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Two Mighty Oaks – Frederick Health Hospice

Oak trees in front of a house

By: Carlos Graveran – Executive Director – Frederick Health Hospice

I recently made the difficult decision to take down the two majestic 70-foot-tall oak trees in my front yard.  While they blocked our view through the front window, it was a difficult decision to make since they were one of my favorite features of the property and shaded our home for so many years.  Sadly, they had become diseased, and since they leaned away from each other from a shared base, like a “V”, we feared an unplanned fall would have devastating consequences for anything or anyone within their reach. 

I was grateful for the skill and care of the arborist and his crew, who helped us safely through the process; we couldn’t have done it without them.  While relieved to see them come down, I honestly didn’t expect to experience the deep sense of loss that came over me. I suddenly had images of my late father and mother flood my mind.  Puzzled at first, I quickly understood the connection. They, too had been the mighty oaks in my life. 

Perhaps it’s just because I deal with grief and loss as an integral part of my work, but the metaphor resonates with me on many levels.  I had no idea who to call for help, I never had a need for that service.  It was my neighbor who recommended someone who had helped him in the past. The same was true with the passing of my father.  At the time, I had little, if any, personal experience with death and was ill-equipped for it. It was hospice that helped us through it.

Now, after decades of experience as a hospice professional, I can say that the same can be said about most families.  People spend more time planning their next vacation than how they want to spend their final days. Conversations about end-of-life are avoided as if just discussing the subject would somehow cause it to occur. Yet, for those who do call hospice and take the time to share their wishes, the experience is far less painful for both the patient and their family.  

For more than 43 years, Frederick Health Hospice has provided compassionate care to those approaching end-of-life and their families. When a cure is no longer an option, hospice prioritizes the in-home care and comfort of the patient so he or she can make the most of the time they have remaining. Our hospice focuses on what is possible and most needed. We constantly look for opportunities to improve the individual care of our patients and for ways to leverage our strengths in support of families and our community at large. Programs like Music Therapy, our Veterans Program, extensive bereavement services, and Camp Jamie (grief camp for children and teens) are just a few examples, and all are provided free of charge.  Most importantly, no one is ever turned away for inability to pay.  

My father was four months shy of his 76th birthday when cancer took him from us. Like all families who have shared the experience, we were left with more questions than answers: regrets and second guesses. We all uttered the refrain we hear most often from our families, “… I wish I had known about hospice sooner.”  While he was not in hospice for very long, I can tell you that it was a blessing to our entire family. It allowed us to be his family again, not his caregivers. He received tender care that allowed him to live out his final days in peace and dignity, and we received the emotional and grief support we so desperately needed to carry on without him.  

I learned through that experience that grief will always be with me but will not define me. Though painful, it reminds me of his strength and the love I feel for him. Like those fallen trees that shaded me, their absence has altered how I see the landscape of my life. While I can see much farther now, I will always miss my two mighty oaks.

Mr. Carlos Graveran has more than 30 years of experience in various facets of the healthcare industry. He currently serves as Executive Director of Frederick Health Hospice, a non-profit hospice agency in Frederick, Maryland. Prior to his current appointment in July of 2016, he served as vice president of operations for a national for-profit hospice agency and has held various other leadership positions in the hospice, home health and pharmaceutical industries. He is a passionate advocate for hospice and end-of-life care with demonstrated knowledge of hospice operations, leadership, financial management and strategy development. Mr. Graveran Co-Chairs the Public Policy Committee for the Hospice and Palliative Care Network of Maryland. He serves on the Board of Directors for several charitable organizations and enjoys giving back to the community as a volunteer to children’s charities and veterans causes. When not at work he enjoys spending time with his wife and two children, camping, hiking, hunting and travel. A graduate of the University of Maryland, Carlos is also a very proud U.S. Army veteran (Paratrooper, 82nd Airborne Division).

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Thinking about a life estate in Maryland? Learn the benefits, risks, Medicaid concerns, and alternatives before adding children to your deed.

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A life estate can be a useful planning tool for some Maryland families who want to protect a home, avoid probate, and plan ahead for the future. At the same time, life estates create permanent legal and financial consequences that are often misunderstood. Knowing when a life estate works well and when it creates long-term problems is essential before moving forward. This article explains how life estates function in Maryland, common risks families encounter, how life estates interact with Medicaid planning, and alternatives that may offer greater flexibility. What Is a Life Estate? A life estate allows more than one person to hold ownership interests in the same property at different times. In Maryland, this typically allows a parent to live in and control a home for life while naming children or other individuals to receive the property automatically after death. The person living in the home is called the life tenant. The individuals who will receive the property later are known as remaindermen. While remaindermen cannot take possession during the life tenant’s lifetime, they hold a present ownership interest in the property. Life estate deeds are often used to avoid probate, support long-term planning goals, and simplify the transfer of a home. These benefits must be balanced against the legal limitations created by the deed. When a Life Estate May Make Sense In limited situations, a life estate can serve a practical purpose. This is most common in straightforward family arrangements where a parent intends to remain in the home for life and wants the property to pass directly to a specific individual without probate. Life estates may also be considered when flexibility is not a priority and future long-term care needs are unlikely. Even in these situations, careful legal review is critical before creating the deed. When Life Estates Create Problems for Maryland Families Limits on Selling or Refinancing Once a life estate is created, the life tenant generally cannot sell or refinance the property without the consent of all remaindermen. This can create serious challenges if care needs change or the property must be sold to cover expenses. Some families explore tools such as a testamentary power of appointment or a nominee realty trust to increase flexibility, but these options require careful planning and are not appropriate in every case. Difficulty Changing Ownership Removing a remainderman from a life estate deed is far more complex than changing a beneficiary on a financial account. Once added, that ownership interest is legally significant and often cannot be undone without consent or legal action. Exposure to Remainderman Issues After a remainderman is added to the deed, their legal and financial issues may affect the property. Court judgments, tax liens, divorce proceedings, or bankruptcy can complicate ownership and create unexpected risks. If a remainderman passes away before the life tenant, their interest may pass through their estate, potentially requiring probate and introducing new parties into the ownership structure. Medicaid Look-Back Concerns Creating a life estate involves transferring a property interest. If long-term care is needed within five years of that transfer, Maryland Medicaid rules may impose a penalty period. Timing and structure matter, and mistakes can be costly. Nursing Home Recovery Risks If the home is sold while the life tenant is receiving nursing home care, the state may assert a claim against the proceeds to recover Medicaid benefits paid. This outcome often surprises families. Life Estates and Medicaid Planning in Maryland A common misconception is that a life estate automatically protects a home from Medicaid. While a life estate may avoid probate, it does not replace a comprehensive Medicaid planning strategy. Medicaid planning is highly timing-sensitive and should be coordinated with broader elder law goals. Families often benefit from reviewing life estates alongside other options discussed in our Maryland elder law resources. Alternatives That Offer Greater Flexibility Depending on family goals, other planning tools may provide better long-term outcomes. Revocable trusts, irrevocable trusts, and coordinated elder law planning strategies often allow for asset protection while preserving flexibility and control. These approaches may integrate more smoothly with Medicaid planning and incapacity planning and can reduce risk as circumstances change. Reviewing a Life Estate as Part of a Larger Plan Life estates affect more than property ownership. They influence taxes, Medicaid eligibility, and the ability to respond to future care needs. 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Life Estates in Maryland: Benefits, Risks, and Better Planning Options

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To schedule a confidential consultation, contact us onlin e, call our Columbia office at 443-339-5638, or dial 240-456-1657 to reach our Rockville office.

 2026 Maryland Super Lawyers and Rising Stars Lists

Managing Principal Stephen Elville, Principal Attorneys Shannon Goodwin and Shannon Ladner, and Associate Attorney Sara von Stein Echeverria Honored on the 2026 Maryland Super Lawyers and Rising Stars Lists

Authored by: Jeffrey D. Stauffer – Community Relations Director It was announced on Friday, December 19 th that Managing Principal Stephen Elville, Principal Attorneys Shannon Goodwin and Shannon Ladner, and Associate Attorney Sara von Stein Echeverria were honored on the 2026 Maryland Super Lawyers and Rising Stars Lists. Stephen R. Elville, J.D., LL.M. — Managing Principal Stephen R. Elville, President, CEO, and Managing Principal of Elville & Associates, P.C., has again been selected to the 2026 Maryland Super Lawyers List — his 11th overall and 10th consecutive year receiving this recognition. Mr. Elville’s practice centers on helping individuals and families through challenging legal landscapes with clarity, compassion, and technical skill. He leads the firm’s work in estate planning, elder law, special needs planning, tax planning and asset protection and preservation, long-term care planning, and more. Clients working with Mr. Elville benefit from his deep experience navigating both pre-crisis planning and complex crisis situations — giving them peace of mind and a personalized, long-term strategy. Throughout his career, Mr. Elville has built a reputation as one of Maryland’s most respected attorneys. His broad legal-technical knowledge, combined with a caring and client-focused approach, enables him to address a wide range of legal matters with confidence and clarity. In addition to his client work, he is a seasoned educator and speaker, regularly offering webinars and workshops for clients and the surrounding community, along with continuing education events for financial advisors. Mr. Elville is an active member of several professional organizations including the National Association of Elder Law Attorneys (NAELA), WealthCounsel, the Academy of Special Needs Planners, and as well as the EPIC Peer Group where he travels around the country each quarter learning from and teaching likeminded attorneys. He has held leadership roles including the past Chair of the Estates & Trusts & Elder Law Sections of the Howard County Bar Association, past President of the Coalition of Geriatric Services (COGS), and past Chair of the Elder Law & Disability Rights Section Council of the Maryland State Bar Association. He was also the long-term Chair for Law Day Maryland and recently served as Chair of the Pro Bono Subcommittee of the Elder Law Disability Rights Section Council. Outside of his legal practice, he is President of the Friends of Baltimore Classical Music, Inc. and Founder of the Elville Center for the Creative Arts, Inc. — a nonprofit dedicated to furthering music education for students with limited means.  Mr. Elville had a feature story written about him in the national Super Lawyers Magazine about the Elville Center and his efforts surrounding this initiative. Along with his charitable endeavors, Mr. Elville also supports community organizations such as the Autism Society of Maryland, the Brain Injury Association of Maryland, the National Alliance on Mental Illness of Howard County, the Howard County Public Library System Veterans Book Group program, and more. Shannon Goodwin, J.D. — Principal Attorney Shannon Goodwin has been named to the 2026 Rising Stars List for a third consecutive year. In her role as Principal Attorney, she leads Elville and Associates’ Estate and Trust Administration Department along with estate planning and tax planning. Ms. Goodwin guides clients through every aspect of administering estates — from the probate process and inventory reporting, to accountings, final distributions, and all detailed estate tasks. Her insight and dedication help families navigate what can often be complicated and emotionally difficult processes. Her background includes undergraduate studies at North Carolina State University, followed by law school — during which she distinguished herself as a member of the Syracuse Law Review. After graduation, she gained important legal experience working as a Judicial Law Clerk for three years in the Circuit Court for Washington County, and in the District Court for Washington and Frederick Counties. She joined Elville and Associates in 2021, bringing with her a strong foundation and commitment to client care. Shannon F. Ladner, J.D. — Principal Attorney Shannon F. Ladner has earned her place on the 2026 Rising Stars List for the fourth year in a row. She leads the firm’s Estate Planning Department, where she assists clients through every stage of planning — from initial consultation to plan design and implementation, and ongoing updates as laws and life circumstances evolve. Ms. Ladner’s practice emphasizes estate planning and special needs planning. Her work is grounded in a thoughtful, client-centered approach, ensuring that each plan reflects the client’s values, goals, and unique family situation. During law school, she contributed her talents to the Human Trafficking Prevention Project Clinic, representing victims of human trafficking as a Rule 19 Student Attorney. After receiving her J.D., she served as a Judicial Law Clerk for Magistrates Susan M. Marzetta and Lori Joy Eisner in the Circuit Court for Baltimore City. Before joining Elville and Associates, she practiced at a small law firm in Towson, Maryland where she gained valuable experience representing clients in family law and criminal matters. Sara von Stein Echeverria, J.D. — Associate Attorney 2026 is Sara von Stein Echeverria’s first of what we see as many future inclusions on the Maryland Rising Stars list.  Ms. von Stein Echeverria focuses her practice on estate planning, estate and trust administration, special needs planning, asset protection, and tax planning. She is known for her thoughtful, client-centered approach and her ability to guide individuals and families through complex planning decisions with clarity, empathy, and care. Sara works closely with clients to develop comprehensive plans that protect loved ones, reflect personal values, and provide long-term peace of mind. Sara earned her Juris Doctor, summa cum laude, from the University of Baltimore School of Law, where she distinguished herself through academic excellence and legal scholarship. She also holds a Master of Science from Birkbeck College, University of London, and a Bachelor of Arts, cum laude, from Dickinson College. Prior to joining Elville and Associates, her work included humanitarian and immigration-related legal advocacy, experience that continues to inform her compassionate and inclusive approach to client service. Sara is admitted to practice in Maryland and is an active member of the Maryland State Bar Association, the American Bar Association, and the Baltimore City Bar Association. To learn more about this year’s honorees and the entire team at Elville and Associates, please visit www.elvilleassociates.com. The firm is steadfast in its commitment to client education, compassionate legal service, and providing peace-of-mind solutions across estate planning, elder law, special needs planning, and beyond. Super Lawyers, a Thomson Reuters business, is a rating service of outstanding lawyers from more than 70 practice areas who have attained a high degree of peer recognition and professional achievement. The annual selections are made using a patented multiphase process that includes a statewide survey of lawyers, an independent research evaluation of candidates and peer reviews by practice area. The result is a credible, comprehensive and diverse listing of exceptional attorneys. The Super Lawyers lists are published nationwide in Super Lawyers Magazines and in leading city and regional magazines and newspapers across the country. Super Lawyers Magazines also feature editorial profiles of attorneys who embody excellence in the practice of law. For more information about Super Lawyers, visit SuperLawyers.com. #elvilleeducation