Assisted Living

[Chief]

A couple both 83 years old lived in an assisted living facility jan thru May 2013 All of their costs which they paid them selves qualified as medical expenses. They moved into a condo that they owned and immediately went to a home health care basis. Their medical doctor has signed a statement that the wife must receive an assisted level of care. The husband lived an independent life style. In figuring the cost of the assisted living style for the wife may one figure the standard lodging of $77 per night and $51 per day for food (they have actual receipts by credit card) A maid service comes in weekly for house cleaning at a cost of $85 per week. All of these would qualify as medical expenses. In addition there are actual receipts for a home health aide $150 per week, a nurse every other weeks for $300, a physical therapist at $300 a weeks, a service dog with expenses of $250 per month, medical bills paid $11,000 per year.

The cost of a 24 hour care home health aide/nurse/cna would be approximately $5200 a month according to a social worker. What would be a reasonable cost for the husband to claim for his care of the wife which includes bathing other hygiene tasks, ordering medication and giving it, constant care and taking care of her (she is in significant stage s of alzheimer's) What would be a reasonable cost of the son who chauffers the couple around and does maintenance of the condo they live in?

What is your take on such a situation. I want to be ready to assist this couple in planning for the future because the husband is a veteran who qualifies for a VA pension. Do you have any suggestions for me?

[MDEA]

Assisted living

Has he applied to the VA for money for the care of his wife?I do not know all the rules but my mother in law receives over $1100. a month for care from her husbands VA benefits.He is deceased do not know if that matters.

[Burke]

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The cost of a 24 hour care home health aide/nurse/cna would be approximately $5200 a month according to a social worker. What would be a reasonable cost for the husband to claim for his care of the wife which includes bathing other hygiene tasks, ordering medication and giving it, constant care and taking care of her (she is in significant stage s of alzheimer's) What would be a reasonable cost of the son who chauffers the couple around and does maintenance of the condo they live in?

Are you trying to calculate this for benefit purposes? Because there is no tax deduction for the spouse's time value of his services. Are they actually paying the son? Otherwise, none for him either.

[mactoolsix]

A couple both 83 years old lived in an assisted living facility jan thru May 2013 All of their costs which they paid them selves qualified as medical expenses. They moved into a condo that they owned and immediately went to a home health care basis.

They moved from the assisted living to the condo which they own - they cannot deduct anything for lodging - THEY OWN THE LODGING - There is no expense.

Their medical doctor has signed a statement that the wife must receive an assisted level of care.

The medical statement would help for deducting the ALF costs, but you cannot claim a cost for the spouse's services & time.

The husband lived an independent life style.

Good for him - tell him to enjoy it, but Uncle Sam isn't going to pay him.

In figuring the cost of the assisted living style for the wife may one figure the standard lodging of $77 per night and $51 per day for food (they have actual receipts by credit card) All of these would qualify as medical expenses.

Per Pub 502, ALF meals are deductible only for the "chronically ill" and if included as part of the inpatient care.

In addition there are actual receipts for a home health aide $150 per week, a nurse every other weeks for $300, a physical therapist at $300 a weeks, a service dogs with expenses of $250 per month medical bills paid $11,000 per year.

OKAY - I'd claim these as other medical

The cost of a 24 hour care home health aide/nurse/cna would be approximately $5200 a month according to a social worker. What would be a reasonable cost for the husband to claim for his care of the wife which includes bathing other hygiene tasks, ordering medication and giving it, constant care and taking care of her (she is in significant stage s of alzheimer's) What would be a reasonable cost of the son who chauffers the couple around and does maintenance of the condo they live in?

ZERO

What is your take on such a situation. I want to be ready to assist this couple in planning for the future because the husband is a veteran who qualifies for a VA pension. Do you have any suggestions for me?

Definitely have them look into VA assistance if he qualifies. There are even organizations that will help fill out the proper paper work. It takes months to get, so apply as soon as eligible.

Here's the link: http://elder-care-community.aplacefo...px?PageIndex=1

Mike

[Chief]

Assissted Living

Yes the husband has applied for the VA pension which I understand is nontaxable. They own the condo; could they deduct the going rental rate and the maintenance fees and utilities? Could
The charges for the ALF the month of May were $3800 monthly which were totally deductible as a medical expense. Could they deduct the $51 per day for the wife of should they use actual receipts for food costs which include restaurant and grocery receipts. The situation involves two considerations: the IRS tax return for 2013, and the planning for the VA pension. In addition an attorney was hired ($1000) for drawing up wills, and trusts for the couple.
The only pay the son received was constantly taking him to eat in restaurants and paying a number of his bills. A record was not kept of these expenditures.
Thanks to those you who took the time to post to this thread.

[mactoolsix]

Yes the husband has applied for the VA pension which I understand is nontaxable. They own the condo; could they deduct the going rental rate and the maintenance fees and utilities?

Yes, the VA Assistance is non-taxable.
NO, the going rental rate for maintenance, utilities etc is not deductible - do you normally deduct these items for anyone that is not ill and lives at home?

The charges for the ALF the month of May were $3800 monthly which were totally deductible as a medical expense.

YES

Could they deduct the $51 per day for the wife of should they use actual receipts for food costs which include restaurant and grocery receipts.

NEITHER THE DAILY RATE OR THE FOOD IS DEDUCTIBLE

The situation involves two considerations: the IRS tax return for 2013, and the planning for the VA pension. In addition an attorney was hired ($1000) for drawing up wills, and trusts for the couple.

The Tax Return and Tax planning fees are deductible. The cost for a will, family trust etc is not.

The only pay the son received was constantly taking him to eat in restaurants and paying a number of his bills. A record was not kept of these expenditures.

NOT DEDUCTIBLE

Mike

[FEDUKE404]

Not much available

With the possible exception (more facts needed - facility usually provides a "tax statement") of Jan-May ALF charges, I don't see anything you could legitimately deduct as a medical expense. Certainly not the cost of the home nor food nor "husband's services" nor cleaning services. (The specific medical charges would likely be deductible, although I assume insurance paid some of those specific costs.)

There may be some pocket change in the lawyer's fees (invoice specifies for management of financial assets, etc) but those would have to survive the 2% misc deductions haircut.

BTW: I find it curious "their medical doctor has signed a statement that the wife must receive an assisted level of care" but yet they moved into their private home?? That action would almost seem indicative
they needed less care the second half of the year. Furthermore, if the ALF costs were for both H/W, it almost sounds as if the W only needed (and qualifies for) deduction of her portion of the ALF charges.

FE

[mactoolsix]

With the possible exception (more facts needed - facility usually provides a "tax statement") of Jan-May ALF charges, I don't see anything you could legitimately deduct as a medical expense.

Per pub 502:
Meals
You can include in medical expenses the cost of meals at a hospital or similar institution if a principal reason for being there is to get medical care. The doctors statement shows a need for a facility for medical care, thus the meals (for the wife) would be deductible.

Furthermore, if the ALF costs were for both H/W, it almost sounds as if the W only needed (and qualifies for) deduction of her portion of the ALF charges.

FE

Agree - probably gonna need a statement to breakdown the ALF charges.

Mike

[FEDUKE404]

Meals differ within year

Per pub 502:
Meals
You can certainly include in medical expenses the cost of meals at a hospital or similar institution if a principal reason for being there is to get medical care. The doctors statement shows a need for a facility for medical care, thus the meals (for the wife) would be deductible.

Mike

I was assuming the meals (wife only) were already included in the ALF charges for the first part of the year. In most cases, true ALF charges (virtually all) are deductible, especially if the meal charges are included in the cost of such "care." The twist here is that somehow the husband's expenses apparently are mixed in with those of the wife for that period of time. Those expenses must definitely be excluded.

OTOH, I see no way the meals for the wife in the second half of the year can be construed as a "medical expense."

FE

[Chief]

Assissted Living

The basic question here is can the wife claim assisted living while under home care of medical professionals. Regardless of that fact all the expenses plus the income of the couple plus the estate planning figure into the couple application for a VA pension.

[mactoolsix]

The basic question here is can the wife claim assisted living while under home care of medical professionals. Regardless of that fact all the expenses plus the income of the couple plus the estate planning figure into the couple application for a VA pension.

Chef - I have to hand it to you - you are persistent.

If the person with the doctors statement has expenses related to their medical care, they can take a medical deduction. If there are medical professionals providing home care, that would be deductible.

The problem is in your op, you indicated she had moved into a condo she owned and her husband was providing care - none of this would be deductible as there has not been any expenses paid. AND NO the husband can not bill his spouse for services rendered.


Pertaining the VA Aid & Attendance - I believe this would be considered medical reimbursement, thus reducing any deductible medical expenses, however I could not find anything to cite for this.

Mike

[FEDUKE404]

Husband is not a "medical professional" ?

The basic question here is can the wife claim assisted living while under home care of medical professionals. Regardless of that fact all the expenses plus the income of the couple plus the estate planning figure into the couple application for a VA pension.

I cannot answer anything as to what does/does not apply to any VA pension issues.

As for the "basic question," if I read you correctly you are trying to claim as a Schedule A medical deduction expenses incurred for the wife (latter part of the year) living in her own home with her spouse. She cannot claim the operating expenses of the home, nor any meals, and certainly not the presumed value of any potential "care" provided by her spouse. She cannot claim any per diem dollar amount, as a medical deduction, for lodging/meals. Should there be identifiable medical expenses, such as nursing care, home health care specialist, or physical therapy then those should be deductible as a medical expense. Those expenses, of course, would have to be reduced by any insurance benefits received for the payment of same.

This is a tax board, so that somewhat determines the manner of responses you will receive here.

If goes without saying there are many older couples, NOT living in an assisted care facility but rather in their own home, where the able spouse expends much energy and expenses maintaining the home and caring for the less able spouse. But those normal expenses of maintaining a home cannot meet the IRS definitions for assisted living (deductible) expenses, hence no deduction.

BTW: You have never responded to several inquiries here re the assisted living expenses for the first part of the year. Based upon the statements you have made, I would deem the following to be an incorrect conclusion: "All of their costs which they paid them selves qualified as medical expenses." You might have a very difficult time proving to the IRS the valid medical/assisted-living expenses for the able-bodied husband who was merely living under the same roof as his spouse.

It should be noted there is now more "wiggle room" than before for legitimate expenses for a person with cognitive issues. There is apparently a window of opportunity available for some "maintenance and personal care expenses" incurred in their (non-assisted living) home, but again I don't think you are going to be able to claim the husband as being "paid" any theoretical expenses. Nice summary is here: http://www.seniorlivingresidences.co...vised-2013.pdf

Again, I think the income tax issues are reasonably clear as to what you might/might not legitimately deduct. Someone knowledgeable in dealing with VA benefits/claims would have to advise you on that aspect of your situation.

FE

[Chief]

Assisted Living

Now suppose the daughter who is a CNA provides home health services. Would all the pay be deductible as a medical expense. Also regarding the son who would be state licensing as a home health aide would payments to him be deductible as medical expenses? Yes, Mike I am persistent?
Thanks to all you who replied on this board. If you are ever in the Tampa Bay are call and I will treat you to an Acropol Steak dinner or one of the best Greek dishes you have ever had.

[TAX4US]

Have a TP(83) who is in a nursing home due to stroke and large % of heart not working. Left side totally messed up. Has very little use. ocassionally ask nurses or staff to bring TP outside food because he doesn't like the food at NH. What would the possibility of deducting these. I personally do not think so.

[Chief]

Assisted Living

The only way to deduct these would be to give the money unrestrictive to the institution which would then pay the costs of the outside food. You would have a charitable contribution to the institution. This line of action raises a whole new set of questions

What a tangled we weave .........