John Bullis: Medical expenses for assisted living and nursing home expenses

Medical expenses are an itemized deduction for individuals to the extent the total is more than 10% of adjusted gross income.

Assisted living and nursing home expenses can be qualified deductions depending on the health status of the person living in the facility.

The expenses must be necessary diagnostic, preventive, therapeutic, curing, treating, mitigating and rehabilitative services, and maintenance or personal care services that are required for a chronically ill individual and are provided under a plan of care prescribed by a licensed health care practitioner.

Also, the licensed health practitioner needs to have certified within the previous 12 months that the individual is unable to perform, without substantial assistance from another individual, at least two of the daily living activities, for a period of at least 90 days due to a loss of functional capacity, or substantial supervision is required to protect the individual from threats to health and safety due to severe cognitive impairment.

The daily living activities that require substantial assistance from someone else are: eating, toileting, transferring, bathing, dressing and continence.

Substantial assistance is both hands-on assistance and standby assistance. Hands-on assistance is the physical assistance of another person without which the individual would be unable to perform the activity of daily living.

Standby assistance is the presence of another person within arm’s reach of the individual that is necessary to prevent, by physical intervention, injury to the individual while the individual is performing the activity of daily living. An example is being ready to catch the individual if the individual falls while getting into or out of the bathtub or shower as part of bathing. Another example is being ready to remove food from the individual’s throat if the individual chokes while eating.

Substantial supervision is continual supervision by another person that is necessary to protect the severely cognitively impaired individual from threats to his health or safety (such as may result from wandering).

The main point is for a plan of protection is certified by a licensed health provider.

Did you hear? “We think too much and feel too little. More than machinery, we need humanity; more than cleverness, we need kindness and gentleness. Without these qualities, life will be violent and all will be lost,” said Charles Chaplin.

John Bullis is a certified public accountant, personal financial specialist and certified senior adviser who has served Carson City for 45 years. He is founder emeritus of Bullis and Company CPAs.


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