During the current year, Madeline gives each of her three grandchildren, Mary, Mike and Molly, cash in the amount of $13,000. In addition, Madeline pays college tuition of $20,000 for Mary and private high school tuition of $10,000 for Mike, directly to their respective schools. Madeline also pays $8,000 in medical bills for Molly to the hospital where she received care. What are the gift tax implications for Madeline given these facts?