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Assisted Living Refund Huge

Mom's medical deductions include $126,000 for Assisted Living memory care (private pay, 24/7 care).  Her federal refund is now nearly $10K. Is this correct? Thanks!

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14 Replies
Vanessa A
Expert Alumni

Assisted Living Refund Huge

Possibly.  Did she have a pension or social security and have almost $10k withheld for taxes?  If so, it is possibly that her medical deductions took her taxable income down to $0. This would make anything she paid in refundable.

 

If she did not have any taxes withheld from any income sources, then you would need to go back through the return and check the entries to be sure everything is accurate. 

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Assisted Living Refund Huge

No taxes withheld on $26K from SS. However, we did liquidate her IRA ($73K) to help pay for assisted living.

I'm wondering if I should remove the $126,000 from assisted living and just keep the $9K paid out of pocket for doctors and prescriptions.

Assisted Living Refund Huge


@Cyndi12 wrote:

No taxes withheld on $26K from SS. However, we did liquidate her IRA ($73K) to help pay for assisted living.

I'm wondering if I should remove the $126,000 from assisted living and just keep the $9K paid out of pocket for doctors and prescriptions.


Three comments.

 

1. Print the tax return before you file.  The form itself is a list of simple addition and subtraction steps.  The rules for what things are added and subtracted may be complicated, but the form itself should be easy to follow.  You should be able to see why her taxable income is so low that she gets a refund of tax (including the withholding from the IRS liquidation.)

 

2. Why would you want her to pay more tax than required?  If she had qualifying medical expenses, why not claim them?

 

3. Be aware that assisted living may not be considered deductible medical expenses.  This is long so be patient and read all the way through.

 

Is memory care a deductible medical expense?  Normally, deductible medical expenses are doctor and nursing care, medications and so on.  Nursing care includes the kinds of care provided by a nurse but does not have to be provided by an actual nurse, and can include assistance with bathing, dressing, eating, and taking medications.  Other costs of assisted living facilities, like room and board, housecleaning, laundry and companionship are not deductible.  The facility should be able to provide a breakdown of costs.

 

There is a special rule for people with chronic illnesses, including cognitive impairment.  All of her memory care expenses are deductible medical expenses if you meet all these tests:

  1. your mother has a chronic illness that is certified by a doctor to last at least one year or lead to death
  2. your mother requires assistance with 2 or more activities of daily living, OR requires constant care due to a cognitive impairment to prevent her from becoming a danger to herself or others.  Activites of daily living are eating, bathing, toileting, dressing, transferring, and continence.
  3. her care is being provided according to a written care plan developed by a qualified professional that is reviewed and updated at least once a year.  Most memory care facilities will have a nurse, doctor or social worker on staff who can develop qualifying written care plans for their residents. 

If you must pay an entrance or initiation fee to the care facility, that is also a qualified medical expense if the three tests are met.  However, if any part of the fee is refunded when she dies or is transferred out to another facility, and you took a tax deduction before, the refunded portion may be taxable income at that time, since it is a reimbursement of a previous deduction.

 

If you don't have a written care plan, then only actual medical costs are deductible, and the facility can give you a breakdown of what is medical and what is not.  And obviously you should get a written care plan so you can deduct the expenses in the future. 

Assisted Living Refund Huge

Thanks for the response. Last year I paid an accountant to do her taxes. He did include the residence fees under Schedule A as a medical deduction (he did not include a worksheet specifying the type of deduction specifically). I hate the thought of having to go back to him since her taxes are so easy now. I just don't know if the $10K refund will send up a red flag.  I always did her taxes with TurboTax until 2020 when I sold her house and moved her into assisted living. 

ColeenD3
Expert Alumni

Assisted Living Refund Huge

Look over your 1040 and supporting schedules to see how this was calculated. As VanessaA said, there must have been withholding on some tax form, probably the 1099-R that accounts for the figure.

 

There is no reason to reduce legitimate expenses because you get your entire withholding back.

Assisted Living Refund Huge

As Opus17 mentioned, her Assisted Living bill every month does break down between the rent for the room ($8,000) and the medical  ($3,000) amount paid each month.  So, I'm thinking now just add the medical portion (help bathing, dressing and dispensing drugs), and leave out the room rent that includes cleaning (which they barely do, and I end up doing!), utilities, food (that she barely eats, I buy Ensure and Depends for her, so I'll include that) and social activities (that she never does -- she never leaves her room).

Assisted Living Refund Huge


@Cyndi12 wrote:

As Opus17 mentioned, her Assisted Living bill every month does break down between the rent for the room ($8,000) and the medical  ($3,000) amount paid each month.  So, I'm thinking now just add the medical portion (help bathing, dressing and dispensing drugs), and leave out the room rent that includes cleaning (which they barely do, and I end up doing!), utilities, food (that she barely eats, I buy Ensure and Depends for her, so I'll include that) and social activities (that she never does -- she never leaves her room).


Again, there is no reason to omit a legitimate expense just because you are afraid of the IRS.  They can't deny you a legitimate deduction if you can prove it.

 

However, in the case of assisted living facilities, you do need that written care plan that is updated at least yearly. 

Vanessa A
Expert Alumni

Assisted Living Refund Huge

The refund will not send up a red flag, if she had that much withheld and is getting money back.  If she had taxes withheld on her IRA withdrawal, and medical expenses that basically wiped out her income, it is not a red flag.  

 

Just be sure you are claiming the correct medical expenses. You do not need to lower your expenses just to lower your refund.  

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Assisted Living Refund Huge

Last year I sold her 50 year old house for $1.9M (really, the land, the house was worth nothing). I liquidated all of her stock ($150K). So, last year paid $429K in taxes. I don't want a red flag to go up with the IRS for 2021 if I suddenly get her a $10K refund.

Assisted Living Refund Huge


@Cyndi12 wrote:

Last year I sold her 50 year old house for $1.9M (really, the land, the house was worth nothing). I liquidated all of her stock ($150K). So, last year paid $429K in taxes. I don't want a red flag to go up with the IRS for 2021 if I suddenly get her a $10K refund.


Life happens.  Last year she had a huge schedule D for capital gains income, this year you don't.

Assisted Living Refund Huge

I just checked. Taxes *were* taken out of the IRA.  No taxes were taken out for her SS. 

Assisted Living Refund Huge

Assisted Living bill does break it down between a "residency fee" (room, food, activities, utilities)

 

Medication fees and Assistance fees.  So, do you think I should just include these two and leave out the room & board fee? Then the refund shrinks down to about $3K.

Assisted Living Refund Huge


@Cyndi12 wrote:

Assisted Living bill does break it down between a "residency fee" (room, food, activities, utilities)

 

Medication fees and Assistance fees.  So, do you think I should just include these two and leave out the room & board fee? Then the refund shrinks down to about $3K.


Does your mother have a written care plan for her condition, on file at the facility, and does she meet the chronic illness test (requires assistance with 2 or more ADLs or would be a danger to herself without supervision)?

 

If the does not meet the chronic illness test or does not have a care plan, then you only deduct medical and assistance.  (You should also get a care plan in place ASAP so you can deduct the full cost next year.)

 

If she meets the tests and has a written care plan, there is no reason to limit your deduction and leave your mother's money in the hands of the government. 

Assisted Living Refund Huge

Yes, I do have a care plan written up by assisted living. It describes how much care she needs. Now I know why they gave it to me! So, it does look like I should put in the full amount. Thank you SO MUCH for all your help!

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