I. FACTS
Eve Hargrave crushed her hip in a serious car accident. After surgery she regained her ability to walk, but still had significant nerve damage. This causes her to experience severe pain when preforming daily tasks. The doctors stated she will have this pain forever, therefore they suggested she complete whirlpool therapy treatments twice a day. The closest therapy facility is 50 miles away, so doctors recommended for Eve to install the exact whirlpool tub in her house that therapy facilities use. Since these treatments had previously helped Eve with her pain, she made improvements to her home to install the therapy tub, which she strictly uses for her treatments. She had to enlarge her bathroom because the tub was larger than a traditional
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IRC Section 213(d)(1) states that “‘medical care’ means amounts paid for the diagnosis, cure, mitigation, treatment, or prevention of disease, or for the purpose of affecting any structure or function of the body” (IRC Section 213(d)(1)(A)). Treas. Reg. Section 1.213-1(e)(1)(ii) goes on to say, “amounts paid for operations or treatments affecting any portion of the body... (are) paid for medical care…Deductions for expenditures for medical care allowable under section 213 will be confined strictly to expenses incurred primarily for the prevention or alleviation of a physical or mental defect or illness.” Treas. Reg. Section 1.213-1(e)(1)(iii) states that “a capital expenditure made by the taxpayer may qualify as a medical expense, if it has as its primary purpose the medical care of the taxpayer…A capital expenditure for permanent improvement or betterment of property which would not ordinarily be for the purpose of medical care…may, nevertheless, qualify as a medical expense to the extent that the expenditure exceeds the increase in the value of the related property, if the particular expenditure is related directly to medical care.” In Haines v. Commissioner (1979), Haines fractured his leg while skiing, reducing his ability to walk. Between surgeries his doctor recommended to exercise the leg with physical therapy which included whirlpool treatment, massage, and active and passive exercise. He used friends’ swimming pools before he built his own, and realized that swimming helped his leg. When filing taxes that year, he deducted $13,149.28 of the $19,732.92 of his new swimming pool. The court ruled that for the expenses to be deductible for medical care, they had to be “primarily for” the prevention or alleviation of the illness and “related directly to”
Maricopa County worked with Jorgensen after his first injury they gave him a weight limit and other accommodations to help him with his job. However, after his second injury Jorgensen was in no position by doctor’s order to perform the duties his job required him to do. Maricopa County also helped him by extending his work insurance to help him cover surgeries that were needed, because they did happen during work hours, and extended it 6 months even when he was on sick leave without
May 18th 2014 Mr. Beaird fell and broke his hip. This followed hip surgery performed by Dr. Baker and 21 day rehabilitation form Cordova NH. Before his 21 days was up Mr. Beaird tried to break out of NH by running his scooter though the front door at the NH. When the scooter hit the door, the door opened and Mr. Beaird rolled onto the front porch during this altercation, his foot was injured and the ambulance was called. Mr. Beaird was admitted to Senior Care and diagnosed with a
Working got a little more emotional when he saw the hot tub. “I suffered a back injury in Viet Nam. In 1986 arthritis had started and I became paralyzed. By 1996 I had 3 back surgeries and was in a wheelchair. It took awhile, but I finally got out of that wheelchair. The hot tub makes my back feel so much better,” he said.
“Bonnie Bowser, eighty-two years old, fell and severely injured her elbow. She was examined at the Emergency Department of the Miraculous Regional Health System and diagnosed with a fractured olecranon process, and referred to an orthopedic surgeon. The surgeon who examined Mrs. Bowser scheduled her for corrective surgery the next day. He noted in his examination that she had a past medical history of hypertension, diabetes mellitus, two myocardial infarctions with quadruple bypass surgery, and a cerebrovascular accident affecting her left side. She was taking several medications including Lasix (a diuretic), Vasotec (for treatment of hypertension and symptomatic congestive heart failure), Kylotrix (potassium supplement),
displayed signs of a suspected left hip fracture. Clinical indications would most likely show that the leg is held in external rotation and abduction, and appeared shortened when the patient lay in the supine position (LeBlanc et al., 2014). The patient would be in a high degree of pain and discomfort. Due to her care responsibilities, Mrs B. is keen to return home, and may be concerned about her ability to provide the same level of care after her injury. Where uncooperativeness and non-compliance with the requests of the nursing staff results, Milne, 2018, advises that patient cooperation relies on patience and good interprofessional communication.
In Mason, the taxpayer suffered a severe attack of paralytic poliomyelitis. The cost of installation of a specially designed swimming pool, installed on the advice of a physician to provide hydrotherapeutic treatment for the taxpayer was found by jury to constitute a deductible medical expense and not a nondeductible capital expenditure. The swimming pool in Mason covered an area of thirty by fifteen feet, had a depth of four to six feet, and included a ramp designed to facilitate entry by wheel chair. The jury held for the taxpayer and allowed a deduction of the pool as a medical expense because the design of the pool catered to the taxpayer’s medical needs.
Thus, a capital expenditure which is related only to the sick person and is not related to permanent improvement or betterment of property, if it otherwise qualifies as an expenditure for medical care, shall be deductible; for example, an expenditure for eye glasses, a seeing eye dog, artificial teeth and limbs, a wheel chair, crutches, an inclinator or an air conditioner which is detachable from the property and purchased only for the use of a sick person, etc. Moreover, a capital expenditure for permanent improvement of property may qualify as a medical expense to the extent that the expenditure exceeds the increase in the value of the related property, if the particular expenditure is related directly to medical care. Such a situation could arise, for example, where a taxpayer is advised by a physician to install an elevator in his residence so that the taxpayer's wife who is afflicted with heart disease will not be required to climb stairs. If the cost of installing the elevator is $1,000 and the increase in the value of the residence is determined to be only $700, the difference of $300, which is the amount in excess of the value enhancement, is deductible as a medical expense. If, however, by reason of this expenditure, it is determined that the value of the residence has
In Marsha Mouse’s case, therefore, it is necessary to determine whether the cost of installing an elevator is a medical care.
One night, my grandmother sprained her ankle quite badly on her way out from the bathroom. I saw my grandmother grimace in pain. I held her hands, cleaned her up, and hoped the pain she felt would stop. However, I was not trained enough to assist her. I took her to her normal podiatry clinic for the first time.
After coming home two and a half months from the hospital, the pain did not stop there. Amy had gotten two prosthetic legs, but that did not stop Amy from
Ivy, a 60 years old Asian woman sustains an ankle fracture from a fall in a shopping mall. After the surgery, Ivy goes to an Orthopedic surgeon for follow up, who does an initial history and physical checkup. Ivy has an active life. She walks every day about two miles and stays busy with household works. She has habits of drinking a few cups of coffee and a moderate amount of wine and also smoking. About two years ago she was diagnosed with rheumatoid arthritis.
She has refused to have a shower and do her routine ROM exercises due to the pain in her knee. She requires assistance to perform ADLs at this stage and expresses feelings of embarrassment and frustration. Mrs. Green has also reported that she has not opened her bowels since the operation.
Mrs Smith, 5 days prior to visiting hospital tripped and fell, her injury’s prevented her from standing up. At hospital she was diagnosed with a left fractured neck of the femur (L NOF) and required an immediate left total hip replacement surgery. Mrs Smith is 85 years old, lives with her husband at home, has no children however has a strong social support network through her church. She is involved in her community and continues to teach piano. Mrs Smith only known medicine issue is urinary incontinence. 10 days’ post-surgery Mrs Smith developed a urinary tract infection increasing her length of stay in the hospital. This led to the diagnosis of delirium, worsening of her continence issues impacting negatively on her mental health. This has resulted in slow progress in mobility and delay of her rehabilitation plan. Mrs Smith’s anxiety levels are heightened as she is fearful of falling again and is concerned whether she will be able to return home as her mother passed away shortly after she broke her hip. This case study will examine if Mrs Smith will be able to return home with an effective management & discharge plan based on a multidisciplinary team using a person centred approach. The treatment plan will endeavour to assist Mrs Smith to return home. A full health, coordination and function analysis is scheduled to assess to identify any underlying medical condition and possible risk factors for further falls.
Jane had undergone several surgeries to her left leg due to crushing both her tibia, fibula as well as her broken ankle. Jane had also broken her femur on her left leg. Jane spent several weeks in the hospital recovering from her injuries. When she was stable enough, she was transferred to an inpatient rehabilitation facility in the hospital. Jane had spent about two weeks at that facility. During which her daughter had moved her dad in with her due to his needs. Jane was now even further away from her family. Jane had demonstrated good steady progress however, due to
Patient has also been having problems with functional urinary incontinence because of her inability to get to the bathroom in time. Her oral intake had decreased and she has lost 10 pounds in the last six months. Her baseline weight is 230 pounds. She ambulates with the walker, but only when she must go to the bathroom.