of a plan that addresses the concerns of the individual as a whole as well as the family. To this end, our model of practice includes a Care Coordinator (usually a nurse or social worker), whose expertise complements our team of attorneys.
When the road of life is smooth, decisions about legal and financial matters are easy to push aside for “a rainy day.” Planning ahead, however, will allow for more options as you view the map of where you’ve been and where you want to go. Don’t let a crisis limit your choices or derail your plans.(717) 697-3223