One of the greatest advantages of home ownership at The Cloister is the Universal Design features built into every Cloister home. Universal design creates an attractive, stylish space that everyone, regardless of age, size, or ability, can live in or visit. A home with Universal Design makes it easier for us to live in, and for guests to visit now and in the future, even as everybody’s needs and abilities change.
Home Features and Products Using Universal Design
Downsizing to a universal design home is usually much cheaper than remodeling a house with traditional design features although I have seen a ranch style home on Brook Hollow Road in West Meade where the entire front yard was landscaped to change a four step entry porch to a stepless entry front entrance.
Having Universal Design features and products in a home makes good sense and can be so attractive that no one notices them — except for how easy they are to use.
Essential Universal Design features include:
- No-step entry: At least one step-free entrance into your home — either through the front, back, or garage door—lets everyone, even those who use a wheelchair, enter the home easily and safely.
- Single-floor living: Having a bedroom, kitchen, full bathroom with plenty of maneuvering room, and an entertainment area on the same floor makes life convenient for all families.
- Wide doorways and hallways: With your home’s doorways at least 36 inches wide, you can easily move large pieces of furniture or appliances through your home. Similarly, hallways that are 42 inches wide and free of hazards or steps let everyone and everything move in, out, and around easily.
- Reachable controls and switches: Anyone — even a person in a wheelchair — can reach light switches that are from 42-48 inches above the floor, thermostats no higher than 48 inches off the floor, and electrical outlets 18-24 inches off the floor.
- Easy-to-use handles and switches: Lever-style door handles and faucets, and rocker light switches, make opening doors, turning on water, and lighting a room easier for people of every age and ability.
There are many other universal design features and products that many people put into their homes, including:
- Raised front-loading clothes washers, dryers, and dishwashers
- Side-by-side refrigerators
- Easy-access kitchen storage (adjustable-height cupboards and lazy Susans)
- Low or no-threshold stall showers with built-in benches or seats
- Non-slip floors, bathtubs, and showers
- Raised, comfort-level toilets
- Multi-level kitchen countertops with open space underneath, so the cook can work while seated
- Windows that require minimal effort to open and close
- A covered entryway to protect you and your visitors from rain and snow
- Task lighting directed to specific surfaces or areas
- Easy-to-grasp D-shaped cabinet pulls
Before and After Bath Remodel
Sometimes money is a great Christmas gift to our children and grandchildren. It can be a good gift on other occasions. But sometimes gifts are taxable…….
Reporting Gifts to the IRS
How and when is the gift reported? The IRS has a form, Form 709, designated specifically for reporting the gift and it is due on or before April 15th following the year the gift was completed.
A completed gift as opposed to a gift of future interest is one in which there are no strings attached and no expectation of getting the property back. A gift of a future interest is one that the recipient will not be allowed to enjoy fully for a number of years, for example a gift to an irrevocable trust where the beneficiary does not have the immediate right to withdraw and use the gifted property.
Gift Taxes Due?
What about any tax implications for the recipient? Property is received at the tax basis of the grantor. So highly appreciated property may have a significant capital gains burden for the recipient one day when the property is sold.
Gift Tax Exclusion
What’s the difference between an exclusion and an exemption? The annual exclusion amount is $14,000 for 2013 and will remain $14,000 for 2014 per person except for gifts made to your spouse who is an United States citizen. Gifts made to a spouse, that is an United States citizen, are not subject to the exclusion amount. Married couples can combine their annual exclusion amounts for gifting to someone else. For example, if a married couple wanted to make a gift to someone else each of them could give up to the annual exclusion amount without having to paying any taxes. An exemption from gift taxes is the life time amount that a person can gift away from their estate without incurring any federal gift tax.
Gift Tax Exemption
Any lifetime gift tax exemption used will reduce the estate tax exemption of the person making the gift. The 2013 limit is $5,250,000.00 and this amount will increase in 2014 to $5,340,000.00. Tennessee abolished its gift tax effective January 2012.
To summarize; gifts greater than the annual exclusion amount are reportable but can be applied toward the life time exemption amount. However use of the lifetime exemption will reduce the estate tax exemption amount available at death. Gift taxes may not be due presently or ever, depending on the size of the overall estate. As always we recommend seeking the advice of an accountant or tax specialist for specific questions.
Gifts and Medicaid
Another related area of confusion is the relationship of gift tax law and the penalties Medicaid may impose on gifts within the designated look back period. These are two completely separate aspects of the same action. Older persons considering gifting significant resources, not usual and customary holiday gifts, may need to take into consideration the implications of that gift on potential future public benefit needs.
Source of this information:
Blue Cross/Blue Shield plan will cut out middle man markups that doctors and medical clinics charge for outside lab services …….a St Thomas MD and the Tennessee Medical Association give their opinion.
Patients may get stuck with lab bills after insurers cut reimbursements
Dec. 6, 2013 |
Patients may be writing multiple checks and paying more for a visit with their doctor as insurers slash reimbursements to physicians for blood work.
After a similar move by its competitors, BlueCross BlueShield of Tennessee has notified doctors that it will cut payments for lab tests in half. The trend puts the pinch on physician practices that do their own lab work as well as those that can make money by outsourcing the service.
The scenario sets the stage for consumers to be billed directly by lab companies, said Dr. Sally Burbank, a Nashville internist. Health care consumers could end up with multiple invoices for a doctor’s visit just as they do with a hospital stay. One bill would come from the practice for the time spent with a physician. The other would come from the laboratory that did the blood work.
“If we refuse to pay the lab bill, then the lab will be direct-billing the patients or the insurance company,” Burbank said. “If they bill insurance but it’s all deductible, then the patient has to pay it.
“The labs charge patients much, much more than doctors because patients have a history of not paying their lab bills.”
Burbank said that after Cigna lowered its reimbursement for lab work, her practice got out of that billing cycle.
“Every time I did lab work, I lost money,” she said. “I was paying people’s lab bills, then losing money.”
Patients on high-deductible plans were “madder than a hornet” when they received bills directly from the independent labs, she said.
BlueCross BlueShield gave doctors within its preferred network until today to reject the change but said it had the option of terminating network status for those doctors who did. Doctors removed from the BlueCross network would lose patients because it would cost their patients more to use an out-of-network physician.
BlueCross plans to cover only 52 percent of what Medicare pays for lab tests instead of matching the Medicare reimbursement rate as it currently does.
Paying market rates
Roy Vaughn, vice president of BlueCross in Tennessee, said the insurer simply wants to pay the real market rate for lab services instead of paying more than what its competitors pay. And he said the insurer has already contracted directly with lab companies that will do the services for the new reimbursement rates. Doctors have the option of sending specimens to those labs, he said.
“We want to make sure we are paying market rates — not more than market rates — because if we’re paying more than market rates, it inhibits our ability to win customers,” Vaughn said. “The bottom line of it all is when we pay more, it costs our customers more.”
The Tennessee Medical Association, which represents state doctors, has asked BlueCross BlueShield to reconsider.
“BlueCross is the biggest player in the state,” said Yarnell Beatty, vice president of advocacy for the association. “In most parts of the state, the largest pool of patients are going to be covered by BlueCross. It’s a volume issue. If you significantly cut reimbursements for a large pool of your patients, that’s going to have a significant impact on medical practices’ bottom line.”
Contact Tom Wilemon at 615-726-5961 or email@example.com.
Doctors are fighting mightily to maintain their income as Obama Care continues to reduce health care costs and they are squeezed by Medicare as the Baby Boomers reach Medicare age.
In a recent Blog……
The Centers for Medicare and Medicaid Services could have spent $1 billion less in 2011 by negotiating lower rates for lab tests in the same way that state Medicaid plans and private insurers did. This is the finding of the most recent inspector general’s report.
According to The Wall Street Journal recently, a review of rates for the twenty most common lab tests discovered that CMS paid 18 to 44 percent more than state Medicaid plans and private insurers, soaking taxpayer for at least $910 million in unnecessary expenses. The figure is likely to be much higher once all 1,100 lab test fees are reviewed. A CMS spokesperson claimed that the department may not have the authority to revise payments, a claim that hardly seem feasible considering all of the cuts made my CMS in recent months.
Medicare is the largest consumer of clinical lab services in the USA, spending over $8 billion on tests in 2010. The IG suggested Medicare could cut costs by requiring fee-for-service beneficiaries to contribute with a co-pay or deductible for lab services. This is the norm with most private insurers. Eleven states also require lab fee co-payments in their Medicaid programs.
Mr. Bynon is a Medicare benefits expert, senior rights activist, proud U.S. Navy veteran and coffee achiever extraordinaire. He blogs regularly on MedicareWire.com (Medicare news) and AllMedicare.com (senior health). Connect with him on Twitter @MedicareWire.
Sometimes when you pass our Cloister home you will see a tiny sign on a wire stuck in the corner of our front lawn. A company called Prime Lawn offers a great deal to Cloister residents that helps keep our lawns looking good….and for $15 per treatment. Jim Johnson has been treating our lawn and that of some of our neighbors for a number of years. This is an example of some of the treatments he offers…
Jim doesn’t even bother us when he is in the neighborhood. He simply leaves his little sign and mails a bill
The Affordable Care Act, Obamacare, improves Medicare coverage but threatens the Silver Sneakers coverage by reducing funding for Medicare Advantage.
From The Tennessean
But it does not change the dangerous hospital “admission for observation” practice.