17.12 Nurses’ Wages

Wages or fees paid for nursing services are medical expenses subject to the AGI floor.(17.1) Include any Social Security or Medicare (FICA) tax, federal unemployment (FUTA) and state unemployment tax that you pay for the nurse. A nurse does not have to be registered or licensed so long as he or she provides you with nursing services. Nursing services include giving medications, changing dressings, and bathing and grooming the patient. If the nurse also performs personal or household services, you generally can deduct only that part of the pay attributable to nursing services for the patient. However, if the patient is considered chronically ill, certain maintenance or personal care services are deductible as long-term care services (17.15).

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Nurse’s Services
The cost of a nurse’s services is a deductible medical expense, even if the nurse is not licensed or registered, so long as he or she provides the patient with nursing services. If household services are also provided, only the portion of the nurse’s pay attributable to the provision of nursing services qualifies.
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The cost of an attendant’s meals is included in your medical expenses. Divide total food costs among the household members to determine the attendant’s share.

The salary of a clerk hired specifically to relieve a wife from working in her husband’s store in order to care for her ill mother was allowed as a medical expense; see the Ungar Example (17.11).

EXAMPLE
Dodge’s wife was arthritic. He was advised by her doctor to have someone take care of her to prevent her from falling. He moved her to his daughter’s home and paid the daughter to care for her mother. He deducted the payments to his daughter. The IRS disallowed the deduction, claiming that the daughter was not a trained nurse. The Tax Court allowed that part of the deduction specifically attributed to nursing aid. Whether a medical service has been rendered depends on the nature of the services rendered, not on the qualifications or title of the person who renders them. Here, the daughter’s services, following the doctor’s advice, qualify as medical care.

Costs eligible for tax credit.

If, in order to work, you pay a nurse to look after a physically or mentally disabled dependent, you may be able to claim a credit for all or part of the nurse’s wages as a dependent care expense (25.4). You may not, however, claim both a credit and a medical expense deduction. First, you claim the nurse’s wages as a dependent care cost. If not all of the wages are allowed as dependent care costs because of the expense limits (25.5), the remaining balance is deductible as a medical expense.

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Does Equipment Increase Value of Home?
When special equipment is installed in your home to alleviate a disease or ailment, you must determine if it increases the value of your home. You generally may claim a medical deduction only to the extent that the cost of the equipment exceeds the increase in value. However, if you install a ramp or railing, widen doorways or hallways, or add similar improvements to cope with a disability, these are usually treated by the IRS as not adding to the value of the home.
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