What Portion of Memory Care Homes is Deductible?

I was going to post this on the old CH forum, but the whole thing appears to be gone now.

My father is in a Dementia care home that cost $5500 a month last year. (This year it is $5800!) Medicare pays for none of it, and he had no long-term care insurance.

When they sent an annual summary, they only listed the rent, plus trivial amounts for “personal supplies” like toothpaste, floss, shampoo, etc.

Is any of the $5500 a month deductible? Surely some of it can be classified as medical care instead of all of it room and board. We already had $10,000 a month unreimbursed for home nursing aides we can deduct, so it would be nice if some of the rent was deductible as well.

This is big enough that I’d probably contact a tax professional instead of us.

As for it counting as medical, maybe some pieces, but I’m skeptical about most. Most of the memory care places are specific about the type of care they provide and won’t call it medical.

We had a flexible spending account and my wife’s adult day care qualified for that, just like the kid’s daycare. After their max, I could count the rest under the dependent care credit.

Long-term care qualifies but the question is the amount of the rent that counts for custodial care and how much is merely your food, clothing, shelter.

I can’t answer your question, but I’ll let you interpret what the IRS says. This is their related publication.

That is what I was trying to get them to break down for me, and they wouldn’t. Meals and shelter cost would not be deductible. We buy his clothes.

But apparently from your reference, ALL of the nursing home cost is deductible, if it is necessary for his health.

“You can include in medical expenses the cost of medical care in a nursing home, home for the aged, or similar insti- tution, 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.”

The reason he is in there is he has dementia and cannot be left alone.

I would look into whether they draw a distinction, as many do, between assisted living centers, which most memory care places are, and skilled nursing facilities (nursing homes). The latter provide more medical care, but it can get fuzzy.

They get Dad out of bed, help in the bathroom, shave him, dress him, wheel him to meals, bandage his wounds, etc. He really cannot do any of these things by himself anymore. Sad to see a former airline pilot go down like this. Probably will happen to me one day.

I thought meals and shelter were deductible if they were required for care?

I am not an accountant just to be clear.

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Apparently after reading some IRS regs, you are correct.

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I know mileage can be claimed in some cases.

Due to the dollar amount. I wouldn’t take my advice. I’d get an accountant. That could be a sizable deduction.

Our tax system is overly complicated.

Thanks. She has a CPA and even he is unsure of it!

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As I said our system is overly complicated. It shouldn’t be that complicated.

My GF had a glitch on her taxes. It took 6 CPA to figure out how to fix it. It was based on a prior tax credit she had to pay back and nobody knew how to document it properly.

I am sorry you are having to deal with this. My grandparents are going through the same thing.

Makes me think about my parents in 20 years, and then myself & my wife.

Often I hope I go down quickly, even at an earlier age, rather than slowly & painstakingly losing my faculties.

There is one positive that I see. Losing all your memories means you lose your bad memories. My mother does not remember that my father cheated on her. Not remembering hurts makes it impossible to hold grudges. It sort of returns one to the stage of innocence a child has.

That kind of thing varies tremendously.

There is an old saying, “Once an adult. Twice a child.”

I suppose an absence of bad memories is a silver lining, but I suspect I would be overwhelmingly sad & depressed to see a beloved family member succumbing to dementia & approaching death.

It is sad for me to see Mom and Dad like this, after seeing them live such accomplished lives.

But in another sense, both seem happier than they ever were, freed of memories of hurt and regret. No worries about taxes and bookkeeping, as I take care of it all. They gave a very motivated investment manager, as the better I do with their portfolios, the more my sister and I will inherit eventually.

The two of them (in different facilities) have company always, and are never at a lack for people to talk to. Every day is a new day. Monotony is not a problem because even if they do exactly what they did the day before, they don’t remember what they did the day before. Therefore, every day’s experiences are like no others before.

Routine is very helpful with dementia patients.

I am glad your parents have gone in the direction of contentedness.

Yes, we found routine is important. When my parents are finally allowed to leave, we might try to take them somewhere for a little while, but they will likely be uncomfortable outside their familiar environment. Mom does not even remember what her house looked like or where it is anymore.

Well said. I believe your positive attitude is extremely helpful to everyone involved.