Excessive medical expenses

Technical topics regarding tax preparation.
#1
JoJoCPA  
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I have a client who is considered "chronically ill". They are very wealthy and they are paying for 24/7 home health care. 2022 total costs were $150K. That represents only 1/2 year though. 2023 will be closer to $300K.

Is there a cap on how much you can reasonably deduct if your home health care costs exceed what a nursing home might cost? Can you be penalized and have your deduction capped for paying for the very best care possible at your own home? Never heard of such a cap. But never seen costs this high before.
 

#2
Nilodop  
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I sure hope not! Never been questioned.
 

#3
jon  
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There are 5 critical factors and if you cannot do 2 (or 3) of them, you get all of the care

My current medical expense is my client who has had cancer treatment for years has trouble walking without help. the Doctor gave the orders he needed an elevator for his home and it cost $68,000. The problem is no one knows realtors how much does it increase the value of the house. Common answer is it depends on the buyer?? HELP!!
 

#4
JAD  
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jon wrote:The problem is no one knows realtors how much does it increase the value of the house. Common answer is it depends on the buyer?? HELP!!


What a pathetic response. Really, there is no one you can pay who will provide a value? Perhaps you have to go upstream to an appraiser.
 

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JAD wrote:
jon wrote:The problem is no one knows realtors how much does it increase the value of the house. Common answer is it depends on the buyer?? HELP!!


What a pathetic response. Really, there is no one you can pay who will provide a value? Perhaps you have to go upstream to an appraiser.


Agreed. Go directly to an appraiser. Some realtors are real useless...obviously, the ones you've contacted won't even help you get connected with professionals they interact with regularly.
~Captcook
 

#6
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Depending on the house, it may not even increase the value.
I agree, get an appraisal.
 

#7
EZTAX  
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To OP, household employees are W-2 unless the agency is dealing with it. With such a large deduction make sure your bases are covered.
 

#8
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Yes. It’s an agency. But thx.
 

#9
jon  
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Realators all said they would rather sell a house without an elevator, but if the buyer was handicapped it may have some value.
 

#10
sjrcpa  
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The responders here said to go to an appraiser, not a realtor.
 

#11
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My personal experience is that, while appraisers have "rules" to follow (and for the most part they do), realtors exercise judgment based on current state of the market (or state at the date the valuation reflects). Both have merits, both have flaws, neither is perfect. IRS likes appraisals.

Example - request value at date of death, say one year earlier. Market was not so active around that date, but for reasons not directly relevant to value, such as pandemic. Appraiser has to go find whatever similar properties sold for then (not many). Realtor knows what he/she could have gotten for that house then. Wide disparity possible.
 

#12
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probably a decline in property value - how many people actually want an elevator in their house?
 

#13
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HenryDavid wrote:how many people actually want an elevator in their house?


Depends on the area I suppose. They're not uncommon in three and four level townhouses in my area, and are quite handy for getting groceries from the garage on the ground level to the kitchen (which is usually on the second or third level), and laundry between the levels.
 


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