Conference News & Views

Dr. Vincent (Vin) Walkup, President of the Nashville Area United Methodist Foundation reminds you that the Pension Protection Act of 2006, which is scheduled to expire on December 31, 2007, allows person 70½ and older to give directly from a traditional or Roth Individual Retirement Account to a church and/or charitable ministry. How can a person unleash this potential? This may be done, with consultation from the administrator of the IRA, an accountant or other professional advisor, by transferring the amount that is required to be withdrawn this year (or any other amount up to a total of $100,000) to the church, the ministry, or institution.

Gifts must fully qualify for the charitable deduction and generally may not be made to a private family foundation or advised fund. Also, they cannot be used to fund a charitable remainder trust or gift annuity and still qualify for the tax-free status of the gift.

Are there any special procedures? Yes. It is important that tax-free gifts not be withdrawn by the individual, but instead be distributed directly to the church, ministry, and/or institution. We suggest that the individual check with the administrator of the IRA or other advisors for more information.

If a person directs a portion of an IRA or other retirement assets to his/her church, to ministries, or institutions related to the church, as part of an estate plan also help save taxes? Yes. Funds remaining in retirement accounts at death are considered part of an estate for federal tax purposes and could be subject to estate taxes. Unlike most other assets left to heirs, retirement funds that remain after estate taxes will also be subject to income taxes. Many well-advised people will choose to avoid this “double-taxation” by funding charitable gifts with such funds. Once again, your Foundation recommends that you check with your financial advisors to see the best ways in which you can maximize your estate giving and minimize the taxes your estate and heirs will pay.

The purpose of sharing this is to provide general gift, estate and financial planning information. This is not intended to provide legal, accounting, or other professional advice. You may contact Vin Walkup at the Nashville Area United Methodist Foundation, 304 S. Perimeter Park Dr., Suite 3, Nashville, Tennessee, 37211, (615)259-2008, or by email at vwalkup@nashaumf.org. He continues to be available for stewardship programs, general gift-planning seminars and to work with individuals and their advisors to discern ways to extend the love of Christ across time.

An Open Letter to Commissioner Susan Cooper, Tennessee Department of Health

A society ... in particular its leaders ... will be judged by how well it cares for its most vulnerable members. How will our society be judged? How will you be judged?

As you know, last week McKendree Village was informed that its Medicare/Medicaid certification would be terminated on December 29, 2007. As a result, those of us who have family members on Medicaid have been told that we need to be prepared to move them to another facility. At the present time, there are simply no beds available in the Nashville area. Even if there were, in my opinion, the emotional and physical trauma of transfer to a new facility would be harmful to the current residents many of whom are very fragile.

My mother has been at McKendree since August of 2006. I chose McKendree because I believed it to be the best nursing home (which accepts Medicaid patients) in the Nashville area. I still believe it is the best for her to be. Before Mom went to McKendree, she was in a vicious cycle of spending 3 or 4 days in the hospital for severe urinary tract infections, pulmonary emboli, dehydration, and mental confusion ... going to rehab for 2 or 3 weeks ... then coming home only to repeat the cycle of hospitalization and rehab a month or so later. From November of 2005 to July of 2006 (the eight months prior to her admission to McKendree), my mother had 4 hospital admissions and 3 rounds of rehab. Since she has been at McKendree (the last 16 months), she has had no hospital admissions and no need for rehab. I attribute her stability and improved physical condition to the quality of nursing care that she has received at McKendree.

I realize that the Tennessee Department of Health has been charged with surveying facilities like McKendree for the Center for Medicare/Medicaid Services. And I understand that such inspections are intended to promote the welfare of a facility's residents. What I don't understand is ...

• how can McKendree suddenly have 19 deficiencies ... when it has had an excellent record of caring for sick and elderly for 40 years and has received certifications from two national organizations?
• why was the certification terminated when McKendree was obviously working to address the issues raised? At the re-inspection, all but 3 points had been resolved.
• why is the final report (with the documentation about those 3 remaining violations) not going to be available until December 13th ... thus allowing only 9-10 business days to make any further corrections (when you deduct weekends and the Christmas holiday)?
• why is the sanction so severe? ... given that remaining deficiencies are related to procedural issues regarding incident reports and given the fact that no patient was harmed.
• it is my understanding that one of the members of the survey team was a former employee of McKendree who had been fired ... why was such a person allowed to participate in McKendree's survey? Can a person who has been dismissed be fair? Is it reasonable (or ethical) to put a possibly disgruntled former employee in the position of evaluating McKendree's performance?
• why at Christmas? The holidays are particularly difficult for older people. They are lonely. They feel isolated. They are grieving the absence of spouses, family members, and friends who have preceded them in death. How do I tell my mother that she will have to leave the place which she now calls "home?"
• given the holiday and the long delay in receiving the final report ... why can't the deadline for correcting the remaining 3 points be extended?
• are you willing to assume responsibility for the consequences of this action? The trauma of transfer will undoubtedly cause suffering to those least able to bear it. Can you, in good conscience, stand by a decision that may result in a worsening of their physical condition or death?
• in the end ... the residents effected remain Medicaid patients. If moving them to another facility results in a deterioration of their condition and the need for hospitalization, is the state prepared to assume that additional financial burden?

It is my belief that the decision to terminate Medicare/Medicaid payments to McKendree is NOT in the best interest of anyone ... the elderly, sick, and poor at the health care facility, their families, the staff and administration of McKendree, or the state of Tennessee.

I am asking you to step forward and stand with some of the most vulnerable members of our society. I am asking you to use your influence and do all that you can to make it possible for those with Medicaid benefits to remain at McKendree through the appeals process. I trust that, given time and the opportunity, McKendree will address the concerns of the Department of Health.

Can I trust you? How will you be judged?

May God grant you wisdom and a compassionate heart. And may the least of God's children have a "room in the inn" throughout this holiday season and in the weeks and months to come.

Sincerely,

Paula C. Hoos
221 Vantage Way
Franklin, TN 37067

We share a letter to Governor Bredesen from the son of a McKendree healthcare patient. The names of other facilities have been removed for the sake of privacy.

Dear Governor Bredesen,

My name is Chuck Lister and I’m writing on behalf of my Mother. I want to let you know that she (and I) are now facing a very serious situation due to the Tennessee Department of Health’s actions toward McKendree Village in Hermitage, TN.

Please allow me to give you some background leading up to this situation. In June of 1995 my Mother was stricken with viral encephalitis...only 2 years after retiring from years of dedicated work for the Red Cross and Eastman Chemical. At that point in time, she lived in her own home in Kingsport, TN. This illness or virus attacked the temporal lobes of her brain and she went into a coma for 2 weeks. When she finally awoke, we found that much of her long term memory was kind of a confused mess or completely gone. Also, emotions were confused and short term memory was maybe 15 seconds at best.

I can’t explain well enough with my poor writing skills the total emotional upheaval I felt. Doctors could not diagnose with complete confidence what the future would hold for her, but told me her chance of recovery was likely very slim at best. So we (I, my wife, and some family members) began trying to figure out a way to care for my Mom.

This is a brief summary of that history:
.1st two years…we paid caregiver type people to live with her at home in Kingsport. Finally, we had to come to terms with the fact that it was not likely that she would ever get better enough to ever regain her prior life and independence.
.Approx 1997, we moved her to Nashville where she lived with my sister during the week and with me and my wife on the weekends. After about 6 or 8 weeks, we realized this too was not going to work well as a long term solution for her care.
.So I took her to the Parthenon Pavilion and they helped evaluate her needs. Finally, they told me clearly that she needed 24 hour supervision in a secure or “locked” environment.

Over the next 8 or so years my wife and I made arrangements for her to live at the following places:

XXXXXXX Health Care in Nashville. My Mother stayed there until all of her money was gone. Since it is private pay only, I had to move her.

Metro Bordeaux Alzheimer’s Unit…she lived there for about 2 or 3 years. Then a friend told me about a place closer to my home in Antioch where her Mother stayed. So I decided to move her.

XXXXXXXXXXX Health Care…she lived at this place also for about 2 years. And it was while she lived at XXXXXXXXXX that we began to fully understand the differences in care that a person can receive. We had the normal everyday type issues…she sometimes was not properly dressed, they couldn’t find her shoes, etc. But since the place was only about 5 miles from my home, we just kept battling those relatively mundane issues with the hope of making the place better for her and others as well. Then we had some major issues:

• In the late summer of 2001, I received a call at ~ 10:30 PM. My Mother was at the Southern Hills Hospital emergency room. She had been found lying in a ditch near XXXXX Nursing Home. She was badly scratched, bruised, and battered. One eye was blackened and swollen shut…apparently she had fallen on her face. Since XXXXX did not even know she was gone when the police found her, she could have easily been run over and killed by someone in a car…we were very lucky to have had that policeman’s help.
  
  After that, XXXXX put some countermeasures in place to ensure the residents could not elope by locking the doors and stationing a person at the entrance 24 hours per day.
  
• Then another issue came…they allowed a dentist to see her and gave them permission to pull a tooth…without any notice or communication to me! When I visited her, the tooth was gone. After raising the issue and investigating, we found the Administrator had signed off on the approval form. This was completely against the rules and he was subsequently fired.
  
• Then she was somehow allowed to walk out the front door again. This time she was found at the local Mapco several blocks away.
  
  At this point, we knew we had to give up on XXXXXXXXX and move her to a better facility.

XXXXXXXXXX in Smyrna…she lived there for about a 2 year period.

Then around June 2005 I was notified that McKendree Village had an opening…we had been on their waiting list for about 7 years! And honestly at this point, I was in a quandary as to what would be the best for my Mother…move her again or continue staying at XXXXXXX where we were not having any issues worthy of mentioning.

My wife and I thought about this as intensely as possible. And finally, we decided that we believed McKendree would be the best for her long term care even if it meant another move and the upsetting of her normal routine…at least as much as she could have of a routine. So we took the risk and moved her again.

Now I must tell you something very important…that is absolutely one of the BEST decisions we ever made for her. The care she has received, the resources made available for her, the overall experience there --everything is so completely unmatched by any other facility that there is no way to compare them to McKendree. I firmly believe and have witnessed that McKendree Village is at an entirely higher level than the others. Honestly speaking, we should use McKendree as a benchmark to compare others as a way to heighten the performance of the healthcare system overall.

Finally, I know you can’t feel my emotion with these few words. But I hope you can somehow understand that I love my Mother very dearly. Taking away the funding for her care at McKendree Village is a nightmare for me and I think of it as a travesty of justice.

Whoever is forcing this issue to happen or endorses harsh actions against McKendree should be relieved of their responsibility. I say this because it is blatantly apparent that they do not know the real life situations regarding this type of issue. The actions taken against McKendree are most hurtful to the very people our Department of Health officials are charged with protecting.

I sincerely hope and am requesting your help to stop the harm being done…actually to my Mother…by the Tennessee Department of Health.

Respectfully,

Chuck Lister