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The Future of Long Term Care in America
By Ivan Michael Tucker, Esq.
Altamonte Springs, Florida
An ElderCare Matters Partner
The future of long term care in America is heading for a real crisis. The intent of this article is not to scare the average citizen but to give him or her early warning as to the impending changes in Medicaid as we know it. One problem with predicting the future, even with all the cards on the table, is knowing precisely when this change is coming about.
In addition to the inevitable change, to make matters worse is the reality that this is a political question. Neither the Democrats nor the Republicans want to be known as the party that killed the golden goose. That includes the President whoever that may be at the time that the inevitable becomes reality for our elderly population.
According to the 2012 Social Security Fiscal Report, 76 million Americans will turn 65 from 2007-2027; that averages out to 10,000 everyday. That means 200 new senior citizens each day in each state. Of those, 70% will require some form of Long Term Care in their lifetime. That's 53.2 million long term care patients. And of those, 50% or 26.6 million people will need care that will last for more than one (1) year.
The 2009 National Nursing Home Survey reports that the average patient stays in a Long Term Care for approximately thirty (30) months. While the Congressional Budget Office projected that the average cost of care in 2014 will be $7,833 per month or $93,996 a year. Of course, an average means that the cost of care in some states already exceeds the national average.
The reality is that most people will not be able to afford to pay $7,833 a month or $93,996 a year for long term care. Granted that some of this care is already picked up through an individual's Social Security monthly income, but Medicaid pays the bulk of the long term care bill. Even the Veterans Administration cuts its pay out to disabled veterans and their spouses from perhaps several thousand dollars each month for home care and assisted living expenses to just $90 a month or $1,080 a year when the eligible patient must be placed into a skilled nursing facility.
Ask yourself these questions, can I afford to pay upward of $93,966 per year for my long term care or my spouse's care? Can my children pay upward of $93,966 for my long term care? Who pays for me and my spouse when we are both in a nursing home at the same time and the total bill runs to $187,992 for the year? Can you afford $234,990 to take care of you or your spouse for 2.5 years in a long term nursing facility? Can you afford $469,990 to take care of you and your spouse for 2.5 years in a long term nursing facility? What will be the effect of inflation on these numbers over the coming years?
Since for most people their largest asset is their home, the current protection for their home under the Medicaid rules must and will change. That doesn't mean that they will lose their home to the government as most people wrongly fear today. But, people will have to tap into their home equity to pay for long term care in the future. This will, undoubtedly, mean that seniors will have to obtain a reverse mortgage on their home to pay for long term care insurance.
Even with the addition of long term care insurance, that doesn't mean that the need for some reduced form of Medicaid will not be needed. There will still be costs that will not be covered due to inflation. There will still be costs for those that haven't purchased enough long term care insurance protection and there, of course, will be those that have no protection, at all, when the need for long term care becomes a reality.
While this article will certainly make you stop and take notice of the impending problem, its true purpose is to cause you to realize that NOW is the time to take positive action for your future. The only resolution, in whole or in part, to this problem is to PLAN, PLAN and PLAN for that future. Those that are wise and successful will act like squirrels and prepare for the impending winter. Those that don't take this warning will be like the ostrich that hides his head in the sand. Wouldn't you rather be a squirrel?
If you need help with this or other Elder Care Matters, you can find thousands of Elder Care Professionals on ElderCareMatters.com – America's National Directory of Elder Care / Senior Care Resources for Families.
The Do's and Don'ts of Signing a Nursing Home Admission Agreement
as a Responsible Party
Henry C. Weatherby, Esq,, CLU, ChFC, CEBS
Bloomfield, Connecticut
An ElderCare Matters Partner
When a person is admitted to a nursing home, it is often a family member who manages the details of the move. If you are managing a loved one's transition into a nursing home, you will likely be asked to sign a nursing home admission agreement as your loved one's "responsible party." These agreements can be very thick, complicated, and confusing. To make matters worse, you are often asked to sign them as soon as the person is admitted, at a time when you would rather be focused on making sure your family member is comfortable. You are likely to be facing a great amount of stress. Don't feel pressured to sign an admission agreement on the spot. Take the time to review the document and make sure you understand what you are signing. You do not want to accidentally accept financial responsibility for your loved one's care or give up any of your loved one's rights.
Federal law and CT state law prohibits nursing homes from requiring you to guarantee payment of nursing home bills. This means that they cannot require you to sign as responsible party upon your loved one's admission. Importantly, the your loved one cannot be refused admission due to your refusal to sign. The simplest way to avoid the risk of signing as a responsible party is by having your loved one sign the nursing home admissions agreement him- or herself. If the person is unable to sign due to a severe cognitive impairment or a physical limitation, you may decide to sign on that person's behalf. If this is the case, there are other things you can watch out for to avoid liability for the nursing home costs. No matter who signs the agreement, it is important to take the time to make sure that person understands what it means.
Even if you are not made personally responsible for a resident's nursing home costs, an admission agreement may still require a responsible party to use the resident's assets to pay the nursing home costs and to help the resident qualify for Medicaid. In Connecticut, nursing homes have successfully sued the responsible party under such a contract. The nursing homes argued that the responsible party breached the contract by failing to qualify the resident for Medicaid in a timely manner, unreasonably delaying the Medicaid application process, or improperly transferring the resident's assets. Even if you are only signing the admission agreement on behalf of the resident under a Power of Attorney, a court may still find that you are a responsible party. If you are managing the financial affairs of a nursing home resident, you need to familiarize yourself with the requirements for Medicaid. You should consult an attorney with Medicaid experience so that you do not unintentionally jeopardize the resident's Medicaid eligibility and create liability for yourself.
In addition to understanding the implications of signing as a responsible party, there are other provisions to look for when signing a nursing home admission agreement. Keep an eye out for a binding arbitration provision. This type of provision will state that all disputes regarding the resident's care will be decided through arbitration. You should know that signing such a provision means you are giving up your right to go to court to resolve a future dispute with the nursing home. The nursing home cannot require you to sign such a provision. However, if you do sign a contract including an arbitration provision, it will generally be enforceable.
If you are helping a loved one's move to a nursing home, getting informed is one of the best ways you can protect your loved one and yourself. If at all possible, consult an experienced Elder Law Attorney before signing any documents from the nursing home. You can find experienced Elder Law Attorneys near you on ElderCareMatters.com and on ElderLawAttorneys.us – two online elder care resources sponsored by the national ElderCare Matters Alliance – Elder Care / Senior Care Professionals who can help you plan for and deal with a wide range of elder care matters.
"If Only . . .": Why You Owe it to Yourself and Your Family to Execute an Advance Medical Directive
By John J. Campbell, Esq., CELA
An ElderCare Matters Partner
Terri Schiavo was only 26 years old in 1990, when her heart stopped as the result of an eating disorder. Terri suffered serious brain damage that left her in a persistent vegetative state with little, if any, hope of recovery. Terri could breathe on her own, but required artificial nourishment and hydration because she could not swallow. Terri's husband believed that Terri would not want to continue living in that state, so he sought to have her feeding tube removed. Terri's parents believed that Terri would want to continue living in the hope that someday she could be cured.
And so the ordeal began. Terri's husband and parents began litigating over Terri's fate in 1998 in the Florida Courts. Surely, you or someone you know has read about it in the papers or has heard about it on the evening news over the past several years. As of the writing of this article in January, 2005, that litigation rages on.
In the interim, there were trials, hearings and appeals to determine whether Terri would want to continue receiving medical treatment merely intended to keep her alive without a reasonable chance of recovery or cure. Finally, the Florida Supreme Court entered an order in 2003, directing that Terri's feeding tube be removed.
Within a week, Governor Jeb Bush successfully lobbied the Florida legislature to pass "Terri's Law", a special law directed specifically at Terri's case, requiring that her feeding tube be reinserted. That law was successfully challenged in the Florida courts, ultimately resulting in a holding by the Florida Supreme Court that the law was unconstitutional. On January 24, 2005, the United States Supreme Court declined to hear the appeal from the Florida Supreme Court's final decision.
Terri's law is no more. The battle is over, but not the war. Motions and appeals are still pending in the Florida courts that must be resolved before the final outcome is known. In the meantime, Terri continues in her persistent vegetative state, kept alive by artificial nourishment and hydration.
It seems that everyone involved has an opinion or belief as to what Terri would have wanted. Surely, all of those persons are well-meaning and believe that they know Terri's wishes and are looking after her best interests. However, in all the arguments before all the courts, in all the pleadings and briefs, there is one opinion that has not been and probably never will be expressed – Terri's. Ironically, the one voice that could silence all of the controversy and speculation once and for all cannot speak.
If only Terri had executed a living will while she was still competent, her family might have been spared 7 years of litigation and all of the expense, stress and heartbreak that has gone along with it.
You and every competent adult in the United States have a legal right to refuse unwanted medical treatment. This means you can accept, question, reject, or withdraw any medical procedures or treatments offered to you.
If you become incapacitated (unable to make decisions), decisions concerning your medical treatment may be made by another person for you. If you execute an advance medical directive while you still have the legal capacity to do so, that directive would provide guidance to the person making those decisions. The directive might even determine who would make those decisions for you. However, if you become incapacitated and have not executed an advance medical directive, you and your loved ones could very well find themselves having to resort to the courts.
There are two legal documents in virtually every state that allow you to make advance medical directives: the Living Will and the Medical Durable Power of Attorney. You can take affirmative steps now to preserve your right to make medical decisions in case you later become incapacitated.
A "Living Will" is a document which says that, if you are terminally ill or injured and unconscious, comatose or incompetent, you do not want to be kept alive by medical procedures which merely postpone the moment of death. Although a Living Will is very limited in scope, it is nonetheless a powerful statement of your intent.
A Living Will may be executed by any competent adult who is eighteen (18) years of age or older. The will must be in writing, signed by you or signed by another in your presence and at your request. The signing must be in the presence of at least two witnesses, who must also sign. A witness cannot be an heir or one who stands to inherit, and cannot be a doctor, nurse, or other employee of the attending physician or treating facility. You may revoke the Living Will at any time: orally, in writing, or by burning, tearing, canceling, obliterating, or destroying it.
Once the Living Will is executed, it can be applied only in restricted situations. You must be certified as being in a terminal condition by a physician (by two (2) physicians in some states); have been unconscious, comatose or incompetent for the time specified in your state's Living Will statute; and you usually cannot be pregnant. The physician must give notice to your nearest family members and wait a statutorily prescribed period of time, usually 48 hours, after certification for any response. If there is an objection, a guardian is appointed for you by the court and a hearing is held. After the foregoing procedure has been followed, with court permission the physician may withhold life support.
Withholding life support does not normally include withholding pain medication. Usually, you may choose in the Living Will whether withholding life support includes withholding artificial nourishment.
Your attending physician must honor the directives of the Living Will or relinquish your care to another physician who will. The statute specifically states that death due to compliance with the Living Will is not suicide or homicide.
A Living Will only applies in situations where death is imminent. It does not apply where death is not imminent, but you are unable to make medical decisions for yourself. Because a Living Will is so limited in application and does not appoint an agent or surrogate on your behalf, it is not sufficient by itself to cover all types of medical decisions. It is far better to also execute a Medical Durable Power of Attorney.
A Medical Durable Power of Attorney (MDPOA) appoints an agent to speak for you about medical treatment decisions when you cannot. An MDPOA has much wider application than a Living Will because it does not require that you have a terminal condition. There is also much more flexibility in an MDPOA because you can set forth, in your own words, your concerns about "quality of life" issues and other specific wishes about your care. A Medical Durable Power of Attorney can also incorporate Living Will provisions or give your agent specific authority to enforce the terms of your Living Will.
In some states, such as Colorado, health care providers are required to comply first with your wishes, then the statements in a Living Will if your wishes cannot be expressed, and finally the decisions of your agent under an MDPOA. Health care providers are protected from any liability for either following your wishes as stated in a Living Will or following the instructions of an agent under an MDPOA.
A previously executed Living Will could take precedence over an MDPOA. This means that a previously executed Living Will could nullify the authority given to an agent under an MDPOA in any situation where the Living Will would apply. To avoid this problem, it is important that your MDPOA specifically refer to your Living Will and make it clear that your agent has authority to make decisions according to the provisions in your Living Will.
The laws of every state provide some means to create an advance medical directive. Whether you choose to execute a Living Will, a Medical Durable Power of Attorney, or both, it could turn out to be one of the most important choices you have ever made. It is your best chance in a situation where you cannot speak for yourself to ensure that your voice is heard regarding what medical care you wish to receive or decline.
Advance medical directives are among the most powerful legal documents you can create. However, your advance medical directive will be useless if your doctor or medical facility is not aware of its existence. Keep your original Living Will and Medical Durable Power of Attorney in a safe place – preferably a safe deposit box. Make certain that you provide copies of those documents to your primary care physician, to any other physician who treats you and to any hospital or medical facility where you might seek and receive care.
You should also take time to discuss the contents of your advance medical directives with your family and friends. You should especially discuss your directives with anyone whom you may appoint as your agent under an MDPOA. The more thoroughly you make your wishes known, the better chance your wishes will be followed if you are incapacitated.
You owe it to yourself and your loved ones to consider creating an advance medical directive, regardless of your age or your current health. Unexpected tragedies can and often do happen without any warning. If something happens to you, would you want to leave your family and friends wondering: "If only. . ."?
As it turned out, the war was indeed not over. In February, 2005, Judge Greer, the Probate Judge in Florida with jurisdiction over Terri's guardianship, ruled on all pending motions and ordered Terri's artificial nourishment and hydration to be discontinued on March 18, 2005. What ensued over the next month was simply incredible.
Protesters began to gather outside the hospice where Terri was residing. Media coverage intensified. Politicians, religious leaders, doctors, medical ethicists, entertainers and others were quick to voice their opinions on the removal of Terri's artificial nourishment and hydration. The result was a polarized and bitter national debate that rose to fever pitch as the court's March 18 deadline grew nearer.
On March 16, 2005, the U.S. House of Representatives passed a bill directed at preventing the removal of Terri's feeding tube. The following day, the Senate passed its own version. Unable to agree on the contents of the bill, Congress declared on March 18 that it was instituting a congressional investigation and issued a subpoena to Terri, requiring her to appear before Congress and testify. Subpoenas were also issued to the personnel at Terri's hospice, directing them not to carry out the court ordered removal of Terri's feeding tube.
In issuing the subpoenas, Congress was attempting to invoke a federal law providing protection for congressional witnesses. The strategy did not succeed. Judge Greer immediately ordered that the congressional subpoenas be disregarded. The U.S. Supreme Court declined to intervene on the motion of Congress and allowed Judge Greer's ruling to stand. On Friday, March 18, 2005, Terri's feeding tube was removed for the third time since 2001.
On Sunday, March 20, the U.S. Senate held an emergency session which resulted in a bill granting jurisdiction to the federal courts to review Terri's case to determine whether she had received adequate due process protections in the Florida probate proceeding. The House passed the bill just after midnight the next morning and the bill was rushed to President Bush, who immediately signed the bill into law.
Terri's parents filed suit in the U.S. District Court in Florida later that same day. They also asked the Court to enter an injunction to require the reinsertion of Terri's feeding tube pending the outcome of the case. On March 22, 2005, a U.S. District Judge denied the injunction, stating that Terri's parents had failed to demonstrate the likelihood that they could prevail in the case on the merits. Terri's parents filed an emergency appeal in the U.S. 11th Circuit Court of Appeals.
On March 23, a 3 judge panel of the 11th Circuit declined to overturn the District Court's ruling. Terri's parents immediately asked for a review by the full Court, which promptly upheld the decision of the panel. Terri's parents immediately appealed to the U.S. Supreme Court. On March 24, the Supreme Court declined to take the case.
On March 25, Terri's family returned to the U.S. District Court in Florida with a new motion to reinsert Terri's feeding tube. The motion was denied that day. Another emergency appeal to the 11th Circuit by Terri's parents on March 25 failed.
On Saturday, March 26, Terri's family filed a new motion before Judge Greer in the Probate Court, claiming that Terri had tried to say "I want to live" just before her feeding tube was removed. Judge Greer rejected the motion. Another emergency appeal, this time to the Florida Supreme Court, was similarly rejected that afternoon. It had been 8 days since Terri's feeding tube was removed.
In the meantime, the protesters outside Terri's hospice became more and more active. In all, at least 48 were arrested trying to force their way into the hospice with offerings of bread and water. One, who had traveled across country heavily armed and intending to "rescue" Terri, was arrested before he could carry out his plans.
On Monday, March 28, the 11th Circuit Court of Appeals surprisingly entered an order permitting Terri's parents to file another appeal. However, the Court denied the appeal itself the next day. Once more, Terri's parents attempted to invoke the authority of the U.S. Supreme Court. The Court rejected their attempt on Wednesday, March 30, apparently exhausting any remaining legal options that Terri's parents had.
On Thursday morning, March 31, 2005, 13 days after the court-ordered removal of artificial nourishment and hydration, Terri Schiavo died. May she finally rest in peace.
The 'Power' in a Power of Attorney
By Paul T. Czepiga, Esq., CELA
An ElderCare Matters Partner
Lawyers are continually asked by clients whether the client should give their children or others their Power of Attorney. There is no standard answer because everyone's financial situation and relationship to their children is different. A meaningful response requires that the client understand what a POA is and what it can and cannot do for them. My view is "Yes, you should give a POA" but only if you come to that conclusion after first discussing all of the following considerations with your advisor. One can best summarize the utility of a Power of Attorney by borrowing from a well known phrase and saying that "never has so little done so much for so many." The benefits of a POA will be explored later in this article, but let's begin with a basic understanding of what a POA is.
A POA creates an agency relationship between the parent who signs the POA, known as the principal, and the child (or other trusted advisor), known as the agent. Only the parent is required to sign the POA. Because it is an agency relationship, the ability of the child to act on the parent's behalf ends when the parent either dies or revokes the POA. A POA can be granted to enable the child to perform an unlimited number and range of functions on behalf of the parent or to perform only certain functions. The Power of Attorney that will be discussed in this article are durable powers of attorney, meaning that are intended to continue in the event of the principal's incapacity. A POA is durable if it contains language that expressly states that the POA will remain in effect regardless of the principal's subsequent incapacity. Without such a statement, the POA lapses if the parent later becomes incapacitated??something almost always not intended when drafting POAs for estate planning purposes.
Health Care Decisions
It was not until May 1990 when the Connecticut legislature added "health care decisions" to the enumerated list of powers that could be granted under a POA. Therefore, anyone with a pre?1990 POA should execute a new POA that includes health care provisions if they want their agent to have that authority. The definition of health care decisions stops short of (does not include) termination of treatment matters??these are governed by Connecticut's living will statute enacted in 1985 and subsequently amended and expanded in scope in 1991.
Springing Power of Attorney
A second significant change in POAs occurred in 1993 when Connecticut created a Springing Power of Attorney. There had always been a desire on the part of people to be able to grant someone authority as their agent provided that authority did not become effective until some future triggering event. The concern was that the agent would use the POA at times and for purposes not intended by the principal. For example, spinster aunt would like to name nephew as her agent under a POA, but is afraid that nephew might abuse his authority (more on this later). Right now she is perfectly able to manage her affairs and does not want nephew to act for her in any manner until she can no longer do so herself. Before 1993, Connecticut did not give spinster aunt any choice with a POA?it was effective when signed and if nephew wanted to exercise his authority as agent, he could. With a Springing POA, it is now possible to name someone your agent, but the agency is not effective until the future. For example, aunt could name her nephew as agent and provide that his authority does not come into existence until aunt is "no longer capable of managing her affairs" (a mental incapacity) or "attending to her physical needs and care" (a physical infirmity) or both.
Has Aunt succeeded in protecting herself? The answer is yes, but marginally so. Under the new statute the nephew, before he can act under the Springing POA, must sign an affidavit in front of two witnesses and a notary attesting to the facts that 1) aunt named him as agent in a POA, 2) his authority does not take effect until aunt becomes incapable of managing her affairs or attending to her personal needs and care, and 3) one of those prerequisites has occurred. There is no need for independent medical evidence that aunt is really in such a condition unless aunt required it as a condition to nephew's authority.
Choosing An Agent
This scenario takes me to what I consider to be an inviolate litmus test when it comes to counseling someone on whether to grant a POA. If there is no one in whom the principal has full, total, and complete trust, then a POA, regardless of whether it is springing, should not be given. If the principal spends more than a split second pondering if there is such a person, than they have already flunked the test. For example, spinster aunt could have required that nephew's affidavit have attached to it a certification by a Connecticut licensed physician attesting to her incapacity, but if aunt wants or needs such a precaution she has already failed the litmus test. I find that in my practice, about sixty percent (60%) of my clients use the springing POA and the rest use a non-springing POA. There is also a direct correlation, with married couples, between length of marriage and type of POA used?the longer the marriage the more likely it is that a non-springing POA will be used.
Limitations and other Express Powers
As mentioned earlier, in a financial planning and Medicaid context, it is best to give a POA that conveys the broadest possible authority, limited only by the principal's concerns. Connecticut's statutory form POA and Springing POA convey thirteen separate powers, including "all other matters." Although this sounds fairly inclusive, it is not.
The most harmful limitation is that the Connecticut form does not expressly give an child the ability to makes gifts of the parent's assets. One's incapacity does not lessen the need to reduce the gross taxable estate for estate tax reduction purposes or to remove assets out of one's name for Medicaid eligibility purposes. Without an express gift making provision, it will be very difficult to transfers the parent's assets to their beneficiaries even though this is what the parent would have wanted. Even so, gift giving provisions should not be automatically included in all POAs without first pondering the need and ramifications of such a power. If gift giving is to be included, then the parent should also address to whom may gifts be made and to what extent. To the spouse only and unlimited? To children? If to children, must gifts be equal to the children each year? What if there is a change in a child's circumstances (for better or worse)??should or must gifts still be made to that child? If gifts are limited to the annual exclusion, what if there is a need to rapidly deplete the estate for Medicaid purposes?
Other powers that I expressly add to my POA after discussion with the parent include dealing with the State of Connecticut and the IRS on all tax matters?income and gift (including gift splitting) and the DRS for income, gift and sales and use tax, accessing safe deposit boxes, changing domicile, creating, funding and requesting distributions from revocable and irrevocable trusts, changing beneficiary designations on life insurance, annuities, and retirement plans, and further elaborating on health care decisions. Although some of these are arguably included in the statutory form already, it does not hurt to single them out for enforceability purpose.
Acceptability of a Power of Attorney by Third Parties
Enforceability of a gift giving provision can be a daunting task when a bank teller states that bank policy requires a POA not more than two years old and the POA is three years old and the parent is incapacitated . Or the stock broker says that regardless of the POA's age, you must produce a statement from the parent stating that the POA has not been revoked, but the parent is no longer competent. What to do? Add a paragraph to the POA stating that unless the third party has actual notice of revocation they may rely on the agent's authority and include a hold harmless or indemnification of the third party. This may help. The point being that your advisor should add to the POA whatever they can to make it "acceptable" to the outside world.
One curative would be to have on standby (or in lieu of the POA) a living trust. The child can convey the parent's assets to the living trust. This would not be a gift. Once the assets are in the living trust, the trustee can, within the scope of authority conveyed by the trust, do with the assets whatever is needed because the trustee has legal title to the assets. This differs from the agent who does not have legal title to the principal's assets and it is this difference that causes third parties to be wary when dealing with an agent using a POA to give away the principal's assets.
In summary, a POA is a powerful and useful tool for a variety of estate planning needs, both foreseen and unforeseen. Once you sufficiently identify your Medicaid or Estate Planning needs, you should sign a POA as soon as possible (assuming the litmus test is met) so that if there is a need to implement or continue your estate plan after your possible incapacity, your child can effectuate under your POA, as much as possible, your wishes.
If you need help with this or other Elder Care Matters, you can find thousands of Elder Care Professionals on ElderCareMatters.com – America's National Directory of Elder Care / Senior Care Resources for Families.
Trustee Held Responsible for Excessive Distributions
By Ronald A. Fatoullah, Esq.
Being a trustee is not a simple task. Trustees of special needs trusts (SNT) must be careful to explore the possibility of using government benefits to pay for expenses of the beneficiary, or risk having to reimburse the trust for having misspent trust assets.
On June 25, 2013, a New York trial court ordered a trustee of a SNT to reimburse the trust for nearly $180,000 that was misspent on private caregivers, cab rides, and medications that could have been obtained from government sources.
The beneficiary of the trust was injured as a child. In 2003, $422,012.54 from the beneficiary's personal injury lawsuit was placed into a special needs trust for his benefit. The trust specifically stated that the trustees had to make a good-faith effort to determine whether Medicaid would cover home health care services prior to expending trust funds for that purpose. The trust also required that the trustees take the beneficiary's eligibility for government benefits into account before making discretionary payments to him or to his family.
By 2009, only $3,253.03 remained in the trust. When BNY Mellon, the trustee, filed an order requesting that the court approve its account and release it as trustee, the court opened an investigation. The independent examiner discovered that BNY Mellon had paid for $118,064.50 worth of home health care without making an inquiry into whether the beneficiary could qualify for Medicaid payments for his care. BNY Mellon had also paid for $56,320 worth of cab fares for the beneficiary's family and had made payments to the family that rendered the benefiary ineligible for SSI and Medicaid.
The Supreme Court of New York, Kings County, ruled that BNY Mellon must repay the trust for $176,905.99 that it improperly spent while it was trustee. The court found that "it is clear that the trustee relegated [its duties] to others, failing to make the necessary inquiries to ensure the longevity of the Trust Fund. It is clear to the Court that BNY breached its duty under the Trust agreement and failed to properly administer the Trust."
A special needs trust, also known as a supplemental needs trust, is a trust specifically designed to preserve the assets of a disabled person without jeopardizing his or her eligibility for government benefits. This enables the disabled person to have a better quality of life by having the funds in the SNT to supplement "luxury" expenses that are not covered by any governmental program.
Not only is it prudent, but it is a requirement that a trustee explore the possibility of a governmental program being able to cover certain expenses of the beneficiary. For example, Medicaid can pay for home care services if the beneficiary needs them. Furthermore, if a beneficiary is already receiving government benefits, the trustee must ensure that the trust distributions do not disrupt the beneficiary's continuing eligibility. For example, if a beneficiary is receiving Supplemental Security Income (SSI), the trustee may not want to use trust funds to pay for expenses of shelter or food for the beneficiary, as those payments will affect SSI benefits.
Whether you are currently serving as trustee or are considering accepting an appointment as a trustee of a SNT, it is important to consult with an elder law/special needs attorney regarding your duties and obligations as the trustee. An experienced attorney can also advise you about the various government benefits that you should be mindful of when making decisions about distributions.
To find Elder Law Attorneys and Special Needs Attorneys near you who can help you with Special Needs Planning, go to: ElderCareMatters.com – America's National Directory of Elder Care / Senior Care Resources, including Special Needs Resources.
Ronald Fatoullah, Esq., CELA
Great Neck, New York
An ElderCare Matters Partner
Paperless World Can Leave Heirs In The Dark
By: Robert M. Slutsky, Esq.
As people increasingly go "paperless", using the online features of banks and brokerages to manage their accounts, it's complicating the process of helping your heirs sort out your finances once you're gone.
The problem: If you don't keep careful records, your family might not even know where to start looking for accounts. In a worse‑case scenario, some assets may never be found.
But at the same time, you don't want to recklessly list all your private financial‑account passwords somewhere for a bad guy to find. That would be an invitation to theft.
There are several smart steps to take to build a roadmap to your assets. The five key components: information about your assets, names of advisers, details about safe‑deposit boxes, your estate planning documents, and a few other important documents.
For starters, provide details about banking and brokerage accounts, insurance policies, real‑estate and retirement plans, and list account numbers. Explain where to find your will, trust, power of attorney and other estate documents. If you have a safe‑deposit box, give the bank's name and address, and where you keep the keys. If you have a life insurance policy, provide the name and phone number of the agent, and a copy of the policy or its number. Consider listing all the people your heirs will need to contact, including lawyers, accountants, executors or guardians you've named to care for any minor children. Do NOT include your passwords to online accounts. Listing all your passwords in one place, no matter where it's stored, is risky. And anyway, your heirs won't need them. With assets like bank accounts, heirs can usually gain access by showing a copy of a death certificate and proof of named beneficiaries.
Do include computer passwords, if you keep back copies of potentially important paperwork (like old tax returns) on your PC. Your financial planner or estate‑planning attorney can provide guidance in putting together a file meeting your needs.
Lastly, think carefully about how to store the list. Heirs need to be able to locate it when needed but it shouldn't be generally accessible. One option: a fire‑resistant home safe. After all, you can't take it with you B but you wouldn't want someone else to take it from you.
Next: A Letter of Instruction Can Spare Your Heirs Stress
While it is important to have an updated estate plan, there is a lot of information that your heirs should know that doesn't necessarily fit into a will, trust or other components of an estate plan. The solution is a letter of instruction, which can provide your heirs with guidance if you die or become incapacitated.
A letter of instruction is a legally non‑binding document that gives your heirs information crucial to helping them tie up your affairs. Without such a letter, it can be easy for heirs to miss important items or become overwhelmed trying to sort through all the documents you left behind. The following are some items that can be included in a letter:
1. A list of people to contact when you die and a list of beneficiaries of your estate plan;
2. The location of important documents, such as your will, insurance policies, financial statements, deeds, and birth certificate;
3. A list of assets, such as bank accounts, investment accounts, insurance policies, real estate holdings, and military benefits;
4. The location of any safe deposit boxes;
5. A list of contact information for lawyers, financial planners, brokers, tax preparers, and insurance agents;
6. A list of credit card accounts and other debts;
7. A list of organizations that you belong to that should be notified in the event of your death (for example, professional organizations or boards);
8. Instructions for a funeral or memorial service;
9. Instructions for distribution of sentimental personal items;
10. A personal message to family members.
Once the letter is written, be sure to store it in an easily accessible place and to tell your family about it. You should check it once a year to make sure it stays up‑to‑date.
If you need additional information about this or other Elder Care Matters, go to http://www.eldercarematters.com/ – America's National Directory of Elder Care / Senior Care Resources.
Robert M. Slutsky, Esq.
Robert Slutsky Associates
Plymouth Meeting, Pennsylvania
An ElderCare Matters Partner
Identifying and Avoiding Caregiver Burnout
By: Henry C. Weatherby, Esq., CLU, ChFC, CEBS
Many of our clients are caring for or being cared for by a loved one. More than 65 million Americans care for family members who need assistance due to chronic conditions, disabilities, disease, or the frailties of old age. These millions of family caregivers may include spouses, parents, or children of the person receiving care. Even when family members are not providing direct care themselves, they are often still the ones who arrange for and manage the care their loved ones need. These people are still part of the caregiving team and share in the emotional and financial stresses that can result from being a caregiver. Caregivers are often so focused on the needs of the person for whom they are caring that they forget to care for themselves. This puts them at risk for caregiver burnout.
Caregiver burnout is the physical and mental exhaustion caused by the prolonged stress of being a caregiver. If you are a caregiver, you may not even realize that what you are experiencing is burnout or that there are things you can and should do to make things better. If you are acting as a loved one's caregiver, be alert for signs that could indicate that what you are feeling is more than just being a little bit tired. Take a look at the following list of symptoms of caregiver burnout to see if any of them apply to you:
If some of these symptoms apply to you, there is something you can do about it:
1) Protect your health. See your doctor regularly, eat a healthy diet, get sufficient rest, and make time to exercise. Stress doesn't just affect you emotionally; it can also take a physical toll.
2) Develop a strong support system. Find a support group where you can share your situation and learn coping strategies. Talk to supportive friends and family. See a counselor or therapist to help you deal with the emotional impact of being a caregiver.
3) Accept help! Share responsibilities with other family members and friends. Forgive yourself for not being able to do everything – no one can. Giving yourself a break will allow you to be a better caregiver to your loved one. Learn to say no when your responsibilities become too much and identify people you can reach out to when you need a hand. Look into respite care, a short-term care arrangement that can provide a break for family caregivers. The time period for respite care can vary from a couple of days to a couple of months. It can also take different forms. You may prefer to find an in-home option or choose to arrange a temporary stay at a local assisted living community.
4) Stay involved with the things that make you happy. Make time for your hobbies and other interests. Read a book. Take a yoga class. Meet a friend for dinner or a movie. Don't count running errands or doing chores as a break. Take a real break from time to time and do something for yourself.
If you need additional information about this or other Elder Care Matters, go to www.ElderCareMatters.com – America's National Directory of Elder Care / Senior Care Professionals.
Henry C. Weatherby, Esq., CLU, ChFC, CEBS
Weatherby & Associates, PC
An ElderCare Matters Partner
Do It Yourself Estate Planning – Gone Wrong
By: Anne R. Moses, Esq., CELA
Beginning your estate plan requires that you follow certain tips:
If you prepare your own Will from a form on the web, you have no legal advice, and no one is checking to make sure the information is complete and correct. You will not be able to take advantage of the knowledge an estate planning attorney can provide about income and estate taxes and other options that may be available – such as certain trusts to protect minors or disabled individuals, to protect profligate spouses or children; to minimize capital gains tax; to protect an elderly person from financial abuse; and to ensure that a subsequent marriage by your spouse will not undermine your plan.
Here is a list of some of the simplest mistakes that I have encountered, and the family comes to me, after your death, to settle everything:
I'm just getting started! Protect yourself and your family. Don't try this at home. Engage an attorney who knows what he or she is doing about estate planning; who will ask the right questions and give you the opportunity to think through the issues as you may never have before. Does it cost money? Yes. So does fixing the mistakes! And it's a lot more money than the original plan.
If you need additional information about a wide range of Elder Care Matters, go to www.ElderCareMatters.com – America's National Directory of Elder Care / Senior Care Professionals.
Anne R. Moses, Esq., CELA
Moses & Moses, P.C.
An ElderCare Matters Partner
Physician, Heal Thyself
Lifecare Innovations, Inc.
Burr Ridge, Illinois
Member of the national Panel for Elder Care Answers
This article, written by Shay Jacobson, President of Lifecare Innovations, shows the restorative power of guardianship, and demonstrates that the old proverb – Physician, heal thyself – while honorable in its original meaning, may not be quite so honorable in practice.
Imagine a physician, beset by psychiatric problems, who determines her best option is to treat herself.
Delusional, paranoid, in the throes of an unwanted divorce and thoroughly estranged from her children, Dr. S took out her prescription pad and went to work.
Dr. S. developed her own treatment plan for the paranoid schizophrenia that had de-railed her life and damaged her relationships. The results were disastrous. Her illness escalated and the tenuous control she once had over her unraveling life vanished entirely.
This 55-year-old physician was reported to the guardianship court by her divorce attorney. The attorney was trying to represent Dr. S's best interests as her husband, also a physician, sought to end their lengthy marriage. As a wife, her behavior and ability to comprehend the division of their considerable assets was in question, and her attorney believed she needed a surrogate to help protect her interests in the settlement.
Bugged and Bellicose
The case was complicated by Dr. S.'s severe paranoia. She believed her home was bugged and sought refuge in hotels. She relocated to a different hotel nightly, and at no small cost. She was frequently MIA and would resurface when she caused disturbances that required police intervention. Suffice to say, Dr. S was slightly famous among local hotel clerks, and well known to law enforcement.
Dr. S. was estranged from her two adult children who each fled across the country to establish lives that were not controlled by their mother's chaotic mental illness. Although they both loved their mother, they believed sharing in her life would destroy theirs. They flatly refused to participate in the guardianship hearing but provided collateral information to verify the extent of her illness and its startling progress.
The guardianship proceeding started with an extensive psychiatric assessment and included a thorough review of her recent medication history. It was at this time that Dr. S's proclivity for self-prescribing came to light. Also discovered was her uncontrolled diabetes. The court approved a private guardian of person and a bank to act as guardian of estate; each of these entities would represent her interests in the divorce proceedings.
The tangle we encountered at the start of this case was difficult to unwind. Dr .S. was a prominent social figure; she sat on many boards and ran for local political positions. She continued to privately write prescriptions for herself and others, including psychotropic medication. The guardian had her medical license revoked and also withdrew her from local political posts. The divorce was finalized and the rebuilding process commenced in earnest.
The Doctor is Out
As with most adults who obtain a guardianship through contested court procedure, Dr. S. was a reluctant client, to say the least. Her mental illness interfered with her perception of her situation and distorted her understanding of the need to establish a new approach to life and her problems. Every effort to knit her life back together was met with staunch resistance.
As her guardians, we kept reminding ourselves that the only way to climb a mountain was by putting one foot in front of the other. We began by helping her manage her diabetes. Fluctuating blood sugars clearly added to her confusion.
Once the medical situation was stabilized, we developed a plan of treatment to address her mental illness. The illness had been long and ruinous for her. Her children reported that her paranoia had caused the estrangement and spanned at least 15 years. They felt the situation was hopeless and that their mother would never again be a part of their lives.
All of Dr. S's self-prescribed medications were discontinued and her physician admitted her for medication stabilization. She was discharged to her home with 24-hour in-home care to maintain supervision. She placed in excess of 200 phone calls a day to our offices, the courts, and her attorneys. And then the miracles started to happen.
The new medications, delivered in a careful regimen, started to calm her paranoia. With her blood sugars and paranoia under control, she started to take a reality-based look at the rubble left by 15 years of unmanaged mental illness. A sweet and highly intelligent woman by nature, she was shocked at what she saw and began to recalibrate her thinking. Step by step, she regained her insight. We were able to decrease her in-home care to come-and-go caretakers.
Her friends started coming back into her life one at a time.
Restored At Last
We kept in constant contact with her children. They were afraid that this transformation would be temporary and that further disappointment was inevitable. Over time, though, they risked re-involvement and initiated weekly phone calls with their mother. There was a lot of catching up to do as their mother was not a part of their lives and did not know about their marriages and the birth of her first grandchild. They finally took the step to have her visit and from there, the healing process accelerated.
Dr. S. saw renewed purpose in life and worked hard to stay well and strengthen her family ties. We, as guardians, changed our plan to reflect this new reality. We began the restoration process. Dr. S. was fully restored just three years after the initiation of the guardianship.
The rest of the story continues to unfold. Dr. S.'s husband divorced her over her mental illness. As she recovered, so did their relationship. Dr. S. remarried her husband after her restoration. Today she is working toward restoring her medical license and she continues to have her medical and psychiatric treatment managed by professionals.
Our once recalcitrant and delusional ward joined us in our office to celebrate her restoration. She looked and felt wonderful. She remains close to the caregiver who spent many hours sorting through her issues with her during the worst times. She sees her children regularly and has become a doting Grandma.
The story of Dr. S is about many things, but the greatest of these is restoration – specifically, the restorative power of guardianship.
You can find help for this and other elder care matters on America's National Directory of Elder Care / Senior Care Professionals – ElderCareMatters.com.
Caregiver Agreements: Making the Pathway of Caregiving
a Two-Way Street
James J. Ruggiero, Jr., Esq.
State Coordinator of ElderCareMatters.com, Pennsylvania chapter
Family caregivers play a major role in maximizing the health and quality of life individuals with acute and chronic illness in the United States. Recipients of care depend on family caregivers for assistance with daily activities, managing complex care, navigating the overwhelming health and health insurance systems and communicating with health care professionals. Family caregivers provide valuable care out of love and often necessity but the role of caregiver is an extremely demanding job. According to the National Alliance for Caregiving, 37% of caregivers spend more than 40 hours a week providing care and another 30% spend 20-39 hours assisting with needs. Caregivers cope with physical, emotional, spiritual and financial challenges brought about by the demands of the job and the need to reduce or forgo employment to care for a loved one. These challenges affect the caregiver's health and quality of life as well as the recipients.
Long-term caregiving has significant financial consequences for caregivers, particularly for women. Caregivers face the loss of their own income, loss of employer-based benefits, shrinking of saving to pay for caregiving costs and a threat to their retirement income due to fewer contributions to retirement vehicles. One way to compensate an adult child willing to devote so much of his or her time to caring for an ailing or aging family member is through a caregiver agreement. The agreement is essentially an employment contract between the caregiver and the recipient of care. The family member and the caregiver stipulate to a caregiver's tasks, the hours spent caregiving and financial compensation. Often it is hard to accept that a caregiver may want or need to be compensated for services rendered because love doesn't pay the mortgage or for groceries but by having a binding legal contract in effect can protect both parties down the road.
Here are five important ways a caregiver agreement can help your family.
Caregivers get paid for the job they do
It offers a great way to support the person for their time and effort in caring. This may be a caregiver's sole source of income or a second job. How much to pay a caregiver is up to the family. A good place to start is to look at how much a home health agency would charge. Current rates in Chester County PA are $18-25 per hour. These rates often come with minimum requirements and vary based on needs and time etc. After research and discussion, set a salary and establish a schedule for payment.
Define the caregiver relationship
A detailed caregiver agreement sets boundaries. It makes clear the extent of the services being provided and the amount of money the caregiver is getting paid.
Keep peace among family members
Having a caregiver agreement in place helps minimize the conflict between family members over the handling of care. The existence of a contract helps elevate the validity of the arrangement and value the services provided by the caregiver.
Clear the way for Medicaid
With regard to Medicaid eligibility, payments made to a caregiver under contract can reduce the care recipient's countable assets, which in turn may accelerate Medicaid eligibility. Absent an agreement in writing, the money a recipient pays a caregiver may be deemed a gift by Medicaid. This triggering event may cause a period of delay where recipient may not qualify due to the current 5 year Medicaid look-back period. At the time of Medicaid application, Medicaid will total all payments made to caregiver for the past 60 months and divide that by the average monthly cost of a semi-private room at a nursing home in the state. This quotient is the penalty period which equals the number of months Medicaid will not pay for nursing home care. The monetary and emotional cost to the family for the delay in Medicaid far outweighs the time and cost to properly execute a caregiver agreement.
Keep care and money in the family
Many recipients find comfort in having care from a devoted family member over a stranger and the money the family pays for care stays in the family.
Caregiving is a journey. The journey changes daily, weekly monthly and yearly.
The caregiver agreement sets the stage for the journey and makes the pathway to caregiving a two-way street. It fosters open communication amongst caregiver, recipient and family members. It begins a relationship with an elder law attorney and may also be an opportunity to review, update or prepare legal documents including Authorization to Release Health Care Information, Health Care Power of Attorney, Living Will, General Durable Power of Attorney, Will and Trust(s). It paves the way for Medicaid planning, if necessary. The elder law attorney initiates the formation of a support team for the caregiver which includes professionals such as a financial advisor, banker, CPA, trust officer, insurance agent and local resources such as department of aging, religious organizations, hospitals and support groups.
With the understanding of the caregiver role, organization of legal documents and establishment of a support team, the caregiver relationship is on track for success.
Having a detailed, written caregiver agreement allows a caregiver to be Compassionate; Alert to current needs; Resourceful and Energetic in their care for a loved one.
To find elder care professionals near you who can help you with this and other elder care matters, go to: ElderCareMatters.com – America's National Directory of Elder Care / Senior Care Professionals and Resources for Families.
If you need answers to your elder care questions, send your questions to us at:
Answers are provided by our ElderCare Matters Partners, some of America's TOP Elder Care Professionals who have years of experience in helping families plan for and deal with a wide range of Elder Care / Senior Care Services.
All Q&A's are posted on the homepage of ElderCareMatters.com
ElderCare Matters Articles are useful and up-to-date Elder Care / Senior Care articles that are provided by our ElderCare Matters Partners to help you plan for and deal with your family's elder care matters.
If you help familes plan for or deal with elder care matters, then you owe it to yourself and to families across America to become a professional member of the National ElderCare Matters Alliance and to be listed on the many Elder Care / Senior Care Directories that are sponsored by this National Alliance of Elder Care Professionals.
For additional information about professional membership in the National ElderCare Matters Alliance, (including the many benefits of becoming one of our ElderCare Matters Partners) and to download an Application for your Basic, Premium or Partner Membership in the National ElderCare Matters Alliance, visit: ElderCare Matters Alliance.


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- Ohio State's support staff is becoming a popular landing spot for assistant coaches out of work.
Per source, former Wake Forest tight ends coach / special teams coordinator Adam Scheier has joined the Buckeyes as a special teams quality control assistant. Scheier spent the last three years at Wake and the previous five at Bowling Green.
Last year, former Kentucky head coach Joker Phillips and former Indiana defensive coordinator Brian Knorr joined the Buckeyes in quality control roles, and both landed full-time assistant jobs this offseason at Cincinnati (Phillips) and Arizona (Knorr). Not to mention former NFL defensive coordinator Billy Davis joined the Ohio State staff as an analyst and was promoted to linebackers coach.
Alabama's support staff might be the gold standard, but Urban Meyer is taking advantage, too. Given their coaching trees and the prestige of their programs, it's no surprise. See all the support staffers hired to full-time jobs here.
- Is spring break in the middle of spring practice a good thing or a bad thing? Frank Wilson sees it as motivation.
Do you trust players to do the right things? The UTSA head coach says putting spring ball around it puts more pressure on them to do so.
"The buy-in is that much greater that, when they go on spring break, the hard work they put in isn't in vain," Wilson said this weekend. "In their minds, they get to take off their shirts and go flex for the opposite gender. Good for them. I applaud that. They're less likely to do things that deteriorate their body.
"We have conversations about, rule No. 1, protect the team. Don't compromise this team and the things we've done to get your body in the shape it's in. Spring football validates that, and during spring break, they're more conscientious of taking care of their bodies."
Check out UTSA's first "Bird Cage" drill of the spring:
It's back!!! #BIRDCAGE First one of the Spring! #UTSAfootball #BirdsUp pic.twitter.com/P7C2chesLl
— UTSA FOOTBALL VIDEO (@UTSA_FB_VIDEO) March 10, 2017
It's back!!! #BIRDCAGE First one of the Spring! #UTSAfootball #BirdsUp pic.twitter.com/P7C2chesLl
- Chip Lindsey could make the tight end an actual weapon in the Auburn offense this year.
Last year, Jalen Harris had just two catches to lead Auburn tight ends. But so far this spring, he's lining up all over the place. Malzahn has handed the reins to Lindsey, so there will be some changes.
"We want a guy that's versatile," Lindsey said. "At the end of the day, you build an offense around your playmakers, and if your tight ends are in your top three-five playmakers, they're going to catch balls. That's the way it works. If not, you're going to get the ball to the guys that can score.
"At the end of the day, after spring, we'll evaluate the offense and see where we are and who our playmakers are and how we can get them the ball and the chips will kind of fall where they do."
- Texas Tech will hold its spring game at the Dallas Cowboys practice facility for several reasons.
The Red Raiders will have their game at The Star in Frisco on April 1. The purpose behind it is recruiting, alumni and simulating a road trip. Other schools have done similar events, including Ohio State once having its spring game at the Cincinnati Bengals stadium.
"It's huge for us," Kliff Kingsbury said. "In that area, there are so many great players and programs. High school coaches and recruits can come, our alumni in the DFW area is insane. We couldn't be more fired up to go and work our travel process and see how players respond in front of a big crowd. It's a perfect fit."
- One school opens spring practice today: Bowling Green.
The Falcons went 4-8 in Mike Jinks' first season, but won their final three games. Their spring game is April 8.
Keep track of spring dates for all FBS teams here.
- Watch new LSU offensive coordinator Matt Canada mic'd up at practice, courtesy of WBRZ.
LSU's new OC Matt Canada mic'd up. I think I know why Coach O hired him. @WBRZ pic.twitter.com/mn3A1D6Zu9
— Brandon Saho (@BrandonSaho) March 11, 2017
LSU's new OC Matt Canada mic'd up. I think I know why Coach O hired him. @WBRZ pic.twitter.com/mn3A1D6Zu9
Chris Vannini is in his fifth year with CoachingSearch.com and serves as its managing editor. He has previously written for the Detroit Free Press, The Oakland Press, The State News, MLive.com, 247Sports and SB Nation. A graduate of Michigan State University, Chris now lives in the Dallas-Fort Worth area. Be sure to follow @coachingsearch and send emails to email@example.com.

subset: commoncrawl


text:
Words containing ernent
Found 5 words containing ernent. Browse our Scrabble Word Finder, Words With Friends cheat dictionary, and WordHub word solver to find words that contain ernent. Or use our Unscramble word solver to find your best possible play! Related: Words that end in ernent
- Scrabble
- Words With Friends
- WordHub
- Crossword


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Well if you don't have a background in computers, you might just think that a router is the tool you use for woodworking. You aren't wrong, but the kind of router, I'm talking about is the kind that you would have in your house to connect your computer and devices to the internet.
This whole post was started by a podcast on Howstuffworks.com called, "What is a router?" This very information podcast helped to fill in the blanks and teach me some new things that I never knew about router.
OK. So, let's start with the basics of network communication before we get to what a router is. There are 7 layers of communication, but to get to understand what a router we only need to know the first three.
layer 1 – a device. the information moving around inside it
layer 2 – device to device. a direct connection between the two devices or multiple more devices locally located creating a network
layer 3 – networks talking to other networks (AKA the internet)
OK…. DUN DUN DUN the magical router. So the router is the part that connects layer 2 to Layer 3. It can act and be programmed to be a firewall, a spam blocker, or detect intrusions into your network. SOOO…. You might be saying, "Tell me what it does! Already!!!"
Well the router is basically a simple computer that takes the information from your computer and devices, tags them, breaks it down into packets, launches them out into the internet, and then when packets come flying back at it, it resembles them and send them to the proper device. That sir, is the short and simple answer of what a router was. Yes, there is more technical stuff such as routing tables that where your router and other routers are mapping out the fastest ways to send information through the internet because the fastest way maybe not be the most direct way (look at Atlanta traffic). Or the fact that your router in your house gives each device in your house a unique identifier called a mac (media access control) address. The mac address lets the router know which device information came from and where to send it to when information comes in.
That's all for now. Below leave a comment and let me know what you think about routers and my explanation…
source - http://podcasts.howstuffworks.com/hsw/podcasts/techstuff/2011-08-08-techstuff-routers.mp3


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We stayed here for the first two nights of our honeymoon. It was a great base to see the Pyramids but a half hour drive into the centre of Cairo; we hired a guide and driver for a full day's sightseeing so this wasn't too much of a problem. The staff at the hotel were excellent and the food was fine. The roof top cafe has a lovely view of the pyramids. Good hotel for a short stay.
- Official Description (provided by the hotel):
- Only a short distance from Giza at the foot of the Pyramids lies the Cairo Pyramids Hotel. The hotel is the perfect starting point for sightseeing, relaxation and business meetings alike. With elegantly appointed rooms and suites, two swimming pools and a variety of bars and restaurants to choose from. Both the Garden wing and the newly opened Pyramids wing are offering guests a contemporary, convenient and comfortable experience. Just 35 kilometer from downtown and 51 kilometers from Cairo airport and with easy access to the new industrial areas around the city. ... more less
- Reservation Options:
- TripAdvisor is proud to partner with Hotels.com, Expedia, Ctrip TA, Booking.com, TripOnline SA and HotelQuickly so you can book your Cairo Pyramids Hotel reservations with confidence. We help millions of travellers each month to find the perfect hotel for both holiday and business trips, always with the best discounts and special offers.
- Also Known As:
- Moevenpick Resort Cairo - Pyramids Hotel Giza
- Moevenpick Hotel Cairo Pyramids
- Cairo Pyramids Hotel Egypt/Giza


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By James Rollins
The Rand clinical excursion entered the plush barren region of the Amazon and not lower back. Years later, one in every of its participants has stumbled out of the world's such a lot inhospitable rainforest--a former designated Forces soldier, scarred, mutilated, terrified, and mere hours from demise, who went in with one arm lacking . . . and got here out with either intact.
not able to appreciate this inexplicable occasion, the govt sends Nathan Rand into this impenetrable mystery global of undreamed-of perils, to persist with the path of his vanished father . . . towards mysteries that needs to be solved at any expense. however the nightmare that's waiting for Nate and his staff of scientists and professional U.S. Rangers dwarfs any chance they expected . . . an historic, unstated terror--a energy past human imagining--that can perpetually modify the realm past the darkish, deadly confines of . . .
Read Online or Download Amazonia PDF
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Yet Garcia may regularly push his palms backtrack and canopy him back with blankets. because the sunlight set and evening swept over the forests, Garcia sat with the Bible in hand and prayed for the fellow. yet in his center, the padre knew his prayers wouldn't be replied. Kamala, the shaman, was once right in his evaluation. the fellow wouldn't final the evening. As a precaution, in case the guy was once a baby of Christ, he had played the sacrament of final Rites an hour past. the guy had stirred as he marked his brow with oil, yet he didn't wake. His forehead burned feverishly. The antibiotics had didn't holiday during the blood infections. Resolved that the fellow may die, Garcia maintained his vigil. It used to be the least he may possibly do for the bad soul. yet as hour of darkness neared and the jungle aroused from sleep with the whining sounds of locusts and the cronking of myriad frogs, Garcia slipped to sleep in his chair, the Bible in his lap. He woke hours later at a strangled cry from the guy. Believing his sufferer was once gasping his final breath, Garcia struggled up, knocking his Bible to the ground. As he bent to select it up, he stumbled on the fellow staring again at him. His eyes have been glassy, however the delirium had pale. The stranger lifted a trembling hand. He pointed back to his discarded outfits. "You can't leave," Garcia stated. the fellow closed his eyes a second, shook his head, then with a pleading glance, he back pointed to his pants. Garcia eventually relented. How may he refuse this final feverish request? status, he crossed to the foot of the mattress and retrieved the rumpled pair of pants. He passed them to the demise guy. The stranger grabbed them up and instantly all started pawing alongside the size of 1 leg of his garment, following the interior seam. ultimately, he stopped and fingered a piece of the cotton denim. With shaking palms, he held the pants out to Garcia. The padre proposal the stranger used to be slipping again into delirium. in truth, the terrible man's respiring had turn into extra ragged and coarse. yet Garcia humored his nonsensical activities. He took the pants and felt the place the guy indicated. To his shock, he came upon whatever stiffer than denim below his palms, whatever hidden lower than the seam. A mystery pocket. Curious, the padre fished out a couple of scissors from the first-aid equipment. Off to the aspect, the fellow sank right down to his pillow with a sigh, sincerely content material that his message had ultimately been understood. utilizing the scissors, Garcia trimmed in the course of the seam's threads and opened the key pocket. attaining inside of, he tugged out a small bronze coin and held it as much as the lamp. a reputation used to be engraved at the coin. "Gerald Wallace Clark," he learn aloud. used to be this the stranger? "Is this you, senhor? " He glanced again to the mattress. "Sweet Jesus in heaven," the padre mumbled. Atop the cot, the fellow stared blindly towards the ceiling, mouth lolled open, chest unmoving. He had permit cross the ghost, a stranger now not. "Rest in peace, Senhor Clark. " Padre Batista back raised the bronze coin to the lantern and flipped it over. As he observed the phrases inscribed at the contrary aspect, his mouth grew dry with dread.


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New Fashion Gintama Sakata Gintoki PU Durable Waterproof Shoulder Bag Leisure Messenger Crossbody Bag Satchel
New Fashion Gintama Sakata Gintoki PU Durable Waterproof Shoulder Bag Leisure Messenger Crossbody Bag Satchel
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Join GayCities, the fun way to discover the worldSee where your friends and people like you are going and what they say about places and events worldwide.
Cut Hair Salon
All you need in one place
Cut Hair Salon has all the necessities to make you feel like you again. Haircuts, color, perms, waxing and yes, even manscaping. This salon is usually more geared to men, however, all are welcome.
Tags: Hairstyling, Spa, Massage
Added by: Navigaytour
Is this your business? CLAIM IT » Report Incorrect Info / Closed » Verified on: Apr 8, 2017
204 S 13th St (at Walnut St)
Philadelphia, PA 19107
Washington Square West
(215) 545-3930
Tuesday through Friday - 11:00 AM to 7:00 PM
Saturday - 10:00 AM to 5:00 PM
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Optimal Sport Health Club
1315 Walnut St
Andre Richard Salon
1218 Locust Street
Salon K
1216 Locust St
12th Street Gym
204 South 12th Street
Charlie Salon
203 S 12th St
You Love This Place, Now Tell us Why
So you like Cut Hair Salon? Write a review and tell everyone why.
YOU ARE NO LONGER A FAN OF wutezair Salon
You are no longer a fan of Cut Hair Salon.


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Dr. Rogy Masri is a doctor stationed at a settlement in Northern Lebanon. His team primarily treats Syrian refugees, who have flooded into Lebanon and other neighboring countries to escape escalating violence.
It's not a job for the faint of heart; medications are in short supply, electricity routinely cuts out, and patients are suffering from all manner of horrible ailments from lice and rat bites to sexually transmitted infections.
Masri, who is a volunteer with Doctors Without Borders, must make do with limited tools and equipment. When a patient walks in with a common ailment, he can typically send them away with a treatment. But that's not always the case.


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If you've spent any amount of time here on the blog or on my social media then you know I love cupcakes! Like they're my favorite y'all! A world with cupcakes is just a better world. But I have discovered a way to make them even better…use Girl Scout cookies to make them! So I figured it would be the kind thing to do to gather up all of the best recipes for Girl Scout cupcakes and share them with you. This way you can take your cupcakes to the next level.
As with most of my posts, some links may be affiliate links. This means at no additional cost to you, I may make a small commission on anything you buy through the link. You don't pay anything extra, but you help support your favorite blog with something you would have bought anyways.
The great news is, if it's not cookie season you can order them from Amazon (each type of cookie has a link where you can get them on Amazon). Which means you can make these cupcakes in the middle of summer. Even if you've already eaten the last box of Thin Mints you stashed away in February!
Samoa Cookies
Samoa Cupcakes from Baking Mischief
Decadent Samoa Cookie Cupcakes from Virtually Yours
Tagalong Cookie Cupcakes from Inside Bru Crew Life
Tagalong Cupcakes from My Baking Addiction
Thin Mints
Thin Mint Chocolate Cupcakes from "Cents"able Momma
Thin Mint Cupcakes from Your Cup of Cake
Thin Mint Cupcakes from Just 2 Sisters
And if these Girl Scout cupcakes aren't enough cupcakes for you, you can find more cupcake inspiration, go check out my Cupcakes board on Pinterest. This is a carefully curated board filled with hundreds of yummy ideas! And I'm certain hundreds of cupcake recipes is always a good thing.


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What Fits
While we have about another month of hot weather I've got to get in as much hot weather clothing as possible. I've had this skirt in my closet all summer and knew it was something I needed to throw on. I've been through a lot of positive body changes this past year (much thanks to KTX Fitness) so this coming fall I'm going to need to shop for new stuff. New clothes always make me happy and best believe I've had a running list of what I need for a while now!
Keeping it simple as always in my favorite Theory t-shirt, Bebe skirt and Envy espadrilles
xx, Courtney
Courtney Creer


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High standard conference and meeting facilities
Our restaurant facility can be divided into 3 parts with quality soundproofing. The usually vibrant environment with full hotel services can be transferred into a calm, functioning meeting and conference facility, enabling you to hold a successful meeting. The facilities are also suitable for group seminars, conferences and training purposes.
Equipment available for meetings include data projector, overhead projector, a screen, a flipchart and marker pens.
We can also provide on-site catering facilities for snacks, meals, or break-time treats. Please let us know when booking so we can make the necessary arrangements.
The meeting facilities and equipment are free of charge for hotel guests!


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Author Archives: aleid
AMF Friends Concert this Saturday 16th September!
Dear All As you make fun family/ friendly plans for this coming weekend don't forget about our Friends Concert on Saturday 16th September at 3.30pm in the Long Room at Michael Hall School. Delight in about an hour's worth of … Continue reading
Friends Concert: Saturday 16th September
Dear All, As summer slips subtly into autumn I'm turning my mind to this year's AMF adventures! Hopefully many of you have marked your calendars for this year's One Day of Music Festival on Saturday 11th November. We will be in touch with … Continue reading
Happy New Year!
Dear Fans and Friends of the AMF, Let me take this opportunity to wish you all a very Happy New Year! As we look forward to 2017 I wanted to take a moment to look back at the … Continue reading
ONE week to the AMF Gala Concert!
Next week around this time a whole host of musicians will be itching to kick off a brilliant and breathtaking programme. Be sure to book your seat NOW for the Ashdown Music Festival's fifth annual Gala Concert. We've got … Continue reading
One week to AMF Super Saturday!
Dear Audiences and Supporters of the AMF, Our countdown clock is ticking away: only ONE week to go until our Super Saturday. On Saturday 5th November at 11am (Christian Community Church, Forest Row) the Magnard Wind Ensemble will host our … Continue reading
AMF Opening Concert ONE Week Today!
Our concert countdown has started! This time next week we'll be warming up for our Opening Concert (Friday 4th November, 7.30pm, Christian Community Church, Forest Row). A beautifully balanced programme pulled from the solo and chamber repertoires. Award-winning English pianist … Continue reading
The AMF Is Almost Here!
Dear Friends of the AMF, Music Lovers and Festival Supporters, This past weekend has been a busy behind-the-scenes one for the AMF as kitchen surfaces were given over to mixing bowls and baking tins. We've been tweaking our bakes and … Continue reading
Concert this Sunday!
Our Friends Concert is taking place this Sunday (18th Sep) at 3pm. Location: Christian Community Church, Forest Row. This event is free for Friends of the Ashdown Music Festival and a PLUS ONE. For anyone who is not (yet!) a … Continue reading
Final Countdown to AMF 2016 Tickets going ON SALE!
Dear AMF Audiences and Supporters, I'm about to press the big red button! TICKET SALES for this year's Ashdown Music Festival officially OPEN at 00:00 on Thursday 1 September. We have a smorgasbord of musical delicacies so please do take … Continue reading
Amended Concert start-time and Friends Concert
Dear Friends and Fans of the AMF, There has been an adjustment to the start-time of one of this year's concerts: The Brook Street Band's performance in the Christian Community Church on Saturday 5th November will now start at 4:30pm … Continue reading


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By Olwyn M. Blouet
When american citizens search an get away from the concerns and dilemmas of way of life, the crystal blue waters and white sands of the Caribbean islands appear like the reply to a prayer. but this photo of a tourist's paradise hides a tumultuous historical past marked via strife and department over race, political energy, and financial inequality. Olwyn Blouet explores the story of "the Caribbean" over the past 50 years, revealing it to be a quarter situated on the center of a few the main famous geopolitical problems with sleek times.
Navigating a wealthy mélange of cultures and histories, Blouet reveals a posh narrative that's often ignored in histories of the Americas. In stark distinction to widely-read guidebooks, this chronicle unflinchingly probes strikingly diverse worlds within the Caribbean islands—those of the haves and the have-nots—created by way of the unstable mix of colonial politics, racial segregation, and financial upheaval. The strategic political kin among Caribbean countries, Cuba specifically, and the area powers in the course of the chilly warfare; the commercial differences instigated through tourism; and the modernizing efforts of Caribbean international locations with the intention to meet the calls for of a globalizing twenty-first century industry are one of the various concerns explored via Blouet in her efforts to redress the old record's imbalance. The modern Caribbean also explores the proud histories of the region's many nations in activities resembling cricket and baseball, in addition to their famed cuisines, and the uneasy stability at the present time among neighborhood traditions and the vestiges of colonial influence.
Read or Download The Contemporary Caribbean: Life, History and Culture Since 1945 (Contemporary Worlds) PDF
Best Americas books
The Complete Idiot's Guide to the American Revolution
You are no fool, in fact. you recognize that the yankee Revolution all started while these men in Boston threw a few tea off a ship. Or used to be it while Paul Revere made his recognized experience? let's accept it: by way of understanding approximately our nation's fight for independence, our grade-school stories are approximately as reliable as Benedict Arnold.
Warpaths: Invasions of North America
In 1513, just a couple of years earlier than Cortes conquered the Aztec empire, Juan Ponce de Leon and 3 shiploads of conquistadores landed simply south of what's now St. Augustine, Florida. The Spanish adventurers, even if, have been quick pushed away by way of the Timucua humans; extra landings have been equally defeated via the intense archers of the Calusa, who finally took the lives of Hernandez de Cordoba and Ponce de Leon himself.
As If an Enemy's Country: The British Occupation of Boston and the Origins of Revolution (Pivotal Moments in American History)
Within the dramatic interval resulting in the yank Revolution, no occasion did extra to foment patriotic sentiment between colonists than the armed profession of Boston through British squaddies. as though an Enemy's state is Richard Archer's gripping narrative of these severe months among October 1, 1768 and the iciness of 1770 while Boston was once an occupied city.
Great Issues in American History, Vol. I: From Settlement to Revolution, 1584-1776
This primary quantity of significant matters in American historical past -- 3 volumes of records that hide the heritage of the US from its cost to the current -- supplies us a beneficiant sampling from the foremost political controversies within the Colonial interval. integrated are such records as Richard Hakluyt's "Discourse of Western Planting" (1584), "Letter from Christopher Columbus to the King and Queen of Spain" (undated, most likely 1694), "The 3rd Virginia constitution" (1612), Thomas Paine's "Common experience" (1776) and "The statement of independence" (July four, 1776).
Additional resources for The Contemporary Caribbean: Life, History and Culture Since 1945 (Contemporary Worlds)


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Polished Chrome Bathroom Accessories
Photo 1 of 5Next
In addition to that, sometimes we are confused. Polished Chrome Bathroom Accessories that we need while at work is essential, but around the other-hand we likewise feel waste, office seats on which we've been there it's merely the form and color have not been suitable.
- Modify the colour of the couch along with your flavor and shade of one's business furniture.
- Pick A chair in line with the budget / requires of your corporation.
- Pick A guaranteed manufacturer office seats chairs normally have both thighs of the seat, hydraulic a guarantee of 2 years, and the arms of the chair through the decided.
- Select A couch that has comfortable if you sit-down or an appropriate foam.


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DENVER -- A mother in Denver is telling the story of how she fought off an armed man who broke into her home and attacked her.
The intruder is still on the run Wednesday night ... after she turned the tables on him.
This happened near 6th Avenue and Raleigh Street. The suspect had no idea just how powerful a mother's protective instinct can be. He found himself with her gun pointed at him, and the mother and her son escaped unharmed.
Mary Kelso says she and her young son were spending a quiet morning at home when a man knocked on the door.
"He said he knew my husband and asked me for his phone number."
She didn't recognize him, so she closed the door to get a pen and paper. That's when she says he burst through the door with his gun drawn.
"He let himself in ... took me to my bedroom at gunpoint."
But he didn't know that Mary had a gun, too.
"I have a concealed carry permit and a handgun and I immediately went for that. I grabbed my firearm and we both just aimed at each other but mine was in the case so I couldn't pull the trigger."
She says he threw her onto the bed.
"I immediately thought he was going to shoot me and I was trying to figure out how I was going to shoot him -- injured -- because my son was in the house."
Mary fought back, kicking him into the dresser.
"I grabbed my gun and reached around to hit him. We struggled with his gun ... I ended up pulling the trigger."
The bullet went through the bedroom wall into the bathroom. She doesn't think he was hit. Police scoured the area for clues.
The whole thing took just moments. Mary says she was just thinking about protecting herself and her son.
"You always have to fight in that situation because you never know what that person is there to do. So you have to do your best."
The intruder has the following description:
- White male
- 5'10"
- 190 lbs.
- Navy blue beanie
- Grey hoodie
- Jeans
- Construction boots


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<Steps to follow>
Step1: Online applications (24 January 2018, 12:00pm – 23 February 2018, 3:00pm)
Step2: Submission of documents (Deadline: 12 March 2018, 5:00pm)
first screening
Step3: Oral examination/ Skype interview (3 April 2018 – 5 April 2018)
second screening
Step 4: Annoucement of Final results (10 May 2018, 3:00pm)
updated!(2nd August 2017)
<Admission Guidelines (simplified ver.)>
Admission Guidelines (simplified ver.) for 2018 Master's Programme in Sport and Olympic Studies
For October 2018 enrolment
These Admission Guidelines (simplified ver.) outline our admission examination procedures before the release of the official Admission Guidelines in early November. Please make sure to check the guidelines on our website again at that time and follow the instructions provided.
この募集要項(簡易版)は、平成29 年11 月上旬に公表される募集要項に先立って入学試験概要をお知らせするものです。詳細については、必ず平成29 年11 月上旬以降に本ホームページから募集要項を確認の上、出願等の手続きをしてください。
1. For International Students
2018 Admission Guidelines Simplified ver. for International Students
2. For Japanese Students
2018 Admission Guidelines Simplified ver. for Japanese Students
<Tips for preparing documents for your application>
- All the certificates and documents to be submitted must be either the originals or certified copies(*). We do NOT accept uncertified photocopies. (Please also note that submitted documents will not be returned in principle.)
- All the documents must be in either English or Japanese. If not, it should be translated by registered translator. Do not translate documents by yourself.
- English scores or results of TOEIC/ TOEFL/ IELTS(academic module) must be taken in or after February 2016.
*certified copy is a copy of a document that can be used instead of the original one because an official has checked it and formally approved it as a true and accurate copy by signing it.
Please do not hesitate to contact TIAS Admission Office if you have anything unclear.
Email : email@example.com
<TIAS Scholarship>
TIAS Scholarship 2018 for international students is planned to be released later.
Reference: Details of TIAS Scholarship for students to be enroled in Oct. 2017
TIAS Scholoarship 2017 (for International Students)
<Useful link for prospective students>
*University of Tsukuba Official Website(English/Japanese)
*Enrollment Guidebook for International Students(English/ Japanese)
*University of Tsukuba Student Residence Hall website(English/Japanese)
*Procedures for Entering and Residing in Japan(English/Japanese) (The Ministry of Foreign Affairs of Japan)
*Welcome to the City of Tsukuba(English/Chinese) (City of Tsukuba)
Tsukuba International Academy for Sport Studies (TIAS)
Academic Service Office for the Art and Sport Science
Area, University of Tsukuba
1-1-1 Tennodai, Tsukuba, Ibaraki
Email : email@example.com
Hours : Monday – Friday, 9:00 -17:00 (JST)
※Office closed on Sat, Sun, public holidays and New Years (29th Dec. – 3rd Jan.)