Who Can Visit You in the Hospital? Anyone You Want!

We've all experienced it.  We wanted to visit a friend or relative in the hospital, but were told that visits were restricted to immediate family members.

No More!  Under new federal regulations, hospitals are now required to allow patients to have any visitors they want.

This new policy, which took effect in November 2010, recognizes that a patient should be able to choose whoever they'd like to be at their bedside.  Hospital care should be as "patient-centered" as possible, not guided by blanket rules designed to make life easier for hospital staff.  The policy recognizes that it's important for the patient to have the person who knows the patient's medical condition best to be present to talk with hospital staff, especially if the patient has difficulty recalling or communicating their own medical information.  In many cases, this person is not always a member of the patient's immediate family or "next of kin."

Of course, hospitals have the right--and the responsibility--to limit this visitor permission in certain circumstances, such as infection control, bad behavior of visitors, and other circumstances that would "jeopardize the care of the patient or other patients."  But these limitations are expected to be the rare exception rather than the rule.

So, while it's still probably not a good idea to invite the entire neighborhood to a party in your hospital room, you now have a great deal more control over which smiling faces you invite to come by and spend time with you.  And that can mean a lot!

Still Stuck in Estate Tax "Purgatory"!*

Here's an oxymoron for you--as an advisor, I want to be able to share an "update" with my clients and readers regarding the estate tax "repeal" situation, and there's really no solid update to report!  So, instead, I'll share a little bit of what has been going on behind the scenes...

There have at least been some meetings that have taken place.  There have been a number of different bills introduced, but nothing has really gotten very far.  The three most likely scenarios at this point are as follows:

1) A reinstatement of the estate tax with an exemption of $3.5 Million and a tax rate of 45%.

2) A reinstatement of the estate tax with an exemption of $5 Million and a tax rate of 35%.

3) Congress does nothing, and the estate tax comes back with an exemption of $1 Million and a tax rate of 55%.

Generally, Republicans favor the highest exemption and lowest tax rate, while Democrats generally favor reinstatement at the middle numbers (2009 levels).

Two developments have taken place seemingly make it less and less likely that there will be any action taken soon, however.

First, although Democratic leaders seemed willing to agree to Republican demands in recent talks, they still broke down.  It seems that there are many rank and file Democrats who are now willing to let the tax issue take care of itself, preferring to not take the political risk of appearing to pass legislation favoring the richest Americans--especially so soon before the November elections.

The Democratic leadership appears to be unwilling to bring legislation forward that does not have the support of the majority of the party.  One Senator is quoted as saying more than 80% may be opposed to the increased exemption and lower tax rate discussed by party leaders.  Thus, it may be that nothing is addressed prior to November and that any action taken would be rushed, as was the case with the failed effort to address the situation at the end of 2009.

The second issue that originally looked promising in terms of pushing early action was that of retroactive application of any reinstatement.  Retroactive application was "iffy" during the best of times.  Now, it seems like a long shot.

In late March, Texas billionaire Dan Duncan died.  With an estate estimated at $9 Billion dollars, Duncan was listed on Forbes as the world's 74th wealthiest person.  A lawsuit was a certainty if retroactivity was pursued by Congress at any point.  Now there are significant resources that would obviously be available to oppose any attempt to apply taxes retroactively.  Thus, the compelling urgency originally felt by those who want to reinstate the tax retroactively, already losing steam with each passing day, has now been undercut severely--and probably completely.

So, these are just a few key tidbits--I definitely haven't covered everything that's going on right now--but it doesn't appear that we'll be leaving estate tax "purgatory" quite yet.

*Adapted from the Planning Partners Press.

Patient's Rights: Non-Discrimination in Hospital Visitation

Did you know that there are some hospitals and medical facilities that will keep an unmarried person from visiting his or her partner?  There are.  And, many times it doesn't even matter if the people are in a heterosexual or same-sex relationship.  That's about to change.

On April 15, 2010, President Obama signed a presidential memorandum directing the Secretary of Health and Human Services to implement new rules to ensure that hospitals that participate in Medicare or Medicaid respect the rights of patients to designate visitors, and that such visitors should enjoy visitation privileges that are no more restrictive than those that immediate family members enjoy.

After such rules are promulgated, participating hospitals will no longer be able to deny visitation privileges on the basis of race, color, national origin, religion, sex, sexual orientation, gender identity, or disability.  However, the rules will still take into account the need for hospitals to restrict visitation in medically appropriate circumstances, as well as the clinical decisions that medical professionals make about a patient's care or treatment.

Further, the Memorandum directs that rules be put into place to ensure that hospitals that receive Medicare or Medicaid respect a patient's decision contained in the patient's advanced directives, such as durable powers of attorney and health care proxies, and that the patient's representatives otherwise have the right to make informed decisions regarding the patient's care.

This is great news for unmarried couples, whether they be in heterosexual or same-sex relationships, as well as people who wish to designate someone other than a family member to make their healthcare decisions for them.

To read the entire text of the Presidential Memorandum, click here.