Universal Design Makes Life Easier at The Cloister

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:

1. 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.
2. 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.
3. 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.
4. 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.
5. 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:

1. Raised front-loading clothes washers, dryers, and dishwashers
2. Side-by-side refrigerators
3. Easy-access kitchen storage (adjustable-height cupboards and lazy Susans)
4. Low or no-threshold stall showers with built-in benches or seats
5. Non-slip floors, bathtubs, and showers
6. Raised, comfort-level toilets
7. Multi-level kitchen countertops with open space underneath, so the cook can work while seated
8. Windows that require minimal effort to open and close
9. A covered entryway to protect you and your visitors from rain and snow
10. Task lighting directed to specific surfaces or areas
11. Easy-to-grasp D-shaped cabinet pulls

Before and After Bath Remodel

https://cloisterliving.wordpress.com/2012/06/23/making-cloister-life-a-little-easier/

For Those With Just About All They Need and Almost Everything That They Want

Gift ideas for Downsized Seniors (Courtesy of Harpeth’s “The Meadows” Website)

• A warm fuzzy throw.  You can’t have too many throws that keep you warm when you are watching television or reading a book.  And they make a nice lighter blanket for a single bed.  Throws can even be customized with photos or favorite sports teams.
• Food.  What about a special fruit basket or fruit-of-the-month club?  Or maybe a special batch of their favorite cookie, fudge or cake that they no longer make. They might like a special candy.  Hard candies are nice for those taking medicine that creates a dry mouth. Local produce delivered to their home might be welcome as well.   It’s a thoughtful treat they might not think about for themselves.
• Clothes.  Sometimes shopping trips become less frequent and a senior might need a new sweater or jacket.  Front opening blouses or shirts are easier for many to put on.  Jogging suits are also popular with both men and women.  They might appreciate sleepwear, robes, slippers or underwear.
• Batteries.  It is always a good idea to have extra batteries on hand.  Many need batteries for hearing aids, watches and maybe a favorite electronic device.
• Movies.  Classic movies like Sound of Music, My Fair Lady and A Wonderful Life would be fun to watch as a family and provide future entertainment for your family member.  Other popular movies include “The Bucket List”, “Lincoln” or movies they can watch with their grandchildren like “Up”, “The Princess Bride” or “The Polar Express”.
• Kindle or Tablet. Think about loading a Kindle or iPad with books, movies, family photos and magazines they would like.  Then spend an afternoon showing them how to use it, send emails to their grandkids and even surf the internet.
• Easy to use Mobile Phones.  Many smartphones of today offer large buttons, photo speed dial, visual rings and more. There are also landline phones that can be adjusted for volume.
• Lift Chairs.  For those who have trouble with their knees or experience weakness, a recliner built with an easy-to-use lift might be just what the doctor ordered.
• A Magnifier and Family Photo Album.  A family album already filled with pictures that bring back special memories of friends and families is always valued.  Why not add a lighted magnifier to assist in viewing those great photos?
• Lap Desk.  A bean bag lap desk, some note cards and stamps would make a great gift.  A portable lap desk can be used for crafts, eating and reading.
• Grocery store and restaurant gift certificates.  Being able to manage grocery expenses or splurge on a lunch or dinner with friends helps ensure good nutrition.
• Coupons for Rides.  If your family member has stopped driving, provide a book of coupons for excursions they can share with family members.
• Donations to a favorite cause or charity of your relative or friend.  A friend of mine asked her family to provide a piano for their church.  She can attend weekly and enjoy her “present”.
• Walking shoes.  Athletic or comfort shoes that encourage walking or exercise can provide healthy benefits.  A handsome walking cane might be appreciated as well.  The folding canes are especially handy.
• Manicure, massage or spa treatment.  A day of pampering might fit the bill.  Whether it is massage, a manicure/pedicure or a welcome haircut, these personal treats boost well-being.
• Movie, concert or play tickets.  Retirees on a budget might not spend on these type of outings so tickets would be welcome.  And also, maybe your accompaniment.
• Classes or lessons.  Maybe your family member always wanted to learn how to use a computer, play a card game or tackle a new craft.  A class at a senior center or community center might encourage social interaction and new skills.
• Wreath for their front door.  While holiday decorating might not be as important, a fresh new wreath for their door is a welcoming touch for their home.
• A Handyman Day.  Putting in new light bulbs, fixing a squeaky door or repairing an appliance might be more meaningful than any other gift.  Put a bow on your head.
• Easy to use tools and pens.  For those with arthritis or grip problems, there are many padded grip tools like the OXO Good Grips kitchen tools and soft pens.

Link

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:

http://www.elderlaweducation.com/Blog/December_2013/Thinking_of_Giving_and_Gift_Taxes

Beware of Increased Deductibles and Copays on Lab Tests and Procedures

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 |

Written by
Tom Wilemon
The Tennessean

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 twilemon@tennessean.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.

About David Bynon

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.

The Tiny Sign on My Front Lawn

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

Real Estate Taxes at The Cloister

A Cloister neighbor recently sent a note about how she has reduced the real estate taxes for her unit. This may be a good deal for some Cloister residents.

Link

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.