17.11 Nursing Homes

Your payment for medical services, meals, and lodging to a nursing home, convalescent home, home for the aged, or sanitarium is treated as a medical expense subject to the AGI floor (17.1) if you, your spouse, or dependent is confined for medical treatment.

If obtaining medical care is not the main reason for admission, but you can show the part of the cost covering actual medical and nursing care, that amount is deductible, but not the cost of meals and lodging.

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Meal Costs at a Nursing Home
If the patient entered a nursing home to receive medical care, a deduction may be taken for meals and lodging while there, in addition to medical care costs.
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Establishing medical purpose.

The following facts are helpful in establishing the full deductibility of payments to a nursing home, convalescent home, home for the aged, or sanitarium:

  • The patient entered the institution on the direction or suggestion of a doctor.
  • Attendance or treatment at the institution had a direct therapeutic effect on the condition suffered by the patient.
  • The attendance at the institution was for a specific ailment rather than for a “general” health condition. Simply showing that the patient suffers from an ailment is not sufficient proof that he or she is in the home for treatment.

In an unusual case, a court allowed a medical expense deduction for apartment rent of an aged parent; see the following Example.

EXAMPLE
A doctor recommended to Ungar that his 90-year-old mother, convalescing from a brain hemorrhage, could receive better care at less expense in accommodations away from a hospital. A two-room apartment was rented, hospital equipment installed, and nurses engaged for seven months. The rent totaled $1,400. Ungar’s sister, who worked in her husband’s shoe store, nursed her mother for six weeks. Ungar paid the wages of a clerk who was hired to substitute for his sister in the store. Ungar deducted both the rent and wages as medical expenses. The IRS disallowed them; a Tax Court reversed the IRS’s decision. The apartment rent was no less a medical expense than the cost of a hospital room. As for the clerk’s wages, they too were deductible medical costs. The clerk was hired specifically to allow the daughter to nurse her mother, thereby avoiding the larger, though more direct, medical expense of hiring a nurse.
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