# Nursing Home Receipt



## Belguy

Last year, my mother moved into a nursing home. They recently sent me a list of fees which mom paid for each month of her residency there. They only show the total fee by month with no further breakout.

My question pertains to what I can do with this information as it relates to her 2011 income tax form?


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## kcowan

You cannot claim anything without a further breakdown. My suspicion is that it contains things like haircuts and nail clipping so none of it is claimable...


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## MoneyGal

A portion is claimable as rent, and a portion may be claimable as a health care expense. See http://www.cra-arc.gc.ca/tx/ndvdls/...ng/ddctns/lns300-350/330/ttndcr/menu-eng.html


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## MoneyGal

kcowan said:


> You cannot claim anything without a further breakdown. My suspicion is that it contains things like haircuts and nail clipping so none of it is claimable...


Haircuts and nail clipping are explicitly claimable. From the link I provided above: 

Which attendant care expenses can you claim as medical expenses? You can claim attendant care expenses as medical expenses that include your share of the salaries and wages paid for care in an establishment, to all employees performing the following duties:

•food preparation;
•housekeeping services for a resident's personal living space;
•laundry services for a resident's personal items;
•health care (registered nurse, practical nurse, certified health care aide, personal support worker);
•activities (social programmer);
•*salon services (hairdresser, barber, manicurist, pedicurist*) if included in the monthly fee;
•transportation (driver); and
•security for a secured unit


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## praire_guy

kcowan said:


> You cannot claim anything without a further breakdown. My suspicion is that it contains things like haircuts and nail clipping so none of it is claimable...


My mother in law gets one receipt, with no breakdown of anything. In Manitoba you pay a daily amount, based on income. The more you make, the more you pay. 

For a care home to break down how much is spent on services per person based on income would be unrealistic. 

We get a letter from the home stating the amount paid, and what it includes, rent, food prep, prescription drugs, etc. 

Never had a problem with CRA except last year we got a letter asking for documentation as she effiled her return. 

We submitted the letter, with no break down and CRA replied back saying they Allowed the deductions. 

She claimed 26k in care home expenses. Things like cable, phone, haircuts (not included in her "rent") are on a separate trust account. 

So you do not need a breakdown, kcowan. 

However if you are living in a 55+, or assisted living the yes you need to break down and separate things for CRA. Maybe this is what you were thinking of?

There is nothing to separate in a personal care home.


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## MoneyGal

We get a breakdown for my grandmother-in-law. It isn't based on her income (how would they know what her income is?) -- it's based on what she pays. It isn't down to the level of haircuts received etc. but it breaks out rent and attendant care expenses. We were also asked to verify last year's paper-filed return and CRA adjusted the amount reported by the retirement home.


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## Homerhomer

praire_guy said:


> For a care home to break down how much is spent on services per person based on income would be unrealistic.
> 
> .


It actually is being broken down by categories, unless Manitoba is that much different then ON when it comes to filing personal income taxes, medical expenses (including prescriptions and nursing care) is claimed seperately from rent, and food can't be claimed at all. That's why it is broken down by nursing homes by category and given to each individual.


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## praire_guy

In Manitoba you can pay from 800 a month, up to 2200 per month, based on income. 

Every year you have to provide a copy of your notice of assessment. It would be hard to determine everyone's individual costs. They don't pay nurses less per hour to look after the person who only pays 800 a month then they do someone who pays 2200. 

Not sure if I am making sense. She gets a receipt for 26 k at the end of the year. It includes everything except hair cuts, cable, etc. 

Rent is included, nurses salaries, food prep, and food, attendant care, laundry etc. we claim the full amount. 

How do care homes work in other provinces? Does everyone pay the same amount?


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## praire_guy

Btw, I am not talking retirement home, 55 plus, or assisted living. 

I am talking about a personal care home with 24/7 nursing, doctors, pharmacy, occupational therapists, etc.


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## MoneyGal

I think we are probably talking about different things, to some extent. 

Publicly-funded "nursing homes" (properly called "long-term care facilities") charge a fee based on the individual's income. 

Of the amount that is paid by that individual, the facility will (typically) provide a breakdown as Homerhomer and I suggested. 

However, people use the phrase "nursing home" to mean any kind of facility, whether publicly-funded or not, that provides what is called "attendant care" to occupants (usually the elderly, but also people with cognitive or other impairments). 

For public long-term care facilties, the amount that an individual pays will vary - but the shortfall, where there is one (typically there is, otherwise they would not be there), is made up with a public subsidy. So it isn't that they "pay less," but that they receive a taxpayer-funded subsidy for the shortfall. The total bill COULD look like (but does not) a bill which shows the total cost for the room, board and services, the amount paid by the occupant, and the amount of subsidy. That amount is 100% known and available, but it isn't published in the way I'm suggesting. 

My grandmother-in-law lives in a "retirement home" -- not a publicly-funded long-term care facility -- and she gets a detailed receipt every year. I do her taxes and claim rent and attendant care expenses for her on her tax return.


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## MoneyGal

x-post with PG. The facility I am talking about in my family's case also includes 24/7 nursing, on-site doctors, pharmacy, etc. The relevant factor isn't any of those things - it's the presence or absence of public funding.


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## praire_guy

Yes I am talking about a long term care facility. 

We do not get a break down, only a letter stating how much was paid (26k), and a brief list of what is included in this amount. 

I was told by HR block and CRA that you claim the full amount for a long term care home, and you have to break down amounts if it is not a long term care home ie 55 plus, lions club home. Basically if you are just old you claim only medical expenses, but if you are in a long term care facility you claim the whole amount as a medical expense. 

Not sure if I am making sense but person A pays 9600 a year and person B pays 26k how do you determine how much went to pay salaries ? Everybody who works the facility looks after everybody regardless of what is paidby the patient. 

Itis what it is. You make this much and this is how much you pay to stay. 

As stated we claimed the whole amount which is all inclusive and cRA was ok with it. 

In order to claim the full amount we had to apply for a medical disability certificate. 

You can't also claim the 10k disability amount, but not both.


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## MoneyGal

praire_guy said:


> Not sure if I am making sense but person A pays 9600 a year and person B pays 26k how do you determine how much went to pay salaries ? Everybody who works the facility looks after everybody regardless of what is paidby the patient.


It's broken down by services received, irrespective of how the people providing the services were paid. I think you are confusing two things here.


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## MoneyGal

I don't think we are helping Belguy. Belguy, you should contact the place where your mother is living and ask them directly how you are to report her expenses on her tax return.


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## praire_guy

MoneyGal said:


> It's broken down by services received, irrespective of how the people providing the services were paid. I think you are confusing two things here.


I am not confused I am having a hard time trying to say what I mean. People pay different amounts. How can they determine how much is paid for services? Is 10 % goes to nursing , 5% goes to drugs?

From the letter we get each year:


"this fee is an amount set by the Manitoba govt (Manitoba health and healthy living) based on the income of an individual, which covers 24 care at a personal care facility. Manitoba health does not provide a breakdown of this amount. The payment is used to provide 24 hour care , which includes:

-meals
-assistance with daily living activities like bathing, dressing, using the bathroom. 
-salaries paid for medical and pharmaceutical services, registered nurses, health care aids;
-salaries paid for food prep, maintenance personnel, housekeeping, and laundry, and recreation co ordinators
-transportation and security services
-routine medical and surgical supplies
-prescription drugs eligible under Manitobans personal care program
-physiotherapy and occupational therapy
-routine laundry and linen service

If you have the disability certificate and are in a long term care facility you claim the full amount, with no break downs


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## MoneyGal

Well, it may be that for publicly-funded long-term care homes, no breakdown is ever provided. However, I can tell you that when there are no public funds, a breakdown is provided, at least in the cases with which I am familiar!


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## Homerhomer

MoneyGal said:


> Well, it may be that for publicly-funded long-term care homes, no breakdown is ever provided. However, I can tell you that when there are no public funds, a breakdown is provided, at least in the cases with which I am familiar!


Absolutely.

I don't see how food can be claimed on personal income tax regardless if the payment is made to a local grocery store, restaurant or a health care facility.
Rent is rent, if someone stays at the facility full time then portion of the payment is rent, again doesn't matter who the rent is paid to it should be claimed as rent on T1, not as medical expense.

In every case I had to deal with the amount was itemized by category either in dollars or percentage.

Maybe there are such differences from province to province.


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## praire_guy

All I'm saying is that even with no break down, you claim the full amount 26k in our case, provided that we have the 2201 disability tax credit certificate. 

No certificate, then you have to separate rent and food, etc. 

Out of curiosity MG, how much do care homes cost in your neck of the woods? I think Manitoba and Saskatchewan are income based. Not sure about everywhere else. 

Just wondering where we sit in Manitoba. 

Ultimately regardless of what she has to pay, she is in good hands, and the facility is excellent. She enjoys a great quality of life, given the bad situation she is in, and is well cared for. 

At the end of the day that's all that matters.


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## MoneyGal

Taxtips agrees with PG: 

Nursing home expensesIncome Tax Act s. 118.2(2)(d)

*When the expenses are for full-time care in a nursing home, there is no limit on the total expenses that can be claimed as medical expenses for yourself or your spouse or common-law partner, but the disability tax credit cannot be claimed.* When these costs are claimed for other eligible dependents, they are subject to the limits for medical expenses for other eligible dependents. When claiming expenses for full-time care in a nursing home, either

Form T2201 Disability Tax Credit Certificate must be submitted and approved, or

a letter from a medical practitioner must be provided which certifies that the person needs a full-time attendant due to mental or physical infirmity, will be likely continue to be dependent on others for the long term.

See http://www.taxtips.ca/filing/attendantcareexpenses.htm


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## MoneyGal

There is a HUGE range in what people pay in Ontario. My grandmother in law is not in a "nursing home" (although she is turning 95 in May!) but she is in a private retirement residence that provides a very high level of care. She doesn't require more care than what she is getting now, for which we are very grateful. I did briefly look into nursing home facilities in Toronto but we do not require (1) that level of care or (2) public assistance.


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## praire_guy

I know what you mean and this is what I am trying to get across. When she was healthy she had a paid for home, so no rent, and she deducted drugs, cane, etc. 

Now it coasts her 26k a year rent and food (if you call tube feeding food) is included in this amount. 

Phone CRA and tell them your situation. They will tell you what I am telling you. Form 2201 and you deduct the full amount. 

It shouldn't matter province to province. We were asked last year to provide documentation for the 26k deduction. That allowed it. Food, and "rent" as well. 

Believe me with such a large deduction, if there was a problem CRA would have disallowed it or re adjusted. 

Also, we do have privately run homes, as well as church run homes. Doesn't matter, it is all based on income in Manitoba. 

I am talking LTC facilities, not assisted living, Kiwanis club, or lions club homes for old people. 

MG, I am curious as to the range of costs? I'm not sure I follow. You say it is not based on income, what are the ranges based on?


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## caricole

*



prairy guy....In order to claim the full amount we had to apply for a medical disability certificate. 

You can't also claim the 10k disability amount, but not both.

Click to expand...

**We had to take it one step further

Private old age HOME.....she was cooking her own meals

We claimed the TOTAL COST OF RENT AND SERVICES (no food included)....BUT

1) Had to provide a DISABILITY CERTIFICATE

2) Had to provide A LETTER FROM THE DOCTER STATING « THE HOME PROVIDES NECESSARY SERVICES REQUIRED FOR HER DISABILITY CONDITION».....(in this case...mobility problem...but every room was equiped with a panic button in case of a fall) and personal available come to the room and help

3) Included also the jurisprudence stating «RENT CAN BE A MEDICAL EXPENCE IN SOME CASES»

4) It was hard to get it accepted, but when it was, we used it up and till her dead at 84 without further problem*


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## Belguy

I would like to thank everyone for your thoughtful responses but am still confused. When Mom entered the nursing home, I remember that they provided a form to claim disability but I did nothing with it as she has already been claiming the disability amount for some years now. Despite that, do I still have to fill out another form in order to now claim the FULL nursing home fee in lieu of the disability amount for the first time on her 2011 tax form? I also plan to ask the nursing home how to handle this whole sordid mess as I am not very good at such things. Why, on the federal tax website, do they say that a complete breakout of costs is required in order to determine what is eligible for a deduction when the provincially supported nursing home does not supply this breakout? It sounds like the usual government bungling to me!! Does the government not ever know how to make things simple?


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## OhGreatGuru

I don't know where you get the impression that you need a breakdown of costs for a long-term care facility. Read p.14 of T4068:
_Generally, you can claim the entire amount paid for full-time care in a nursing home._

There is a presumption that all the costs in a Nursing home's annual receipt are necessary for the care of the resident. Non-care costs such as cable TV & telephone are either billed separately, or at least won't be included in the nursing home's income tax statement. You may get separate invoices for some visiting care services such as dentists and foot care nurses - these would be claimable as additional medical/care expenses. The long-term care facility for my father (in Ontario) provided no breakdown.

If you already have a valid disability certificate for your mother you should not have to submit a new one. From CRA T2201: _"If we have already told you that you are eligible, do not send another form unless we ask for one."_ The form letter your mother received from CRA approving her application for a disability certificate should say the same thing, unless her disability was expected to be temporary.


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## Homerhomer

I am glad this was brought up and PG fought tooth and nail ;-), didn't know it as every case I dealt with had the amount broken down.

Thank you.


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## OhGreatGuru

Homerhomer said:


> Absolutely.
> 
> I don't see how food can be claimed on personal income tax regardless if the payment is made to a local grocery store, restaurant or a health care facility.
> Rent is rent, if someone stays at the facility full time then portion of the payment is rent, again doesn't matter who the rent is paid to it should be claimed as rent on T1, not as medical expense.


- To get into a long term care facility, you have to be suffficiently disabled that you cannot live independently.
Nearly all long-term care in Canada is government subsidized, whether it is publicly owned or privately owned. 
- The rates are set by the province, and people who can't afford the set rate can apply for further subsidy.
- The statement you receive from the Long Term Care facility is only for the amount paid by the resident - it does not include the government subsidy, and therefore does not represent the total cost of care, housing, and feeding. The typical $26K bill could easily be attributed to the 24-hr.nursing care alone .
- I have heard that there are some fully-private, non-subsidized long term care facilities in some provinces. In those maybe you get a breakdown of costs.
- In Ontario, the cost of "Assisted Living" in a seniors' residence can be twice what it costs for long term care, because they are not subsidized. These facilites aren't required to provide a completely detailed breakdown, but are required to provide an annual statement identifying the portion of monthly fees that are for salaries and wages only for staff providing meal services, personal housekeeping, laundering of personal items, social programming, transportation services, and health care/nursing services. This amount is normally all claimable as "Attendant Care Services Provided in a Retirement Residence".


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## MoneyGal

Absolutely there are non-publicly-funded long-term care facilities in Ontario and throughout Canada. 

There is no need to "fight tooth and nail" on this issue. You need to know whether the costs are for a long-term care facility, in which case apparently all costs are deductible and no breakdown is required; or a "retirement home"/ assisted living facility / "seniors' residence / basically anything OTHER than a publicly-funded long-term care facility, in which case a breakdown is required because the full freight is not claimable -- only the elements relating to attendant care and/or the rent portion.


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## praire_guy

No fighting here. I just wanted to get the info out, although sometimes whats in my head doesn't seem to come out right. 

I've been there, done that, and it is stressful/ sad enough having to put a parent in a care facility, I just wanted to point the op in the right direction.


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## MoneyGal

I'm sorry if I seemed overly brusque. I'm not at the point of seeing my own parents through this -- but I am grateful for the continued health of my husband's grandmother; my kids' "great-mama."


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## Belguy

Well, I visited the nursing home today and took the form which they sent me showing only the total amount paid each month last year with no breakdown of the costs. I asked the administrative assistant how to handle this on my mom's income tax form. She either had no idea or did not have the time of day to give to me. And so, the forum members have been much more helpful and so I will go over your responses and go from there or contact the friendly folks at the income tax office and see if they have anything to add. Thanks again!!


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## OhGreatGuru

I'm not surprised. Nursing home staff are not in the business of giving out income tax advice, nor are they likely qualified to do so.
One day some smart nursing home manager is going to figure out that they could run a profitable side business doing this for a fee though.


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## fraser

My mother was in a nursing home for several years. We got one receipt, broken down by month. It did not include anything but basic rent, ie the extras were on a seperate account that we did not get a tax receipt for. Drugs were receipted by the drug store where they came from.

Her tax return was actually tagged for a desk audit by CRA because of the high medical expenses. I submitted the account receipt, along with other medical expenses. CRA sent them back 2 months later...the tax return was accepted as originally filed. Never had another issue.


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## praire_guy

Belguy for what it's worth I called my in laws finance dept. 
They told me that they bill "all in one" for my in law because they know the facility is a long term care home and will qualify for a total deduction, and that if the home does not qualify, they breaks down the costs for individual deduction. 

It is still up to the individual to apply for the disability certificate. You cannot claim total costs without it. 

By all means call CRA.


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## Belguy

Just to revisit this one last time, Mom stayed at the nursing home for the last four months of last year and paid a total of $7853.11. I note that the 2011 disability amount is $7239.00. Therefore am I correct in forgetting about the disability amount and going with the nursing home fee instead since I cannot apparently claim both? Do I enter the nursing home fee as part of her medical expenses? Since she has been claiming the disability amount for many years now, can I conclude that she does not need to submit a new form #2201 Disability Tax Credit Certificate? Thanks again for your assistance.


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## caricole

@ Belguy

Since it is a nursing home. you claim the total cost as Medical expences and forget about the Disability amount (The disability certificate is in her CRA file and remains valid)

You can claim some other Medical Expences....not provided by the nursing home, HOME SERVICE FEE nails clipping, maybe some prescription drugs not provided by the nursing home, HOME SERVICE FEE for hairdresses etc.

Keep everything well documented....often they ask for documented proof

my opinion:02.47-tranquillity:

PS:

Where was she staying for the 8 months before ?

A retirement home with «SOME» services

In that case

There would be a possibility to claim «RENT (for 8 months) AS MEDICAL EXPENCES» as stated before


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## Belguy

Mom was in the hospital for two months prior to her transfer to the nursing home. The excess hospital fees were covered by her Blue Cross plan. I do, of course, claim her Blue Cross fees. Prior to that, she lived in her own home.


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## Belguy

Please advise where you enter the total nursing home fee on the tax form. Thanks. 

I have been quite ill since I had to put my dog down three weeks ago but I am starting to feel better now. That was a worse experience than I ever thought it would be. Thanks for all of your support during what was a very difficult time for me. 

The only symptom that I have now is a pain in the rear end but the doctor tells me that it is 'tax pain' and that there is nothing that they can do for that!!


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## Belguy

As near as I can tell, the nursing home fee should be entered on line 330 as part of the overall medical costs. Would someone please confirm that this is correct? Thanks.


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## praire_guy

Correct. 330 is the correct line. I used hr block online to do taxes. There was a specific line to enter expenses for long term nursing care in the software, but it all ended up on 330 in the final return.


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## Belguy

Thanks, praire_guy. It seems like such a large sum of money to just have it lumped in with the rest of the medical expenses but the tax man sometimes works in mysterious ways.


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## OhGreatGuru

It is all explained in RC4064 and IT-519 from CRA.


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## kcowan

BTW Cra sees much less detail than you do. The Netfile numbers are very much summaries.


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## Belguy

OhGreatGuru said:


> It is all explained in RC4064 and IT-519 from CRA.


Being basically a simple man, I guess that I am not too up on my RC's and IT's.:rolleyes2::stupid::frown:


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## OhGreatGuru

The only reason I know is because I had to manage my father's financial affairs for a few years.


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## timjn

My mother living in a nursing home in Minnesota, I pay a quarterly fee and there are not many extra costs. But I know that Publicly-funded "nursing homes" charge a fee based on the individual's income.


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## OhGreatGuru

timjn said:


> ... But I know that Publicly-funded "nursing homes" charge a fee based on the individual's income.


Not relevant to a discussion about Canadian nursing homes (aka Long Term Care Facilities). Levels of government support vary some between provinces, but in Ontario nearly all Nursing Homes, whether private or public, charge regulated rates set by the province, and the province subsidizes these rates. If a person cannot pay this rate, they can apply for further subsidy based on their income.


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