Assisted Living

[FEDUKE404]

Review assisted living payments?

Thanks to all you who replied to this thread. My decision is to deduct all their medical expenses that have not been reimbursed by insurance and let the rest to sleeping dogs. I did not want to over look anyh possibilities that would benefit this couple. You are a great asset and a darn smart group of advisors.

You certainly are entitled to do whatever you and the clients are comfortable with.

That being said, based upon the facts provided, I would personally NEVER claim the "expenses" of the (apparently able-bodied) husband while he was living with his wife in the assisted living facility. It is not uncommon to have a scenario such as that, so that the couple can continue to live together while also relying upon needed professional assistance. But that just does not justify deductible "medical expenses" for the spouse who is not in a medical condition requiring a care level consistent with that provided in an assisted living facility.

With this situation, I feel it is an error to deduct 100% of the expenses paid to the assisted living facility as a qualifying medical deduction.

FE

[Chief]

Assisted Living

Thanks to all you who replied to this thread. My decision is to deduct all their medical expenses that have not been reimbursed by insurance and let the rest to sleeping dogs. I did not want to over look anyh possibilities that would benefit this couple. You are a great asset and a darn smart group of advisors.

[Chief]

Assisted Living

Yes Acropol is the name of the best restaurant in the area. Located on Starkey road between ulmerton and East Bay Roadsl The Largo area.

[Burke]

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.

Paying a CNA or a state-licensed home health aide directly (whether or not they are the TP's children) would involve payroll, W-2's, tax withholding, etc, etc. It can be deductible, IMO, if they are providing medical care. I have deducted such expenses for a stroke victim, albeit they were not relatives. Since the employment is in the home, workman's comp is also involved here -- and expensive. See Publication 926, Household Employees, table on page 4.

PS: I have relatives in Tampa. Is Acropol the name of the restaurant?

[mactoolsix]

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.

Chef - If the daughter is actually paid as a caregiver, then the payments would be deductible for the parents, and income for the daughter. I don't see the benefit here - especially if the daughter is a CNA, she may be required to file a Sch. C and SE Tax. Read this on Family Caregivers and SE Tax http://www.irs.gov/Businesses/Small-...Employment-Tax

I'm not sure the son even needs to be "state licensed" - but again you may be opening up more taxes and filing requirements than it's worth.

Mike

[FEDUKE404]

Negative

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.

Somewhat in the range of zero.

What is the demonstrable medical necessity for the "outside food" ??

As for any allowable "contribution," what exactly would be the qualifying (recipient) institution for the largesse of the donor ??

(Oh yes - I would think the medical staff might be on somewhat thin ice for providing non-approved food to a patient, especially if dietary concerns were an issue. "Can you bring me a pack of cigarettes to smoke when no one is looking?")

On further review, I think perhaps "zero" is an optimistic guess.

FE

[WhiteOleander]

That would not necessarily create a charitable contribution. They would have to be a charitable org.

[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 .........

[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

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.

[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

[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

[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.

[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

[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