Revenue Canada Taxation Head Office
R. B. Day (613) 957-2136
XXXX
MAR - 3 1988
XXXX
We are writing in reply to your letter of January 21, 1988, wherein you requested our views regarding the deductibility of maintenance costs paid by taxpayers for long term care at your Homes for the Aged, XXXX as well as costs paid by taxpayers for participation in your Senior Day Care Program, as medical expenses under subparagraph 110(1)(c)(iv) of the Income Tax Act (the "Act").
As we understand it your Municipal Homes for the Aged provide long term care to seniors who are unable to live on their own in the community. They also provide both Residential and Extended Care with 24 hour nursing supervision, under the direction of a Medical Director. Residential Care serves those who are relatively self-sufficient but who require some supervision, for example, for bathing and medications. Extended Care serves those who are in need of additional direct supervision and nursing assistance, and require more than one and a half hours of nursing care daily.
A XXXX Home is a private home run by individuals under the direct supervision of the Municipality with a purchase of service contract between the two parties. XXXX Homes provide accommodation for seniors 60 years of age and over capable of normal activities of living with supervision of medication and special diets. Consideration is also given to physically and developmentally handicapped seniors. The Medical Director approves all admissions to the XXXX Homes.
The Senior Day Care program is a program for seniors 60 years of age or over who experience some difficulty in living alone or with family members in the community, but who do not require to live in a long term facility. Day Care also helps family members who are providing care to seniors. Two-thirds of your Day Care participants are afflicted with Alzheimer's Disease. This program alleviates the need for family members to provide 24 hour supervision and allows them the freedom to carry out their normal daily activities.
In order for an expense to qualify as a deductible medical expense, it must be specifically provided for in the Act or the Income Tax Regulations. In addition to the above, a taxpayer must fulfil all of the requirements of any particular provision in order for the expenses to qualify for this deduction.
In your letter, you referred to subparagraph 110(1)(c)(iv) of the Act, with specific reference to the meaning of "full-time care". In order for a taxpayer to claim medical expenses under this subparagraph the payments must be made "... for the full-time care in a nursing home of, a person who is the taxpayer, his spouse or any such dependent and who has a severe and prolonged mental or physical impairment that is certified as such in prescribed form by a medical doctor ...". In other words, if a taxpayer required full-time care in a nursing home by reason of the certified medical impairment referred to in subparagraph 110(1)(c)(iv) of the Act, the expenses paid with respect thereto would qualify. A similar claim under subparagraph 110(1)(c)(v) of the Act, requires a taxpayer to have expenses "... for the full-time care in a nursing home of the taxpayer, his spouse or any such dependent, who has been certified by a qualified medical practitioner to be a person who, by reason of lack of normal mental capacity, is and in the foreseeable future will continue to be dependent on others for his personal needs and care,". Once again the requirement involves full-time care in a nursing home and a certified mental incapacity as described above.
While there is no requirement that a "nursing home" be licensed for purposes of subparagraphs 110(1)(c)(iv) or (v) of the Act, it is expected that there will be qualified medical personnel in attendance of a calibre and in sufficient numbers to provide care to the patients on a 24 hour basis.
From the information provided in your letter it would appear that the Municipal Homes and XXXX Homes are senior citizens residences and not nursing homes that provide nursing care to patients.
It is our view, therefore, that the amounts paid by taxpayers with respect to maintenance costs in the Municipal Homes and the XXXX Homes, along with the costs paid under the Senior Citizens Day Care Program, would not be deductible as medical expenses under paragraph 110(1)(c) of the Act.
In a situation where a taxpayer does, in fact, make payments to a qualified nursing home it is our view that all reasonable fees paid to such a nursing home for full-time care qualify as medical expenses whether they are for food, accommodations or nursing care provided they meet the other criteria of subparagraph 110(1)(c)(iv) of the Act and the taxpayer has not been reimbursed nor is he entitled to reimbursement for the fees. Fees paid for other specified personal expenses, such as hairdressers' fees etc., would not be deductible.
We are enclosing for your information a copy of Interpretation Bulletin IT-509 which discusses medical expense deductions in greater detail.
Yours truly,
for Director Small Business and General Division Specialty Rulings Directorate Legislative and Intergovernmental Affairs Branch
Enclosure