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Mom has been in Memory Care since early this year. After a stroke in 2022, her mental and physical states have significantly deteriorated. She has had to transition from our home to Assisted Living, and now to Memory Care. Unfortunately she does not have Long-Term Care Insurance, so she is paying everything out-of-pocket. Since Medicare (and supplemental insurance) does not pay for non-medical components of Memory Care living, I am looking closely at the tax rules on medical deductions in IRS publications, specifically Publication 502 which outlines allowable medical expenses. It states, "You can include in medical expenses the cost of medical care in a nursing home, home for the aged, or similar institution, for yourself, your spouse, or your dependents. This includes the cost of meals and lodging in the home if a principal reason for being there is to get medical care. Don't include the cost of meals and lodging if the reason for being in the home is personal.” Another section of that same publication discusses long-term care services for chronically ill individuals and describes them as such: “if, within the previous 12 months, a licensed health care practitioner has certified that the individual meets either of the following descriptions: 1) The individual is unable to perform at least two activities of daily living without substantial assistance from another individual for at least 90 days, due to a loss of functional capacity. Activities of daily living are eating, toileting, transferring, bathing, dressing, and continence. 2) The individual requires substantial supervision to be protected from threats to health and safety due to severe cognitive impairment.”. Both of these descriptions fit Mom. Based on this wording, I strongly believe that Mom should qualify for the full cost of Memory Care based on substantial assistance for ADL and substantial supervision needed. Am I wrong? Is anyone else in this network in the same situation? If so, was there a specific form you needed from the "licensed health care practitioner" to justify this and did you run into issues with the IRS, such as an audit? Of course, we want to be perfectly legal,
I know that Medicaid might be an end option if she exhausts her resources, but we are hoping to avoid getting to that point, and it seems that the medical tax deduction would help tremendously. Any advice or insights would be appreciated!!

OH CPA here. All these expenses are 100% deductible. There is a high ceiling to meet in order to get any tax benefit from all these expenses; i.e. the medical expenses must exceed 7.5% of the person's adjustable gross income. If Mom has no income this should be easy; however she would not owe tax anyway if she has no income. If she is your dependent you can take the deduction, but again the dollar amount has to be more than 7.5% of your AGI to get any benefit.

Also, if you meet the above criteria, you must itemize in order to get the benefit. Almost no one itemizes any more, unless you have extraordinary expenses in one of the itemized categories.
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Reply to LakeErie
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I used a CPA who was a CFP MPA for filing my Mom's taxes for 4 years while she was in assisted living. He said all her AL expenses were fully deductible including room and board and I submitted all receipts to him. He filed accordingly and I have had no queries from the IRS. CPA said as long as there was a "Plan of Care" in place by a doctor it was all fully deductible. Her assisted living expenses exceeded her income and she received an annual refund of taxes witheld.
That being said you should consult a knowledgeable cpa cfp in your area to get specifics.
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Reply to Pjdela
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MurfPete: Pose your question to a CPA.
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Reply to Llamalover47
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The facility will give you a summary statement at the end of the year if you tell them you need it for taxes. Also make a complete list of things paid for separately, such as prescriptions, doctor visits, physical therapy sessions (if billed separately from the facility statement), premiums for Medicare and supplemental policies, etc. It should all or mostly be deductible and yes, that can make a big difference financially. I suggest for this year you take all the information to a tax accountant to give you the peace of mind that it has been done correctly. Then in subsequent years you can decide whether to continue with the accountant or do the same work yourself, if you feel confident about it.
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Reply to MG8522
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IRS has specific requirements to qualify for 100% deduction of cost to live and be cared for in Memory Care facility. Check out page 10 of IRS Publication 502 (irs.gov/pub/irs-pub/p502.pdf). As I understand it, there are specific requirements for documentation that you should have from the patient’s doctor and that the documentation should be updated annually. Probably best to get the advice of a tax professional—CPA or attorney to make sure you dot all the i’s and cross all the t’s.
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Reply to Maloneym2
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I deducted spouse’s MC monthly expenses for 2 months of 2023 and have had no IRS questions. Plan to do same for 12 months of 2024. I use TurboTax.
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Reply to Babsy1
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One of my mom's MC sent a paper indicating the percentage for medical care. Average is 41 to 44% of the monthly bill. When moved, I consulted with a new accountant and filed at 42%. Since all of her expenses were for her care, I brought itemized expenses. Each month I made a spreadsheet with the MC bills, professional services if a lawyer was needed, all medical expenses and her church donations
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Reply to MACinCT
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our memory care administrator gave me a percentage they felt was for actual care..I wrote it off as an itemized expense for 5 years with no issues..a good $20,000-25,000 a year..mom finally depleted all her money/assets and was moved to a NH on medicaid..Nothing left to worry about..
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Reply to Sadinroanokeva
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I have claimed my moms Assisted Living and later Memory Care expenses as a medical expense for the last decade. She has dementia and cannot live alone, cannot cook, cannot make medical decisions, cannot handle financial decisions, cannot give her own meds. As of the last two years, she cannot dress herself of even feed herself. I claim all of her income as a medical expense except the $52 per month they allow her to keep for clothing or haircuts. We have never had an issue with the IRS.

My mom is in these facilities because she has a mental condition that causes her to not be able to take care of herself or be left alone...Dementia. So yes, her residing there is a medical expense.
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Reply to Jamesj
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I'm an AARP tax aide volunteer, and also have a brother in law who's in a nursing home so am familiar with IRS regulations around tax deductibility of care. It does sound as though OP's mother meets the IRS criteria for being able to take the medical deduction for her care. Even though part of the services she receives is the room and board portion, her reason for being in the facility is based on the medical criteria, so the full cost is deductible when itemizing (with the proviso that you can only deduct the medical expenses that are more than 7.5% of your income). I do my brother in law's taxes, and have deducted his full NH bills every year with no problem. The IRS does not require any documentation be submitted. Presumably if a person is in a facility they have to meet medical necessity criteria to be there, and that's enough for the IRS.

Assisted Living is different, in that part of the bill is for room and board and part is for services. As tax preparers, we've found that most AL places will provide residents with an itemized statement showing how much of their bill is for room and board and how much is for services; we will include only the services portion as a medical deduction (if the person is itemizing).
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Reply to newbiewife
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This is not a medical expense its her residence.
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Reply to JoAnn29
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(author note): I want to clarify that the taxes are under Mom's own name. My wife and I do not declare her as a dependent, and she has no dependants of her own.
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Reply to MurfPete
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Full cost is never deductible, no. Because full cost includes room and board which isn't deductible that I am aware of.

You know, when my brother was in care for his Lewy's this question came up.
The CPA who had for life handled his taxes said "When your brother moves from ALF to MC you come to me with everything. I will let you know. This is all about percentages that go for this and percentages that go for that, and meeting a level where it reaches my ability to make anything tax deductible; and the truth is you want not to meet that level, because it is high".
He kind of smiled at thinking he could possibly explain to me how it all worked. He tried a bit, but as with a doctor knowing that the removal of your appendix is quite complicated and inexplicable, you kind of hire the expert, give him all the stats and let him go.

Wishing you good luck on that hard day. But for legal stuff you need, when you need expert advice, not a Forum, not a good book, but an attorney. For Financial it is the CPA just as for medical it is the MD. You really need an expert.
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Reply to AlvaDeer
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MargaretMcKen Nov 22, 2024
Alva, the quote OP gave us says that the deduction “includes the cost of meals and lodging in the home if a principal reason for being there is to get medical care. Don't include the cost of meals and lodging if the reason for being in the home is personal”.
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I'm assuming she's in the US?

See this article: https://www.aplaceformom.com/caregiver-resources/articles/tax-deduction-for-memory-care-facility#

Why don't you have her pay a CPA to answer this question accurately once and for all? H&R Block? Turbo Tax?
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MurfPete Nov 22, 2024
Excellent article, Geaton777. Thank you! Yes, she resides in Tennessee about 1.5 miles from us in a Memory Care facility.
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Hi! First up, I’m answering this based on a lawyer’s understanding of what you have quoted, I have no other knowledge. I qualified in South Australia and requalified in London England, not in the USA. Based on that, I’d say that you can go ahead with a certification from a licensed health care practitioner. No form is indicated, but clearly it should be on letterhead with all the qualification ‘tickets’ stated including license number if appropriate. My advice is to get a mainstream doctor, not a chiropractor or any ‘practitioner’ on the ‘maybe’ side. If you do that and it is questioned, if M gets knocked back there shouldn’t be any penalty because it is clearly genuine. So nothing to lose except the ‘practitioner’s’ fee. I’d give it a go. I don't think a local lawyer's appointment would give you any better protection than this. You can quote me if it helps. Best wishes, Margaret McKenzie LLB FCCA
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(author note here...) MargaretMcKen, good point. She files taxes for herself (of course, with our help!), so the medical deduction would be for her, not on our form with her as a dependent. She is not our dependent, and has none of her own.
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Reply to MurfPete
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It would help if you could make it quite clear if you are looking at M claiming as ‘yourself’ on her own tax return, rather than you claiming for her as a ‘dependent’ on your tax return.
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MurfPete Nov 21, 2024
MargaretMcKen, good point. She files taxes for herself (of course, with our help!), so the medical deduction would be for her, not on our form with her as a dependent. She is not our dependent, and has none of her own.
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