Medical exp in nursing home question

[MN-Investor]

My mom moved to a nursing home this past October. I don't know how other states do it, but in Minnesota the state sets the rates each nursing home can charge a resident. There are 36 payment categories and each resident is scored based on "how much assistance you needed with bed mobility, transferring from one position to another, eating, and toilet use. The total score increases as you need more assistance from staff."

For my Mom's nursing home, the highest rate is $272.21/day. That's for someone completely bedridden and requiring services such as IV therapy and a respirator. The lowest rate is $129.71/day. My mom needs a small amount of assistance and so pays $159.37/day.

The bill Mom receives lists each day separately and states "Room and Board" and an amount of $159.37. I would make the argument that Mom is actually paying $129.71/day for room and board, and the difference of $29.66/day is for nursing care. That amounts to more than $10K/year, so it's certainly worth pursuing.

So... do I have a leg to stand on?

[commentator]

Many nursing facilities have the good grace to provide the portion of the total bill which is medical services.

IRS Publication 502 says this:

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.

So, the direct costs of medical care are deductible even if the main reason for being there do not include getting health care. If a principal reason for being there is to get health care, then all the costs are deductible including room and board.

Short answer: Yes, from your facts, I believe your mom may have at least a $29.66/day medical deduction.

Note that Pub 502 also says this about nursing care:

You can include in medical expenses wages and other amounts you pay for nursing services. The services need not be performed by a nurse as long as the services are of a kind generally performed by a nurse. This includes services connected with caring for the patient's condition, such as giving medication or changing dressings, as well as bathing and grooming the patient. These services can be provided in your home or another care facility.